Relationships between scores on the Jefferson Scale of physician empathy, patient perceptions of physician empathy, and humanistic approaches to patient care: a validity study.

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient\u27s awareness of the physician\u27s empathic concern can lead to a more positive clinical outcome. MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians\u27 humanistic approaches to patient care. RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p CONCLUSIONS: These findings provide further support for the validity of the JSPE. Implications for the assessments of empathy in the physician-patient relationship as related to clinical outcomes are discussed

Computing equilibrium states of cholesteric liquid crystals in elliptical channels with deflation algorithms

We study the problem of a cholesteric liquid crystal confined to an elliptical channel. The system is geometrically frustrated because the cholesteric prefers to adopt a uniform rate of twist deformation, but the elliptical domain precludes this. The frustration is resolved by deformation of the layers or introduction of defects, leading to a particularly rich family of equilibrium configurations. To identify the solution set, we adapt and apply a new family of algorithms, known as deflation methods, that iteratively modify the free energy extremisation problem by removing previously known solutions. A second algorithm, deflated continuation, is used to track solution branches as a function of the aspect ratio of the ellipse and preferred pitch of the cholesteric.Comment: 9 pages, 6 figure

Changing the Scene: applying four models of social evolution to the scenescape

This paper elaborates a multi-model approach to studying how local scenes change. We refer to this as the "4 D's" of scene change: development, differentiation, defense, and diffusion. Each posits somewhat distinct change processes, and has its own tradition of theory and empirical research, which we briefly review. After summarizing some major trends in scenes and amenities in the US context, for each change model, we present some initial findings, discussing data and methods throughout. Our overall goal is to point toward new research arcs on change models of scenes, and to give some clear examples and directions for how to think about and collect data to understand what makes some scenes change, others not, why, and in what directions.Comment: Published at Journal Wuhan Universit

Quantum Effects in Black Hole Interiors

The Weyl curvature inside a black hole formed in a generic collapse grows, classically without bound, near to the inner horizon, due to partial absorption and blueshifting of the radiative tail of the collapse. Using a spherical model, we examine how this growth is modified by quantum effects of conformally coupled massless fields.Comment: 13 pages, 1 figure (not included), RevTe

Non-perturbative intertwining between spin and charge correlations: A "smoking gun" single-boson-exchange result

We study the microscopic mechanism controlling the interplay between the local charge and local spin fluctuations in correlated electron systems, via a thorough investigation of the generalized on-site charge susceptibility of several fundamental many-electron models, such as the Hubbard atom, the Anderson impurity model and the Hubbard model. By decomposing the numerically determined generalized susceptibility in terms of physically transparent single-boson exchange processes, we unveil the microscopic mechanisms responsible for the breakdown of the self-consistent many-electron perturbation expansion. In particular, we unambiguously identify the origin of the significant suppression of its diagonal entries in (Matsubara) frequency space and the slight increase of the off-diagonal ones which cause the breakdown. The suppression effect on the diagonal elements directly originates from the electronic scattering on local magnetic moments, reflecting their increasingly longer lifetime as well as their enhanced effective coupling with the electrons. The slight and diffuse enhancement of the off-diagonal terms, instead, can be mostly ascribed to multiboson scattering processes. The strong intertwining between the spin and charge sector is partly weakened at the Kondo temperature due to a progressive reduction of the effective spin-fermion coupling of local magnetic fluctuations in the low frequency regime. Our analysis, thus, clarifies the precise way in which the physical information between different scattering channels of interacting electron problems is transferred and highlights the pivotal role played by such an intertwining in the physics of correlated electrons beyond the perturbative regime.Comment: 31 pages, 14 figures, submission to SciPos

Amplification of High-Order Rainbows of a Cylinder with an Elliptical Cross Section

The intensity of high-order rainbows for normally incident light and certain rotation angles of a cylinder with an elliptical cross section is greatly amplified with respect to the intensity for a circular cross-sectional cylinder. The amplification is due to a number of the internal reflections occurring past the critical angle for total internal reflection, and the effect is especially strong for odd-order rainbows, beginning with the third order. Experimentally, the fourth-and the fifth-order rainbows of a nearly elliptical cross-sectional glass rod were observed and analyzed. (C) 1998 Optical Society of America

Patient information in radiation oncology: a cross-sectional pilot study using the EORTC QLQ-INFO26 module

