Individual differences in self-reported lie detection abilities

Previous literature on lie detection abilities bears an interesting paradox. On the group level, people detect others' lies at guessing level. However, when asked to evaluate their own abilities, people report being able to detect lies (i.e., self-reported lie detection). Understanding this paradox is important because decisions which rely on credibility assessment and deception detection can have serious implications (e.g., trust in others, legal issues). In two online studies, we tested whether individual differences account for variance in self-reported lie detection abilities. We assessed personality traits (Big-Six personality traits, Dark Triad), empathy, emotional intelligence, cultural values, trust level, social desirability, and belief in one's own lie detection abilities. In both studies, mean self-reported lie detection abilities were above chance level. Then, lower out-group trust and higher social desirability levels predicted higher self-reported lie detection abilities. These results suggest that social trust and norms shape our beliefs about our own lie detection abilities.

Entrepôts de données cliniques, outil du pilotage de crise

Introduction

La crise sanitaire COVID-19 a nécessité un suivi épidémiologique et d'activité pour adapter, en situation d'incertitude, la gestion hospitalière (capacitaire comme ressources humaines) au fil des jours. Le département de santé publique du CHRU de Tours a créé et automatisé un tableau de bord (TdB) de suivi COVID en utilisant son entrepôt de données cliniques.

Méthodes

L’équipe d’épidémiologie, en collaboration avec la cellule de crise du CHRU comprenant soignants, virologues et directeurs, a construit des indicateurs de suivi épidémique consultables dans un TdB interactif. Les données sont issues de l'entrepôt eHOP® qui intègre en temps réel les données du dossier patient informatisé : comptes rendus, biologie, prescriptions. Ces indicateurs sont mis à jour automatiquement toutes les six heures sur l'intranet du CHRU (Dashboard R Shiny®), accessible à tous les agents. L'identification des cas COVID-19+ se base sur les données virologiques et/ou déclaration de cas SI-VIC, pour les patients testés en ambulatoire. La guérison est définie par la sortie vers le domicile. En parallèle, les données départementales et régionales (data.gouv.fr : hospitalisation SI-VIC, dépistage SI-DEP, vaccination SI-VAC) ont été intégrées au TdB.

Résultats

Sont consultables à tout moment via des graphiques interactifs : l’évolution des hospitalisations COVID au sein des différents secteurs (médecine, réanimation…), les caractéristiques des patients (hospitalisés, guéris, décédés), les passages aux urgences pour suspicion COVID dont ceux ayant nécessité une hospitalisation, le nombre et taux de positivité des tests de dépistage (RTPCR, TAG) et sérologies réalisés par le laboratoire de virologie pour le CHRU et le GHT élargi. Les données de couverture vaccinale des agents y sont implémentées depuis janvier 2021. Au niveau départemental et régional sont consultables : évolution des incidences, hospitalisations (dont tension en réanimation) et couverture vaccinale en population générale, cartographies (dépistage, incidences, hospitalisations).

Discussion/Conclusion

Un TdB automatisé en temps réel permet une aide à la décision réactive en situation de crise et favorise l'information et la transmission de messages-clés aux agents (hygiène, vaccination, …).

Saccadic Eye Movements in Elderly Depressed Patients With Suicidal Behaviors: An Exploratory Eye-Tracking Study

Suicidal behaviors (SBs) are often associated with impaired performance on neuropsychological executive functioning (EF) measures that encourage the development of more specific and reliable tools. Recent evidence could suggest that saccadic movement using eye tracking can provide reliable information on EF in depressive elderly. The aim of this study was to describe oculomotor performances in elderly depressed patients with SB. To achieve this aim, we compared saccadic eye movement (SEM) performances in elderly depressed patients (N = 24) with SB and with no SB in prosaccade (PS) and antisaccade (AS) tasks under the gap, step, and overlap conditions. All participants also underwent a complete neuropsychological battery. Performances were impaired in patients with SB who exhibited less corrected AS errors and longer time to correct them than patients with no SB. Moreover, both groups had a similar performance for PS latencies and correct AS. These preliminary results suggested higher cognitive inflexibility in suicidal patients compared to non-suicidal. This inflexibility may explain the difficulty of the depressed elderly in generating solutions to the resurgence of suicidal ideation (SI) to respond adequately to stressful environments. The assessment of eye movement parameters in depressed elderly patients may be a first step in identifying high-risk patients for suicide.

