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https://www.readbyqxmd.com/read/29650067/diagnostic-errors-and-the-bedside-clinical-examination
#1
REVIEW
Bennett W Clark, Arsalan Derakhshan, Sanjay V Desai
Diagnostic errors are common in clinical practice and lead to adverse patient outcomes. Systematic reviews have shown that inadequate history taking and physical examination lead to a plurality, if not a majority, of diagnostic errors. Recent advances in cognitive science have also shown that unconscious biases likely contribute to many diagnostic errors. Research into diagnostic error has been hampered by methodologic inconsistency and a paucity of studies in real-world clinical settings. The best evidence indicates that educational interventions to reduce diagnostic error should give physicians feedback about clinical outcomes and enhance their ability to recognize signs and symptoms of specific diseases at the bedside...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29626497/time-course-of-influence-on-the-allocation-of-attentional-resources-caused-by-unconscious-fearful-faces
#2
Yunpeng Jiang, Xia Wu, Rami Saab, Yi Xiao, Xiaorong Gao
Emotionally affective stimuli have priority in our visual processing even in the absence of conscious processing. However, the influence of unconscious emotional stimuli on our attentional resources remains unclear. Using the continuous flash suppression (CFS) paradigm, we concurrently recorded and analyzed visual event-related potential (ERP) components evoked by the images of suppressed fearful and neutral faces, and the steady-state visual evoked potential (SSVEP) elicited by dynamic Mondrian pictures. Fearful faces, relative to neutral faces, elicited larger late ERP components on parietal electrodes, indicating emotional expression processing without consciousness...
April 4, 2018: Neuropsychologia
https://www.readbyqxmd.com/read/29582388/action-influences-unconscious-visual-processing
#3
Jihyun Suh, Richard A Abrams
It has long been known that action is tightly linked to visual perception. In support of this connection, recent studies have shown that making a simple action towards a visual object can bias subsequent visual processing of features of the acted-on object. The present study examined whether conscious awareness of the acted-on object is necessary to yield this action effect. In two experiments, we found that making an action towards an invisible object resulted in greater priming in a subsequent visual search task...
March 26, 2018: Attention, Perception & Psychophysics
https://www.readbyqxmd.com/read/29571927/implicit-physician-biases-in-periviability-counseling
#4
Natasha Shapiro, Elena V Wachtel, Sean M Bailey, Michael M Espiritu
OBJECTIVE: To assess whether neonatologists show implicit racial and/or socioeconomic biases and whether these are predictive of recommendations at extreme periviability. STUDY DESIGN: A nationwide survey using a clinical vignette of a woman in labor at 232/7 weeks of gestation asked physicians how likely they were to recommend intensive vs comfort care. Participants were randomized to 1 of 4 versions of the vignette in which racial and socioeconomic stimuli were varied, followed by 2 implicit association tests (IATs)...
March 20, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29533865/unconscious-priming-dissociates-free-choice-from-spontaneous-urge-responses
#5
MarĂ­a Tortosa Molina, Greg Davis
Advances in neuroscience offer the exciting prospect of understanding 'free' choices - the subject of the free will debate in philosophy. However, while physiological techniques and analysis have progressed rapidly to meet this challenge, task design has not. The challenge is now to develop laboratory tasks that adequately capture 'free' picking or choosing. To isolate 'internally' generated intentions from those impelled by external stimulus, observers are asked to 'choose freely' or to wait for a felt 'urge'...
March 10, 2018: Consciousness and Cognition
https://www.readbyqxmd.com/read/29422449/attention-bias-in-individuals-with-addictive-disorders-systematic-review-protocol
#6
Melvyn Zhang, JiangBo Ying, Guo Song, Roger Cm Ho, Daniel Ss Fung, Helen Smith
BACKGROUND: Globally, substance disorders, particularly that of opiate use, cannabis use, and stimulant use disorders, are highly prevalent. Psychological treatments are an integral aspect of intervention, but a proportion of individuals still relapse despite having received such an intervention. Recently, the dual-process theory proposed that the unconscious processes of attention biases are responsible for these relapses. Prior meta-analyses have reported the presence of attention bias in alcohol and tobacco use disorders...
