Differences between GP perception of delivered empathy and patient-perceived empathy: a cross-sectional study in primary care

Contains fulltext : 196756.pdf (Publisher’s version ) (Closed access)BACKGROUND: Empathy has positive effects on a range of healthcare outcomes. It is therefore an important skill for a GP. However, the correlation between GP perception of delivered empathy and patient perception of GP empathic communication during consultations is still unclear. AIM: To investigate the correlation between GP perception of delivered empathy and patient-perceived empathy. DESIGN AND SETTING: Cross-sectional study in primary care in the Netherlands, between December 2016 and February 2017. METHOD: GPs and their patients were asked to fill in an empathy questionnaire directly after a consultation. Patient perception of received empathy during the consultation was measured through the Dutch version of the Consultation and Relational Empathy (CARE) questionnaire. GP perception of delivered empathy during the consultation was measured with an adapted version of the CARE questionnaire. RESULTS: The authors obtained questionnaires from 147 consultations by 34 different GPs in 16 primary care practices. A total of 143 consultations were eligible for inclusion in the analysis. Mean patient-perceived empathy score was significantly higher than mean GPs' empathy score (42.1, range 20.0 to 50.0 and 31.6, range 24.0 to 41.0, respectively, P<0.0001). Furthermore, a low correlation (r = 0.06) was found between GP empathy score and patient-perceived empathy score. CONCLUSION: GPs rate the delivered empathy during consultations consistently and significantly lower than their patients experience empathy during consultations. Moreover, GPs' impressions of the empathy delivered during the consultation do not predict the actual amount of empathy perceived by their patients. Patients experience a great deal of empathy during their clinical encounter. GPs' self-reports on empathy delivered gives an inaccurate reflection, and underestimates patient-perceived empathy

Safeguarding public values by project-based construction clients: Leads for future research

In an environment with large interdependencies like the construction industry, projectbased public construction organisations are challenged to seek for 'new' ways to safeguard public values and project outcomes. Public bodies increasingly depend on private parties to achieve public values. Hence, due to the character of their tasks, they remain socialpolitically responsible. In order to find leads for future research into safeguarding public values by construction clients, an explorative literature study was conducted. The fields of institutional logics, public organisation science and public value management were used to gain insights in relevant multi-level organisational concepts considering the meaning of public values in the daily practice of public clients. Hybridity was found as characteristic of public-private partnerships. Furthermore, the management of institutional complexity as a central task for public construction clients implies the importance of monitoring ambidexterity and accountability. Future research into the understanding of safeguarding public values at all levels of public construction clients must centralise these concepts in order to contribute to the professionalization of public construction clients.</p

Assessing the Maturity of Public Construction Client Organisations

The construction sector is changing, and commissioning organisations have to rethink the way they approach the market. This is especially important for client organisations operating in the public domain, because of their role as change agent in the sector and their social responsibilities. The ‘Public Commissioning Maturity Model’ (PCMM), first presented in 2014, was created to raise awareness amount construction clients’ organisations to the range and width of their commissioning task. It provides a means to elicit discussion on the current and desired state of the organisation’s competences, thereby supporting these organisations in further professionalization. As a result of sixworkshop-based discussion sessions and five panel discussions, the value of the model was determined. In this paper, the validation path of the model in practice is described. The findings resulted in changes to improve the usability of the model for the construction sector, as well as alterations to increase the understanding of the model for workshop participants. Adjustments regarding stylistic issues and elements in the maturity model and supporting materials were also made. Applying the PCMM has proven to enableassessment of the current and desired organisational performance on different aspects of public commissioning by eliciting discussion and raising awareness. It is however not constituted for numerical ranking, sector-wide monitoring or benchmarking purposes, while these needs also exist among client organisations. Furthermore, it was found that the model is less suitable for organisations in the middle of a comprehensive change process

The Polysaccharide Capsule of Streptococcus pneumonia Partially Impedes MyD88-Mediated Immunity during Pneumonia in Mice

Contains fulltext : 154128.PDF (publisher's version ) (Open Access

Prolactin release in children treated with risperidone: impact and role of CYP2D6 metabolism.

Contains fulltext : 53270.pdf (publisher's version ) (Closed access)OBJECTIVE: Little is known about the role of CYP2D6 polymorphism in risperidone-induced prolactin release in children. METHOD: Twenty-five children (aged 5-15 years) with pervasive developmental disorders were genotyped for CYP2D6 polymorphisms. Serum prolactin, risperidone, and 9-hydroxyrisperidone were assessed at baseline and after 8 weeks of risperidone treatment (mean dosage, 0.06 +/- 0.03 mg/kg/d). After 24 weeks of treatment, prolactin was measured in a subsample of 15 children. Adverse effects were evaluated using a clinician-rated survey. RESULTS: Mean +/- SD prolactin levels increased from 7.8 +/- 8.0 ng/mL at baseline to 33.2 +/- 12.8 ng/mL at week 8 (P < 0.001), with a slight decrease to 28.8 +/- 13.6 ng/mL at week 24. At week 8, serum prolactin level was positively correlated with dose per kilogram (r = 0.648, P < 0.001), number of functional CYP2D6 genes (J = 2.117, P = 0.034), and serum 9-hydroxyrisperidone concentration (r = 0.664, P = 0.001) and was negatively correlated with the risperidone/9-hydroxyrisperidone ratio (r = -0.571, P = 0.004) but not with risperidone concentration (r = -0.243, P = 0.264) nor age (r = 0.072, P = 0.733). Prolactin elevation was not associated with adverse effects. CONCLUSIONS: Low-to-intermediate doses of risperidone induced a 4-fold prolactin increase in children without a clear development of tolerance up to 6 months. CYP2D6 ultrarapid metabolism may be a risk factor for more pronounced prolactin elevation

A novel quantitative PCR assay for the detection of Streptococcus pneumoniae using the competence regulator gene target comX

Contains fulltext : 170357.pdf (publisher's version ) (Closed access