741 Restarting Elective Orthopaedic Surgery During The COVID-19 Pandemic: Experiences and Patient Outcomes

Aim

The COVID-19 pandemic resulted in postponing all non-urgent elective surgeries from April 2020. As we emerged from the first peak, restarting non-urgent services such as elective orthopaedic surgery was important for patients with chronic debilitating conditions. Our hospital successfully restarted orthopaedic surgery during the pandemic to help improve the quality of life of patients. This study describes the development of local protocols and pathways to allow for a safe restart of elective orthopaedic surgery in a COVID-19 free site. It presents the morbidity and mortality outcomes of those patients.

Method

This is a prospective cohort study evaluating all patients undergoing non-emergency orthopaedic procedures through a COVID-19 free pathway in a DGH from 18th May – 10th July 2020. 104 patients were identified, and their outcomes analysed during the 2 weeks following their surgery.

Results

No patients developed COVID-19 in the 2-weeks post-operative period. There were no ITU admissions or in-hospital deaths. 22(21.15%) out of 104 patients developed 23 complications within 2 weeks of surgery. These included: TIA, PE, AF, superficial wound infection, oozy wound and post-operative anaemia. They all made full recovery. There was no statistical difference in the development of complications for age (< 70; >70), gender, BMI, or ASA grades.

Conclusions

This study describes a roadmap to setting up a protocolised elective operating service for orthopaedic surgery. It has shown that standardised protocols in a COVID-19 free site, pre-operative COVID-19 testing and adherence to national guidelines on self-isolation prior to surgery can help prevent COVID-19 infection and its related risks post-operatively.

Les entrepôts de données cliniques : un outil d’aide au pilotage de crise

Introduction

La crise sanitaire COVID-19 a nécessité la mise en place d’un suivi épidémique quotidien (épidémiologie et activité) en établissements de santé pour adapter, en situation d’incertitude, la gestion hospitalière (capacités comme ressources humaines). Le département de santé publique du CHU a créé et automatisé un tableau de bord (TdB) de suivi COVID en temps réel en utilisant son entrepôt de données cliniques.

Matériels et méthodes

Dès mars 2020, l’équipe d’épidémiologie et de santé publique, en collaboration avec la cellule de crise du CHU constituée de soignants, virologues et directeurs, a construit des indicateurs de suivi épidémique consultables dans un TdB interactif. Les données utilisées sont issues de l’entrepôt eHOP® implémenté au CHU qui intègre en temps réel les données du dossier patient informatisé : comptes rendus médicaux, biologie, prescriptions. Ces indicateurs sont automatisés et mis à jour toutes les 6 heures sur l’intranet du CHU (Dashboard R Shiny®), accessible en temps réel pour tous les agents. En parallèle, des données d’open data départementales et régionales (data.gouv.fr : hospitalisation SI-VIC, dépistage SI-DEP, vaccination SI-VAC) ont été intégrées au TdB.

Résultats

Sont consultables à tout moment via des graphiques interactifs : l’évolution des hospitalisations COVID au sein des différents secteurs (médecine dont secteur COVID ou non, réanimation, autres) ; les caractéristiques des patients hospitalisés, guéris et/ou décédés ; les passages aux urgences pour suspicion COVID, dont les cas confirmés et ceux ayant nécessité une hospitalisation ; le nombre et le taux de positivité des tests de dépistage (RT-PCR, TAG) et des sérologies réalisés par le laboratoire de virologie, que ce soit pour des personnes du CHU ou du GHT élargi. Les données de couverture vaccinale des agents du CHU par professions, ainsi que le nombre de vaccinations effectuées pour des personnes hors CHU (patients, professionnels libéraux) y sont implémentées depuis janvier 2021. Au niveau départemental et régional sont consultables : l’évolution des incidences, par âge et départements, et des hospitalisations COVID du département et de la région (dont mortalité et tension en réanimation), ainsi que des cartographies hebdomadaires sur l’activité de dépistage (taux de dépistage, de positivité, d’incidence) et hospitalière.

Conclusion

Le développement d’un TdB automatisé permet une aide à la décision de la cellule de crise du CHU par la mise à disposition en temps réel de données objectives et donc une gestion réactive et agile. L’information continue des agents favorise la transmission d’informations et de messages clés, comme la promotion de la vaccination.

643 Near-Peer Surgical Teaching for Junior Doctors: A 16-Month Retrospective Analysis

Introduction

Surgical departments across the UK are having to mitigate service demands, budget constraints and changes to work patterns with their statutory duty to provide high-quality training and education. Securing consultant-led teaching has also become increasingly difficult leading to the rise of near-peer teaching. We evaluate the long-term effectiveness of near-peer surgical teaching for junior doctors.

