Decision-Making Styles in Medical Students and Healthcare Professionals: The Roles of Personality Traits and Socio-Emotional Intelligence Factors.

Intuitive and deliberative styles can be considered the best-known decision-making styles, which are thought to be linked to actual workplace performance. However, there is a limited research on individual differences in these styles among individuals who provide healthcare. Therefore, adopting the self-report approach, this study examines the roles of the Big Five personality traits and socio-emotional intelligence factors in intuitive and deliberative decision-making styles among medical students and healthcare professionals. The research sample consists of 203 participants (50 medical students, 153 healthcare professionals) who completed the Big Five Inventory, the Trait Meta-Mood Scale, the Tromsø Social Intelligence Scale, and the Preference for Intuition and Deliberation Scale. The regression analyses revealed that attention to one's emotions and social information processing were positively related to intuitive decision-making style, while the clarity of one's emotions and social awareness were negatively related to intuitive decision-making style. It was further shown that conscientiousness, neuroticism, repair of one's emotions, and social information processing were positively related to deliberative decision-making style. The findings highlight the importance of personality and socio-emotional intelligence in understanding decision-making. Specifically, they point out that Big Five personality traits better explain deliberative style, while socio-emotional intelligence factors better explain intuitive style.

Public's awareness of biobanks and willingness to participate in biobanking: the moderating role of social value orientation.

Although the awareness of biobanks is considered to be a key factor in the willingness to participate in biobanking, the empirical evidence on their relationship is inconsistent. The present study investigated social value orientation as an explanatory factor in this relationship. A representative sample of 600 Slovaks completed Slider Measure to assess their social value orientation. Thereafter, they reported their level of awareness of biobanks and their willingness to provide biospecimens and personal information to biobanks. The results showed a positive relationship between awareness and willingness. Although social value orientation was not the moderator, we found that this relationship was significant only in the groups of altruists and individualists. The results remained robust after taking sociodemographic and institutional trust factors into account. Our findings imply that biobank awareness programmes should highlight both prosocial and proself motives to attract people with various social value orientations to participate in biobanking.

Epithelioid sarcoma with retained INI1 expression as a cause of a chronic leg ulcer.

Epithelioid sarcoma is a rare soft-tissue sarcoma typically presenting itself as a subcutaneous or deep dermal mass in distal portions of the extremities of adolescents and young adults. They are frequently mistaken for ulcers, abscesses, or infected warts resistant to standard medical treatment. Patients often develop multiple local recurrences with subsequent metastases. We report a case of a 66-year-old patient with chronic leg ulcer who died of generalization of an epithelioid sarcoma.

Markers of cognitive skills important for team leaders in emergency medical services: a qualitative interview study.

BACKGROUND: Cognitive skills and other non-technical skills are key for emergency medical services (EMS); however, there have been a limited number of their markers identified. This study aims to identify markers of cognitive skills-situation awareness and decision making-important for team leaders in EMS. The focus is on any markers of cognitive skills that are associated with quality and safety at EMS work. METHOD: In-depth semi-structured interviews were conducted with 20 EMS team leaders (10 EMS physician team leaders and 10 paramedic team leaders) and analysed by the structured approach utilising the known framework of cognitive skill elements. RESULTS: The data analysis revealed a set of 50 markers falling into elements of situation awareness (gathering information, interpreting information, anticipating states), elements of decision making (identifying options, implementing decisions, re-evaluating decisions), and an additional cognitive element (maintaining standards). These markers represented cognitive processes, acts, and communications, therefore, some of them can be observable and others rather unobservable. The identified markers were not too specific, applicable mostly in various challenging situations with patients' medical problems and in EMS team leaders working in ground ambulances in urban and rural/remote areas. CONCLUSION: The findings provide a better understanding of EMS team leaders' cognitive skills, and can aid in the development of assessment and training tools suited particularly to them.

Work-related factors, cognitive skills, unsafe behavior and safety incident involvement among emergency medical services crew members: relationships and indirect effects.

Objectives. This study examines relationships between work-related factors - stress and fatigue, cognitive skills - situation awareness and cognitive flexibility, unsafe behavior and safety incident involvement among emergency medical services (EMS) crew members, and whether cognitive skills and unsafe behavior together indirectly affect the relationship between work-related factors and safety incident involvement. Methods. A sample of 131 EMS crew members working in ground ambulances (physicians, paramedics, ambulance drivers) completed self-report questionnaires. Results. The correlation analysis showed significant positive interrelationships between work-related factors, unsafe behavior and safety incident involvement, and that cognitive skills were significantly negatively related to these variables. The multiple indirect effects analysis revealed significant indirect effects of both work-related factors on safety incident involvement through situation awareness and unsafe behavior, but not through cognitive flexibility. Conclusion. In terms of reducing the number of EMS provider and patient safety incidents, the findings suggest the importance of reducing stress and fatigue in EMS crew members, improving their cognitive skills, in particular situation awareness, and supporting their safety compliance behavior.

Cognitive skills of emergency medical services crew members: a literature review.

