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Cognitive bias and patient safety

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https://www.readbyqxmd.com/read/29130474/interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#1
REVIEW
Christopher Eccleston, Emma Fisher, Kyla H Thomas, Leslie Hearn, Sheena Derry, Cathy Stannard, Roger Knaggs, R Andrew Moore
BACKGROUND: This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29067332/ub-311-a-novel-ubith-%C3%A2-amyloid-%C3%AE-peptide-vaccine-for-mild%C3%A2-alzheimer-s%C3%A2-disease
#2
Chang Yi Wang, Pei-Ning Wang, Ming-Jang Chiu, Connie L Finstad, Feng Lin, Shugene Lynn, Yuan-Hung Tai, Xin De Fang, Kesheng Zhao, Chung-Ho Hung, Yiting Tseng, Wen-Jiun Peng, Jason Wang, Chih-Chieh Yu, Be-Sheng Kuo, Paul A Frohna
INTRODUCTION: A novel amyloid β (Aβ) synthetic peptide vaccine (UB-311) has been evaluated in a first-in-human trial with patients of mild-to-moderate Alzheimer's disease. We describe translational research covering vaccine design, preclinical characterization, and phase-I clinical trial with supportive outcome that advances UB-311 into an ongoing phase-II trial. METHODS: UB-311 is constructed with two synthetic Aβ1-14-targeting peptides (B-cell epitope), each linked to different helper T-cell peptide epitopes (UBITh(®)) and formulated in a Th2-biased delivery system...
June 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/28968372/the-implication-of-diagnostic-errors
#3
Raghav Govindarajan
Diagnostic errors are mistakes in the diagnostic process that lead to a misdiagnosis, a missed diagnosis, or a delayed diagnosis. While the past decade's impetus to improve patient safety has focused on medication errors, health care-associated infections, and postsurgical complications, diagnostic errors have received comparatively less attention. Diagnostic errors will continue to play a major role in the patient safety and quality improvement movement because of their burden on care and their financial burden...
October 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28967695/intravenous-immunoglobulin-for-the-treatment-of-childhood-encephalitis
#4
REVIEW
Mildred A Iro, Natalie G Martin, Michael Absoud, Andrew J Pollard
BACKGROUND: Encephalitis is a syndrome of neurological dysfunction due to inflammation of the brain parenchyma, caused by an infection or an exaggerated host immune response, or both. Attenuation of brain inflammation through modulation of the immune response could improve patient outcomes. Biological agents such as immunoglobulin that have both anti-inflammatory and immunomodulatory properties may therefore be useful as adjunctive therapies for people with encephalitis. OBJECTIVES: To assess the efficacy and safety of intravenous immunoglobulin (IVIG) as add-on treatment for children with encephalitis...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28955138/alpha7-nachr-agonists-for-cognitive-deficit-and-negative-symptoms-in-schizophrenia-a-meta-analysis-of-randomized-double-blind-controlled-trials
#5
Ye Jin, Qi Wang, Yan Wang, Mengxi Liu, Anji Sun, Zhongli Geng, Yiwei Lin, Xiaobai Li
BACKGROUND: Previous clinical trials of α7-nicotinic acetylcholine receptor agonists (α7-nAChR agonists) showed mixed results in treating the cognitive and negative symptoms of schizophrenia. AIMS: To assess the efficacy and safety of α7-nAChR agonists in treating the cognitive and negative symptoms in schizophrenia. METHODS: A literature search was conducted to identify randomized double-blind placebo-controlled trials for schizophrenia published before May 26, 2017, by searching PubMed, Embase, ClinicalTrials...
August 25, 2017: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/28937178/cognitive-biases-can-lead-to-serious-patient-safety-events
#6
Carlos Pellegrini
More than 100 cognitive biases are believed to exist. They are flaws or distortions in judgment and decision making, which have become increasingly recognized as contributors to patient safety events....