February 8, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29410872/visual-processing-conscious-until-proven-otherwise
#7
Tarryn Balsdon, Colin W G Clifford
Unconscious perception, or perception without awareness, describes a situation where an observer's behaviour is influenced by a stimulus of which they have no phenomenal awareness. Perception without awareness is often claimed on the basis of a difference in thresholds for tasks that do and do not require awareness, for example, detecting the stimulus (requiring awareness) and making accurate judgements about the stimulus (based on unconscious processing). Although a difference in thresholds would be expected if perceptual evidence were processed without awareness, such a difference does not necessitate that this is actually occurring: a difference in thresholds can also arise from response bias, or through task differences...
January 2018: Royal Society Open Science
https://www.readbyqxmd.com/read/29367322/catalogue-of-bias-observer-bias
#8
Kamal Mahtani, Elizabeth A Spencer, Jon Brassey, Carl Heneghan
This article is part of a series featured from the Catalogue of Bias introduced in this volume of BMJ Evidence-Based Medicine that describes biases and outlines their potential impact in research studies. Observer bias is systematic discrepancy from the truth during the process of observing and recording information for a study. Many healthcare observations are at risk of this bias. Evidence shows that treatment effect estimates can be exaggerated by a third to two-thirds in the presence of observer bias in outcome assessment...
February 2018: BMJ evidence-based medicine
https://www.readbyqxmd.com/read/29235686/the-missing-father-function-in-psychoanalytic-theory-and-technique-the-analyst-s-internal-couple-and-maturing-intimacy
#9
Michael J Diamond
This paper argues that recovering the "missing" paternal function in analytic space is essential for the patient's achievement of mature object relations. Emerging from the helpless infant's contact with primary caregivers, mature intimacy rests on establishing healthy triadic functioning based on an infant-with-mother-and-father. Despite a maternocentric bias in contemporary clinical theory, the emergence of triangularity and the inclusion of the paternal third as a separating element is vital in the analytic dyad...
October 2017: Psychoanalytic Quarterly
https://www.readbyqxmd.com/read/29137509/explicit-bias-toward-high-income-country-research-a-randomized-blinded-crossover-experiment-of-english-clinicians
#10
Matthew Harris, Joachim Marti, Hillary Watt, Yasser Bhatti, James Macinko, Ara W Darzi
Unconscious bias may interfere with the interpretation of research from some settings, particularly from lower-income countries. Most studies of this phenomenon have relied on indirect outcomes such as article citation counts and publication rates; few have addressed or proven the effect of unconscious bias in evidence interpretation. In this randomized, blinded crossover experiment in a sample of 347 English clinicians, we demonstrate that changing the source of a research abstract from a low- to a high-income country significantly improves how it is viewed, all else being equal...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29091241/teaching-strategies-to-increase-nursing-student-acceptance-and-management-of-unconscious-bias
#11
Paula L Schultz, Janet Baker
BACKGROUND: Medical providers' unconscious biases may contribute to health disparities. Awareness and self-reflection strategies commonly used to teach cultural competence in academic settings are generally ineffective in reducing unconscious bias or motivating change. METHOD: This article describes the innovative teaching strategies implemented in a graduate setting (N = 75) to increase nursing learners' acceptance and management of unconscious bias. Strategies used guided the debriefing and feedback that incorporated implicit association testing, interactive audience polling, categorized management strategies, and perspective taking...
