Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms

Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Design: Retrospective analysis of audio-video recorded neonatal simulation training. Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Subjects: Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Interventions: Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. Measurements and Main Results: The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Conclusions: Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings

Influence of the physical structure of an invasive barnacle in structuring macroinvertebrate assemblages

Para asentarse y evitar la depredación y la desecación, muchas especies de invertebrados usan los microhábitats que generan los cirripedios. En la Argentina, el cirripedio acorazado invasor Balanus glandula no sólo coloniza las costas rocosas; también ha invadido con éxito marismas de fondos blandos, donde forma grandes estructuras tridimensionales que facilitan la presencia de otros invertebrados. Esto afecta la estructura de la comunidad. Se colocaron cirripedios artificiales en una marisma de la Patagonia para imitar la estructura física de los agregados naturales. El experimento incluyó controles naturales y de materiales, y dos niveles de complejidad estructural que representaron la variedad de los agregados que se encuentran en la naturaleza: a) agregados con espacios vacíos internos y galerías entre los cirripedios, y b) agregados sin espacios y galerías. Después de nueve meses, el ensamble de macroinvertebrados se comparó entre tratamientos. La composición del ensamble fue significativamente diferente entre los tratamientos artificiales y las parcelas control, pero no hubo efecto de los cirripedios artificiales sobre la riqueza y diversidad de macroinvertebrados. Esto sugiere que la estructura física de B. glandula podría explicar el efecto ejercido sobre la comunidad. Por otra parte, se registraron reclutamiento de B. glandula sobre los cirripedios artificiales, lo que resalta la importancia que la estructura física de esta especie tendría sobre su persistencia en las marismas de fondos blandos.Many invertebrate species use the microhabitats generated by barnacles to settle and to avoid predation and desiccation. In Argentina, the acorn barnacle Balanus glandula not only colonizes rocky shores but has also successfully invaded soft bottom salt marshes, where it form large three-dimensional structures that facilitate the presence of other invertebrates, thus affecting the whole species assemblage. Artificial barnacles were deployed on a Patagonian salt marsh to reproduce the physical structure of natural aggregates. The experiment included natural and material controls and two levels of structural complexity that represent the variety of aggregates found in nature: (i) aggregates with internal empty spaces and galleries among barnacles and (ii) aggregates without spaces and galleries. After nine months, the macroinvertebrate assemblages were compared between treatments. The results showed that the composition of the assemblage differed significantly between artificial treatments and control plots. However, there was no effect of the mimic barnacles on macroinvertebrate richness and diversity. In this way, our results suggest that the physical structure of B. glandula could modify the composition of macroinvertebrate assemblages. Besides, B. glandula recruits were registered on the mimics highlighting the importance that the physical structure supplied by this species could have on its own persistence within invaded soft bottom salt marshes

Doctoral Education and Preparation for Nursing Faculty Roles

Background Despite increased enrollment in doctoral programs and the encouraging numbers of graduates intending to pursue faculty positions, lack of adequate preparedness to assume the faculty role may adversely impact retention and consequently undermine efforts to reduce the shortage. Purpose Understanding doctoral nursing students’ and recent graduates’ expectations of their educational experience related to preparation for an academic career is needed to inform curricular revisions and advise guidance to ensure role readiness. Methods A secondary analysis of 24 interviews with current PhD and doctor of nursing practice (DNP) students and recent graduates from both degree programs was performed to gain a deeper understanding of expectations and perceptions of doctoral education. Results Two themes emerged: (1) met and unmet expectations of programs and (2) equivocal preparation for teaching. Conclusions PhD and DNP curricula should include coursework on teaching, as well as research, to prepare graduates for faculty roles

Measuring a photonic qubit without destroying it

Measuring the polarisation of a single photon typically results in its destruction. We propose, demonstrate, and completely characterise a \emph{quantum non-demolition} (QND) scheme for realising such a measurement non-destructively. This scheme uses only linear optics and photo-detection of ancillary modes to induce a strong non-linearity at the single photon level, non-deterministically. We vary this QND measurement continuously into the weak regime, and use it to perform a non-destructive test of complementarity in quantum mechanics. Our scheme realises the most advanced general measurement of a qubit: it is non-destructive, can be made in any basis, and with arbitrary strength.Comment: 4 pages, 3 figure

On the unique possibility to increase significantly the contrast of dark resonances on D1 line of 87^{87}Rb

We propose and study, theoretically and experimentally, a new scheme of excitation of a coherent population trapping resonance for D1 line of alakli atoms with nuclear spin $I=3/2$ by bichromatic linearly polarized light ({\em lin}$||${\em lin} field) at the conditions of spectral resolution of the excited state. The unique properties of this scheme result in a high contrast of dark resonance for D1 line of $^{87}$Rb.Comment: 9 pages, 7 figures. This material has been partially presented on ICONO-2005, 14 May 2005, St. Petersburg, Russia. v2 references added; text is changed a bi

Versorgung und Reanimation des reifen Neugeborenen nach der Geburt : Basierend auf der aktuellen Leitlinie des European Resuscitation Council 2021

