Front Syst Neurosci. 2014 Apr 2;8:46. eCollection 2014.

Sleep for cognitive enhancement.

Diekelmann S.

Author information

• Institute of Medical Psychology and Behavioral Neurobiology, University Tübingen Tübingen, Germany.

Abstract

Sleep is essential for effective cognitive functioning. Loosing even a few hours of sleep can have detrimental effects on a wide variety of cognitive processes such as attention, language, reasoning, decision making, learning and memory. While sleep is necessary to ensure normal healthy cognitive functioning, it can also enhance performance beyond the boundaries of the normal condition. This article discusses the enhancing potential of sleep, mainly focusing on the domain of learning and memory. Sleep is known to facilitate the consolidation of memories learned before sleep as well as the acquisition of new memories to be learned after sleep. According to a widely held model this beneficial effect of sleep relies on the neuronal reactivation of memories during sleep that is associated with sleep-specific brain oscillations (slow oscillations, spindles, ripples) as well as a characteristic neurotransmitter milieu. Recent research indicates that memory processing during sleep can be boosted by (i) cueing memory reactivation during sleep; (ii) stimulating sleep-specific brain oscillations; and (iii) targeting specific neurotransmitter systems pharmacologically. Olfactory and auditory cues can be used, for example, to increase reactivation of associated memories during post-learning sleep. Intensifying neocortical slow oscillations (the hallmark of slow wave sleep (SWS)) by electrical or auditory stimulation and modulating specific neurotransmitters such as noradrenaline and glutamate likewise facilitates memory processing during sleep. With this evidence in mind, this article concludes by discussing different methodological caveats and ethical issues that should be considered when thinking about using sleep for cognitive enhancement in everyday applications.

From Mayo Clinic: Honoring our donors: A survey of memorial ceremonies in United States anatomy programs

Anat Sci Educ. 2013 Oct 8. doi: 10.1002/ase.1413. [Epub ahead of print]

Honoring our donors: A survey of memorial ceremonies in United States anatomy programs.

Author information

• 1Mayo Medical School, College of Medicine, Mayo Clinic, Rochester, Minnesota.

Abstract

Many anatomy programs that incorporate dissection of donated human bodies hold memorial ceremonies of gratitude towards body donors. The content of these ceremonies may include learners' reflections on mortality, respect, altruism, and personal growth told through various humanities modalities. The task of planning is usually student- and faculty-led with participation from other health care students. Objective information on current memorial ceremonies for body donors in anatomy programs in the United States appears to be lacking. The number of programs in the United States that currently plan these memorial ceremonies and information on trends in programs undertaking such ceremonies remain unknown. Gross anatomy program directors throughout the United States were contacted and asked to respond to a voluntary questionnaire on memorial ceremonies held at their institution. The results (response rate 68.2%) indicated that a majority of human anatomy programs (95.5%) hold memorial ceremonies. These ceremonies are, for the most part, student-driven and nondenominational or secular in nature. Participants heavily rely upon speech, music, poetry, and written essays, with a small inclusion of other humanities modalities, such as dance or visual art, to explore a variety of themes during these ceremonies.

From the Houston Chronicle: Lindsay: UT regent case muddies right to transparency

Lindsay: UT regent case muddies right to transparency

Public institutions should not ignore fact-finding requests

By Thomas K. Lindsay | April 23, 2014 

"One study finds that 31 percent of 2009 graduates, unable to secure full-time employment, moved back into their parents' homes. Consequently, 57 percent of prospective students told a Pew survey that college no longer delivers a value worth its cost; 75 percent deem college simply unaffordable."

Scott W. Aesif, David M. Parenti, Linda Lesky, and John F. Keiser (2014) A Cost-Effective Interdisciplinary Approach to Microbiologic Send-Out Test Use. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

A Cost-Effective Interdisciplinary Approach to Microbiologic Send-Out Test Use

Scott W. Aesif , MD, PhD; David M. Parenti , MD; Linda Lesky , MD; John F. Keiser , MD, PhD

From the Department of Pathology (Drs Aesif and Keiser), and

the Divisions of Infectious Diseases (Dr Parenti) and

Hospital Medicine (Dr Lesky), Department of Medicine, The George Washington University, Washington, DC.

