Comparison of performance and patient satisfaction of two types of ERG electrodes

BACKGROUND: An age-controlled comparison concerning patient satisfaction and electrical performance of microfibres (DTL) and rigid contact lens (Henkes) corneal ERG electrodes was carried out. METHODS: 36 test persons underwent complete ophthalmological examination and were equally distributed into 3 age groups. Electroretinograms were recorded according to ISCEV standards. Randomly, in one eye a Henkes electrode was used and in the other eye a DTL electrode. Amplitudes of a- and b-waves and implicit times were measured and compared for the two electrode types. RESULTS: 34 of 36 test persons preferred DTL electrodes. Electrical performance concerning b-wave amplitudes was comparable. Statistically significant differences were detected only for scotopic combined cone-rod stimulation in the age groups 20 - 40 and 41 - 60 years between the different electrodes. Other recordings did not show differences. A statistically significant reduction of signal amplitudes with age was detected for scotopic isolated rod signals and combined cone-rod signals. Significance level was p < 0.05. No conjunctival or corneal erosions were found after ERG recordings for either electrode. CONCLUSIONS: Electrical performance is comparable between electrodes. For scotopic stimulations age was a significant influencing factor for signal amplitude and should be respected for normative values. DTL electrodes were preferred by the vast majority of patients. No adverse clinical effects were observed for either electrode. DTL electrodes should be preferred due to hygienic reasons (single use) and patient comfort.

Outcome and patients' satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices

BACKGROUND: In some Western countries, more and more patients seek initial treatment even for minor injuries at emergency units of hospitals. The initial evaluation and treatment as well as aftercare of these patients require large amounts of personnel and logistical resources, which are limited and costly, especially if compared to treatment by a general practitioner. In this study, we investigated whether outsourcing from our level 1 trauma center to a general practitioner has an influence on patient satisfaction and compliance. METHODS: This prospective, randomized study, included n = 100 patients who suffered from a lateral ankle ligament injury grade I-II (16, 17). After radiological exclusion of osseous lesions, the patients received early functional treatment and were shown physical therapy exercises to be done at home, without immobilization or the use of stabilizing ortheses. The patients were randomly assigned into two groups of 50 patients each: Group A (ER): Follow-up and final examination in the hospital's emergency unit. Group B (GP): Follow-up by general practitioner, final examination at hospital's emergency unit. The patients were surveyed regarding their satisfaction with the treatment and outcome of the treatment. RESULTS: Female and male patients were equally represented in both groups. The age of the patients ranged from 16 - 64 years, with a mean age of 34 years (ER) and 35 years (GP). 98% (n = 98) of all patients were satisfied with their treatment, and 93% (n = 93) were satisfied with the outcome. For these parameters no significant difference between the two groups could be noted (p = 0.7406 and 0.7631 respectively). 39% of all patients acquired stabilizing ortheses like ankle braces (Aircast, Malleoloc etc.) on their own initiative. There was a not significant tendency for more self-acquired ortheses in the group treated by general practicioners (p = 0,2669). CONCLUSION: Patients who first present at the ER with a lateral ankle ligament injury grade I-II can be referred to a general practitioner for follow-up treatment without affecting patient satisfaction regarding treatment and treatment outcome.

CHANGE FOR GOOD? AN ASSESSMENT OF THE DISCONNECT BETWEEN PERCEIVED BENEFITS BY ENGOS AND USER SATISFACTION OF SOLAR BOTTLE LIGHTS IN INFORMAL SETTLEMENTS OF DHAKA CITY, BANGLADESH