Method

We developed a rolling 12-week trainee-led didactic surgical education programme for Foundation doctors and Core Surgical Trainees. Junior doctors delivered teaching to peers with registrar input; session and supervision feedback was recorded using 5-point scales and free-text responses.

Results

42 junior doctors responded to our end-of-programme feedback surveys covering December 2018 to April 2020. The overall programme (8.83±1.08/10), relevance (4.62±0.58/5), presentation quality (4.60±0.50/5) and supervisor knowledge (4.81±0.40/5) were rated highly by respondents. Attendees also reported significant improvements in subject knowledge (3.72±0.92/5 to 4.50±0.56/5, P < 0.0001), clinical confidence, presentation and teaching skills.

Conclusions

Our near-peer teaching programme addressed the educational needs of junior doctors and developed their presentation and organisational skills. Supervision and input from registrars facilitated discussion and reinforced key concepts. The success of this programme highlights the role that trainees can play in designing, developing, and leading an effective surgical teaching programme.

Universal Patterns in Color-Emotion Associations Are Further Shaped by Linguistic and Geographic Proximity

Many of us “see red,” “feel blue,” or “turn green with envy.” Are such color-emotion associations fundamental to our shared cognitive architecture, or are they cultural creations learned through our languages and traditions? To answer these questions, we tested emotional associations of colors in 4,598 participants from 30 nations speaking 22 native languages. Participants associated 20 emotion concepts with 12 color terms. Pattern-similarity analyses revealed universal color-emotion associations (average similarity coefficient r = .88). However, local differences were also apparent. A machine-learning algorithm revealed that nation predicted color-emotion associations above and beyond those observed universally. Similarity was greater when nations were linguistically or geographically close. This study highlights robust universal color-emotion associations, further modulated by linguistic and geographic factors. These results pose further theoretical and empirical questions about the affective properties of color and may inform practice in applied domains, such as well-being and design.

[Cesarean sections in the Centre-Val de Loire region: Practices and indications-the Robson Classification]

BACKGROUND

To study the cesarean section (c-section) practices in the French Centre-Val de Loire region: incidence of planned c-section and rate variations between maternities, incidence of potentially avoidable cesarean sections.

METHODS

The data were extracted from the 2016 regional birth register, which permitted classification of each planned c-section according to the pre-existing risk of c-section (high or low) as defined by the Robson classification. To enhance the data, especially the indications for c-section, which are not included in the register, a survey was conducted from September 2016 to February 2017 in all of the 20 maternities in the region.

RESULTS

In 2016, nearly 26,000 women gave birth in the CVL region, of whom 19.2% by c-section (7.0% planned c-sections). The planned c-section rate was higher for breech presentation and scarred uterus, and decreased according to level of the maternity (I 41% - II 35% - III 32%). Concerning the c-section indications, 1,979 c-sections were studied during the period (18.6% of births), including 762 planned c-sections (7.1% of births). Among them, 246 (32%) were potentially avoidable, mainly isolated indications of scarred uterus with only one previous c-section or breech presentation, and 17 due to unfavorable radiologic pelvimetry in nulliparous women.

CONCLUSION

Specific actions were identified: targeted use of radiologic pelvimetry, targeted c-section on scarred uterus with only one previous cesarean section or breech presentation, as recommended by the national guidelines. The Robson classification should be widely used to evaluate and enhance practices, in particularly through painstakingly interpreted inter-maternity comparisons.

Burnout-Depression Overlap: Exploratory Structural Equation Modeling Bifactor Analysis and Network Analysis

Burnout has been viewed as a work-induced condition combining exhaustion, cynicism, and professional inefficacy. Using correlational analyses, an exploratory structural equation modeling bifactor analysis, structural regression analyses, and a network analysis, we examined the claim that burnout should not be mistaken for a depressive syndrome. The study involved 1,258 educational staff members. Burnout was assessed with the Maslach Burnout Inventory-General Survey and depression with the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale. Illegitimate work tasks and work-nonwork interferences were additionally measured. We notably found that (a) on average, exhaustion, cynicism, and professional inefficacy correlated less strongly with each other than with depression; (b) exhaustion-burnout's core-was more strongly associated with depression than with either cynicism or professional inefficacy; (c) the Patient Health Questionnaire-9 did not correlate more strongly with the Hospital Anxiety and Depression Scale than with exhaustion; (d) exhaustion and depression loaded primarily on a general distress/dysphoria factor in the exploratory structural equation modeling bifactor analysis; (e) on average, burnout and depression were related to job stressors in a similar manner; (f) work-nonwork interferences were strongly linked to distress/dysphoria. Overall, burnout showed no syndromal unity and lacked discriminant validity. Clinicians should systematically assess depressive symptoms in individuals presenting with a complaint of "burnout."