Context.— Use of reference laboratories for selected laboratory testing (send-out tests) represents a significant source of laboratory costs. As the use of more complex molecular analyses becomes common in the United States, strategies to reduce costs in the clinical laboratory must evolve in order to provide high-value, cost-effective medicine.

Objective.— To report a strategy that employs clinical pathology house staff and key hospital clinicians in the effective use of microbiologic send-out testing.

Design.— The George Washington University Hospital is a 370-bed academic hospital in Washington, DC. In 2012 all requisitions for microbiologic send-out tests were screened by the clinical pathology house staff prior to final dispensation. Tests with questionable utility were brought to the attention of ordering clinicians through the use of interdisciplinary rounds and direct face-to-face consultation.

Results.— Screening resulted in a cancellation rate of 38% of send-out tests, with proportional cost savings. Nucleic acid tests represented most of the tests screened and the largest percentage of cost saved through screening. Following consultation, requested send-out tests were most often canceled because of a lack of clinical indication.

Conclusions.— Direct face-to-face consultation with ordering physicians is an effective, interdisciplinary approach to managing the use of send-out testing in the microbiology laboratory.

From Columbia U: Psychology and social networks: A dynamic network theory perspective

Am Psychol. 2014 Apr;69(3):269-84. doi: 10.1037/a0036106.

Psychology and social networks: A dynamic network theory perspective.

Westaby JD, Pfaff DL, Redding N.

Author information

• Program in Social-Organizational Psychology, Teachers College, Columbia University.

Abstract

Research on social networks has grown exponentially in recent years. However, despite its relevance, the field of psychology has been relatively slow to explain the underlying goal pursuit and resistance processes influencing social networks in the first place. In this vein, this article aims to demonstrate how a dynamic network theory perspective explains the way in which social networks influence these processes and related outcomes, such as goal achievement, performance, learning, and emotional contagion at the interpersonal level of analysis. The theory integrates goal pursuit, motivation, and conflict conceptualizations from psychology with social network concepts from sociology and organizational science to provide a taxonomy of social network role behaviors, such as goal striving, system supporting, goal preventing, system negating, and observing. This theoretical perspective provides psychologists with new tools to map social networks (e.g., dynamic network charts), which can help inform the development of change interventions. Implications for social, industrial-organizational, and counseling psychology as well as conflict resolution are discussed, and new opportunities for research are highlighted, such as those related to dynamic network intelligence (also known as cognitive accuracy), levels of analysis, methodological/ethical issues, and the need to theoretically broaden the study of social networking and social media behavior. 

Oh? "Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis."

World J Surg. 2014 Apr 22. [Epub ahead of print]

Tragic Knowledge: Truth Telling and the Maintenance of Hope in Surgery.

Suri M1, McKneally M, Devon K.

Author information

• 1Department of Surgery, University of Toronto, Toronto, ON, Canada, megha_suri@hotmail.com.

Abstract

Surgeons often are faced with the challenge of balancing truth telling and the maintenance of hope in the setting of a poor prognosis. This ethical dilemma is informed by conflicting appeals to principles of autonomy and nonmaleficence, where a patient's right to be told important medical information must be weighed against the potential harm that may result from the knowledge of an unfavourable diagnosis. Truth telling in surgery raises questions on the nature of truth itself, how much information ought to be shared, what information can be withheld, and how surgeons should share tragic knowledge with patients. This paper will address these questions and provide some insight on how surgeons may navigate the sharing of tragic knowledge.

J Bioeth Inq. 2014 Apr 22. [Epub ahead of print]

Human Dignity as a Component of a Long-Lasting and Widespread Conceptual Construct.

Baertschi B.

