In this task, you are given a text of many news articles seperated by special token "|||||". Your task is to summarize them.
Q: Martin A Makary , professor 1 , Michael Daniel , research fellow 1 1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA Correspondence to: M A Makary mmakary1{at}jhmi.edu 
  
 Medical error is not included on death certificates or in rankings of cause of death. Martin Makary and Michael Daniel assess its contribution to mortality and call for better reporting 
  
 The annual list of the most common causes of death in the United States, compiled by the Centers for Disease Control and Prevention (CDC), informs public awareness and national research priorities each year. The list is created using death certificates filled out by physicians, funeral directors, medical examiners, and coroners. However, a major limitation of the death certificate is that it relies on assigning an International Classification of Disease (ICD) code to the cause of death.1 As a result, causes of death not associated with an ICD code, such as human and system factors, are not captured. The science of safety has matured to describe how communication breakdowns, diagnostic errors, poor judgment, and inadequate skill can directly result in patient harm and death. We analyzed the scientific literature on medical error to identify its contribution to US deaths in relation to causes listed by the CDC.2 ||||| Emotions tend to run high in hospitals, and patients or patients’ loved ones can be rude to medical professionals when they perceive inadequate care. 
  
 But berating your child’s doctor could have harmful — even deadly — consequences, according to new research. 
  
 The findings by University of Florida management professor Amir Erez and doctoral student Trevor Foulk reinforce their prior research that rudeness has “devastating effects on medical performance,” Erez said. 
  
 A Johns Hopkins study estimated that more than 250,000 deaths are attributed to medical errors in the U.S. annually—which would rank as the third-leading cause of death in the U.S., according to statistics from the Centers for Disease Control and Prevention. 
  
 Some errors could be explained by a doctor’s poor judgment due to a chronic lack of sleep. Those types of circumstances, according to prior research from Erez and Foulk, account for about 10 to 20 percent of the variance in practitioner performance. 
  
 The effects of rudeness, Erez said, account for more than 40 percent. 
  
 “[Rudeness] is actually affecting the cognitive system, which directly affects your ability to perform,” Erez said. “That tells us something very interesting. People may think that doctors should just �?get over’ the insult and continue doing their job. However, the study shows that even if doctors have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it.” 
  
 In a previous study, Erez and Foulk examined the effects of rudeness from a colleague or authority figure on individual medical professionals. This study analyzed team performance and the effects rudeness has when it comes from a patient’s family member. 
  
 In the new study, 39 neonatal intensive care unit teams (two doctors and two nurses) from Israel simulated five scenarios where they treated infant medical mannequins for emergency situations such as severe respiratory distress or hypovolemic shock. An actress playing the baby’s mother scolded certain teams while the control groups experienced no rudeness. 
  
 Erez and Foulk found that the teams that experienced rudeness performed poorly compared to the control groups. The teams that encountered rudeness were deficient in all 11 of the study’s measures, including diagnostic accuracy, information sharing, therapy plan, and communication, over the course of all five scenarios showing that the negative effects last the entire day. 
  
 To combat the effect of rudeness, the researchers included “interventions” for selected teams. Some teams participated in a pre-test intervention which consisted of a computer game based on a cognitive-behavioral attention modification method intended to raise the threshold of the participants’ sensitivities to anger and aggression. Other teams participated in the post-test intervention, which consisted of team members writing about the day’s experience from the perspective of the baby’s mother. 
  
 Erez and Foulk found no difference in the performances of the control groups and the teams that played the computer game. The teams recognized the mother’s rudeness —both midway and after the simulation — but were not affected by it. 
  
 “It’s really shocking how well it worked,” Erez said. “They were basically immunized from the effects of rudeness.” 
  
 Conversely, the post-test intervention, which research has shown to be extremely successful for victims of trauma, actually had a negative effect on teams. 
  
 “What is really concerning is that, at midday, these teams recognized the mother was rude to them,” Erez said. “But at the end of the day, they did not. So not only did it not work, but it caused them to not recognize rudeness later.” 
  
 Considering the researchers’ findings and the large number of deaths attributed to medical errors, teaching medical professionals to handle rudeness more effectively should be a priority for the medical community. 
  
 “In the medical field, I don’t think they take into account how social interactions affect them,” said Erez, “but it’s something they’re starting to pay attention to. The purpose of this research was to identify what’s going on here. Now that we’ve found serious effects, we need to find more realistic interventions.” 
  
 Dr. Arik Riskin, a professor of Neonatology at the Technion, Israel Institute of technology, and Peter Bamberger, a professor of management at Tel Aviv University in Israel, also collaborated on this research. The study, “Rudeness and Medical Team Performance,” appears in the January issue of Pediatrics. ||||| Rude parents can rattle medical staff enough to compromise the quality of care their critically ill child receives, a new study suggests. 
  
