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Sensitivity of bird species to environmental metal pollution varies but there is currently no general framework to predict species-specific sensitivity. Such information would be valuable from a conservation point-of-view. Calcium (Ca) has antagonistic effects on metal toxicity and studies with some common model species show that low dietary and circulating calcium (Ca) levels indicate higher sensitivity to harmful effects of toxic metals. Here we measured fecal Ca and five other macroelement (potassium K, magnesium Mg, sodium Na, phosphorus P, sulphur S) concentrations as proxies for dietary levels in 66 bird species to better understand their interspecific variation and potential use as an indicator of metal sensitivity in a wider range of species (the main analyses include 39 species). We found marked interspecific differences in fecal Ca concentration, which correlated positively with Mg and negatively with Na, P and S levels. Lowest Ca concentrations were found in insectivorous species and especially aerial foragers, such as swifts (Apodidae) and swallows (Hirundinidae). Instead, ground foraging species like starlings (Sturnidae), sparrows (Passeridae), cranes (Gruidae) and larks (Alaudidae) showed relatively high fecal Ca levels. Independent of phylogeny, insectivorous diet and aerial foraging seem to indicate low Ca levels and potential sensitivity to toxic metals. Our results, together with information published on fecal Ca levels and toxic metal impacts, suggest that fecal Ca levels are a promising new tool to evaluate potential metal-sensitivity of birds, and we encourage gathering such information in other bird species. Information on the effects of metals on breeding parameters in a wider range of bird species would also help in ranking species by their sensitivity to metal pollution. [Display omitted] • Low dietary Ca levels are known to make birds prone to metal toxicity. • Nestlings' fecal macroelement levels were measured for 66 bird species. • Insectivorous species showed lowest Ca levels, being potentially sensitive to toxic metals. • Omnivores and ground foragers showed high Ca levels, being likely less sensitive to toxic metals. [ABSTRACT FROM AUTHOR]

Abstract: Background: Survival improves in witnessed out-of-hospital cardiac arrest if the victim receives bystander-initiated cardiopulmonary resuscitation and rapid defibrillation (BLS/AED). The European Resuscitation Council has a simple programme to teach these life-saving skills that require no previous experience of automated external defibrillators (AEDs). To be able to implement the use of AEDs widely, many instructors are needed, and therefore, lay persons may also be used as trainers. The purpose of this randomized study was to compare lay volunteers trained by a lay person with those trained by a health care professional using the Objective Structured Clinical Examination (OSCE). Methods: Eight instructors, including four lay persons and four health care professionals, were given a basic course and an instructor course in CPR-D by the same instructor. All newly trained instructors trained 38 lay volunteers (19 pairs) who had no previous training in the use of a defibrillator. The lay volunteers performed the OSCE 2–3 weeks after the course. The OSCE comprised two scenarios with a manikin: the first, a patient in cardiac arrest with ventricular fibrillation, and the second, an imminent cardiac arrest with asystole as the initial rhythm. The same OSCE was performed by a group of lay first aiders practicing every 2 weeks who served as the control group. Results: No statistical difference was present between the two groups of lay volunteers in the OSCE. All were able to use the AED and follow instructions. They identified patients with ventricular fibrillation and cardiac arrest, but had difficulties identifying cases with imminent cardiac arrest. The control group of trained first aiders performed significantly more effectively than the newly trained lay persons. Conclusions: No significant benefit exists in the trainer being a health care professional, but thorough training and subsequent rehearsing of the skills learned are crucial. [Copyright &y& Elsevier]

Abstract This person-centered study examined the patterns and the dynamics of pattern change based on 1666 Finnish students' self-reported psychological well-being during the transition from primary school to lower secondary school. Moreover, we examined the stability in the profile memberships and the influence of changes in perceived support from teachers, families, and peers on changes in students' psychological well-being. Six student profiles were identified using the I-states-as-objects-analysis (ISOA) procedure: (a) High well-being profile; (b) Average well-being but low educational aspirations profile; (c) Low well-being profile; (d) Low well-being but high educational aspirations profile; (e) Low well-being but average self-esteem profile; and (f) Average well-being but high educational aspirations profile. Students' psychological profiles changed more often from lower well-being to higher well-being, rather than the other way round, indicating a tendency for improved well-being. Changes in peer support was the most robust variable to explain changes in profile membership. Highlights • Students' psychological well-being in school transition was examined. • Six distinct psychological well-being profiles were identified in Grades 6 and 7. • More profile changes were from worse to better well-being profile than vice versa. • Peer support explained both decreases and increases in students' well-being. [ABSTRACT FROM AUTHOR]

Background: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams.Methods: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management. The patients served by six ambulance helicopters and six rapid response vehicles in Denmark, Finland, Norway, and Sweden from May 2015 to November 2016 were included.Results: The critical care teams attended to 32 007 patients; 2028 (6.3%) required pre-hospital tracheal intubation. The overall success rate of pre-hospital tracheal intubation was 98.7% with a median intubation time of 25 s and an on-scene time of 25 min. The majority (67.0%) of the patients' tracheas were intubated by providers who had performed >2500 tracheal intubations. The success rate of tracheal intubation on the first attempt was 84.5%, and 95.9% of intubations were completed after two attempts. Complications related to pre-hospital tracheal intubation were recorded in 10.9% of the patients. Intubations after rapid sequence induction had a higher success rate compared with intubations without rapid sequence induction (99.4% vs 98.1%; P=0.02). Physicians had a higher tracheal intubation success rate than nurses (99.0% vs 97.6%; P=0.03).Conclusions: When performed by experienced physician anaesthetists and nurse anaesthetists, pre-hospital tracheal intubation was completed rapidly with high success rates and a low incidence of complications.Clinical Trial Number: NCT 02450071. [ABSTRACT FROM AUTHOR]