Author information

• Institute for Ethics, History, and the Humanities, University of Geneva, CMU 1, rue Michel-Servet 1211, Geneva 4, Switzerland, bernard.baertschi@unige.ch.

Abstract

For some decades, the concept of human dignity has been widely discussed in bioethical literature. Some authors think that this concept is central to questions of respect for human beings, whereas others are very critical of it. It should be noted that, in these debates, dignity is one component of a long-lasting and widespread conceptual construct used to support a stance on the ethical question of the moral status of an action or being. This construct has been used from Modernity onward to condemn slavery and torture as violations of human dignity. In spelling it out, we can come to a better understanding of what "dignity" means and become aware that there exists a quite useful place for this notion in our ethical thought, albeit a modest one.

Clin Anat. 2014 Apr 19. doi: 10.1002/ca.22405. [Epub ahead of print]

Using and respecting the dead human body: An anatomist's perspective.

Jones DG.

Author information

• Department of Anatomy, University of Otago, Dunedin, New Zealand.

Abstract

In his stimulating article enquiring into what the living owe the dead, Wilkinson (2013, Clin. Anat. DOI: 10.1002/ca.22263) sought to unpack a range of ethical questions of considerable interest to anatomists. In this, he looked closely at the extent to which we are or are not to respect all the prior wishes of the deceased, and the implications of this for the role of the family in providing consent, the use of unclaimed bodies, and the public display of bodies. Some of his conclusions challenge widely encountered views by anatomists. In this response I have re-visited these topics in an attempt to ground his arguments in the experience of anatomists, by emphasizing the many intimate connections that exist between each of these areas. The following emerge as issues for further debate. I accept that the wishes of the deceased are preeminent, so that authorities should make every effort to abide by these. This reiterates the importance of body bequests over against unclaimed bodies, and provides a context for assessing the role of family consent. This has repercussions for all activities employing dead bodies, from the dissecting room to public plastination exhibitions. In determining the extent to which the wishes of the deceased are followed the input of other interested parties is a relevant consideration. An ethical assessment of the public display of bodies needs to take into account the nature of the plastination process.

Support Care Cancer. 2014 Apr 22. [Epub ahead of print]

Characteristics of taste and smell alterations reported by patients after starting treatment for lung cancer.

McGreevy J1, Orrevall Y, Belqaid K, Wismer W, Tishelman C, Bernhardson BM.

Author information

• 1Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden, jenny.mcgreevy@virginmedia.com.

Abstract

PURPOSE:

Taste and smell alterations (TSAs) in patients with lung cancer are poorly understood. This study investigates characteristics of TSAs when most severe, reported by patients after starting treatment for lung cancer.

METHODS:

Data was collected regarding TSAs, symptoms, food intake and nutritional status through structured interviews using the Taste and Smell Survey, the Patient-Generated Subjective Global Assessment and 3-day food diaries. This data derives from a longitudinal project and the interview with each patient when TSAs were most severe was purposefully selected for analysis.

RESULTS:

Sixty-one of the 89 patients reported TSAs, and the TSAs group were on average younger and more frequently smokers. Thirty-one patients reported symptoms impacting negatively on food intake, with 87 % in the TSAs group and 13 % in the no-TSAs group. Most commonly reported were loss of appetite, nausea and early satiety. Gender differences were seen with more women reporting stronger sensation(s) and more men reporting weaker sensation(s) and other changes. TSAs were described as affecting enjoyment of food and eating. A trend was seen where energy intakes declined with increasing TSAs. Energy intakes in the total study population were below recommended.

CONCLUSION:

TSAs varied in characteristics and interacted with other symptoms. Gender differences may highlight a need to investigate approaches for identification and management of TSAs in men and women. Patients reported TSAs impacting on food enjoyment, and the hypothesis that patients with higher TSS scores have lower nutritional intakes should be followed up with a larger study in the lung cancer population.

FCC's Ajit Pai: "Our red line should be any change to the Internet’s governance structure that would provide repressive foreign governments with any more influence at all over the Internet."