 Medical teams in a neonatal intensive care unit made worse decisions during simulated emergency scenarios if they had been treated rudely by an actress playing the role of an angry family member, the researchers found. 
  
 Exposure to rudeness helped explain about 40 percent of the variance in good medical decision-making between different teams in the study, said co-author Amir Erez. He is a professor with the University of Florida Warrington College of Business. 
  
 “There is a lot of concern about medical errors, but the medical field is not paying attention at all to the effect that social interactions can have on performance,” Erez said. “They need to pay attention to this, because this could potentially save lives.” 
  
 But, the researchers also found that doctors and nurses could “inoculate” themselves against potential rudeness by taking part in computer training that decreased their emotional sensitivity, Erez said. 
  
 In the study, four medical teams at an Israeli teaching hospital had to perform a full day’s worth of five emergency scenarios. 
  
 Three of the teams started their day confronted by a “mother” who accused them of misdiagnosing her child. The fourth team served as a “control” group, and was not exposed to rudeness. 
  
 The actress told the teams, “I knew we should have gone to a better hospital where they don’t practice Third World medicine!” and threatened to move the child to another hospital. 
  
 One team received no preparation for this encounter. But, the second team took part in a 20-minute computer game beforehand that exposed them to angry and happy faces, providing feedback that made them less sensitive to hostile emotions. 
  
 The members of the third team were asked to write a narrative about the rude event after it had occurred, to possibly diminish any lasting effect it might have on them. 
  
 Earlier studies have shown that rudeness from an authority figure can affect a medical team’s performance, and this study revealed that rudeness from a parent can also cause doctors and nurses to make poor decisions, Erez said. 
  
 However, the computerized training beforehand erased this effect, by subconsciously raising the team’s tolerance for negative emotions, he added. 
  
 “When we raised the threshold of people’s sensitivity to anger, they didn’t perform less well than the control group,” Erez said. 
  
 Writing a narrative about the rude event had no benefit on performance, possibly because the exercise affected participants on a conscious rather than subconscious level, Erez suggested. 
  
 The study was published online Jan. 10 in the journal Pediatrics. 
  
 These findings show that doctors and nurses are human beings vulnerable to the effects of harsh emotions, said Dr. Brian Alverson, chairman of the American Academy of Pediatrics’ section on hospital medicine. 
  
 “The reality is when we as humans are emotional, logical cognitive thought is a lot more difficult,” said Alverson, an associate professor of pediatrics at Brown University in Providence, R.I. “When you’re being emotionally attacked, it’s harder to sit there and crunch the numbers quick.” 
  
 Dr. Jessica Madden, a neonatologist with the Cleveland Clinic, added that the problem is made worse by the fact that intensive care unit teams often work in high-stress environments with colleagues they barely know. 
  
 “We’re continually working with teams who come together who really haven’t worked together before,” Madden said of neonatal intensive care units. “They can literally be meeting for the first time to take care of a sick baby.” 
  
 Training currently focuses on communication within the newly formed team, “but it doesn’t factor in that with the patient-centered care model, we do have the parents with us,” Madden said. “That’s another layer of stress and worry that’s going on as we try to focus.” 
  
 However, Alverson is concerned that extrapolating the study findings -- for example, by applying them to other units not faced with split-second life-and-death decisions -- could lead doctors and administrators to shrug off real and lasting problems in each hospital’s system. 
  
 “When families come in and act rude, the majority of the time it’s because of something we’ve done. [For example,] we left them five hours in an ER waiting room without talking to them,” Alverson said. “It’s an opportunity lost where we could be looking at ourselves and asking how we can conduct our practice so people are happier.” |||||
A: 
If you think being tough with your child's doctor is the right way to ensure better care, think again. A new study out of the University of Florida suggests that rude parents can cause serious, even deadly, consequences. Researchers who staged emergency situations in a neonatal intensive care unit at an Israeli hospital found that doctors and nurses performed significantly worse when confronted with an actress playing an angry mother. While there is much concern about medical errors, the third-leading cause of death in the US, medical professionals are "not paying attention at all to the effect that social interactions can have on performance," co-author Amir Erez tells HealthDay. The new findings, he adds, "could potentially save lives." In the study, four medical teams were assigned to treat infant dummies during day-long emergency situations including respiratory distress and shock. An actress playing a rude mom harangued three of the teams first thing in the morning, accusing them of doling out "Third World" care and threatening to seek treatment elsewhere. The fourth team served as a control group and was spared the hostility. The teams exposed to rudeness underperformed in all of the study's 11 measures throughout the day. But researchers found they could "immunize" doctors to rudeness by prepping them ahead of time with computer games that desensitized them to sharp emotions. In the end, the lesson is that doctors and nurses are people, too, and find it harder to work when they're "being emotionally attacked," says an American Academy of Pediatrics rep. (In lighter fare, politeness can help in online searches, too.)