Life Support Course for Nurses: beyond competency training.

The Life Support Course for Nurses (LSCN) equips nurses with the resuscitation skills needed to be first responders in in-hospital cardiac arrests. Previous published articles on the LSCN were mainly focused on the development of the LSCN in Singapore, as well as nurses' confidence level, defibrillation experience and outcomes, the perceived barriers faced by nurses and the usefulness of the course. This paper highlights the importance of two key learning methodologies in the LSCN: deep learning and reflection.

A randomised control trial to compare retention rates of two cardiopulmonary resuscitation instruction methods in the novice.

BACKGROUND: Studies show that after implementation of chest compression only CPR (CCC) in the community, there was an increase in bystander CPR rates and survival of OHCA victims. There have been very few studies to compare the retention rates of CCC and conventional CPR (CVC) in lay people. METHODS: First year nursing students were randomised into one of the two CPR training methods: CVC - 30 chest compressions, followed by 2 mouth-to-mouth ventilations; and CCC - 100 chest compressions with 10s of rest before the next compression cycle. Within each group, they were sub-randomised into two groups for locating chest compression landmark: 2F - 2 finger-breadth proximal from xiphoid process, identified by tracing the lower margin of the victim's rib cage; or SL - shown the approximate location on the lower half of the sternum. 6 months later, participants underwent an unannounced test to perform one-man CPR on a moulaged mannikin. RESULTS: During the test, CVC groups did significantly fewer chest compressions per minute than CCC groups (57.8±23.7 vs 77.7±24.2, adjusted p<0.001). SL groups compressed significantly deeper than 2F groups (34.3±11.5cm vs 27.3±13.7cm, adjusted p<0.001), and was associated with higher rate of correct landmark for chest compression. 50.0% of the participants did not compress at the correct location. For those who were trained in CVC, only 3.7% were able to perform ≥10 effective ventilations in 5min. CONCLUSION: CCC, with SL as the method to locate landmark for chest compression, should be taught to lay people.

Identification of p10 as a neurotoxic product generated from the proteolytic cleavage of the neuronal Cdk5 activator.

The involvement of cyclin-dependent kinase-5 (Cdk5) and p25, the proteolytic fragment of activator p35, has long been implicated in the development of neuron-fibrillary tangles (NFTs), a hallmark of Alzheimer's disease (AD). Findings in this area over the past decade have been highly controversial and inconclusive. Here we report unprecedented detection of endogenous p10, the smaller proteolytic fragment of the Cdk5 activator p35 in treated primary cortical neurons that underwent significant apoptosis, triggered by proteasome inhibitors MG132 and lactacystin, and protein kinase inhibitor staurosporine (STS). p10 appeared exclusively in the detergent-resistant fraction made up of nuclear matrix, membrane-bound organelles, insoluble membrane proteins, and cytoskeletal components. Intriguingly, transient overexpression of p10 in neural cells induced apoptotic morphologies, suggesting that p10 may play an important role in mediating neuronal cell death in neurodegenerative diseases. We demonstrated for the first time that p10-mediated apoptosis occurred via a caspases-independent pathway. Furthermore, as p10 may contain the myristoylation signal for p35 which is responsible for binding p35 to several intracellular components and the membrane, all in all these novel results present that the accumulation of p10 to the detergent-insoluble fraction may be a crucial pathological event to triggering neuronal cell death.