APRIL 23, 2014 12:25 PM

Giving Up the Internet: Still Risky 
Relinquishing control of ICANN to international stakeholders could empower repressive regimes. 

By Ajit Pai

"The Commerce Department has assured us that it will not accept a “government-led or intergovernmental organization solution” as a replacement for the U.S. role. But just ruling out the possibility that foreign governments will control the new steward isn’t good enough. Our red line should be any change to the Internet’s governance structure that would provide repressive foreign governments with any more influence at all over the Internet."

HT:SD

MD Anderson's DePinho: "Every one of us deserves access to the best cancer experts..."

DePinho: Access to top cancer centers can be life-or-death issue

Affordable Care Act must answer need for very best treatment

By Ron DePinho | April 22, 2014 

"Every one of us deserves access to the best cancer experts when our very survival might depend on it."

Int J Biochem Cell Biol. 2014 Apr 13. pii: S1357-2725(14)00121-6. doi: 10.1016/j.biocel.2014.04.006. [Epub ahead of print]

Cystic fibrosis, a multi-systemic mucosal disease: 25 years after the discovery of CFTR.

Edelman A1, Sallenave JM2.

Author information

• 1INSERM, U1151, Paris, France; Faculté de Médecine, Université Paris Descartes, Paris, France.
• 2INSERM, UMR1152, Paris, France; University Paris Diderot, Sorbonne Paris Cité, Paris, France. Electronic address: jean-michel.sallenave@pasteur.fr.

"2014 marks the 25th anniversary of the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene, both a timely and relevant event to dedicate a Directed Issue to this disease. Given some of the recent therapeutic developments (see below), this is indeed an exciting time to revisit some of the history behind the discovery of this gene, as well as the developments in the understanding of the biochemical, cellular and physiological mechanisms underlying CFTR function, in health and disease.

The CFTR gene, when mutated, can cause the deadly cystic fibrosis (CF) disease, which first description was made in the Middle Ages, with the realization that the ‘child will soon die whose forehead tastes salty when kissed’. Following these early days, the first proper description of the disease was done in 1606 by the Spanish Professor of Medicine Juan Alonso y de los Ruyzes de Fontecha."

Sarcopenia "is associated with increased short- and long-term mortality in hospitalized older adults."

J Gerontol A Biol Sci Med Sci. 2014 Apr 17. [Epub ahead of print]

Association of Sarcopenia With Short- and Long-term Mortality in Older Adults Admitted to Acute Care Wards: Results From the CRIME Study.

Vetrano DL1, Landi F, Volpato S, Corsonello A, Meloni E, Bernabei R, Onder G.

Author information

• 1Centro Medicina dell'Invecchiamento, Dipartimento di Geriatria, Ortopedia e Neuroscienze, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Roma, Italy. davidevetrano@gmail.com.

Abstract

BACKGROUND:

Sarcopenia is a common condition in older and frail populations, and it has been associated with adverse health outcomes. However, impact of sarcopenia on mortality in hospitalized older adults has rarely been evaluated. Aim of the present study was to investigate the association between sarcopenia and mortality during hospital stay and at 1 year after discharge in older individuals admitted to acute care wards.

METHODS:

This is a multicentre observational study involving 770 in-hospital patients. Muscle mass was quantified with the bioelectrical impedance analysis. The diagnosis of sarcopenia was based on the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). After discharge, participants were followed for 1 year. Mortality was assessed during hospital stay and during 1-year follow-up.

RESULTS:

Within the 770 participants (mean age: 81 ± 7 years, 56% women), sarcopenia was present in 214 (28%) of them, 22 participants died during hospital stay, and 113 in the year after discharge. Participants with sarcopenia had a significantly higher in-hospital (6% vs 2%; p = .007) and 1-year mortality (26% vs 14%; p < .001) as compared with participants without sarcopenia. After adjusting for potential confounders, sarcopeniaresulted significantly associated with in-hospital (hazard ratio: 3.45; 95% CI: 1.35-8.86) and 1-year mortality (hazard ratio: 1.59; 95% CI: 1.10-2.41).

