The Influence of Patient-Centeredness on Minority and Socioeconomically-Disadvantaged Patients’ Trust in their Physicians: An Evidence-Based Structural Equation Modeling Investigation

The purpose of this investigation was to determine the effect of physician patient-centeredness on patient trust across randomly selected groups of patients from an inner city medical practice serving a preponderance of minority and socioeconomically-disadvantaged patients. METHODS: A two-factor multigroup structural equation modeling design was employed, with randomly selected test (N = 300) and cross-validation (N = 300) samples of medical practice patients. Equality constraints were established to test the invariance of effects across groups. The model was compared to its unconstrained counterpart to further test its trustworthiness. An additional 5,000 nonparametric bootstrapped samples for each group were generated to further cross-validate and assess the stability of effect estimates. RESULTS: The model fit well. Physician patient-centeredness significantly influenced patient trust, explaining 82 percent of its variability. When physician patient-centeredness increased by one unit, the predicted value for patient trust increased by 1.043 units (.903 standardized). Patient-centered physician behaviors increased patients’ confidence in and likelihood to recommend their physician. This pattern of effects held across the test and cross-validation groups. The hypothesized model was sustained when compared to its competing counterpart. CONCLUSIONS: Evidence supported the factor and structural validity of the model. This study offers a plausible two-factor model for the measurement and improvement of patient-centeredness, and concomitantly, patient trust in an inner city medical clinic serving minority and socioeconomically-disadvantaged patients. In addition to quality improvement and outcome measurement, the results have implications for improving patient-centeredness, patient trust, the patient–provider relationship, medical education, and reducing health care disparities

Unfamiliar faces might as well be another species: Evidence from a face matching task with human and monkey faces

Humans are good at recognizing familiar faces, but are more error-prone at recognizing an unfamiliar person across different images. It has been suggested that familiar and unfamiliar faces are processed qualitatively differently. But are unfamiliar faces at least processed differently from monkey faces? Here we tested 366 volunteers on a face matching test – two images presented side-by-side with participants judging whether the images show the same identity or two different identities – comparing performance with familiar and unfamiliar human faces, and monkey faces. The results showed that performance was most accurate for familiar faces, and was above chance for monkey faces. Although accuracy was higher for unfamiliar humans than monkeys on different identity trials, there was no unfamiliar human advantage over monkeys on same identity trials. The results give new insights into unfamiliar face processing, showing that in some ways unfamiliar faces might as well be another species

(1S,2E,6R,7aR)-2-Benzyl­idene-1,6-dihy­droxy-2,3,5,6,7,7a-hexa­hydro-1H-pyrrolizin-3-one

In the title compound, C14H15NO3, the conformation of the double bond was determined to be E, confirming the result obtained from two-dimensional NMR data. The five-membered rings of the pyrrolizine unit exhibit C-envelope conformations, with C atoms displaced from the mean planes formed by the remaining rings atoms by 0.1468 (15) and 0.5405 (17) Å. The mean planes of these rings (through all ring atoms) have a dihedral angle of 49.03 (10)°. In the crystal, mol­ecules are linked by O—H⋯O hydrogen bonds. The absolute configuration of the mol­ecule was established, as judged by the, as judged by the obtained values for the Hooft and Flack parameters

Nurses\u27 Alumnae Association Bulletin - Volume 17 Number 1

Alumnae Notes Committee Reports Digest of Alumnae Association Meetings Greetings from Miss Childs Greetings from the Educational Director Greetings from the President Graduation Awards - 1951 Jefferson\u27s New Hospital Addition Marriages Necrology Neurosurgery Department New Arrivals New Drugs Notes on the Cause of Leukemia Nursing Staff Saul Among the Prophets Staff Activities, 1951-1952 Students\u27 Corner The Hospital Pharmacy The Student Nurse Association of Pennsylvania White Haven and Barton Memorial Division

Inductive Game Theory and the Dynamics of Animal Conflict

Conflict destabilizes social interactions and impedes cooperation at multiple scales of biological organization. Of fundamental interest are the causes of turbulent periods of conflict. We analyze conflict dynamics in an monkey society model system. We develop a technique, Inductive Game Theory, to extract directly from time-series data the decision-making strategies used by individuals and groups. This technique uses Monte Carlo simulation to test alternative causal models of conflict dynamics. We find individuals base their decision to fight on memory of social factors, not on short timescale ecological resource competition. Furthermore, the social assessments on which these decisions are based are triadic (self in relation to another pair of individuals), not pairwise. We show that this triadic decision making causes long conflict cascades and that there is a high population cost of the large fights associated with these cascades. These results suggest that individual agency has been over-emphasized in the social evolution of complex aggregates, and that pair-wise formalisms are inadequate. An appreciation of the empirical foundations of the collective dynamics of conflict is a crucial step towards its effective management

1,4-Di-tert-butyl (2R,3R)-2-({(2E)-3-[4-(acet­yloxy)phen­yl]prop-2-eno­yl}­oxy)-3-hy­droxy­butane­dioate

The title compound, C23H30O9, has an approximate T-shape with the tert-butyl ester groups lying either side of the benzene ring. The acetyl group is almost perpendicular to the benzene ring to which it is connected [C—C—O—C torsion angle = −106.7 (3)°]. The conformation about the C=C double bond [1.331 (4) Å] is E. Linear supra­molecular chains along the a axis mediated by hy­droxy–carbonyl O—H⋯O hydrogen bonds feature in the crystal packing. The same H atom is also involved in an intra­molecular O—H⋯O inter­action

1,3-Bis(4-bromo­phen­yl)imidazolium chloride dihydrate

In the title hydrated salt, C15H11Br2N2 +·Cl−·2H2O, the complete imidazolium cation is generated by a crystallographic twofold axis, with one C atom lying on the axis. The chloride ion and both water mol­ecules of crystallization also lie on a crystallographic twofold axis of symmetry. The cation is non-planar, the dihedral angle formed between the central imidazolium and benzene rings being 12.9 (3)°; the dihedral angle between the symmetry-related benzene rings is 25.60 (13)°. In the crystal, O—H⋯Cl hydrogen bonds result in supra­molecular chains along c mediated by eight-membered {⋯HOH⋯Cl}2 synthons. These are consolidated by C—H⋯O and π–π [centroid–centroid distance = 3.687 (3) Å] inter­actions