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)     

Imaging of follicular dendritic cell tumours of the liver

Follicular dendritic cell tumour of the liver is a recently recognized entity. To date, only two cases have been described, both in the pathology literature. Histologically, it resembles an inflammatory pseudotumour and immunohistochemical and ultrastructural studies are required for its diagnosis. The ultrasound, computed tomography and angiographic features of two cases of follicular dendritic cell tumour of the liver are described in detail. One of the patients had multiple recurrences of this tumour. The imaging features are very similar to those of hepatocellular carcinoma. As follicular dendritic cell tumour is considered to be of low-grade malignant potential, in contrast to the dismal prognosis for hepatocellular carcinoma, it is important to be able to accurately distinguish between the two types of tumour prior to initiating definitive therapy.     

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.     

Nitrone spin-traps block calcium channels and induce pulmonary artery relaxation independent of free radicals

Free radicals react with nitrones to form stable nitroxides which can be identified by ESR spectroscopy. Unfortunately, little is known regarding the pharmacological properties of these compounds. In this study, three commonly used nitrones, 5,5-dimethylpyrroline-N-oxide (DMPO), alpha-phenyl-tert-butylnitrone (PBN), and alpha-(4-pyridyl 1-oxide)-N-tert-butylnitrone (POBN), were found to induce relaxation of preconstricted isolated rat pulmonary artery rings. Additional experiments with PBN indicated that vasorelaxation could not be attributed to production of endothelial derived factors, prostaglandins, or free radicals. Patch-clamp techniques revealed reversible calcium channel blockade with PBN at a concentration below that needed to detect free radicals. Calcium channel blockade probably accounts for the vasorelaxation observed in the isolated ring preparations described here, and should be considered when using nitrone spin-traps both in in vivo and clinical studies.