Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Mindfulness increases analytical thought and decreases just world beliefs

A growing body of research has found that engaging in mindfulness may alter thought processes in a range of different manners, such as increasing psychological well-being, decreasing stress, decreasing implicit racism, and many other positive psychological effects. The present study investigated whether engaging in mindfulness meditation would influence analytical thought processes. Participants listened to a 10-minute audio recording via noise-canceling headphones then answered a series of questions. Individuals who listened to the mindfulness recording answered more Cognitive Reflection Test questions analytically while participants in the control group answered them more intuitively. Participants in the mindfulness condition also indicated significantly lower scores on the Belief in a Just World scale

Consensus on media violence effects : comment on Bushman, Gollwitzer, and Cruz (2015)

We summarize the main findings of Bushman, Gollwitzer, and Cruz (2015), highlight its empirical contributions, and note interesting patterns and implications for future research. The results demonstrate that consensus exists among experts on the reality of harmful media violence effects on children and adolescents. We note likely differences in the makeup of the different samples and how these might have affected the results. This comment also presents a new breakdown of the Bushman et al. findings, highlighting the high consensus for causal screen media violence effects on aggression, which fairly closely mirrors findings from that voluminous research literature, and compares this to the lack of consensus on the harmful effects of print media violence, which corresponds to a quite small research literature. We conclude with a call for research on how to overcome resistance to unpopular scientific findings.7 page(s