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Cognitive bias and patient safety

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...
2016: Cochrane Database of Systematic Reviews
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
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...
2016: BMJ Open
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...
2016: Trials
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
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
Yi Zheng, Jian-Min Liang, Hong-Yun Gao, Zhi-Wei Yang, Fu-Jun Jia, Yue-Zhu Liang, Fang Fang, Rong Li, Sheng-Nan Xie, Jian-Min Zhuo
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is the most common mental and behavioral disorder in school-aged children. This study evaluated the effect of osmotic-release oral system (OROS) methylphenidate (MPH) on cognitive function and academic performance of Chinese school-aged children with ADHD. METHODS: This 12-week, prospective, multicenter, open-label, self-controlled study enrolled 153 Chinese school-aged children with ADHD and 41 non-ADHD children...
November 20, 2015: Chinese Medical Journal
Tinuade A Ogunlesi, Chibuzo C Odigwe, Olufemi T Oladapo
BACKGROUND: Bacterial meningitis remains a significant cause of neonatal and childhood morbidity and mortality in many countries of the world, particularly in developing countries. In some instances, children recover but remain impaired as a result of neurological sequelae such as hearing loss, developmental delay and cognitive impairment. OBJECTIVES: To assess the effectiveness and safety of adjunctive corticosteroids in reducing death and neurological sequelae in neonates with bacterial meningitis...
2015: Cochrane Database of Systematic Reviews
Wenzheng Wang, Chengcheng Pu, Jiangling Jiang, Xinyi Cao, Jijun Wang, Min Zhao, Chunbo Li
BACKGROUND: The efficacy and safety of the combined treatment of refractory schizophrenia with antipsychotic medications and electroconvulsive therapy (ECT) remain uncertain. AIMS: Conduct systematic review and meta-analysis of available literature in English and Chinese about ECT in the treatment of refractory schizophrenia. METHODS: English and Chinese databases were searched for studies published prior to May 20, 2015 regarding the efficacy and safety of the combined treatment of refractory schizophrenia with antipsychotic medications and ECT...
August 25, 2015: Shanghai Archives of Psychiatry
Mary-Ann Fitzcharles, Peter A Ste-Marie, Winfried Häuser, Daniel J Clauw, Shahin Jamal, Jacob Karsh, Tara Landry, Sharon Leclercq, Jason J Mcdougall, Yoram Shir, Kam Shojania, Zach Walsh
OBJECTIVE: To assess the efficacy, tolerability, and safety of cannabinoids (phyto- and syntheto-) in the management of rheumatic diseases. METHODS: Multiple databases, including Medline, Embase, and CENTRAL, were searched. Randomized controlled trials with outcomes of pain, sleep, quality of life, tolerability (dropouts due to adverse events), and safety (serious adverse events), with comparison of cannabinoids with any type of control, were included. Study methodology quality was evaluated with the Cochrane risk of bias tool...
May 2016: Arthritis Care & Research
Jacqueline S Birks, Lee Yee Chong, John Grimley Evans
BACKGROUND: Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity...
September 22, 2015: Cochrane Database of Systematic Reviews
Cele E Richardson, Michael Gradisar, Sebastian C Barbero
Although individuals with delayed sleep wake phase disorder (DSWPD) and chronic insomnia disorder (CID) share many of the same phenomenological experiences, theories relating to the development and maintenance of these disorders are distinct in focus. Unlike CID, theory relating to DSWPD is primarily physiologically based and assumes almost no cognitive pathway. However, recent research findings suggest that individuals with DSWPD also display many of the sleep-disordered cognitive processes that were previously assumed to be unique to the insomnia experience...
April 2016: Sleep Medicine Reviews
Hilary A Archer, Nadja Smailagic, Christeena John, Robin B Holmes, Yemisi Takwoingi, Elizabeth J Coulthard, Sarah Cullum
BACKGROUND: In the UK, dementia affects 5% of the population aged over 65 years and 25% of those over 85 years. Frontotemporal dementia (FTD) represents one subtype and is thought to account for up to 16% of all degenerative dementias. Although the core of the diagnostic process in dementia rests firmly on clinical and cognitive assessments, a wide range of investigations are available to aid diagnosis.Regional cerebral blood flow (rCBF) single-photon emission computed tomography (SPECT) is an established clinical tool that uses an intravenously injected radiolabelled tracer to map blood flow in the brain...
