Customer satisfaction and self-reported treatment outcomes among psychiatric inpatients

OBJECTIVE: Relationships among different dimensions of patient satisfaction and selected demographic, clinical, and outcome variables were explored in a sample of severely ill people receiving inpatient psychiatric services. METHOD: The sample consisted of 81 patients admitted to and discharged from an inpatient psychiatric unit at a midwestern Veterans Affairs medical center. Stepwise multiple regression was used to examine the relationship between patient satisfaction and self-reported changes in quality of life, symptomatology, and level of functioning as measured by the Treatment Outcome Profile. Other variables such as diagnosis, length of stay, employment, living situation, and prior psychiatric and substance abuse treatment were also considered. A subsample of the most satisfied and dissatisfied patients was chosen to further explore variables contributing to satisfaction with services. RESULTS: Patient satisfaction was related to initial level of functioning, certain diagnoses, and treatment gains. Clinicians were highly accurate in identifying patients who were satisfied, based on blind chart reviews. CONCLUSIONS: This study underscores the significant relationships between patient satisfaction, psychiatric diagnosis, and other outcome measures, and argues for the validity and utility of patient satisfaction measures in assessing the efficacy of inpatient care.     

Use of the suture anchor in open Bankart reconstruction. A follow-up report

We previously reported early results of a new technique using a suture anchor to perform a modified Bankart reconstruction. That study included patients from two medical centers and had an average followup of only 1 year. This report includes patients from a single center with followup extended to a mean of 42 months (range, 33 to 61). Between April 1988 and August 1991, 53 patients with recurrent anterior glenohumeral instability underwent modified Bankart reconstruction with the use of a suture anchor. Thirty-two patients met inclusion criteria (identifiable Bankart lesion, open repair with suture anchors, and minimum followup of 2 years); 4 patients were lost to followup. There have been no complications as a result of this technique. Ninety-three percent of the patients in the study had objectively excellent or good results. There were 2 failures with recurrent anterior dislocation. The use of a suture anchor can simplify the Bankart reconstruction. At average followup of 3 years, 26 patients have returned to presurgery activity levels without recurrent dislocation or subluxation. However, careful attention to anchor placement at the junction of articular cartilage and the glenoid neck is necessary to avoid technical failure.     

S.A.W. 350 ?s binary phase-shift-keyed matched filter

An asynchronous 350 ?s s.a.w. matched filter for a 10.36 Mchip s?1 binary phase-shift-keyed waveform, with 34 dB signal/noise gain (s.n.g.), has been constructed by cascading seven 50 ?s s.a.w. correlators. The effects of device imperfections and the repeated transduction process on the s.n.g. have been analysed. Predictions indicate that it is practicable to extend the technique to achieve millisecond matched filters.     

Stereochemical requirements for intercalation of platinum complexes into double-stranded DNA's

The complexes 1,10-phenanthrolineethylenediamineplatinum(II) and 2,2'-bipyridineethylenediamineplatinum(II) have a planar, aromatic ligand system that facilitates intercalation, as shown by their ability to unwind closed circular duplex DNA. Nonbonded steric interactions can rotate the pryidine ligands out of the coordination plane in bis(pyridine)ethylenediamineplatinum(II), thus preventing intercalation. Fiber x-ray diffraction patterns of the two metallointeracalators indicate that the binding is governed by the neighbor exclusion principle.     

The relationship between dietary phytosterols and the sterols of wild and cultivated oysters

Wild oysters (Crassostrea virginica) contained cholesterol, 24-methyl-cholesta-5, 22-dienol, 24-methylenecholesterol, 22-dehydrocholesterol, 24-methylcholesterol, 24-ethylcholesterol, 24-norcholesta-5, 22-dienol, 24-ethylcholesta-5, 22-dienol and fucosterol. The same species was cultivated on a defined diet ofThalassiosira pseudonana andIsochrysis sp. The dietary algae were cultured and their sterol compositions were analyzed by gas chromatography and mass spectroscopy.T. pseudonana andIsochrysis sp. had 24-methylenecholesterol and 24-methyl-cholesta-5, 22-dienol as their major sterols. The sterol composition of the cultivated oysters revealed the predominance of cholesterol (19%), 24-methyl-cholesta-5, 22-dienol (21%) and 24-methylenecholesterol (46%). Therefore, oysters must be able to bioconvert phytosterols to cholesterol, concentrate dietary cholesterol, or synthesize cholesterol de novo.     

A comparative analysis of pulmonary perfusion scans with pulmonary angiograms

Pulmonary angiograms and pulmonary lung perfusion scans on 162 patients with pulmonary embolism were comparatively analyzed. Among the expert angiographic panel members who independently evaluated the studies there was consistent agreement on the diagnosis, size of the emboli, and severity. Consistency of agreement among the expert pulmonary lung perfusion scan panelists was considerably less. These data demonstrate that, in addition to the lack of specificity of the lung perfusion scan for the diagnosis of pulmonary thromboemboli, there is a considerable problem of interpretation in this patient population.