Influences on Patient Satisfaction in Healthcare Centers: A Semi-Quantitative Study Over 5 Years

BACKGROUND: Knowledge of ambulatory patients\u27 satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. METHODS: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years. Patients\u27 responses to 21 questions were analyzed by principal components varimax rotated factor analysis. Three classifiable components emerged: Satisfaction with Physician, Availability/Convenience, and Orderly/Time. To study the effects of several independent variables (location of clinics, patients\u27 and physicians\u27 age, education level and duration at the clinic), data were subjected to multivariate analysis of variance (MANOVA).. RESULTS: Changes in the healthcare centers over time were not significantly related to patient satisfaction. However, location of the center did affect satisfaction. Urban patients were more satisfied with their physicians than rural, and inner city patients were less satisfied than urban or rural on Availability/Convenience and less satisfied than urban patients on Orderly/Time. How long a patient attended a center most affected satisfaction, with patients attending \u3e10 years more satisfied in all three components than those attending60 years old. Patients were significantly more satisfied with their 30-40 year-old physicians compared with those over 60. On Orderly/Time, patients were more satisfied with physicians who were in their 50\u27s than physicians \u3e60. CONCLUSIONS: Improvement in patient satisfaction includes a need for immediate, specific feedback. Although Medical Directors received feedback yearly, we found no significant changes in patient satisfaction over time. Our results suggest that, to increase satisfaction, patients with lower education, those who are sicker, and those who are new to the center likely would benefit from additional high quality interactions with their physicians

HD152843 b & c: the masses and orbital periods of a sub-Neptune and a super-puff Neptune

We present the characterisation of the two transiting planets around HD 152843 (TOI 2319, TIC 349488688) using an intensive campaign of HARPS-N radial velocities, and two sectors of TESS data. These data reveal a unique and fascinating system: HD 152843 b and c have near equal masses of around 9 M$_\oplus$ but differing radii of $3.05 \pm 0.11$ R$_\oplus$ and $5.94^{+0.18}_{-0.16}$ R$_\oplus$ , respectively, and orbital periods of $11.62071^{+9.6e-05}_{-0.000106}$ days and $19.502104^{+7.4e-05}_{-8.5e-05}$ days. This indicates that HD 152843 c is in the lowest fifth percentile in density of the known exoplanet population, and has the longest orbital period among these low density planets. Further, HD 152843 c's radius places it in the Saturn valley, the observed lack of planets larger than Neptune, but smaller than Saturn. The orbital periods of these planets indicate they are near a 5:3 mean motion resonance, indicating the possibility of transit timing variations, and hints at the possibility of interaction with a third planet at some point in the evolution of this system. Further, the brightness of the host star and the low density of HD 152843 c make it a key target for atmospheric characterisation.Comment: Submitted for review to the Monthly Notices of the Royal Astronomical Society. 13 pages, 16 figure

HD152843 b & c: the masses and orbital periods of a sub-Neptune and a super-puff Neptune

Funding: BN would like to acknowledge support from STFC Consolidated Grant ST/S000488/1 (PI Balbus), and the University of Southern Queensland SAGE program. BN would also like to thank Dr Su Wang for her insights on planetary system dynamics. ACC acknowledges support from STFC consolidated grant number ST/V000861/1, and UKSA grant number ST/X002217/1. The HARPS-N project has been funded by the Prodex Program of the Swiss Space Office (SSO), the Harvard University Origins of Life Initiative (HUOLI), the Scottish Universities Physics Alliance (SUPA), the University of Geneva, the Smithsonian Astrophysical Observatory (SAO), and the Italian National Astrophysical Institute (INAF), the University of St Andrews, Queen’s University Belfast, and the University of Edinburgh.We present the characterisation of the two transiting planets around HD 152843 (TOI 2319, TIC 349488688) using an intensive campaign of HARPS-N radial velocities, and two sectors of TESS data. These data reveal a unique and fascinating system: HD 152843 b and c have near equal masses of around 9 M⊕ but differing radii of 3.05 ± 0.11 R⊕ and 5.94 -0.16 +0.18 R⊕, respectively, and orbital periods of 11.62071-0.000106+9.6e-05 days and 19.502104 -8.5e-05 +7.4e-05 days. This indicates that HD 152843 c is in the lowest fifth-percentile in density of the known exoplanet population, and has the longest orbital period among these low density planets. Further, HD 152843 c’s radius places it in the 'Saturn valley', the observed lack of planets larger than Neptune, but smaller than Saturn. The orbital periods of these planets indicate they are near a 5 : 3 mean motion resonance, indicating the possibility of transit timing variations, and hints at the possibility of interaction with a third planet at some point in the evolution of this system. Further, the brightness of the host star and the low density of HD 152843 c make it a key target for atmospheric characterisation.Peer reviewe