BACKGROUND: Situation awareness and decision making, listed in non-technical skills taxonomies, are critical for effective and safe performance in high-risk professions. These cognitive skills and their behavioral markers have been studied less in emergency medical services (EMS) crew members. This paper aims to review the existing literature and identify important aspects and behavioral markers of situation awareness and decision making in EMS crew members - those who work in the role of prehospital emergency care providers - and to synthesize findings as a basis for developing a rating and training tool. METHOD: The search for relevant articles was conducted using electronic databases, reference lists of relevant reviews and included articles and personal collection of articles. The selection process based on the PRISMA statement yielded a total of 30 articles that met the eligibility criteria. Their findings were qualitatively synthesized using the structured approach, informed by the already known structure: situation awareness and its elements (gathering information, interpreting information, anticipating future states), decision making and its elements (generating and considering options, selecting and implementing an option, reviewing outcome/decision). Moreover, the element of maintaining standards also emerged as highly relevant for cognitive skills. RESULTS: This review found an increased research interest in the non-technical cognitive skills of EMS crew members. The majority of included articles' research designs were qualitative, then mixed, Delphi, and quantitative. It revealed several specifics of cognitive skills, such as EMS crew members need to holistically assess a wide range of cues and information, to make various health- and safety-related decisions and take EMS standards into account. However, there was only a limited number of observable markers of cognitive skills, such as acts and verbalizations, that could be considered as examples of good behavior. In addition, findings indicate a lack of articles focused on mass-casualty incidents and the interconnection of cognitive skills with other non-technical and medical skills. CONCLUSION: Further research is needed to get a more comprehensive view of behavioral markers of cognitive skills and to develop a rating and training tool to improve EMS crew members' cognitive performance.

A pilot evaluation of the 3gLM-R - A new supraglottic airway device.

INTRODUCTION: Supraglottic airway devices are designed for airway management during anaesthesia. The 3gLM is a novel device with a non-inflatable soft cuff and separate channels for gas delivery and drainage of gastric content. MATERIAL AND METHODS: This prospective observational study of the 3gLM, version R, size 4 in 40 adult patients scheduled for elective surgery, evaluated the insertion success rate at the 1st attempt as the primary outcome. Secondary aims included insertion parameters, such as total success rate, insertion time, oropharyngeal seal pressures, postoperative complications and a comparison between males and females. RESULTS: First attempt insertion success rate was 80% (70% in males, 90% in female patients, p=0.24), while total insertion success rate was 92.5% (85% in males, 100% in females, p=0.23). The oropharyngeal seal pressures were 27cmH2O, higher in females (29.4cmH2O) than in males (24.2cmH2O) - p=0.002. Postoperative complications were only temporary and included sore throat (24.3%), hoarseness (10.8%), pain on swallowing (10.8%) and minor tongue haematoma (2.5%). There was no difference in the incidence of postoperative complications between the genders apart from hoarseness. No aspiration of gastric contents or other long-term complications occurred in this cohort. CONCLUSIONS: The 3gLM exhibited oropharyngeal seal pressures adequate for the controlled ventilation in most patients. Size 4 of the device showed higher pressures in females than in men.

Early and subacute inflammatory response and long-term survival after hip trauma and surgery.

BACKGROUND: Hip fractures represent major source of morbidity in elderly patients. There is little evidence about the impact of inflammatory changes induced by hip trauma and surgery on long term survival. METHODS: We evaluated the prognostic significance of the surgery-related dynamics of white blood cell count (WBC), neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), interleukin-6 (IL-6) and soluble adhesion molecules (including P-selectin, E-selectin and VCAM) on survival in 104 consecutive patients with traumatic hip fractures recruited within the 2 years period. RESULTS: In surviving patients, the minimum follow-up length was 48 and maximum 84 months (median 60 months). The mean age of the population was 80 ± 9 years, 72% were women. The survival rates were 69%, 45% and 38% at one, three and five years of the follow-up, respectively. Baseline serum creatinine, older age and subdural anesthesia type were associated with worse survival. The acute inflammatory response failed to predict the long term survival. In contrast, elevated WBC and IL-6 as assessed 21 days after the surgery were associated with a significantly worse outcome. CONCLUSION: The survival of elderly patients undergoing the surgery for acute hip fracture is unfavorable. In contrast to previous reports, we did not confirm that acute inflammatory response to the surgery predicts the long-term survival. On the contrary, persistent elevation of WBC and IL-6 three weeks after the surgery indicates a poor outcome.

Older age and type of surgery predict the early inflammatory response to hip trauma mediated by interleukin-6 (IL-6).

Hip trauma and surgery are associated with systemic inflammatory reaction. However, little evidence exists about the role of IL-6. In order to assess the inflammatory response, we evaluated white blood cell (WBC) count, C-reactive protein (CRP) and IL-6 dynamics in sequential pre- and postsurgical samples collected from 125 elderly patients (mean age 78+/-9 years) undergoing osteosynthesis (OS) for extracapsular hip fractures (n=69), hemiarthroplasty (HA) or urgent total hip arthroplasty for intracapsular fractures (UA) (n=35), and elective total hip arthroplasty for osteoarthrosis (OA) (n=21). Both preoperative CRP and IL-6 levels were higher in patients with intracapsular fractures. IL-6 levels reached peak values immediately after the surgery, while CRP peak levels were reached 48 h after the surgery. The overall inflammatory reaction was more intense in HA patients compared to the other subgroups. Independent of each other, older age and the hip fracture type affected the IL-6 response, while the CRP response depended only on the type of surgery. The abrupt increase in IL-6 immediately after the procedure suggests its involvement in the early stages of the postoperative inflammatory reaction after hip surgery. This reaction is particularly pronounced in elderly patients receiving HA.