Safe, efficient, and effective screening colonoscopy.

PURPOSE OF REVIEW: Colorectal cancer continues to be one of the most common causes of cancer-related death. Widespread dissemination of screening colonoscopy in the United States has led to a significant reduction in the incidence and mortality. Here we review current literature with an aim to highlight recent improvements in the safety, efficiency, and effectiveness of screening colonoscopy. RECENT FINDINGS: Colon capsule endoscopy is an emerging noninvasive method to capture images of colonic mucosa for select patients with appreciable sensitivity for polyp detection. Recent literature supports the use of the novel oral anticoagulant apixaban over other anticoagulants to reduce the risk of gastrointestinal bleeding related to colonoscopy. Cold snare polypectomy for smaller lesions and prophylactic clipping following resection of large polyps in the proximal colon may reduce the rate of delayed bleeding. Novel methods and devices for improving bowel preparation continue to emerge. Mechanical attachment devices and artificial intelligence represent recent innovations to improve polyp detection. SUMMARY: Clinicians should be aware of relevant data and literature that continue to improve the quality and safety of screening colonoscopy and incorporate these findings into their clinical practice.

Adaptive constructive processes and memory accuracy: consequences of counterfactual simulations in young and older adults.

People frequently engage in counterfactual thinking: mental simulations of alternative outcomes to past events. Like simulations of future events, counterfactual simulations serve adaptive functions. However, future simulation can also result in various kinds of distortions and has thus been characterised as an adaptive constructive process. Here we approach counterfactual thinking as such and examine whether it can distort memory for actual events. In Experiments 1a/b young and older adults imagined themselves experiencing different scenarios. Participants then imagined the same scenario again, engaged in no further simulation of a scenario, or imagined a counterfactual outcome. On a subsequent recognition test participants were more likely to make false alarms to counterfactual lures than novel scenarios. Older adults were more prone to these memory errors than younger adults. In Experiment 2 younger and older participants selected and performed different actions, then recalled performing some of those actions, imagined performing alternative actions to some of the selected actions, and did not imagine others. Participants, especially older adults, were more likely to falsely remember counterfactual actions than novel actions as previously performed. The findings suggest that counterfactual thinking can cause source confusion based on internally generated misinformation, consistent with its characterisation as an adaptive constructive process.