December 2016: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28686520/mindfulness-based-interventions-for-women-with-breast-cancer-an-updated-systematic-review-and-meta-analysis
#7
Heidemarie Haller, María M Winkler, Petra Klose, Gustav Dobos, Sherko Kümmel, Holger Cramer
BACKGROUND: The aim of this meta-analysis was to systematically update the evidence for mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) in women with breast cancer. MATERIAL AND METHODS: In October 2016, PubMed, Scopus, and Central were searched for randomized controlled trials on MBSR/MBCT in breast cancer patients. The primary outcome was health-related quality of life. Secondary outcomes were fatigue, sleep stress, depression, anxiety, and safety...
July 7, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28601498/self-reported-cognitive-distortions-in-the-psychosis-continuum-a-polish-18-item-version-of-the-davos-assessment-of-cognitive-biases-scale-dacobs-18
#8
Łukasz Gawęda, Katarzyna Prochwicz, Martyna Krężołek, Joanna Kłosowska, Maciej Staszkiewicz, Steffen Moritz
AIM: The aim of this study was to provide a short version of the Davos Assessment of Cognitive Biases Scale (DACOBS), which is a self-report tool to assess cognitive distortions related to psychosis. METHODS: A principal component analysis (PCA) was conducted on a large non-clinical sample (n=1207) and cross-validated with a confirmatory factor analysis on an independent non-clinical sample (n=653). Discriminative validity was performed by contrasting the high risk for psychosis non-clinical sample (n=63), low risk for psychosis non-clinical sample (n=152), patients with schizophrenia (n=105), and patients with depression (n=56)...
June 7, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#9
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28073958/rudeness-and-medical-team-performance
#10
RANDOMIZED CONTROLLED TRIAL
Arieh Riskin, Amir Erez, Trevor A Foulk, Kinneret S Riskin-Geuz, Amitai Ziv, Rina Sela, Liat Pessach-Gelblum, Peter A Bamberger
OBJECTIVES: Rudeness is routinely experienced by medical teams. We sought to explore the impact of rudeness on medical teams' performance and test interventions that might mitigate its negative consequences. METHODS: Thirty-nine NICU teams participated in a training workshop including simulations of acute care of term and preterm newborns. In each workshop, 2 teams were randomly assigned to either an exposure to rudeness (in which the comments of the patient's mother included rude statements completely unrelated to the teams' performance) or control (neutral comments) condition, and 2 additional teams were assigned to rudeness with either a preventative (cognitive bias modification [CBM]) or therapeutic (narrative) intervention...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28048788/mo-fg-207a-03-radiation-and-cancer-perspectives-from-the-trenches-are-we-providing-care-or-promoting-scare
#11
D Frush
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048056/mo-fg-207a-00-radiation-and-cancer-reality-extrapolations-myths-practice
#12
Madan Rehani, Donald Miller
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047397/mo-fg-207a-01-overview-of-global-usage-of-x-rays-for-diagnostic-purpose-issues-and-approaches-for-safety
#13
M Rehani
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046733/mo-fg-207a-02-what-do-we-really-know-about-cancer-risks-at-doses-pertinent-to-ct-scans
#14
D Brenner
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27529826/non-pharmacological-interventions-for-cognitive-impairment-due-to-systemic-cancer-treatment
#15
REVIEW
Charlene J Treanor, Una C McMenamin, Roisin F O'Neill, Chris R Cardwell, Mike J Clarke, Marie Cantwell, Michael Donnelly
BACKGROUND: It is estimated that up to 75% of cancer survivors may experience cognitive impairment as a result of cancer treatment and given the increasing size of the cancer survivor population, the number of affected people is set to rise considerably in coming years. There is a need, therefore, to identify effective, non-pharmacological interventions for maintaining cognitive function or ameliorating cognitive impairment among people with a previous cancer diagnosis. OBJECTIVES: To evaluate the cognitive effects, non-cognitive effects, duration and safety of non-pharmacological interventions among cancer patients targeted at maintaining cognitive function or ameliorating cognitive impairment as a result of cancer or receipt of systemic cancer treatment (i...