2015: Cochrane Database of Systematic Reviews
R Dersch, M H Freitag, S Schmidt, H Sommer, S Rauer, J J Meerpohl
BACKGROUND AND PURPOSE: Our aim was to evaluate the available evidence for pharmacological treatment of acute Lyme neuroborreliosis as a basis for evidence-based clinical recommendations in a systematic review. METHODS: A systematic literature search of Medline, EMBASE, the Cochrane Library and three trial registries was performed. Randomized controlled trials (RCTs) and non-randomized studies (NRS) were evaluated. Risk of bias was assessed using the Cochrane risk of bias tools...
September 2015: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Cornelius A Thiels, Tarun Mohan Lal, Joseph M Nienow, Kalyan S Pasupathy, Renaldo C Blocker, Johnathon M Aho, Timothy I Morgenthaler, Robert R Cima, Susan Hallbeck, Juliane Bingener
INTRODUCTION: We report the first prospective analysis of human factors elements contributing to invasive procedural never events by using a validated Human Factors Analysis and Classification System (HFACS). METHODS: From August 2009 to August 2014, operative and invasive procedural "Never Events" (retained foreign object, wrong site/side procedure, wrong implant, wrong procedure) underwent systematic causation analysis promptly after the event. Contributing human factors were categorized using the 4 levels of error causation described by Reason and 161 HFACS subcategories (nano-codes)...
August 2015: Surgery
Sarah Chau, Nathan Herrmann, Myuri T Ruthirakuhan, Jinghan Jenny Chen, Krista L Lanctôt
BACKGROUND: Current treatments for Alzheimer's disease (AD) provide modest symptomatic relief but do not slow the progression of the disease. Latrepirdine may modulate several targets involved in AD pathology, including lipid peroxidation, mitochondrial permeability, voltage-gated calcium ion channels as well as neurotransmitter receptor activity, and thus potentially represents both a symptomatic and disease-modifying intervention. Several randomized, placebo-controlled trials have sought to evaluate the effect of latrepirdine on cognition, function and behaviour in patients with AD...
2015: Cochrane Database of Systematic Reviews
Ferrán Catalá-López, Brian Hutton, Amparo Núñez-Beltrán, Alain D Mayhew, Matthew J Page, Manuel Ridao, Aurelio Tobías, Miguel A Catalá, Rafael Tabarés-Seisdedos, David Moher
BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of children and adolescents, with a significant impact on health services and the community in terms of economic and social burdens. The objective of this systematic review will be to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological treatments in children and adolescents with ADHD. METHODS: Searches involving PubMed/MEDLINE and the Cochrane Database of Systematic Reviews will be used to identify related systematic reviews and relevant randomized trials...
2015: Systematic Reviews
Jacqueline S Birks, John Grimley Evans
BACKGROUND: Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity...
2015: Cochrane Database of Systematic Reviews
Rick Dersch, Michael H Freitag, Stefanie Schmidt, Harriet Sommer, Gerta Rücker, Sebastian Rauer, Joerg J Meerpohl
BACKGROUND: Neuroborreliosis is a tick-borne infectious disease of the nervous system caused by Borrelia burgdorferi. Common clinical manifestations of neuroborreliosis are cranial nerve dysfunctions, polyradiculoneuritis, and meningitis. Diagnosis is usually based on clinical presentation, serologic testing, and analysis of cerebrospinal fluid. Many aspects of pharmacological treatment, such as choice of drug, dosage, and duration are subject of intense debate, leading to uncertainties in patients and healthcare providers alike...
2014: Systematic Reviews
Anping Xie, Pascale Carayon
Healthcare systems need to be redesigned to provide care that is safe, effective and efficient, and meets the multiple needs of patients. This systematic review examines how human factors and ergonomics (HFE) is applied to redesign healthcare work systems and processes and improve quality and safety of care. We identified 12 projects representing 23 studies and addressing different physical, cognitive and organisational HFE issues in a variety of healthcare systems and care settings. Some evidence exists for the effectiveness of HFE-based healthcare system redesign in improving process and outcome measures of quality and safety of care...
2015: Ergonomics
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