Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods: The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results: Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions: Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence: Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Team dynamics in emergency surgery teams: results from a first international survey

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma\u2019s causes or the patient\u2019s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients\u2019 and stakeholders\u2019 engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey\u2019s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions

Decentralisation of economic law: an oxymoron

The interest in decentralising governance is increasing worldwide. In Europe too, a policy of decentralisation is being applied. In economic law, notably in both the cases of EC competition and financial services law, new rules are in the process of being introduced. In competition law, the regulation on the implementation of the rules on competition has lead to a decentralised model of law enforcement. In financial services law, the directive on markets in financial instruments has proposed the introduction of a four-level rule-making model, which may represent a participative, decentralised approach, but has resulted in a centralisation of that process, while the enforcement remains decentralised. This essay provides a brief overview of these models of regulation. Then, it examines these regulatory structures and focuses on the question of the impact of the decentralisation process in the context of decentred understandings of regulation. It points to the paradox of law being decentralised where it is a centralised function and thus represents an oxymoron. The paper argues that decentralisation results in an oxymoron depending on the function of law considered. The overall purpose of the paper is to contribute to a better understanding of governance through decentralisation

Truppe e comandanti nel mondo antico

Questo numero ospita gli Atti delle Giornate di Studio su \u201cTruppe e comandanti nel mondo antico. Tra politica societ\ue0 cultura\u201d organizzate nell\u2019ambito delle attivit\ue0 del dottorato di ricerca in Storia della Sicilia e del Mediterraneo antico (Palermo, 16-17 Novembre 2009)