Zusammenfassung Die volle Reanimation eines Neugeborenen mit Beatmungen, Thoraxkompressionen und der Gabe von Medikamenten ist ein äußerst seltenes Ereignis, das selbst neonatologische Teams immer wieder vor Herausforderungen stellt. Gerade in diesen seltenen und häufig dramatischen Situationen ist schnelles und umsichtiges Handeln im Team gefragt. Dabei ist die effektivste und meist einzig notwendige Maßnahme für die erfolgreiche Versorgung eines nicht spontan atmenden Neugeborenen eine suffiziente Maskenbeatmung. Wird diese effektiv durchgeführt, sind beim Neugeborenen in den seltensten Fällen tatsächlich Thoraxkompressionen notwendig. Im März 2021 wurde vom European Resuscitation Council (ERC) die neue Leitlinie zur Reanimation von Neugeborenen publiziert. Auf Basis dieser Leitlinie beschreibt der vorliegende Beitrag detailliert den im Algorithmus der Versorgung und Reanimation von reifen Neugeborenen dargestellten Handlungsablauf. Er richtet sich damit einerseits insbesondere an NichtneonatologInnen, die für die Versorgung v. a. von reifen Neugeborenen nach der Geburt verantwortlich sind. Andererseits soll er auch jenen zur Unterstützung dienen, die medizinisches Personal in der Versorgung von lebensbedrohten Neugeborenen trainieren und den Algorithmus der Neugeborenenreanimation als didaktisches Konzept vermitteln. Abstract The resuscitation of a neonate with the need for ventilation, chest compressions and the administration of drugs is an extremely rare event that repeatedly challenges even neonatal teams. It is precisely in these rare and often dramatic situations that rapid and prudent team action is required. The most effective and usually the only necessary measure for the successful resuscitation of a neonate who is not breathing spontaneously is sufficient mask ventilation. If ventilation is performed effectively, chest compressions are rarely necessary in the neonate. In March 2021, the European Resuscitation Council (ERC) published the new guidelines for neonatal resuscitation. Based on these guidelines, this article describes in detail the course of action outlined in the algorithm for the stabilisation and resuscitation of term neonates. On the one hand, it is aimed at non-neonatologists who are responsible for the care of term neonates after birth. On the other hand, it is also intended to support those who train medical personnel in the care of life-threatened neonates and teach the algorithm of neonatal resuscitation as a didactic concept

Effects of Training on Social Work, Nursing and Medical Trainees' Knowledge, Attitudes and Beliefs Related to Screening and Brief Intervention for Alcohol Use

Indiana University's Schools of Social Work, Nursing and Medicine formed a consortium to advance education for Screening Brief Intervention and Referral to Treatment (SBIRT). Trainees participated in SBIRT training and completed data collection before, immediately after, and 30 days after a face-to-face training. The study explored participants' perceptions about the training and the likelihood of implementing SBI in practice, including attitudes and beliefs that may be predictive of SBIRT utilization in clinical practice. Results show the training targeting SBI and MI behaviors may improve participants' self-reported competence with SBI. This improvement was consistent and strong in all programs. The study results also provided a preliminary indication that the training affected participants' perception of time utilization and compensation for performing SBI

Current research, pressing issues, and lingering questions in marine invasion science: lessons from the Tenth International Conference on Marine Bioinvasions (ICMB-X)

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Fowler, A. E., Blakeslee, A. M. H., Bortolus, A., Dias, J., Tepolt, C. K., & Schwindt, E. Current research, pressing issues, and lingering questions in marine invasion science: lessons from the Tenth International Conference on Marine Bioinvasions (ICMB-X). Aquatic Invasions, 15(1), (2020): 1-10, doi:10.3391/ai.2020.15.1.01.Research on marine bioinvasions is an inherently international collaboration. Species range boundaries have become more fluid in recent decades as a result of enhanced human globalization, leading to species translocations across international boundaries through high profile vectors (e.g., shipping, hull fouling, aquaculture, etc.) (Ruiz et al. 2000; Seebens et al. 2013). Global trade and anthropogenic activities that promote invasive species spread continue to increase, rising by an average of 70% since 1970, with no sign of saturation (Pagad et al. 2015; Seebens et al. 2017). Even though these numbers are primarily based on terrestrial systems, recent work has demonstrated that marine ecosystems are as severely impacted by invasive species as by other human activities including overfishing, pollution (including plastics), climate change, and ocean acidification (Diaz et al. 2019). Species introductions to seas, coasts, and estuaries are therefore a global threat to human and non-human populations alike. As such, scientists and managers are increasingly focused on prevention and management, risk analysis and prioritization, and innovative technologies to detect novel species.The ICMB-X was supported by CONICET, MINCyT, SCTeIP Chubut, Consejo Federal de Inversiones, Biodiversity Heritage Library, Administración Portuaria de Puerto Madryn (APPM), Office of Naval Research Global, Aluar Aluminio Argentino, Madryn Bureau, Ente Mixto Puerto Madryn, Municipalidad de Puerto Madryn, and FAO-GEF-SAyDS