Medication Reconciliation at Discharge from Hospital: A Systematic Review of the Quantitative Literature

Medicines reconciliation is a way to identify and act on discrepancies in patients’ medical histories and it is found to play a key role in patient safety. This review focuses on discrepancies and medical errors that occurred at point of discharge from hospital. Studies were identified through the following electronic databases: PubMed, Sciences Direct, EMBASE, Google Scholar, Cochrane Reviews and CINAHL. Each of the six databases was screened from inception to end of January 2014. To determine eligibility of the studies; the title, abstract and full manuscript were screened to find 15 articles that meet the inclusion criteria. The median number of discrepancies across the articles was found to be 60%. In average patient had between 1.2–5.3 discrepancies when leaving the hospital. More studies also found a relation between the numbers of drugs a patient was on and the number of discrepancies. The variation in the number of discrepancies found in the 15 studies could be due to the fact that some studies excluded patient taking more than 5 drugs at admission. Medication reconciliation would be a way to avoid the high number of discrepancies that was found in this literature review and thereby increase patient safety.

Intergroup Relations and Fundamental Dimensions of Social Judgment

The goal of this paper is to review the literature on the fundamental dimensions of social judgment and reflect on how these can help to boost our understanding of attitudes towards immigrants. We start by reviewing the work on the “fundamental dimensions” along which these judgments are organized, describing the different conceptions that have been put forward, identifying the regularities found in the content of these dimensions and the distinctions between them. Next, we propose a new way of looking at these fundamental dimensions by situating them within the specific field of intergroup relations in an immigration context, and explain how all the different examples of dimensions map onto this “new perspective”. We conclude by discussing how these two dimensions mirror the two fundamental topics that organize the discourse and the opinions about immigrants and immigration in society, and how attitudes towards immigrants can be differentially shaped by these two fundamental dimensions.

Perceptions of intergroup bias : the roles of social projection and meta-stereotypes

Underlying intergroup perceptions include processes of social projection (perceiving personal traitslbeliefs in others, see Krueger 1998) and meta-stereotyping (thinking about other groups' perceptions of one's own group, see Vorauer et aI., 1998). Two studies were conducted to investigate social projection and meta-stereotypes in the domain of White-Black racial relations. Study 1, a correlational study, examined the social projection of prejudice and 'prejudiced' meta-stereotypes among Whites. Results revealed that (a) Whites socially projected their intergroup attitudes onto other Whites (and Blacks) [i.e., Whites higher in prejudice against Blacks believed a large percentage of Whites (Blacks) are prejudiced against Blacks (Whites), whereas Whites low in prejudice believed a smaller percentage of Whites (Blacks) are prejudiced]; (b) Whites held the meta:..stereotype that their group (Whites) is viewed by Blacks to be prejudiced; and (c) prejudiced meta-stereotypes may be formed through the social projection of intergroup attitudes (result of path-model tests). Further, several correlates of social projection and meta-stereotypes were identified, including the finding that feeling negatively stereotyped by an outgroup predicted outgroup avoidance through heightened intergroup anxiety. Study 2 replicated and extended these findings, investigating the social projection of ingroup favouritism and meta- and other-stereotypes about ingroup favouritism. These processes were examined experimentally using an anticipated intergroup contact paradigm. The goal was to understand the experimental conditions under which people would display the strongest social projection of intergroup attitudes, and when experimentally induced meta-stereotypes (vs. other-stereotypes; beliefs about the group 11 preferences of one's outgroup) would be most damaging to intergroup contact. White participants were randomly assigned to one of six conditions and received (alleged) feedback from a previously completed computer-based test. Depending on condition, this information suggested that: (a) the participant favoured Whites over Blacks; (b) previous White participants favoured Whites over Blacks; (c) the participant's Black partner favoured Blacks over Whites; (d) previous Black participants favoured Blacks over Whites; (e) the participant's Black partner viewed the participant to favour Whites over Blacks; or (£) Black participants previously participating viewed Whites to favour Whites over Blacks. In a defensive reaction, Whites exhibited enhanced social projection of personal intergroup attitudes onto their ingroup under experimental manipulations characterized by self-concept threat (i.e., when the computer revealed that the participant favoured the ingroup or was viewed to favour the ingroup). Manipulated meta- and otherstereotype information that introduced intergroup contact threat, on the other hand, each exerted a strong negative impact on intergroup contact expectations (e.g., anxiety). Personal meta-stereotype manipulations (i.e., when the participant was informed that her/ his partner thinks s/he favours the ingroup) exerted an especially negative impact on intergroup behaviour, evidenced by increased avoidance of the upcoming interracial interaction. In contrast, personal self-stereotype manipulations (i.e., computer revealed that one favoured the ingroup) ironically improved upcoming intergroup contact expectations and intentions, likely due to an attempt to reduce the discomfort of holding negative intergroup attitudes. Implications and directions for future research are considered.