<p>Abstract</p> <p>Background</p> <p>The availability of alternative sources of information, e. g. the internet, may influence the quantity and quality of information cancer patients receive regarding their disease and treatment. The purpose of the present study was to assess perception of information in cancer patients during radiotherapy as well as media preferences and specifically the utilization of the internet.</p> <p>Methods</p> <p>In a cross-sectional, single-centre study 94 patients currently undergoing radiotherapy were asked to complete two questionnaires. The EORTC QLQ-INFO26 module was used to assess the quality and quantity of information received by patients in the areas disease, medical tests, treatment, other services, different places of care and how to help themselves, as well as qualitative aspects as helpfulness of and satisfaction with this information. The importance of different media, in particular the internet, was investigated by a nine-item questionnaire.</p> <p>Results</p> <p>The response rate was n = 72 patients (77%). Patients felt best informed concerning medical tests (mean ± SD score 79 ± 22, scale 0-100) followed by disease (68 ± 21). Treatment (52 ± 24) and different places of care and other services (30 ± 36 and 30 ± 30, respectively) ranked last. 37% of patients were very satisfied and 37% moderately satisfied with the amount of information received, 61% wished more information. Among eight media, brochures, television and internet were ranked as most important. 41% used the internet themselves or via friends or family, mostly for research of classic and alternative treatment options. Unavailability and the necessity of computer skills were most mentioned obstacles.</p> <p>Conclusion</p> <p>In a single-center pilot study, radiotherapy patients indicated having received most information about medical tests and their disease. Patients very satisfied with their information had received the largest amount of information. Brochures, television and internet were the most important media. Individual patient needs should be considered in the development of novel information strategies.</p

Acute mesenteric venous thrombosis: Case for nonoperative management

AbstractObjective: Initial treatment in the management of acute mesenteric vein thrombosis (MVT) is controversial. Some authors have proposed a surgical approach, whereas others have advocated medical therapy (anticoagulation). In this study, we analyzed and compared the results obtained with surgical and medical treatment to determine the best initial management for this disease. Methods: We retrospectively reviewed the records of patients treated for MVT in a secondary care surgical department from January 1987 to December 1999. Before January 1995, our departmental policy was to perform surgery in patients with suspected MVT. Since January 1995, we have preferred a medical approach when achievable. Each patient in this study was assessed for diagnosis, initial management (laparotomy or anticoagulation), morbidity, mortality, duration of hospitalization, the need for secondary operation, portal hypertension, and survival rates. Results: Twenty-six patients were treated, 14 before January 1995 (group 1) and 12 since January 1995 (group 2). Morbidity, mortality, secondary operation, portal hypertension, and 2-year survival rates were 34.6%, 19.2%, 15.3%, 19.2%, and 76.9%, respectively. No statistical difference was observed between the two groups. The mean duration of hospitalization was 51.6 days in group 1 and 23.2 days in group 2 (P <.05). Among the 12 patients treated by means of laparotomy with bowel resection, 10 patients (83%) had mucosal necrosis without transmural necrosis at pathologic study. Conclusion: Nonoperative management for acute MVT is feasible when the initial diagnosis with a computed tomography scan is certain and when the bowel infarction has not led to transmural necrosis and bowel perforation. The morbidity, mortality, and survival rates are similar in cases of surgical and nonoperative management. The length of hospital stay is shorter when patients are treated with a nonoperative approach. A nonoperative approach, when indicated, avoids the resection of macroscopically infarcted small bowel (without transmural necrosis) in cases that are potentially reversible with anticoagulation alone. (J Vasc Surg 2001;34:673-9.

Discrete and continuous time simulations of spatial ecological processes predict different final population sizes and interspecific competition outcomes

Cellular automata (CAs) are commonly used to simulate spatial processes in ecology. Although appropriate for modelling events that occur at discrete time points, they are also routinely used to model biological processes that take place continuously. We report on a study comparing predictions of discrete time CA models to those of their continuous time counterpart. Specifically, we investigate how the decision to model time discretely or continuously affects predictions regarding long-run population sizes, the probability of extinction and interspecific competition. We show effects on predicted ecological outcomes, finding quantitative differences in all cases and in the case of interspecific competition, additional qualitative differences in predictions regarding species dominance. Our findings demonstrate that qualitative conclusions drawn from spatial simulations can be critically dependent on the decision to model time discretely or continuously. Contrary to our expectations, simulating in continuous time did not incur a heavy computational penalty. We also raise ecological questions on the relative benefits of reproductive strategies that take place in discrete and continuous time