Abstract. The EPICA (European Project for Ice Coring in Antarctica) Dome C drilling in East Antarctica has now been completed to a depth of 3260 m, at only a few meters above bedrock. Here we present the new EDC3 chronology, which is based on the use of 1) a snow accumulation and mechanical flow model, and 2) a set of independent age markers along the core. These are obtained by pattern matching of recorded parameters to either absolutely dated paleoclimatic records, or to insolation variations. We show that this new time scale is in excellent agreement with the Dome Fuji and Vostok ice core time scales back to 100 kyr within 1 kyr. Discrepancies larger than 3 kyr arise during MIS 5.4, 5.5 and 6, which points to anomalies in either snow accumulation or mechanical flow during these time periods. We estimate that EDC3 gives accurate event durations within 20% (2σ) back to MIS11 and accurate absolute ages with a maximum uncertainty of 6 kyr back to 800 kyr.

Abstract. The EPICA (European Project for Ice Coring in Antarctica) Dome C drilling in East Antarctica has now been completed to a depth of 3260 m, at only a few meters above bedrock. Here we present the new official EDC3 chronology, which is based on the use of 1) a snow accumulation and mechanical flow model, and 2) a set of independent age markers along the core. These are obtained by pattern matching of recorded parameters to either absolutely dated paleoclimatic records, or to insolation variations. We show that this new time scale is in excellent agreement with the Dome Fuji and Vostok ice core time scales back to 100 kyr within 1 kyr. Discrepancies larger than 3 kyr arise during MIS 5.4, 5.5 and 6, which points to anomalies in either snow accumulation or mechanical flow during these time periods. We estimate that EDC3 gives accurate event durations within 20% (2σ ) back to MIS11 and accurate absolute ages with a maximum uncertainty of 6 kyr back to 800 kyr.

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Background Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions. Methods In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis. Results The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation. Conclusions The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.

Aim and objectives The aim of the study was to describe Emergency Medical Services (EMS) nurses’ experiences of and coping with critical incidents, when providing nursing care as a member of a dyadic team. Background Nursing care in EMS is a complex task, taking into account the physical, psychological as well as existential dimensions of the patient's suffering. In this, EMS nurses are dependent on the dyadic team. Teams in EMS are described as essential for providing safe medical care. However, nursing care also comprises relationships with patients as a means of reducing patient suffering. Design The study has an inductive descriptive qualitative design, in adherence to the COREQ‐checklist. Methods A critical incident technique was used. Thirty‐five EMS nurses were interviewed individually, with a focus on dyadic teams providing nursing care. The interviews were analysed with the aim of defining main areas, categories and sub‐categories. Results The experiences of critical incidents emerged to form two main areas: “Functional co‐operation” and “Dysfunctional co‐operation,” comprising seven categories and sixteen sub‐categories. Their coping with critical incidents encompassed two main areas: “Adapting oneself” and “Adapting nursing care and the colleague,” comprising four categories and eight sub‐categories. Conclusions Reflection as part of the daily practice emerges as important for the development of nursing care both in relation to individual team members and also the dyadic team as a unit. In addition, the results highlight consensus within dyadic teams regarding the objectives of nursing care, as well as the importance of defined roles. Relevance to clinical practice This study underlines the importance of strengthening the dyadic EMS team's ability to co‐operate using common goals and knowledge within clinical nursing care. The individual team members’ different roles have to be explicit. In addition, clinical care has to be organised to generate preconditions for mutual performance monitoring through collegial feedback and reflection.

Purpose This study aimed to describe extended collaboration in situations when an ambulance was called, as experienced by older patients, a significant other, and ambulance- and primary healthcare (PHC) centre personnel. Methods The study used a phenomenological reflective lifeworld research (RLR) approach. Participants included in three specific situations with extended collaboration were interviewed: three older patients, one significant other, three ambulance personnel and four personnel at the PHC centre. The transcribed interviews were analysed for meanings of the phenomenon. Results The extended collaboration means that decisions were supported through dialogue by bridging knowledge spaces between person, within-team and across-team levels. Through dialogue experience and knowledge were shared and certainty in decisions was increased. The extended collaboration was built on trust, responsibility taken, shared and entrusted, and the common goal of adapted care for the unique patient. A need for further improvement and transparency was elucidated. Conclusions The difficulty of making care decisions stresses the importance of available extended collaboration based on the dialogue between patients, significant others, and ambulance- and PHC centre personnel to increase certainty in decisions. Collaboration further requires respectful encounters, trust, responsibility and a common goal of adapting the care for the unique patient.