August 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27237931/an-updated-meta-analysis-of-the-efficacy-and-safety-of-acupuncture-treatment-for-vascular-cognitive-impairment-without-dementia
#16
REVIEW
Deng Min, Wang Xu-Feng
Vascular cognitive impairment with no dementia (VCIND) refers to a transitional state and will progress to dementia. Currently, effective medicines to control VCIND are surprisingly scarce. Acupuncture intervention is frequently advocated as an adjunct treatment for VCIND in recent studies. So the aim of this meta-analysis was to assess the clinical efficacy and safety of acupuncture for VCIND. The literature search was conducted in English and Chinese databases from inception until July 2015, and 15 study populations were included in the meta-analysis...
2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/27016244/chinese-herbal-medicine-for-patients-with-vascular-cognitive-impairment-no-dementia-protocol-for-a-systematic-review
#17
Mei Feng, Jingmin Lu, Brian H May, Shaonan Liu, Xinfeng Guo, Anthony Lin Zhang, Charlie Changli Xue, Chuanjian Lu
INTRODUCTION: The aim of this systematic review is to assess the efficacy and safety of Chinese herbal medicine for the treatment of patients with vascular cognitive impairment but no dementia. METHODS AND ANALYSIS: We will perform a comprehensive retrieval in the following electronic databases: PubMed, Cochrane Library, EMBASE, CINAHL, Chinese Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang database and other sources...
March 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/26969128/the-efficacy-of-a-new-translational-treatment-for-persecutory-delusions-study-protocol-for-a-randomised-controlled-trial-the-feeling-safe-study
#18
RANDOMIZED CONTROLLED TRIAL
Daniel Freeman, Felicity Waite, Richard Emsley, David Kingdon, Linda Davies, Ray Fitzpatrick, Graham Dunn
BACKGROUND: Persecutory delusions (strong unfounded fears that others intend harm to the person) occur in more than 70 % of the patients diagnosed with schizophrenia. This major psychotic experience is a key clinical target, for which substantial improvement in treatment is needed. Our aim is to use advances in theoretical understanding to develop a much more efficacious treatment that leads to recovery in at least 50 % of people with persistent persecutory delusions. Our cognitive conceptualisation is that persecutory delusions are threat beliefs, developed in the context of genetic and environmental risk, maintained by a number of psychological processes including excessive worry, low self-confidence, intolerance of anxious affect and other internal anomalous experiences, reasoning biases, and safety-seeking strategies...
March 11, 2016: Trials
https://www.readbyqxmd.com/read/26770817/aviation-and-healthcare-a-comparative-review-with-implications-for-patient-safety
#19
Narinder Kapur, Anam Parand, Tayana Soukup, Tom Reader, Nick Sevdalis
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented...
January 2016: JRSM Open
https://www.readbyqxmd.com/read/26619758/who-am-i-to-decide-whether-this-person-is-to-die-today-physicians-life-or-death-decisions-for-elderly-critically-ill%C3%A2-patients-at-the-emergency-department-icu-interface-a%C3%A2-qualitative-study
#20
Thomas Fassier, Elizabeth Valour, Cyrille Colin, François Danet
STUDY OBJECTIVE: We explored physicians' perceptions of and attitudes toward triage and end-of-life decisions for elderly critically ill patients at the emergency department (ED)-ICU interface. METHODS: This was a qualitative study with thematic analysis of data collected through semistructured interviews (15 emergency physicians and 9 ICU physicians) and nonparticipant observations (324 hours, 8 units, in 2 hospitals in France). RESULTS: Six themes emerged: (1) Physicians revealed a representation of elderly patients that comprised both negative and positive stereotypes, and expressed the concept of physiologic age...
July 2016: Annals of Emergency Medicine
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