November 1, 2017: Journal of Nursing Education
https://www.readbyqxmd.com/read/29065875/a-randomised-trial-of-the-influence-of-racial-stereotype-bias-on-examiners-scores-feedback-and-recollections-in-undergraduate-clinical-exams
#12
RANDOMIZED CONTROLLED TRIAL
Peter Yeates, Katherine Woolf, Emyr Benbow, Ben Davies, Mairhead Boohan, Kevin Eva
BACKGROUND: Asian medical students and doctors receive lower scores on average than their white counterparts in examinations in the UK and internationally (a phenomenon known as "differential attainment"). This could be due to examiner bias or to social, psychological or cultural influences on learning or performance. We investigated whether students' scores or feedback show influence of ethnicity-related bias; whether examiners unconsciously bring to mind (activate) stereotypes when judging Asian students' performance; whether activation depends on the stereotypicality of students' performances; and whether stereotypes influence examiner memories of performances...
October 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28994471/god-of-the-hinge-treating-lgbtqia-patients
#13
Annie Boland
This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non-conforming, cross-dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative...
November 2017: Journal of Analytical Psychology
https://www.readbyqxmd.com/read/28987244/implicit-bias-in-pediatric-academic-medicine
#14
Tiffani J Johnson, Angela M Ellison, George Dalembert, Jessica Fowler, Menaka Dhingra, Kathy Shaw, Said Ibrahim
OBJECTIVE: Despite known benefits of diversity, certain racial/ethnic groups remain underrepresented in academic pediatrics. Little research exists regarding unconscious racial attitudes among pediatric faculty responsible for decisions on workforce recruitment and retention in academia. This study sought to describe levels of unconscious racial bias and perceived barriers to minority recruitment and retention among academic pediatric faculty leaders. METHODS: Authors measured unconscious racial bias in a sample of pediatric faculty attending diversity workshops conducted at local and national meetings in 2015...
2017: Journal of the National Medical Association
https://www.readbyqxmd.com/read/28976555/techniques-for-preventing-hypotension-during-spinal-anaesthesia-for-caesarean-section
#15
REVIEW
Cheryl Chooi, Julia J Cox, Richard S Lumb, Philippa Middleton, Mark Chemali, Richard S Emmett, Scott W Simmons, Allan M Cyna
BACKGROUND: Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury). OBJECTIVES: To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (9 August 2016) and reference lists of retrieved studies...
August 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28959939/rooting-out-bias
#16
Bridget M Kuehn
Tackling unconscious bias is a major challenge for journals and the rest of the scientific community.
September 29, 2017: ELife
https://www.readbyqxmd.com/read/28955268/subliminally-and-supraliminally-acquired-long-term-memories-jointly-bias-delayed-decisions
#17
Simon Ruch, Elizabeth Herbert, Katharina Henke
Common wisdom and scientific evidence suggest that good decisions require conscious deliberation. But growing evidence demonstrates that not only conscious but also unconscious thoughts influence decision-making. Here, we hypothesize that both consciously and unconsciously acquired memories guide decisions. Our experiment measured the influence of subliminally and supraliminally presented information on delayed (30-40 min) decision-making. Participants were presented with subliminal pairs of faces and written occupations for unconscious encoding...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28936782/unconscious-bias-and-the-psychosocially-challenged-patient-a-surgeon-s-perspective
#18
Sean T Campbell
No abstract text is available yet for this article.
September 21, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28870336/unconscious-bias
#19
Nolan Kagetsu, Richard B Gunderman
No abstract text is available yet for this article.
September 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28855358/thermal-facial-reactivity-patterns-predict-social-categorization-bias-triggered-by-unconscious-and-conscious-emotional-stimuli
#20
Giorgia Ponsi, Maria Serena Panasiti, Giulia Rizza, Salvatore Maria Aglioti
Members of highly social species decode, interpret, and react to the emotion of a conspecific depending on whether the other belongs to the same (ingroup) or different (outgroup) social group. While studies indicate that consciously perceived emotional stimuli drive social categorization, information about how implicit emotional stimuli and specific physiological signatures affect social categorization is lacking. We addressed this issue by exploring whether subliminal and supraliminal affective priming can influence the categorization of neutral faces as ingroup versus outgroup...
August 30, 2017: Proceedings. Biological Sciences
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