Overconfidence effects and learning motivation refreshing BLS: An observational questionnaire study.

Aim of the study: Regular refresher skill courses are necessary to maintain competence in basic life support. The utilization of these training programs strongly depends on the motivation to learn. Learning motivation may be affected by overconfidence and clinical tribalism, as they both imply a higher competence compared to others, and therefore, a lower demand for training. This study aimed to assess how overconfidence in basic life support competencies affects learning motivation. Methods: We conducted a cross-sectional, observational, multicenter, anonymous online questionnaire survey using validated psychometric tests for healthcare professionals in Germany. Further, we tested participants' knowledge and attitude regarding international basic life support guidelines. The study was conducted between March and April 2022, and healthcare providers from 22 German emergency medical services and hospitals at all levels were assessed. Results: Of 2,000 healthcare professionals assessed, 407 completed the assessment (response rate, 20.4%). We confirmed the presence of overconfidence and clinical tribalism (identity differentiation between social groups) among the 407 physicians, nurses, and emergency medical service providers who completed the survey. Three different learning-motivation groups emerged from cluster analysis: "experts" (confident and motivated), "recruitables" (overconfident and motivated), and "unawares" (overconfident and unmotivated). The three groups were present in all professional groups, independent of the frequency of exposure to cardiac arrest and educational level. Conclusions: These findings showed the presence of overconfidence effects and different learning motivation types in individuals learning basic life support, even in instructors.

[Educational perspectives in emergency paramedicine : Interdisciplinary discourse on education, professional practice, and challenges in the field of emergency medical services]. / Bildungsperspektive Notfallsanitäter:in : Interdisziplinärer Diskurs zu Ausbildung, beruflicher Praxis und Herausforderungen im Berufsfeld Rettungsdienst.

Societal developments that result in an increase in geriatric, psychosocial, and subacute (i.e. not time-critical) emergencies are changing the demands on emergency care and posing challenges to the system of emergency care and emergency medical services (EMS). The training of emergency paramedics (NotSan) lays the foundation for finding a qualified systemic response to evolving patient needs and requirements. By extending and strengthening their competencies, NotSan are to be understood as basic emergency care providers. Their training should therefore be further developed in terms of evidence-based and patient-centered care in order to increase their competency to act and to achieve demand-oriented holistic (outpatient) care. New EMS resources such as community paramedics (GNFS) and telemedical support systems offer opportunities to strengthen competencies in patient care. The guiding principles of care should be patient safety and patient centeredness. In addition to increasing the basic competencies and equipment of existing EMS resources as well as continuous training opportunities, innovative cross-sectoral and cross-professional care concepts are necessary and must be supported.

Cryo-section Dissection of the Adult Subependymal Zone for Accurate and Deep Quantitative Proteome Analysis.

The subependymal neurogenic niche consists of a paraventricular ribbon of the lateral ventricular wall of the lateral ventricle. The subependymal zone (SEZ) is a thin and distinct region exposed to the ventricles and cerebrospinal fluid. The isolation of this niche allows the analysis of a neurogenic stem cell microenvironment. However, extraction of small tissues for proteome analysis is challenging, especially for the maintenance of considerable measurement depth and the achievement of reliable robustness. A new method termed cryo-section-dissection (CSD), combining high precision with minimal tissue perturbation, was developed to address these challenges. The method is compatible with state-of-the-art mass spectrometry (MS) methods that allow the detection of low-abundant niche regulators. This study compared the CSD and its proteome data to the method and data obtained by laser-capture-microdissection (LCM) and a standard wholemount dissection. The CSD method resulted in twice the quantification depth in less than half the preparation time compared to the LCM and simultaneously clearly outperformed the dissection precision of the wholemount dissection. Hence, CSD is a superior method for collecting the SEZ for proteome analysis.

Defining the Adult Neural Stem Cell Niche Proteome Identifies Key Regulators of Adult Neurogenesis.

The mammalian brain contains few niches for neural stem cells (NSCs) capable of generating new neurons, whereas other regions are primarily gliogenic. Here we leverage the spatial separation of the sub-ependymal zone NSC niche and the olfactory bulb, the region to which newly generated neurons from the sub-ependymal zone migrate and integrate, and present a comprehensive proteomic characterization of these regions in comparison to the cerebral cortex, which is not conducive to neurogenesis and integration of new neurons. We find differing compositions of regulatory extracellular matrix (ECM) components in the neurogenic niche. We further show that quiescent NSCs are the main source of their local ECM, including the multi-functional enzyme transglutaminase 2, which we show is crucial for neurogenesis. Atomic force microscopy corroborated indications from the proteomic analyses that neurogenic niches are significantly stiffer than non-neurogenic parenchyma. Together these findings provide a powerful resource for unraveling unique compositions of neurogenic niches.