Cognition, metacognition and patient safety

This article explores the factors that contribute to patient safety incidents. It highlights the importance of human factors in influencing the clinician's performance. Rather than focusing on clinical skills, the article explores the range of non-technical skills which are seen to each contribute to patient safety, including: communication, teamworking, leadership, active followership, situational awareness, decision-making, assertiveness, and workload management. It asks how cognitive processes can influence safe decision-making.

Potential impacts of climate change on agriculture and food safety within the island of Ireland

Climate and other environmental change presents a number of challenges for effective food safety. Food production, distribution and consumption takes place within functioning ecosystems but this backdrop is often ignored or treated as static and unchanging. The risks presented by environmental change include novel pests and diseases, often caused by problem species expanding their spatial distributions as they track changing conditions, toxin generation in crops, direct effects on crop and animal production, consequences for trade networks driven by shifting economic viability of production methods in changing environments and finally, wholesale transformation of ecosystems as they respond to novel climatic regimes.

A Reappraisal of the Safety and Cost-Effectiveness of Statin Therapy in Primary Prevention

Statins are among the most investigated drugs of all time. There is now a wealth of evidence supporting their use in the primary and secondary prevention arenas. The reduction in event recurrence has since been demonstrated across all levels of risk and in elderly patients. As a result, it is now accepted practice for statins to be prescribed universally in secondary prevention unless contraindicated. The extension of this policy into the primary prevention setting is more problematic, with moral and financial issues arising from the long-term treatment of many young apparently healthy individuals. For these reasons it is necessary to prove not only the financial sustainability of such a strategy but also the long-term safety of statins and the degree of benefit that might be expected.

Food Colours: Existing and Emerging Food Safety Concerns

Food colours are added to different types of commodities to increase their visual attractiveness or to compensate for natural colour variations. The use of these additives is strictly regulated in the European Union, the United States and many other countries worldwide. There is a growing concern about the safety of some commonly used legal food colourants and there is a trend to replace the synthetic forms with natural products. Additionally, a number of dyes with known or suspected genotoxic or carcinogenic properties have been shown to be added illegally to foods. Robust monitoring programs based on reliable detection methods are required to assure the food is free from harmful colours. The aim of this review is to present an up to date status of the various concerns arising from use of colour additives in food. The most important food safety concerns in the field of food colours are lack of uniform regulation concerning legal food colours worldwide, possible link of artificial colours to hyperactive behaviour, replacement of synthetic colours with natural ones and the presence of harmful illegal dyes - both known but also new, emerging ones in food. The legal status of food colour additives in the EU, US and worldwide is summarized. The reported negative health effects of both legal and illegal colours are presented. The European Rapid Alert System for Food and Feed notifications and US import alerts concerning food colours are analyzed and trends in fraudulent use of colour additives identified. The detection methods for synthetic colours are also reviewed.

Development of the Consumer Refrigerator Safety Questionnaire (CRSQ): A Measure of Consumer Perceptions and Practices

Food preparation and storage behaviors in the home deviating from the ‘best practice’ food safety recommendations may result in food borne illnesses. Currently, there are limited tools available to fully evaluate the consumer knowledge, perceptions and behavior in the area of refrigerator safety. The current study aimed to develop a valid and reliable tool in the form of a questionnaire (CFSQCRSQ) for assessing systematically all these aspects. Items relating to refrigerator safety knowledge (n=17), perceptions (n=46), reported behavior (n=30) were developed and pilot tested by an expert reference group and various consumer groups to assess face and content validity (n=20), item difficulty and item consistency (n=55) and construct validity (n=23). The findings showed that the CFSQCRSQ has acceptable face and content validity with acceptable levels of item difficulty. Item consistency was observed for 12 out of 15 refrigerator safety knowledge. Further, all five of the subscales of consumer perceptions of refrigerator safety practices relating to risk of developing foodborne disease food poisoning showed acceptable internal consistency (Cronbach’s α value > 0.8). Construct validity of the CFSQCRSQ was shown to be very good (p=0.022). The CFSQCRSQ exhibited acceptable test-retest reliability at 14 days with majority of knowledge items (93.3%) and reported behavior items (96.4%) having correlation coefficients of greater than 0.70. Overall, the CFSQCRSQ was deemed valid and reliable in assessing refrigerator safety knowledge and behavior and therefore has the potential for future use in identifying groups of individuals at increased risk of deviating from recommended refrigerator safety practices as well as the assessment of refrigerator safety knowledge, behavior for use before and after an intervention.