Indications and practices of Cesarean Sections in a French region – The Robson classification

Background

Cesarian-section (CS) deliveries, although sometimes vital, are associated with increasing immediate- and long-term maternal and/or neonatal risks. The objective was to describe the indications of scheduled CS, measure the potentially avoidable CS and study the rate variations between maternities in one French region, Centre Val-de-Loire (CVL).

Methods

A cross-sectional study was conducted from September 2016 to February 2017. Information about all CS performed in the maternities of the region was collected: medical history, indication, schedule. Data collection was completed with the 2016 regional birth data repository (25,864 deliveries, including 19.2% of CS, among which 7.0% were scheduled). CS were classified according to the pre-existing risk high or low of CS as defined by the Robson classification.

Results

During the study period, 1,979 CS (18.6% of deliveries) were performed, of which 762 were scheduled (7.1% of deliveries). The main indications for planning a CS were: scarred uterus (60%, of which 56% with only one previous CS) or breech presentation (25%), considered at high risk of CS according to the Robson classification. For these two contexts, the regional birth repository showed decreasing scheduled CS rates from high to low level of maternities’ expertise. Remarkly, 22 nulliparous women with a single cephalic pregnancy in spontaneous labor before term (Robson’s low risk of CS) had a CS performed for unfavorable pelvimetry (0.2% of deliveries).

Conclusions

This study allowed identifying specific potential interventions: targeted CS on scarred uterus with only one previous CS or breech presentation, as recommended by national guidelines, and targeted use of radiologic pelvimetry. The Robson classification must be widely used to assess practices through cautious maternity comparisons to improve quality of care.

Key messages

Although potentially avoidable c-sections are rare, interventions were identified: targeted CS on uterus with one previous CS or breech presentation, targeted use of radiologic pelvimetry. The Robson classification must be widely used to assess practices, in order to improve healthcare quality.

Challenges of a French Hospital Discharge algorithm to detect non-accidental paediatric burns

Background

Child maltreatment includes physical, psychological, sexual abuse and acts of neglect. Among the resulting non-accidental injuries, burns are responsible for an important morbi-mortality. The main objective was to build a detection algorithm of non-accidental paediatric burns (NAB), using ICD-10 codes in the hospital resumes from the French Hospital Discharge Database (HDD).

Methods

Children aged 0 to 16 years old hospitalised at the University Hospital of Tours from 2012 to 2017 with a coded burn were included. “Probable” or “possible” HDD cases of NAB were defined based on specific ICD-10 codes during the inclusion stay or the previous year. A chart review was performed on all the HDD cases and HDD non cases matched on sex and age with a 1:2 ratio. Performance parameters were estimated for three clinical definitions of suspected child maltreatment: excluding neglect, including neglect with restriction then broad definition. For clinical cases, report to the judicial authority (RJA) or worrying information (WI) was searched.

Results

Among the 253 included children, 83 “probable” cases and 153 non cases were analysed. Sensitivity varied from 48% (95%CI [36-60]) to 90% [55-100] when excluding neglect, specificity from 70% [63;77] to 68% [61;74]. The positive and negative likelihood ratios varied respectively from 1,6 [1,2;2,3] to 2,8 [2,1;3,7] and from 0,7 [0,6;0,9] to 0,1 [0,0;0,9]. The proportion of clinical cases with no RJA/WI without reason varied from 0 (when excluding neglect) to > 85% (with broadest definition); all corresponded to a possible isolated neglect.

Conclusions

The performances of the algorithm varied tremendously according to the clinical definition level of child maltreatment. Neglect is obviously difficult to clinically detect. Training for healthcare professionals and qualitative studies on obstacles to RJA/WI should be added to this work.

Key messages

The performances of an algorithm to detect non-accidental pediatric burns (maltreatment) using the French hospital discharge database dropped when including neglect, difficult to diagnose clinically. Training for healthcare professionals and qualitative studies on obstacles to the judicial authority (RJA) or worrying information (WI) should be added to this diagnostic study.

Multidisciplinary team meeting for complex bone and joint infections diagnosis: The PHICTOS study

BACKGROUND

In France, the most severe bone and joint infections (BJI), called "complex" (CBJI), are assessed in a multidisciplinary team meeting (MTM) in a reference center. However, the definition of CBJI, drawn up by the Health Ministry, is not consensual between physicians. The objective was to estimate the agreement for CBJI classification.

METHODS

Initially, five experts from one MTM classified twice, one-month apart, 24 cases as non-BJI, simple BJI or CBJI, using the complete medical record. Secondly, six MTMs classified the same cases using standardized information. Agreements were estimated using Fleiss and Cohen kappa (κ) coefficients.