A major challenge for a developing country such as Bangladesh is to supply basic services to its most marginalized populations, which includes both rural and urban dwellers. The government struggles to provide basic necessities such as water and electricity. In marginalized urban communities in Bangladesh, in particular informal settlements, meeting basic needs is even direr. Most informal settlements are built to respond to a rapid immigration to urban centers, and are thought of as ‘temporary structures’, though many structures have been there for decades. In addition, as the settlements are often squatting on private land, access to formalized services such as electricity or water is largely absent. In some cases, electricity and water connections are brought in - but through informal and non-government sanctioned ways -- these hookups are deemed ‘illegal’ by the state. My research will focus on recent efforts to help ameliorate issues associated with lack of basic services in informal settlements in Bangladesh – in this case lack of light. When the government fails to meet the needs of the general population, different non-government organizations tend to step in to intervene. A new emphasis on solar bottle systems in informal urban settlement areas to help address some energy needs (specifically day-time lighting). One such example is the solar bottle light in Bangladesh, a project introduced by the organization ‘Change’. There has been mixed reactions on this technology among the users. This is where my research intervenes. I have used quantitative method to investigate user satisfactions for the solar bottle lights among the residents of the informal settlements to address the overarching question, is there a disconnect between the perceived benefits of the ENGO and the user satisfaction of the residents of the informal settlements of Dhaka City? This paper uses survey responses to investigate level of user satisfaction and the contributing factors.

Theory and Practice: A Matter of Words. Language, Knowledge and Professional Community in Social Work

The relation between theory and practice in social work has always been controversial. Recently, many have underlined how language is crucial in order to capture how knowledge is used in practice. This article introduces a language perspective to the issue, rooted in the ‘strong programme’ in the sociology of knowledge and in Wittgenstein’s late work. According to this perspective, the meaning of categories and concepts corresponds to the use that concrete actors make of them as a result of on-going negotiation processes in specific contexts. Meanings may vary dramatically across social groups moved by different interests and holding different cultures. Accordingly, we may reformulate the issue of theory and practice in terms of the connections between different language games and power relationship between segments of the professional community. In this view, the point is anyway to look at how theoretical language relates to practitioners’ broader frames, and how it is transformed while providing words for making sense of experience.

The Deprofessionalisation Thesis, Accountability and Professional Character

It is said that the deprofessionalisation of social work and other welfare occupations reduces workers' professional discretion and autonomy, and thus their capacity to act in the best interests of their client. Without necessarily regarding the deprofessionalisation thesis as conclusive, this paper will ask how the state's control of the role and task of social workers impacts on their role-implicated obligations as professionals. If workers are reduced (as claimed) to the status of mere functionaries in systems they neither approve of nor control, does this exonerate them from bad outcomes or service failures? How should we view the dramatic increase in formal regulation now seen in the UK - as professionalisation or deprofessionalisation? The paper will argue that whatever the drift of policy, workers remain in some measure personally accountable. Service failures imply faults of practical reason that are partly attributable to the moral and intellectual character of professionals as individuals. It is therefore up to professionals, and their organisations, to attend to the improvement of professional character.

Transition from nerve stimulator to sonographically guided axillary brachial plexus anesthesia in hand surgery: block quality and patient satisfaction during the transition period

OBJECTIVES Sonographic guidance for peripheral nerve anesthesia has proven increasingly successful in clinical practice; however, fears that a change to sonographically guided regional anesthesia may impair the block quality and operating room work flow persist in certain units. In this retrospective cohort study, block quality and patient satisfaction during the transition period from nerve stimulator to sonographic guidance for axillary brachial plexus anesthesia in a tertiary referral center were investigated. METHODS Anesthesia records of all patients who had elective surgery of the wrist or hand during the transition time (September 1, 2006-August 25, 2007) were reviewed for block success, placement time, anesthesiologist training level, local anesthetic volume, and requirement of additional analgesics. Postoperative records were reviewed, and patient satisfaction was assessed by telephone interviews in matched subgroups. RESULTS Of 415 blocks, 341 were sonographically guided, and 74 were nerve stimulator guided. Sonographically guided blocks were mostly performed by novices, whereas nerve stimulator-guided blocks were performed by advanced users (72.3% versus 14%; P < .001). Block performance times and success rates were similar in both groups. In sonographically guided blocks, significantly less local anesthetics were applied compared to nerve stimulator-guided blocks (mean ± SD, 36.1 ± 7.1 versus 43.9 ± 6.1 mL; P< .001), and less opioids were required (fentanyl, 66.1 ± 30 versus 90 ± 62 μg; P< .001). Interviewed patients reported significantly less procedure-related discomfort, pain, and prolonged procedure time when block placement was sonographically guided (2% versus 20%; P = .002). CONCLUSIONS Transition from nerve stimulator to sonographic guidance for axillary brachial plexus blocks did not change block performance times or success rates. Patient satisfaction was improved even during the early institutional transition period.