CONCLUSIONS:

Sarcopenia is a prevalent condition among older adults admitted to acute care wards and it is associated with increased short- and long-term mortality in hospitalized older adults.

"...nothing did more to entrench the acceptance of capitalism than the demise of the movement that had invented the concept."

Thomas Piketty and Millennial Marxists on the Scourge of Inequality

Capitalism’s new critics take on an economics run amok.

Timothy Shenk 

April 14, 2014 

"Socialists might have enjoyed watching the triumph of an idea they had concocted if they had not been busy combating growing dissent within their ranks. These difficulties seemed manageable in the 1970s, when Western governments had many fires of their own to put out. Ten years later, capitalists had regained their footing, while the socialist project continued to decay. Francis Fukuyama’s advertisement for history’s denouement was still on the horizon, but the habits of thinking that would undergird his thesis had already sunk deep roots. Marxism was built upon faith in revolution, but in the West revolution seemed more implausible than ever, and in Eastern Europe the continent’s only widespread revolution had Marxism in its sights. The collapse of communist governments that began in 1989 revealed that history had readied one last twist of the knife: nothing did more to entrench the acceptance of capitalism than the demise of the movement that had invented the concept."

From Georgetown U: Mapping physician twitter networks

J Med Internet Res. 2014 Apr 14;16(4):e107. doi: 10.2196/jmir.3006.

Mapping physician twitter networks: describing how they work as a first step in understanding connectivity, information flow, and message diffusion.

Mishori R1, Singh LO, Levy B, Newport C.

Author information

• 1Department of Family Medicine's Center for Health Communication, Media and Primary Care, Georgetown University School of Medicine, Washington, DC, United States. mishorir@georgetown.edu.

Abstract

BACKGROUND:

Twitter is becoming an important tool in medicine, but there is little information on Twitter metrics. In order to recommend best practices for information dissemination and diffusion, it is important to first study and analyze the networks.

OBJECTIVE:

This study describes the characteristics of four medical networks, analyzes their theoretical dissemination potential, their actual dissemination, and the propagation and distribution of tweets.

METHODS:

Open Twitter data was used to characterize four networks: the American Medical Association (AMA), the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), and the American College of Physicians (ACP). Data were collected between July 2012 and September 2012. Visualization was used to understand the follower overlap between the groups. Actual flow of the tweets for each group was assessed. Tweets were examined using Topsy, a Twitter data aggregator.

RESULTS:

The theoretical information dissemination potential for the groups is large. A collective community is emerging, where large percentages of individuals are following more than one of the groups. The overlap across groups is small, indicating a limited amount of community cohesion and cross-fertilization. The AMA followers' network is not as active as the other networks. The AMA posted the largest number of tweets while the AAP posted the fewest. The number of retweets for each organization was low indicating dissemination that is far below its potential.

CONCLUSIONS:

To increase the dissemination potential, medical groups should develop a more cohesive community of shared followers. Tweet content must be engaging to provide a hook for retweeting and reaching potential audience. Next steps call for content analysis, assessment of the behavior and actions of the messengers and the recipients, and a larger-scale study that considers other medical groups using Twitter.

Pediatrics. 2014 Apr 14. [Epub ahead of print]

Social Media Methods for Studying Rare Diseases.

Schumacher KR1, Stringer KA, Donohue JE, Yu S, Shaver A, Caruthers RL, Zikmund-Fisher BJ, Fifer C, Goldberg C, Russell MW.

Author information

• 1Congenital Heart Center, C.S. Mott Children's Hospital.