Independent validation of the temperate super-Earth HD 79211 b using HARPS-N

This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under grant No. DGE1745303. The HARPS-N project was funded by the Prodex Program of the Swiss Space Office (SSO), the Harvard- University Origin of Life Initiative (HUOLI), the Scottish Universities Physics Alliance (SUPA), the University of Geneva, the Smithsonian Astrophysical Observatory (SAO), the Italian National Astrophysical Institute (INAF), University of St. Andrews, Queen's University Belfast, and University of Edinburgh. Parts of this work have been supported by the National Aeronautics and Space Administration under grant No. NNX17AB59G, issued through the Exoplanets Research Program. Parts of this work have been supported by the Brinson Foundation. R.D.H. is funded by the UK Science and Technology Facilities Council (STFC)'s Ernest Rutherford Fellowship (grant No. ST/V004735/1). T.G.W and A.C.C acknowledge support from STFC consolidated grant Nos. ST/R000824/1 and ST/V000861/1, and UKSA grant ST/R003203/1.We present high-precision radial velocities (RVs) from the HARPS-N spectrograph for HD 79210 and HD 79211, two M0V members of a gravitationally bound binary system. We detect a planet candidate with a period of 24.421−0.017+0.016 days around HD 79211 in these HARPS-N RVs, validating the planet candidate originally identified in CARMENES RV data alone. Using HARPS-N, CARMENES, and RVs spanning a total of 25 yr, we further refine the planet candidate parameters to P = 24.422 ± 0.014 days, K = 3.19 ± 0.27 m s−1, M sin i = 10.6 ± 1.2M⊕, and a = 0.142 ± 0.005 au. We do not find any additional planet candidate signals in the data of HD 79211, nor do we find any planet candidate signals in HD 79210. This system adds to the number of exoplanets detected in binaries with M-dwarf members and serves as a case study for planet formation in stellar binaries.Publisher PDFPeer reviewe

Depression and loneliness in Jamaicans with sickle cell disease

<p>Abstract</p> <p>Background</p> <p>Sickle cell disease (SCD) is the commonest genetic disorder in Jamaica, and has life-long implications for those afflicted with it. It is well known that depression and loneliness may exist in those with chronic diseases, but the coexistence of depression and loneliness in people with sickle cell disease is not clear. The aim of this study is to determine the prevalence of and factors associated with depression and loneliness in the Jamaica Sickle Cell Cohort Study and its age and sex matched controls.</p> <p>Methods</p> <p>277 patients with SCD and 65 controls were administered a questionnaire that studied demographics, disease severity, depression, and loneliness. Regression analyses were done to examine relationships between outcomes and associated variables.</p> <p>Results</p> <p>Depression was found in 21.6% of patients and 9.4% in controls. Loneliness scores were also significantly higher in patients (16.9 ± 5.1) than in controls (14.95 ± 4.69). Depression was significantly associated with unemployment [OR = 2.9, p-value: < 0.001], whereas unemployment (p-value: 0.002), and lower educational attainment were significantly associated with loneliness.</p> <p>In patients with SCD, depression was significantly associated with being unemployed (OR 2.4, 95% CI 1.2,4.6, p-value:0.01), presence of a leg ulcer (OR = 3.8, 95% CI: 1.7, 8.4, p-value: 0.001), frequent visits (OR = 3.3, 95% CI: 1.2, 8.9, p-value: 0.019), and frequent painful crises (OR = 2.5, 95% CI: 1.1, 5.8, p-value: 0.035). Not being employed (Coef.: 2.0; p-value: 0.004) and higher educational attainment (tertiary vs. primary education, Coef.: -5.5; p-value: < 0.001) were significant associations with loneliness after adjusting for genotype.</p> <p>Conclusions</p> <p>Health workers need to actively look for and manage these problems to optimize their patients' total biopsychosocial care.</p

A systematic review of the effectiveness of art therapy delivered in school-based settings to children aged 5–12 years

Background: School-based art therapy aims to facilitate children's personal change and growth through the use of visual arts media, such as drawing, painting, sculpture, clay, or digital art. Aims: To identify and synthesise the types of school-based art therapy interventions, and appraise the effectiveness for children aged 5-12. Methods: Systematic searching through ten major electronic databases, grey literature, and contact with experts in the field. Results: Six completed and two on-going studies were identified. Art therapy was delivered to children with asthma, behavioural disorders, oppositional defiant disorders, separation anxiety disorders, learning disorders, and disruptive behaviours. All interventions were delivered over 7-25 sessions, and lasted 40-60' per session. The sample sizes ranged between 20-109 participants, involving 247 participants in total. Conclusions: Art therapy can be effective in improving children's quality of life; anxiety; self-concept; problem-solving skills, attitudes towards school; emotional and behavioural difficulties. The follow-up findings were also promising; though confirmatory evidence is needed. Implications: The risk of bias was high and unclear, highlighting the importance of following standardised reporting guidelines. Future research needs to focus on the identification of primary outcomes and measures that are tailored to art therapy interventions, and explore the (cost-) effectiveness of shorter versus longer durations of treatment

Medical patients

delineate a cognitive-behavioral model of crisis intervention for the practicing clinician in the medical setting / discuss] the crisis patient, the nature of crises, the most common precipitants of crises in the medical patient, and cognitive-behavioral techniques of crisis intervention / provide a case study of a 41 yr old female with a malignant melanoma behind her retina] to illustrate these principles (PsycINFO Database Record (c) 2012 APA, all rights reserved). (chapter

Assessment of social anxiety: a controlled comparison among social phobics, obsessive-compulsives, agoraphobics, sexual disorders and simple phobies

The construct validity of the Willoughby Personality Schedule (WPS) as an index of social anxiety was established in the present study. The WPS correctly identifies social phobics from controls in 88% of the cases. © 1983