Religiosity, family orientation, and life satisfaction of adolescents in four countries

This study examined the rarely investigated interplay between religiosity, family orientation, and life satisfaction of adolescents across four countries with a Christian tradition and different religious contexts.A mediation relationship between religiosity and life satisfaction through family orientation moderated by the country context of religiosity was examined. In a sample of 1,077 adolescents from France (n = 172), Germany (n = 270), Poland (n = 348), and the United States (n = 287), we found that in all cultures, religiosity had a positive impact on adolescents’ family orientation, which was in turn related to a higher life satisfaction.This link was stronger in cultures with a high overall religiosity (Poland and the United States) as compared to one of the two cultures with the lowest importance of religion (Germany).

Development of self-esteem and relationship satisfaction in couples: Two longitudinal studies

We examined the effects of self-esteem development on the development of relationship satisfaction in 2 samples of couples. Study 1 used data from both partners of 885 couples assessed 5 times over 12 years, and Study 2 used data from both partners of 6,116 couples assessed 3 times over 15 years. The pattern of results was similar across the 2 studies. First, development of relationship satisfaction could be modeled as a couple-level process. Second, initial level of self-esteem of each partner predicted the initial level of the partners’ common relationship satisfaction, and change in self-esteem of each partner predicted change in the partners’ common relationship satisfaction. Third, these effects did not differ by gender and held when controlling for participants’ age, length of relationship, health, and employment status. Fourth, self-esteem similarity among partners did not influence the development of their relationship satisfaction. The findings suggest that the development of self-esteem in both partners of a couple contributes in a meaningful way to the development of the partners’ common satisfaction with their relationship.

Hope as a resource for self-directed career management: Investigatiing mediating effects on proactive career behaviors, life and job satisfaction

ABSTRACT Hope is increasingly recognized as an important psychological resource for career development, yet the empirical research on its functioning in this domain is sparse. This paper describes an investigation of how dispositional hope is related to career decidedness, career planning, and career self-efficacy beliefs and whether these more proximal career attitudes mediate the effects of hope on proactive career behaviors, life satisfaction, and job satisfaction. This investigation was conducted using two independent samples of university students (N = 1,334) and working professionals (N = 233). The results showed that in both samples, hope was significantly related but empirically distinct from career variables. In both samples, hope had a direct effect on proactive career behaviors, partially mediated by more career planning. Hope had significant direct and indirect effects on life satisfaction among students, mediated by the three career development attitudes. Although hope was significantly correlated with job satisfaction among employees, no direct effect of hope was found in the mediation model, but an indirect effect through career decidedness was found. The results suggest that hope is an important resource for proactive career development at different career stages and that the positive relation of hope to life and job satisfaction can partially be attributed to the positive relation between hope and favorable career development attitudes.

Vocational identity achievement as a mediator of presence of calling and life satisfaction

The present study explores what mechanism might be responsible for the reported link between presence of a calling in one’s career and life satisfaction. It is proposed that vocational identity achievement acts as one important mediator of this relation and that the effects can be observed even when controlling for core self-evaluations (CSEs). The study used a short-term longitudinal design based on a sample of 269 German college students from different majors. The results confirmed the mediation model, with calling predicting vocational identity achievement 6 months later and identity serving as a stronger predictor of life satisfaction, all controlling for CSEs. However, contrary to previous research, presence of calling was not directly related to life satisfaction and even showed a negative relation when vocational identity achievement was controlled. The results are interpreted to suggest a multifaceted relation between calling and life satisfaction.

Vocational indentity as a mediator of the relationship between core self-evaluations and life and job satisfaction

This study investigated whether vocational identity achievement mediates the relation between basic personality dispositions (i.e. core self-evaluations) and career and well-being outcomes in terms of job and life satisfaction. Two studies with Swiss adolescents were conducted. Study 1 (N= 310) investigated students in eighth grade, prior to making the transition to vocational education and training (VET); it showed that vocational identity related positively to life satisfaction but that this relationship disappeared once core self-evaluations were controlled. Study 2 (N= 150) investigated students in their second year of VET; it showed that job satisfaction was unrelated to identity and self-evaluations. However, identity fully mediated the relation between self-evaluations and life satisfaction.