Patient perceptions of physician empathy, satisfaction with physician, interpersonal trust, and compliance

Objectives: This study was designed to investigate psychometric properties of the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and to examine correlations between its scores and measures of overall satisfaction with physicians, personal trust, and indicators of patient compliance. Methods: Research participants included 535 out-patients (between 18-75 years old, 66% female). A survey was mailed to participants which included the JSPPPE (5-item), a scale for measuring overall satisfaction with the primary care physician (10-item), and demographic questions. Patients were also asked about compliance with their physician\u27s recommendation for preventive tests (colonoscopy, mammogram, and PSA for age and gender appropriate patients). Results: Factor analysis of the JSPPPE resulted in one prominent component. Corrected item-total score correlations ranged from .88 to .94. Correlation between scores of the JSPPPE and scores on the patient satisfaction scale was 0.93. Scores of the JSPPPE were highly correlated with measures of physician-patient trust (r \u3e.73). Higher scores of the JSPPPE were significantly associated with physicians\u27 recommendations for preventive tests (colonoscopy, mammogram, and PSA) and with compliance rates which were \u3e .80). Cronbach\u27s coefficient alpha for the JSPPPE ranged from .97 to .99 for the total sample and for patients in different gender and age groups. Conclusions: Empirical evidence supported the psychometrics of the JSPPPE, and confirmed significant links with patients\u27 satisfaction with their physicians, interpersonal trust, and compliance with physicians\u27 recommendations. Availability of this psychometrically sound instrument will facilitate empirical research on empathy in patient care in different countries

A Magnetic Resonance Realization of Decoherence-Free Quantum Computation

We report the realization, using nuclear magnetic resonance techniques, of the first quantum computer that reliably executes an algorithm in the presence of strong decoherence. The computer is based on a quantum error avoidance code that protects against a class of multiple-qubit errors. The code stores two decoherence-free logical qubits in four noisy physical qubits. The computer successfully executes Grover's search algorithm in the presence of arbitrarily strong engineered decoherence. A control computer with no decoherence protection consistently fails under the same conditions.Comment: 5 pages with 3 figures, revtex4, accepted by Physical Review Letters; v2 minor revisions to conten

Nonlinear Realization of Chiral Symmetry on the Lattice

We formulate lattice theories in which chiral symmetry is realized nonlinearly on the fermion fields. In this framework the fermion mass term does not break chiral symmetry. This property allows us to use the Wilson term to remove the doubler fermions while maintaining exact chiral symmetry on the lattice. Our lattice formulation enables us to address non-perturbative questions in effective field theories of baryons interacting with pions and in models involving constituent quarks interacting with pions and gluons. We show that a system containing a non-zero density of static baryons interacting with pions can be studied on the lattice without encountering complex action problems. In our formulation one can also decide non-perturbatively if the chiral quark model of Georgi and Manohar provides an appropriate low-energy description of QCD. If so, one could understand why the non-relativistic quark model works.Comment: 34 pages, 2 figures, revised version to be published in J. High Energy Phys. (changes in the 1st paragraph, additional descriptions on the nature of the coordinate singularities in Sec.2, references added

Pharmacokinetic, neurochemical, stereological and neuropathological studies on the potential effects of paraquat in the substantia nigra pars compacta and striatum of male C57BL/6J mice

AbstractThe pharmacokinetics and neurotoxicity of paraquat dichloride (PQ) were assessed following once weekly administration to C57BL/6J male mice by intraperitoneal injection for 1, 2 or 3 weeks at doses of 10, 15 or 25mg/kg/week. Approximately 0.3% of the administered dose was taken up by the brain and was slowly eliminated, with a half-life of approximately 3 weeks. PQ did not alter the concentration of dopamine (DA), homovanillic acid (HVA) or 3,4-dihydroxyphenylacetic acid (DOPAC), or increase dopamine turnover in the striatum. There was inconsistent stereological evidence of a loss of DA neurons, as identified by chromogenic or fluorescent-tagged antibodies to tyrosine hydroxylase in the substantia nigra pars compacta (SNpc). There was no evidence that PQ induced neuronal degeneration in the SNpc or degenerating neuronal processes in the striatum, as indicated by the absence of uptake of silver stain or reduced immunolabeling of tyrosine-hydroxylase-positive (TH+) neurons. There was no evidence of apoptotic cell death, which was evaluated using TUNEL or caspase 3 assays. Microglia (IBA-1 immunoreactivity) and astrocytes (GFAP immunoreactivity) were not activated in PQ-treated mice 4, 8, 16, 24, 48, 96 or 168h after 1, 2 or 3 doses of PQ.In contrast, mice dosed with the positive control substance, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP; 10mg/kg/dose×4 doses, 2h apart), displayed significantly reduced DA and DOPAC concentrations and increased DA turnover in the striatum 7 days after dosing. The number of TH+ neurons in the SNpc was reduced, and there were increased numbers of degenerating neurons and neuronal processes in the SNpc and striatum. MPTP-mediated cell death was not attributed to apoptosis. MPTP activated microglia and astrocytes within 4h of the last dose, reaching a peak within 48h. The microglial response ended by 96h in the SNpc, but the astrocytic response continued through 168h in the striatum.These results bring into question previous published stereological studies that report loss of TH+ neurons in the SNpc of PQ-treated mice. This study also suggests that even if the reduction in TH+ neurons reported by others occurs in PQ-treated mice, this apparent phenotypic change is unaccompanied by neuronal cell death or by modification of dopamine levels in the striatum

AFM-Detected Apoptotic Changes in Morphology and Biophysical Property Caused by Paclitaxel in Ishikawa and HeLa Cells

The apoptosis of cancer cells is associated with changes in the important cell properties including morphology, surface roughness and stiffness. Therefore, the changes in morphology and biophysical properties can be a good way of evaluating the anticancer activity of a drug. This study examined the effect of paclitaxel on the properties of Ishikawa and HeLa cells using atomic force microscopy (AFM), and the relationship between the changes in morphology and the biophysical properties and apoptosis was discussed. The viability and proliferation of the cells were analyzed using the methylthiazol tetrazolium (MTT) method and a TUNEL assay to confirm cellular apoptosis due to a paclitaxel treatment. AFM observations clearly showed the apoptotic morphological and biophysical changes in Ishikawa and HeLa cells. After the paclitaxel treatment, the cell membrane was torn and holed, the surface roughness was increased, and the stiffness was decreased. These changes were observed more apparently after a 24 h treatment and in Ishikawa cells compared to HeLa cells. The MTT and TUNEL assays results revealed the Ishikawa cells to be more sensitive to paclitaxel than HeLa cells and definite apoptosis occurred after a 24 h treatment. These results showed good agreement with the AFM results. Therefore, research on the morphological and biophysical changes by AFM in cancer cells will help to evaluate the anticancer activities of the drugs