SafetyDog

Archive for the ‘Neuroscience’ Category

Neuroscience Saturdays: Stress could be a threat to patient safety

In Human Factors, Neuroscience on August 23, 2014 at 3:43 pm

It is thought that the safest hospitals are the ones with the happiest employees. What is it that makes this so… Pride? engagement?
One thing that we know doesn’t facilitate safety is stress: stress can interfere with cognitive processing..
Watch this cool presentation from the authors of BRAIN RULES a great book if you have not read it

Neuroscience Saturdays: Pain

In Neuroscience on July 13, 2014 at 3:30 pm

From a press release
“Scientists have known for many years that on-going pain in one part of the body is reduced when a new pain is inflicted to another part of the body. This pain blocking is a physiological reaction by the nervous system to help the body deal with a potentially more relevant novel threat. To explore this “pain inhibits pain” phenomenon, painful electric pulses were first administered to a subject’s foot (first pain) and the resulting pain intensity was then measured. Then the subject was asked to put their hand in a bucket of ice water (novel stimulus causing pain reduction), and as they did so, a telephone ringtone sounded in headphones. After this procedure had been repeated several times, it was observed that the pain felt from the electrical stimulation was reduced simply when the ring tone sounded.”

Raymonde Scheuren, Fernand Anton, Nathalie Erpelding, Gilles Michaux. Beep Tones Attenuate Pain following Pavlovian Conditioning of an Endogenous Pain Control Mechanism. PLoS ONE, 2014; 9 (2): e88710 DOI: 10.1371/journal.pone.0088710

WE could use these labels in healthcare

In High Reliability Orgs, Human Factors, Neuroscience on May 4, 2014 at 5:04 pm

If only medical supplies had labels like this instead of the crazy font, placement and design of current hospital supply products. There is no standard place for expiration date or contents..no wonder regulators often find expired items throughout a hospital.

comparisonn-1

Go check out SAFECHART

http://cargocollective.com/petewinslow/SafeChart

The gold standard may be tarnished…

In Neuroscience, safety on October 20, 2013 at 1:38 pm

disturbing news on research replicability in The Economist
Many study results cannot be replicated

http://www.economist.com/news/briefing/21588057-scientists-think-science-self-correcting-alarming-degree-it-not-trouble

Neuroscience Saturdays: Placebo “I shall please”

In Neuroscience on September 21, 2013 at 2:20 pm

From:American Physiological Society

“For many years placebos have been used for the validation of therapies, but they have also traditionally taken as an example of the powerful interaction between mind and body with associated commentary research appearing in psychology literature. Dr. Benedetti’s research is aligned with the current state of placebo research, a complex field of investigation which ranges from psychology to psychophysiology, from pharmacology to neurophysiology, and from cellular/molecular analysis to modern neuroimaging techniques.

Dr. Benedetti’s research methodology employed in this article transcends the traditional division between psychology, the study of the mind and how it works, and biology, the study of all living things. This article clarifies the research conducted to identify the relationship between pharmacological treatments administered to the patient and the role of the mind in the overall patient health. In addition, it clarifies the interaction between psychological processes and the many physiological functions of the human body.
This new discipline acknowledges that placebos and placebo responses with their wide range of physiological responses involving numerous mechanisms across a number of conditions, systems, and interventions represent an active field of neurobiological research. With that, Dr. Benedetti, using biochemical, cellular and physiological tools, aptly summarizes research new findings on describing the placebo effect on psychology and biology and their impact on the doctor-patient relationship. Among the issues discussed in detail are: ■There is no one “the placebo effect.” There are different mechanisms in play across a variety of medical conditions and therapeutic interventions. For example, a placebo effect takes place because there is expectation. The patient expects a therapeutic benefit, and this kind of expectation actually has an effect on the brain and the body.
■The connection between expectation and real improvement that may occur is due at least to two mechanisms. The first may be a reduction of anxiety. The second is between expectation and the activation of a reward mechanism by the region of the brain known as the nucleus accumbens (which also governs pleasure, reinforcement learning, laughter, addiction, aggression, fear, impulsivity and the placebo effect.)
■ When a treatment is given to a patient, be it a placebo or real, it is administered in a complex set of psychological states that vary from patient to patient and from situation to situation. For example, when a placebo is given to relieve pain, it is administered along with stimuli which tell the patient that a clinical improvement should be occurring shortly. These stimuli can include the color and shape of the pill, patient and provider characteristics and the healthcare setting.
■Recent research has revealed a reduced efficacy of drugs when they are administered covertly to the patient. In fact, if the placebo/expectation component of a treatment is eliminated by means of a hidden administration (unbeknownst to the patient), the psychological component of the therapy is absent as well.

For physicians, psychologists, and health professionals these and other recent findings found in Dr. Benedetti’s article can foster enhanced understanding of how their words, attitudes, and behaviors impact on the physiological profile of their patients’ brains.” Read more: http://www.the-aps.org/mm/hp/Audiences/Public-Press/For-the-Press/releases/13/27.html

Neuroscience Saturdays: Want to see? skip the fish

In Neuroscience on September 15, 2013 at 7:52 pm

The health of healthcare workers may affect patient safety in various ways. Accurate vision is necessary for examining patients, reading medication packages, reviewing diagnostic films…etc
Can eating fish compromise vision?

