Development and validation of a questionnaire to assess Healthcare personnel competence in cardiac arrest and resuscitation in pregnancy

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Formation of Phosphate-Containing Calcium Fluoride at the Expense of Enamel, Hydroxyapatite and Fluorapatite

During the caries process complex reactions involving calcium, phosphate, hydrogen and fluoride ions as main species take place. In this study the precipitation and dissolution reactions occurring in suspensions of enamel, hydroxyapatite (HAP) and fluorapatite (FAP) on addition of fluoride were investigated under well-defined conditions. pH and pF were monitored; calcium and phosphate concentrations were measured at selected times; the solid phases were examined by infra-red, X-ray diffraction and transmission electron microscopy. Precipitation of phosphate-containing calcium fluoride crystals, CaF2(P), can cause severe reduction in the calcium ion concentration and release of hydrogen ions from the precipitated phosphate. These reactions result in considerable dissolution of enamel, HAP and even of FAP. More of the added mineral dissolves with 50 mmol/l fluoride than with 10 mmol/l fluoride, mainly due to the greater reduction in calcium ion concentration. This work shows that phosphate-containing calcium fluoride is most likely an important compound to be considered in the caries process

Healthcare personnel self‐assessed competence and knowledge following implementation of a new guideline on maternal resuscitation in Norway. A repeated measure study

Abstract Introduction Cardiac arrest in pregnancy is a rare, yet extremely challenging condition to manage for all healthcare personnel involved. Knowledge deficits and poor resuscitation skills can affect outcomes in cardiac arrest in pregnancy, but research exploring healthcare personnel competence and knowledge about maternal resuscitation is limited. Aims The aim of this study was to explore (1) healthcare personnel self‐assessed competence and knowledge about cardiopulmonary resuscitation (CPR) in pregnancy as well as perimortem caesarean section, before and after implementation of a new guideline, (2) whether there were any interprofessional differences in knowledge about maternal resuscitation, and (3) potential differences between different implementation strategies. Research Methodology The study had a prospective repeated measure implementation design, utilizing a questionnaire before and after implementation of a new guideline on maternal resuscitation after cardiac arrest. Setting All healthcare personnel potentially involved in CPR in six hospital wards, were invited to participate (n = 527). The guideline was implemented through either simulation, table‐top discussions and/or an electronical learning course. Results In total, 251 (48%) participants responded to the pre‐questionnaire, and 182 (35%) to the postquestionnaire. The need for education and training/simulation concerning maternal resuscitation were significantly lowered after implementation of the guideline, yet still the majority of respondents reported a high to medium need for education and training/simulation. Participants' self‐assessed overall competence in maternal resuscitation increased significantly postimplementation. Regardless of professional background, knowledge about CPR and perimortem caesarean section increased significantly in most items in the questionnaire after implementation. Differences in level of knowledge based on implementation strategy was identified, but varied between items, and was therefore inconclusive. Conclusion This study adds knowledge about healthcare personnel self‐assessed competence and knowledge about maternal resuscitation and perimortem caesarean section in pregnancy. Our findings indicate that there is still a need for more education and training in this rare incident

Desistance by design : offenders' reflections on criminal justice theory, policy and practice

This article highlights the views and advice of offenders in Scotland about what helps and hinders young people generally in the process of desistance, why interventions may or may not encourage desistance and what criminal justice and other agencies can do to alleviate the problems which may result in offending. The findings suggest that probation-style supervisory relationships with workers are still the key means to promote desistance but given the fact that offenders perceive desistance to be ‘by design’ rather than ‘by default’, there still needs to be a greater emphasis placed by criminal justice and wider agencies on the structural constraints to a legal, conventional and integrated lifestyle

Communication as a non-technical skill in the operating room: A qualitative study

Aim: The aim of this study was to explore how operating room nurses (ORNs) experience operating room (OR) team communication concerning non-technical skills. Design: Based on the Scrub Practitioners List of Intraoperative Non-Technical Skill (SPLINTS), qualitative individual in-depth semi-structured interviews were conducted with 11 ORNs in a Norwegian university hospital. Braun and Clarke's six analytic phases for thematic data analysis were used. Results: Surgeons being unprepared or demanding different instruments than the preoperative information indicates, cause stress and frustration. So does noise and brusquely or poor communication. Ensuring good information flow within the entire team is important. When silence is required, the ORNs communicate with gestures, looks and nods. Creating a positive and secure team culture facilitates discussions, questions and information sharing. Conclusion: Inappropriate dynamics, inaccurate and/or disrespectful communication and noise may reduce patient safety. Interdisciplinary team training may bring attention to the value of communication as a non-technical skill.publishedVersio