A strategy for improving patient satisfaction by the intensive training of residents in psychosocial medicine: a controlled, randomized study

PURPOSE: To use a controlled, randomized design to assess the effect on patient satisfaction of an intensive psychosocial training program for residents. METHOD: Twenty-six first-year residents, in two internal medicine and family practice community-based programs affiliated with the Michigan State University College of Human Medicine, were randomly assigned during 1991 and 1992 to a control group or a one-month intensive training program. Experiential teaching focused on many psychosocial skills required in primary care. A 29-item questionnaire administered before and after the residents' training evaluated their patients' satisfaction regarding patient disclosure, physician empathy, confidence in physician, general satisfaction, and comparison of the physician with other physicians. Analyses of covariance with groups and gender as factors and pre-training patient satisfaction scores as the covariate evaluated the effect of the training. RESULTS: The patients of the trained residents expressed more confidence in their physicians (p = .01) and more general satisfaction (p = .02) than did the patients of controls. The effect of training on patient satisfaction with patient disclosure (p < .01) and physician empathy (p < .05) was greater for female than for male residents. CONCLUSION: The intensive psychosocial training program for residents improved their patients' satisfaction.     

Sustainable building: Building green

In addition to having one of the top environmental law programs in the United States, the University of Denver College of Law now has a building that demonstrates the institution ‘practices what it preaches’ when it comes to concern for the environment. Built on the front range of the Colorado Rocky Mountains, the 181,000 square foot, $63 million facility which opened in August will be the first certified “green” law school in the country. Don C. Smith, U.S. Correspondent explains the attributes that distinguish the building from conventional ones.     

Appraisal as a Pervasive Determinant of Anger.

L. Berkowitz and E. Harmon-Jones (see record 2004-15096-001) challenge appraisal theories of emotion by describing 2 sets of conditions (physical discomfort and anger-related muscle actions) in which anger appears to be elicited in the absence of theoretically predicted appraisals. In response, the authors discuss the ability of the specific appraisal model they have developed (e.g., C. A. Smith & L. D. Kirby, 2000, 2001; C. A. Smith & R. S. Lazarus, 1990) to account for such instances of anger. First, a number of issues are clarified relevant to the authors' model, including the nature of both the cognitive operations underlying appraisal and the specific appraisals hypothesized to evoke anger. The authors then describe how their model can account for the instances of anger described by L. Berkowitz and E. Harmon-Jones and how both accounts might be tested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Breaking the Nyquist barrier

The author discusses the concept that data sampled beyond the Nyquist frequency is meaningless. A simple signal processing scheme to extend resolution to nearly twice the Nyquist without the problem of alias emerged. It starts by placing one-dimensional signals into a simulated sample-and-hold process in a Mathcad application     

The Study of Heterogeneous Catalysts by High-Resolution Transmission Electron MicroscoDV

Advances in instrumentation have made it possible in recent years to study the microstructure of inorganic materials at atomic resolution using the technique of high-resolution electron microscopy (HREM). Details of instrumentation have been described elsewhere [l], and applications and trends for HREM have recently been reviewed [2]. Although HREM is primarily a technique for studying bulk defects, it is increasingly also being applied in the profile-imaging mode to derive information about surfaces [3]. The high spatial resolution of the electron microscope makes it a valuable tool for the characterization of heterogeneous catalysts. This is evidenced by the growing number of studies wherein electron micrographs are being used to describe the morphology of a particular catalyst. Profile imaging is proving particularly useful in this regard for following changes in surface structure as a function of treatment conditions [4].     

Effects of viscosity on the bitterness and astringency of grape seed tannin

To examine the separate effects of viscosity and sweetness on astringency, aqueous solutions of grape seed tannin (GST) were thickened with carboxymethyl cellulose (CMC) from 2 to 45 cP (experiment 1) or sweetened with 0 to 1.8 g/L aspartame (experiment 2). Trained subjects continuously rated astringency and bitterness in duplicate. Subjects were categorized by the salivary flow induced by citric acid and ability to taste n-propyl thiouracil (PROP). In experiment 1, maximum intensity and total duration of astringency were significantly decreased as viscosity rose, although time to maximum intensity of astringency was not affected. Maximum intensity and total duration of bitterness were not significantly affected by increasing viscosity; however, the onset of bitterness was significantly delayed. In experiment 2, increasing sweetness had no affect on any astringency parameter, although maximum intensity of bitterness was significantly decreased. Neither PROP nor salivary flow-status had any effect on perception of bitterness or astringency in either experiment.     

