Preferences, predictions and patient enablement: a preliminary study

BACKGROUND: The widely used patient enablement instrument (PEI) is sometimes contrasted against measures of patient satisfaction as being a more objective measure of consultation quality, in that it is less likely to be positively influenced by fulfilling pre-existing expectations for specific consultation outcomes (such as prescriptions or referrals). However the relationship between expectation and enablement is underexplored, as is the relationship between ‘expectation’ understood as a patient preference for outcome, and patient prediction of outcome. The aims of the study are to 1) assess the feasibility of measuring the relationship between expectation fulfilment and patient enablement, and 2) measure the difference (if any) between expectation understood as preference, and expectation understood as prediction. METHODS: A questionnaire study was carried out on 67 patients attending three General Practices in the Australian Capital Territory. Patient preferences and predictions for a range of possible outcomes were recorded prior to the consultation. PEI and the actual outcomes of the consultation were recorded at the conclusion of the consultation. Data analysis compared expectation fulfilment as concordance between the preferred, predicted, and actual outcomes, with the PEI as a dependant variable. RESULTS: No statistically significant relationship was found between either preference-outcome concordance and PEI, or prediction-outcome concordance. Statistically insignificant trends in both cases ran counter to expectations; i.e. with PEI (weakly) positively correlated with greater discordance. The degree of concordance between preferred outcomes and predicted outcomes was less than the concordance between either preferred outcomes and actual outcomes, or predicted outcomes and actual outcomes. CONCLUSIONS: The relationship between expectation fulfilment and enablement remains uncertain, whether expectation is measured as stated preferences for specific outcomes, or the predictions made regarding receiving such outcomes. However the lack of agreement between these two senses of ‘patient expectation’ suggests that explicitly demarcating these concepts during study design is strongly advisable.NHMRC (National Health and Medical Research Council of Australia

Ion-exchange hollow fibers

An ion-exchange hollow fiber is prepared by introducing into the wall of the fiber polymerizable liquid monomers, and polymerizing the monomers therein to form solid, insoluble, crosslinked, ion-exchange resin particles which embed in the wall of the fiber. Excess particles blocking the central passage or bore of the fiber are removed by forcing liquid through the fiber. The fibers have high ion-exchange capacity, a practical wall permeability and good mechanical strength even with very thin wall dimensions. Experimental investigation of bundles of ion-exchange hollow fibers attached to a header assembly have shown the fiber to be very efficient in removing counterions from solution

Improved ion exchange membrane

Membrane, made from commercially-available hollow fibers, is used in reverse osmosis, or dialysis. Fiber has skin layers which pass only small molecules. Macromolecules cannot penetrate skin. Fibers can also be used to remove other undesirable anions, such as phosphate, sulfate, carbonate, and uranium in form of uranium-sulfate complex

Impedance Matched Absorptive Thermal Blocking Filters

We have designed, fabricated and characterized absorptive thermal blocking filters for cryogenic microwave applications. The transmission line filter's input characteristic impedance is designed to match $50\,\Omega$ and its response has been validated from 0-to-50\,GHz. The observed return loss in the 0-to-20\,GHz design band is greater than $20\,$dB and shows graceful degradation with frequency. Design considerations and equations are provided that enable this approach to be scaled and modified for use in other applications

QCD Viscosity to Entropy Density Ratio in the Hadronic Phase

Shear viscosity (eta) of QCD in the hadronic phase is computed by the coupled Boltzmann equations of pions and nucleons in low temperatures and low baryon number densities. The eta to entropy density ratio eta/s maps out the nuclear gas-liquid phase transition by forming a valley tracing the phase transition line in the temperature-chemical potential plane. When the phase transition turns into a crossover, the eta/s valley gradually disappears. We suspect the general feature for a first-order phase transition is that eta/s has a discontinuity in the bottom of the eta/s valley. The discontinuity coincides with the phase transition line and ends at the critical point. Beyond the critical point, a smooth eta/s valley is seen. However, the valley could disappear further away from the critical point. The eta/s measurements might provide an alternative to identify the critical points.Comment: 16 pages, 4 figures. Minor typos corrected and references adde