Exploring the impact of outgroup membership discoveries on individual outcomes and intergroup relations

Group memberships represent important components of identity, with people holding membership in various groups and categories. The groups that one belongs to are known as ingroups, and the groups that one does not belong to are known as outgroups. Movement between groups can occur, such that an individual becomes a member of a former outgroup. In some cases, this movement between groups can represent a sudden discovery for the self and/or others, especially when one becomes a member of an ambiguous, concealable, or otherwise not readily visible group. The effects of this type of movement, however, are poorly documented. The purpose of this dissertation is to investigate these outgroup membership discoveries, examining the individual intrapsychic, interpersonal, and potential intergroup effects of both self- and other-outgroup membership discoveries. Specifically, discoveries of homosexuality were examined in three studies. In Study 1, hypothetical reactions to self- and other-homosexuality discovery were assessed; in Study 2, the effects of discovering self-homosexuality (vs. self-heterosexuality) were experimentally examined; and in Study 3, the effects of discovering another’s homosexuality earlier relative to later in a developing friendship were experimentally examined. Study 1 revealed that, upon a discovery of self-homosexuality, participants expected negative emotions and a more negative change in feelings toward the self. Upon a discovery of a friend’s homosexuality, participants expected a more negative change in feelings toward the friend, but more a positive change in feelings toward homosexuals. For both hypothetical self- and friend- homosexuality discoveries, more negative expected emotions predicted more negative expected change in feelings toward the target individual (the self or friend), which in turn predicted more negative expected change in feelings toward homosexuals as a group. Further, for self-homosexuality discovery, the association between negative expected emotions and negative expected change in feelings toward the self was stronger among those higher in authoritarianism. Study 2 revealed that, upon discovering one’s own homosexuality (vs. heterosexuality), heterosexual participants experienced more negative emotions, more fear of discrimination, and more negative self-evaluations. The effect of the homosexuality discovery manipulation on negative self-evaluations was mediated by fear of discrimination. Further, those higher in authoritarianism or pre-test prejudice toward homosexuals demonstrated more negative emotions following the manipulation. Study 3 revealed that upon discovering an interaction partner’s homosexuality earlier (vs. later) participants reported a more positive contact experience, a closer bond with the partner, and more positive attitudes toward the partner. Earlier (vs. later) discovery predicted more positive contact experience, which in turn predicted a closer bond with the partner. Closer bond with the partner subsequently predicted more positive evaluations of the partner. Interestingly, the association between bond with partner and more positive attitudes toward the partner was stronger among those higher in authoritarianism or pre-test prejudice toward homosexuals. Overall, results suggest that self-homosexuality discovery results in negative outcomes, whereas discovering another’s homosexuality can result in positive outcomes, especially when homosexuality is discovered earlier (vs. later). Implications of these findings for both actual outgroup membership discoveries and social psychological research are discussed.

Subliminal Exposure to Empathy Primes: A New Method to Reduce Intergroup Bias?

An abundant literature has demonstrated the benefits of empathy for intergroup relations (e.g., Batson, Chang, Orr, & Rowland, 2002). In addition, empathy has been identified as the mechanism by which various successful prejudice-reduction procedures impact attitudes and behaviour (e.g., Costello & Hodson, 2010). However, standard explicit techniques used in empathy-prejudice research have a number of potential limitations (e.g., resistance; McGregor, 1993). The present project explored an alternative technique, subliminally priming (i.e., outside of awareness) empathy-relevant terms (Study 1), or empathy itself (Study 2). Study 1 compared the effects of exposure to subliminal empathy-relevant primes (e.g., compassion) versus no priming and priming the opposite of empathy (e.g., indifference) on prejudice (i.e., negative attitudes), discrimination (i.e., resource allocation), and helping behaviour (i.e., willingness to empower, directly assist, or expect group change) towards immigrants. Relative to priming the opposite of empathy, participants exposed to primes of empathy-relevant constructs expressed less prejudice and were more willingness to empower immigrants. In addition, the effects were not moderated by individual differences in prejudice-relevant variables (i.e., Disgust Sensitivity, Intergroup Disgust-Sensitivity, Intergroup Anxiety, Social Dominance Orientation, Right-wing Authoritarianism). Study 2 considered a different target category (i.e., Blacks) and attempted to strengthen the effects found by comparing the impact of subliminal empathy primes (relative to no prime or subliminal primes of empathy paired with Blacks) on explicit prejudice towards marginalized groups and Blacks, willingness to help marginalized groups and Blacks, as well as implicit prejudice towards Blacks. In addition, Study 2 considered potential mechanisms for the predicted effects; specifically, general empathy, affective empathy towards Blacks, cognitive empathy towards Blacks, positive mood, and negative mood. Unfortunately, using subliminal empathy primes “backfired”, such that exposure to subliminal empathy primes (relative to no prime) heightened prejudice towards marginalized groups and Blacks, and led to stronger expectations that marginalized groups and Blacks improve their own situation. However, exposure to subliminal primes pairing empathy with Blacks (relative to subliminal empathy primes alone) resulted in less prejudice towards marginalized groups and more willingness to directly assist Blacks, as expected. Interestingly, exposure to subliminal primes of empathy paired with Blacks (vs. empathy alone) resulted in more pro-White bias on the implicit prejudice measure. Study 2 did not find that the potential mediators measured explained the effects found. Overall, the results of the present project do not provide strong support for the use of subliminal empathy primes for improving intergroup relations. In fact, the results of Study 2 suggest that the use of subliminal empathy primes may even backfire. The implications for intergroup research on empathy and priming procedures generally are discussed.