Control-canonical-form method applied to generating systems to improve dynamic stability characteristics

Contents The control-canonical-form (CCF) method is introduced for the purpose of applying it to high-order state-space single-input single or multiple-output (SISO or SIMO) and multiple-input multiple-output (MIMO) linear time-invariant system models to determine closed-loop systems (i.e. design robust controllers) from which enchanced dynamic stability characteristics and overall performance of these systems is achieved. The method has been applied successfully to a SISO 6th-order linearized state-space open-loop model (representing a simplified hydro power system), and to a MIMO 8th-order linearized state-space open-loop model (representing an 87.5 kVA synchronous machine with conventional exciter supplying power to an electric utility system through an interconnection network)

---

Anwendung der kanonischen Form der Zustandsrückführung auf Erzeugersysteme zur Verbesserung der dynamischen Stabilitätseigenschaften

Übersicht Die Methode der kanonischen Form wird auf lineare zeitinvariante Systeme höherer Ordnung im Zustandsraum angewendet, die eine oder mehrere Eingangsgrößen bei einer oder mehreren Ausgangsgrößen aufweisen. Damit werden robuste Regler entworfen, welche die dynamische Stabilität und das gesamte Betriebsverhalten verbessern. Die Methode wurde erfolgreich auf ein linearisiertes Modell sechster Ordnung mit einem Eingang und einem Ausgang angewendet, das vereinfachend eine Wasserkraftanlage darstellt; außerdem auf ein linearisiertes Zustandsmodell achter Ordnung einer Synchronmaschine 87,5kVA mit konventioneller Erregung, die über ein Verbindungsnetzwerk in das öffentliche Netz einspeist.

     

Primary cell culture of human type II pneumonocytes: maintenance of a differentiated phenotype and transfection with recombinant adenoviruses

Studies of the regulation of surfactant lipoprotein metabolism and secretion and surfactant protein gene expression have been hampered by the lack of a cell culture system in which the phenotypic properties of type II cells are maintained. We have developed a primary culture system that facilitates the maintenance of a number of morphologic and biochemical properties of type II pneumonocytes for up to 2 wk. Cells were isolated by collagenase digestion of midgestation human fetal lung tissue that had been maintained in organ culture in the presence of dibutyryl cyclic AMP (Bt2cAMP) for 5 days. The isolated cells were enriched for epithelial components by treatment with DEAE-dextran, plated on an extracellular matrix (ECM) derived from Madin-Darby canine kidney (MDCK) cells, and incubated at an air/liquid interface in a minimal amount of culture medium containing Bt2cAMP. The cell cultures were comprised of islands of round epithelial-like cells containing numerous dense osmiophilic granules, surrounded by sparse spindle-shaped cells with the appearance of fibroblasts. Ultrastructural examination revealed that the osmiophilic granules had the appearance of lamellar bodies, the distinguishing feature of type II pneumonocytes. Additionally, the cultures maintained elevated levels of SP-A gene expression for up to 2 wk. The expression of mRNAs encoding SP-A, SP-B, and SP-C were regulated in the cultured cells by glucocorticoids and cyclic AMP in a manner similar to that observed in fetal lung tissue in organ culture. The differentiated phenotype was most apparent when the cells were cultured at an air/liquid interface. In order to utilize the cultured type II cells for study of the effects of overexpression of various proteins and for promoter analysis, it is of essence to transfect DNA constructs into these cells with high efficiency. Unfortunately, we found the cells to be refractory to efficient transfer of DNA using conventional methods (i.e., lipofection, electroporation, or calcium phosphate-mediated transfection). However, replication-defective recombinant human adenoviruses were found to provide a highly efficient means of introducing DNA into the type II pneumonocytes. Furthermore, we observed in type II cell-enriched cultures infected with recombinant adenoviruses containing the lacZ gene under control of a cytomegalovirus promoter, that beta-galactosidase was expressed uniformly in the islands of type II cells and surrounding fibroblasts. By contrast, in cultures infected with recombinant adenoviruses containing the human growth hormone (hGH) gene under control of the SP-A gene promoter and 5'-flanking region, hGH was expressed only in the type II cells. Thus, this culture system provides an excellent means for identifying genomic elements that mediate type II cell-specific gene expression.     

Loudness balance between acoustic and electric stimulation by a patient with a multichannel cochlear implant

Estimates of loudness balance were obtained for acoustically and electrically presented 250 Hz sine signals from a patient who uses the Ineraid multichannel cochlear implant. Acoustic and electric loudness matching was possible because the patient evidenced a 25 dB HL threshold at 250 Hz in his nonimplanted ear. The level of the electrical stimulus in microamperes required for a balance of loudness grew linearly with equal increments in decibels for the acoustic stimulus. These data, in concert with the very limited data from previous studies, provide a rationale for using a logarithmic transformation of acoustic to electric intensity in signal processors for cochlear implants.