Abstract

For pediatric rare diseases, the number of patients available to support traditional research methods is often inadequate. However, patients who have similar diseases cluster "virtually" online via social media. This study aimed to (1) determine whether patients who have the rare diseases Fontan-associated protein losing enteropathy (PLE) and plastic bronchitis (PB) would participate in online research, and (2) explore response patterns to examine social media's role in participation compared with other referral modalities. A novel, internet-based survey querying details of potential pathogenesis, course, and treatment of PLE and PB was created. The study was available online via web and Facebook portals for 1 year. Apart from 2 study-initiated posts on patient-run Facebook pages at the study initiation, all recruitment was driven by study respondents only. Response patterns and referral sources were tracked. A total of 671 respondents with a Fontan palliation completed a valid survey, including 76 who had PLE and 46 who had PB. Responses over time demonstrated periodic, marked increases as new online populations of Fontan patients were reached. Of the responses, 574 (86%) were from the United States and 97 (14%) were international. The leading referral sources were Facebook, internet forums, and traditional websites. Overall, social media outlets referred 84% of all responses, making it the dominant modality for recruiting the largest reported contemporary cohort of Fontan patients and patients who have PLE and PB. The methodology and response patterns from this study can be used to design research applications for other rare diseases.

Res Q Exerc Sport. 2014 Mar;85(1):1-5.

Tag, catch, and other unnatural acts at recess (Circa 2014).

Sydnor S.

Abstract

This commentary details a news event in which Carrie Weber Middle School in Port Washington, NY, supposedly banned students from using balls, playing tag, and doing cartwheels during recess. Public reaction in the form of news items, tweets, blogs, and commentary is sampled, and news releases from the Weber Middle School that were barely covered by the media and explain their decision to ban hardballs from 20-min recess are brought to light. The commentary then goes on to argue that such trending news events can be interpreted in terms of complex cultural histories, including in the case of Weber Middle School, much intellectual thought pioneered by human movement scholarship. Ideas about social nostalgia and memory, play, hegemony, invention of tradition, and cultural context are overviewed in light of their use in human movement studies and in interpreting the Weber Middle School issue. It is argued that current issues and initiatives surrounding obesity and sport for peace and development are, like the trending Weber Middle School news, sometimes not mapped or critiqued (terms coined by Markula-Denison and Silk in 2011) in the profound ways that cultural studies urge. The commentary ends in a call to scholars and practitioners of human movement studies for self-reflexivity and purposeful awareness of changing social definitions of the "unnatural."

From U Penn Dept of Orthopedic Surgery: Defending Waste, Fraud, and Abuse

Clin Orthop Relat Res. 2014 Apr 17. [Epub ahead of print]

Defending Waste, Fraud, and Abuse.

Bernstein J.

Author information

• Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, Philadelphia, PA, 19104, USA, orthodoc@uphs.upenn.edu.

"In short, orthopaedic surgery is a ripe target for the “waste, fraud, and abuse” crowd. Because most of orthopaedic surgery does not improve life expectancy, it may be perceived as wasteful. Because it is not uncommon for orthopaedic surgeons to participate in the sale of ancillary goods and services, their billing practices can be perceived as abusive. And last, because the rules of coding office visits are more in step with the practice of internal medicine, it is all too easy for an orthopaedic surgeon to engage without intent in what some might denounce as billing fraud."

BMJ Qual Saf. 2014 Apr 19. doi: 10.1136/bmjqs-2014-002875. [Epub ahead of print]

Tweets about hospital quality: a mixed methods study.

Greaves F1, Laverty AA, Ramirez Cano D, Moilanen K, Pulman S, Darzi A, Millett C.

Author information

• 1Centre for Health Policy, Imperial College London, St Mary's Hospital, , London, UK.

Abstract

BACKGROUND:

Twitter is increasingly being used by patients to comment on their experience of healthcare. This may provide information for understanding the quality of healthcare providers and improving services.

OBJECTIVE:

To examine whether tweets sent to hospitals in the English National Health Service contain information about quality of care. To compare sentiment on Twitter about hospitals with established survey measures of patient experience and standardised mortality rates.

DESIGN:

A mixed methods study including a quantitative analysis of all 198 499 tweets sent to English hospitals over a year and a qualitative directed content analysis of 1000 random tweets. Twitter sentiment and conventional quality metrics were compared using Spearman's rank correlation coefficient.