RESULTS

Inter-expert agreement during one MTM was moderate (κ=0.49), and fair (κ=0.23) when the four non-BJIs were excluded. Intra-expert agreement was moderate (κ=0.50, range 0.27-0.90), not improved with experience. The overall inter-MTM agreement was moderate (κ=0.58), it was better between MTMs with professor (κ=0.65) than without (κ=0.51) and with longer median time per case (κ=0.60) than shorter (κ=0.47). When the four non-BJIs were excluded, the overall agreement decreased (κ=0.40).

CONCLUSION

The first step confirmed the heterogeneity of CBJI classification between experts. The seemingly better inter-MTM than inter-expert agreement could be an argument in favour of MTMs, which are moreover a privileged place to enhance expertise. Further studies are needed to assess these results as well as the quality of care and medico-economic outcomes after a MTM.

National epidemiological study reveals longer paediatric bone and joint infection stays for infants and in general hospitals

AIM

Published studies have suggested that two to five days of intravenous treatment could effectively treat paediatric bone and joint infections (PBJI), allowing a faster discharge. This study analysed the factors associated with PBJI hospital stays lasting longer than five days using the French National Hospital Discharge Database.

METHODS

We selected children under 15 years hospitalised in 2013 with haematogenous PBJIs using a validated French algorithm based on specific diagnosis and surgical procedure codes. Risk factors for stays of more than five days were analysed using logistic regression.

RESULTS

In 2013, 2717 children were hospitalised for PBJI, with 49% staying more than five days. The overall incidence of 22 per 100 000, was highest in males and toddlers. The main causes were septic arthritis (50%) and osteomyelitis (46%) and 50% of the pathogens were Staphylococci. The odd ratios for stays of five days or more were infancy, coded bacteria and sickle cell disease (7.0), having spondylodiscitis rather than septic arthritis (2.2) and being hospitalised in a general hospital rather than a teaching hospital (1.6).

CONCLUSION

Half of the hospital stays exceeded five days, despite scientific evidence supporting a shorter intravenous antibiotherapy regimen. Greater knowledge and widespread use of short treatment regimens are needed.

Memory bias toward emotional information in burnout and depression

A sample of 1015 educational staff members, exhibiting various levels of burnout and depressive symptoms, underwent a memory test involving incident encoding of positive and negative words and a free recall task. Burnout and depression were each found to be associated with increased recall of negative items and decreased recall of positive items. Results remained statistically significant when controlling for history of depressive disorders. Burnout and depression were not related to mistakes in the reported words, or to the overall number of recalled words. This study suggests that burnout and depression overlap in terms of memory biases toward emotional information.

Key features of bone and joint infections following the implementation of reference centers in France

OBJECTIVES

French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers.

PATIENTS AND METHODS

BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed.

RESULTS

BJI prevalence increased in 2013 (70 vs. 54/100,000 in 2008). Characteristics of BJI remained similar between 2008 and 2013: septic arthritis (50%), increasing prevalence with age and sex, case fatality 5%, mean length of stay 17.5 days, rehospitalization 20%. However, device-associated BJIs increased (34 vs. 26%) as well as costs (€421 million vs. €259 in 2008). Similar device-associated BJI characteristics between 2008 and 2013 were: septic arthritis (70%), case fatality (3%), but with more hospitalizations in reference centers (34 vs. 30%) and a higher cost per stay. Among the 7% of coded complex BJIs, the mean length of stay was 22.2 days and mean cost was €11,960.

CONCLUSIONS

BJI prevalence highly increased in France. Complex BJI prevalence assessment is complicated by the absence of clinical consensus and probable undercoding. A validation of clinical case definition of complex BJI is required.

Biological research on burnout-depression overlap: Long-standing limitations and on-going reflections

In this commentary, we discuss seldom-noticed methodological problems affecting biological research on burnout and depression and make recommendations to overcome the limitations of past studies conducted in this area. First, we suggest that identified subtypes of depression (e.g., depression with melancholic features and depression with atypical features) should be taken into account in future biological research on burnout and depression, given that different subtypes of depression have been associated with distinct autonomic and neuroendocrine profiles. Second, we underline that research on burnout-depression overlap is made difficult by the absence of a consensual conceptualization and operationalization of burnout. In order to resolve this problem, we draw researchers' attention to the urgency of establishing a commonly shared, clinically valid diagnosis for burnout. Finally, we question the possibility of identifying a biological signature for burnout in light of global research on burnout-depression overlap.