“Researchers are studying the potential effects of low level chronic exposure to methylmercury, which is of global concern due to methylmercury presence in fish, but the message that I want to get across is that such exposures may negatively affect vision. Our study clearly shows that we need more research into the direct effects of methylmercury on the eye,” Korbas concluded.”

Read more http://pubs.acs.org/doi/abs/10.1021/cb4004805
“Human populations experience widespread low level exposure to organometallic methylmercury compounds through consumption of fish and other seafood. At higher levels, methylmercury compounds specifically target nervous systems, and among the many effects of their exposure are visual disturbances, including blindness, which previously were thought to be due to methylmercury-induced damage to the visual cortex”

Neuroscience Saturdays: Sleep and the full moon

In Neuroscience on July 27, 2013 at 7:56 pm

It’s real!
“We found that around full moon, electroencephalogram (EEG) delta activity during NREM sleep, an indicator of deep sleep, decreased by 30%, time to fall asleep increased by 5 min, and EEG-assessed total sleep duration was reduced by 20 min” (Cajochen, et al., 2013)

Evidence that the Lunar Cycle Influences Human Sleep

Neuroscience Saturdays: Probiotics can control emotion

In Neuroscience on June 8, 2013 at 7:22 am

Dr. Kirsten Tillisch, an associate professor of medicine at UCLA’s David Geffen School of Medicine: “Our findings indicate that some of the contents of yogurt may actually change the way our brain responds to the environment. When we consider the implications of this work, the old sayings ‘you are what you eat’ and ‘gut feelings’ take on new meaning.”
We know the brain in times of stress sends signals to the gut resulting in nausea, vomiting, diarrhea, constipation, slow motility, flatus, etc. This study shows that signals might travel the opposite way as well. Poor gut function may send stress and emotional signals to the brain!

Eating better at work may help reduce emotional response to events and feelings of stress. this may lead to clearer thinking in terms of providing safe care.
Keep your gut flora healthy for patient safety.

Read summary.
Read full article in Gastroenterology and decide for yourself if the evidence is there.

Neuroscience Saturdays: Muscle response to Sound

In Neuroscience on May 11, 2013 at 6:34 am

A car’s brakes screech and as a pedestrian your muscles automatically react. But how does the brain figure out how close the danger is or whether to freeze or run? How does the auditory system in the brain transmit information that leads to decisions and actions?

Researchers in Cold Spring Harbor, NY trained rats to listen for sounds and act based on those sounds. According to Zador what we know is sound comes in the ear and what comes out is some kind of decision or action.
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“These experiments in rats have implications for how neural circuits make decisions, according to Zador. Even though many neurons in auditory cortex are “tuned” to low or high frequencies, most do not transmit their information directly to the striatum. Rather, their information is transmitted by a much smaller number of neurons in their vicinity, which convey their “votes” directly to the striatum.

This is like the difference between a direct democracy and a representative democracy, of the type we have in the United States,” Zador explains. “In a direct democracy model of how the auditory cortex conveys information to the rest of the brain, every neuron activated by a low- or high-pitched sound would have a ‘vote.’ Since there is noise in every perception, some minority of neurons will indicate ‘low’ when the sound is in fact ‘high,’ and vice-versa. In the direct democracy model, the information sent to the striatum for further action would be the equivalent of a simple sum of all these votes.

In contrast – and this is what we found to be the case – the neurons registering ‘high’ and ‘low’ are represented by a specialized subset of neurons in their local area, which we might liken to members of Congress or the Electoral College: these in turn transmit the votes of the larger population to the place — in this case the auditory striatum — in which decisions are made and actions are taken.”

http://www.nature.com/nature/journal/vaop/ncurrent/full/nature12077.html

Research related to how we act in response to sound cues could help us figure out how to best utilize clinical alarms in healthcare. What factors are involved? should clinical staff have regular hearing tests?
Should the hearing test be geared to the frequencies of sound from the area in which staff perform? Could we test the muscle response to various alarms to determine the psychological and physiological components of alarm fatigue?
PAtient Safety interventions should be guided by the amalgamation of reseach in neuroscience, psychology, engineering, medicine and nursing.

Neuroscience Saturdays

In Neuroscience on April 27, 2013 at 6:12 pm

On saturdays I will try and post some research from neuroscience that may impact patient safety. Today’s tidbit involved sleep and is from from U-California, Berkley (2011).

Exerpt:
“”We need to ensure that people making high-stakes decisions, from medical professionals to airline pilots to new parents, get enough sleep,” Walker said. “Based on this evidence, I’d be concerned by an emergency room doctor who’s been up for 20 hours straight making rational decisions about my health.”
Read more summary information: http://www.sciencedaily.com/releases/2011/03/110323105211.htm

Full article
N. Gujar, S.-S. Yoo, P. Hu, M. P. Walker. Sleep Deprivation Amplifies Reactivity of Brain Reward Networks, Biasing the Appraisal of Positive Emotional Experiences. Journal of Neuroscience, 2011; 31 (12): 4466 DOI: 10.1523/JNEUROSCI.3220-10.2011

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