KEY RESULTS:

11% of tweets to hospitals contained information about care quality, with the most frequent topic being patient experience (8%). Comments on effectiveness or safety of care were present, but less common (3%). 77% of tweets about care quality were positive in tone. Other topics mentioned in tweets included messages of support to patients, fundraising activity, self-promotion and dissemination of health information. No associations were observed between Twitter sentiment and conventional quality metrics.

CONCLUSIONS:

Only a small proportion of tweets directed at hospitals discuss quality of care and there was no clear relationship between Twitter sentiment and other measures of quality, potentially limiting Twitter as a medium for quality monitoring. However, tweets did contain information useful to target quality improvement activity. Recent enthusiasm by policy makers to use social media as a quality monitoring and improvement tool needs to be carefully considered and subjected to formal evaluation.

"...wrong-site confusion is among the most common mistakes in the operations of paired organs..."

Risk Manag Healthc Policy. 2014 Apr 8;7:77-80. doi: 10.2147/RMHP.S60728. eCollection 2014.

"It is the left eye, right?".

Pikkel D1, Sharabi-Nov A2, Pikkel J3.

Author information

• 1Risk Management and Patient Safety Unit, Assuta Hospital, Ramat Hachayal, Tel-Aviv, Israel.
• 2Research Wing, Ziv Medical Center, Safed, Israel ; Tel-Hai Academic College, Upper Galilee, Israel.
• 3Department of Ophthalmology, Ziv Medical Center, Safed, Israel ; Faculty of Medicine, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel.

Abstract

OBJECTIVE:

Because wrong-site confusion is among the most common mistakes in the operations of paired organs, we have examined the frequency of wrong-sided confusions that could theoretically occur in cataract surgeries in the absence of preoperative verification.

METHODS:

Ten cataract surgeons participated in the study. The surgeons were asked to complete a questionnaire that included their demographic data, occupational habits, and their approach to and the handling of patients preoperatively. On the day of operation, the surgeons were asked to recognize the side of the operation from the patient's name only. At the second stage of the study, surgeons were asked to recognize the side of the operation while standing a 2-meter distance from the patient's face. The surgeons' answers were compared to the actual operation side. Patients then underwent a full time-out procedure, which included side marking before the operation.

RESULTS:

Of the total 67 patients, the surgeons correctly identified the operated side of the eye in 49 (73%) by name and in 56 (83%) by looking at patients' faces. Wrong-side identification correlated with the time lapsed from the last preoperative examination (P=0.034). The number of cataract surgeries performed by the same surgeon (on the same day) also correlated to the number of wrong identifications (P=0.000). Surgeon seniority or age did not correlate to the number of wrong identifications.

CONCLUSION:

This study illustrates the high error rate that can result in the absence of side marking prior to cataract surgery, as well as in operations on other paired organs.

From Texas A&M: Beliefs in moral luck: When and why blame hinges on luck

Br J Psychol. 2014 Apr 16. doi: 10.1111/bjop.12072. [Epub ahead of print]

Beliefs in moral luck: When and why blame hinges on luck.

Lench HC1, Domsky D, Smallman R, Darbor KE.

Author information

• 1Department of Psychology, Texas A&M University, College Station, Texas, USA.

Abstract

Belief in moral luck is represented in judgements that offenders should be held accountable for intent to cause harm as well as whether or not harm occurred. Scores on a measure of moral luck beliefs predicted judgements of offenders who varied in intent and the outcomes of their actions, although judgements overall were not consistent with abstract beliefs in moral luck. Prompting participants to consider alternative outcomes, particularly worse outcomes, reduced moral luck beliefs. Findings suggest that some people believe that offenders should be punished based on the outcome of their actions. Furthermore, prompting counterfactuals decreased judgements consistent with moral luck beliefs. The results have implications for theories of moral judgement as well as legal decision making.