Summary: Background: Survival after in-hospital cardiac arrest (IHCA) differs considerably between hospitals. This study tries to determine whether this difference is due to patient selection because of the hospital level of care or to effective resuscitation management. Methods: Prospectively collected data on management of in-hospital cardiac arrests from Sahlgrenska Hospital, a tertiary hospital in Gothenburg, Sweden (cohort one) and from five Finnish secondary hospitals (cohort two). A multiple logistic regression model was created for predicting survival to hospital discharge. Results: A total of 954 cases from Sahlgrenska Hospital and 624 patients from the hospitals in Finland were included. The delay to defibrillation was longer at Sahlgrenska than at the five Finnish secondary hospitals (p =0.045). Significant predictors of survival were: (1) age below median (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.5–2.8); (2) no diabetes (OR 1.9, CI 1.2–2.9); (3) arrests occurring during office hours (OR 1.5, CI 1.1–2.2); (4) witnessed cardiac arrest (OR 6.3, CI 2.6–15.3); (5) ventricular fibrillation or ventricular tachycardia as the initial rhythm (OR 4.9, CI 3.5–6.7); (6) location of the arrest (compared to arrests in general wards, GW): thoracic surgery and heart transplantation ward (OR 2.9, CI 1.5–5.9), interventional radiology (OR 4.8, CI 1.9–12.0) and other in-hospital locations (3.0, CI 1.6–5.7) and (7) hospital (compared to arrests at Sahlgrenska Hospital); arrests at Etelä-Karjala Central Hospital [CH] (OR 0.3, CI 0.1–0.7), Päijät-Hame CH (OR 0.3, CI 0.1–0.8) and Seinäjoki CH (OR 0.4, CI 0.3–0.7). Conclusion: The comparison of survival following IHCA between different hospitals is difficult, there seems to be undefined factors greatly associated with outcome. A great variability in survival within different hospital areas probably because of differences in patient selection, patient surveillance and resuscitation management was also noted. A locally implemented strong in-hospital chain of survival is probably the only way to improve outcome following IHCA. [Copyright &y& Elsevier]

Summary: Introduction: Construction of an effective in-hospital resuscitation programme is challenging. To document and analyse resuscitation skills assessment must provide reliable data. Benchmarking with a hospital having documented excellent results of in-hospital resuscitation is beneficial. The purpose of this study was to assess the resuscitation skills to facilitate construction of an educational programme. Materials and methods: Nurses working in a university hospital Jorvi, Espoo (n =110), Finland and Sahlgrenska University Hospital, Göteborg (n =40), Sweden were compared. The nurses were trained in the same way in both hospitals except for the defining and teaching of leadership applied in Sahlgrenska. Jorvi nurses are not trained to be, nor do they act as, leaders in a resuscitation situation. Their cardiopulmonary resuscitation (CPR) skills using an automated external defibrillator (AED) were assessed using Objective Structured Clinical Examination (OSCE) which was build up as a case of cardiac arrest with ventricular fibrillation (VF) as the initial rhythm. The subjects were tested in pairs, each pair alone. Group-working skills were registered. Results: All Sahlgrenska nurses, but only 49% of Jorvi nurses, were able to defibrillate. Seventy percent of the nurses working in the Sahlgrenska hospital (mean score 35/49) and 27% of the nurses in Jorvi (mean score 26/49) would have passed the OSCE test. Statistically significant differences were found in activating the alarm (P <0.001), activating the AED without delay (P <0.01), setting the lower defibrillation electrode correctly (P <0.001) and using the correct resuscitation technique (P <0.05). The group-working skills of Sahlgrenska nurses were also significantly better than those of Jorvi nurses. Conclusions: Assessment of CPR-D skills gave valuable information for further education in both hospitals. Defining and teaching leadership seems to improve resuscitation performance. [Copyright &y& Elsevier]

We explored the stability of sense of coherence (SOC) and the relationship between SOC and health in two cross-lagged longitudinal samples by using structural equation modeling. In Study 1, comprising 577 municipal male and female employees, SOC was found to be stable in both sexes. In women, SOC significantly predicted sickness absences in the 4-year follow-up period. A low SOC, but not a high SOC, was associated with health prospects. Surprisingly, SOC did not influence sickness absences among men. Study 2 further tested the relationship between SOC and health in 320 male technical designers. Although SOC was cross-sectionally associated with psychological and somatic health complaints, it did not predict later health complaints in a 5-year follow-up. Thus, the present study supports the dispositional character of SOC in both sexes and its predictive validity among women. No support was found to the salutogenic status of SOC and an unexpected gender difference was revealed. [ABSTRACT FROM AUTHOR]