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.

Actor and partner effects of self-esteem on relationship satisfaction and the mediating role of secure attachment between the partners

We examined actor and partner effects of self-esteem on relationship satisfaction, using the actor-partner interdependence model and data from five independent samples of couples. The results indicated that self-esteem predicted the individual’s own relationship satisfaction (i.e., an actor effect) and the relationship satisfaction of his or her partner (i.e., a partner effect), controlling for the effect of the partner’s selfesteem. Gender, age, and length of relationship did not moderate the effect sizes. Moreover, using one of the samples, we tested whether secure attachment to the current partner (assessed as low attachment-related anxiety and avoidance) mediated the effects. The results showed that attachment-related anxiety and avoidance independently mediated both the actor and the partner effect of self-esteem on relationship satisfaction.

The adaptive power of the present: Perceptions of past, present, and future life satisfaction across the life span

Despite remarkable stability of life satisfaction across the life span, it may be adaptive to perceive change in life satisfaction. We shed new light on this topic with data from 766 individuals from three age groups and past, present, and future life satisfaction perceptions across the life span. On average, participants were most satisfied with their current life. When looking back, satisfaction increased from past to present, and when looking ahead, satisfaction decreased into the future. Trajectories were best fitted with a curvilinear growth model. Neuroticism and extraversion predicted the level of trajectories, but none of the Big Five predicted the slope. We conclude that humans have an adaptive capacity to perceive the present life as being the best possible.

How large are actor and partner effects of personality on relationship satisfaction? The importance of controlling for shared method variance

Previous research suggests that the personality of a relationship partner predicts not only the individual’s own satisfaction with the relationship but also the partner’s satisfaction. Based on the actor–partner interdependence model, the present research tested whether actor and partner effects of personality are biased when the same method (e.g., self-report) is used for the assessment of personality and relationship satisfaction and, consequently, shared method variance is not controlled for. Data came from 186 couples, of whom both partners provided self- and partner reports on the Big Five personality traits. Depending on the research design, actor effects were larger than partner effects (when using only self-reports), smaller than partner effects (when using only partner reports), or of about the same size as partner effects (when using self- and partner reports). The findings attest to the importance of controlling for shared method variance in dyadic data analysis.

Changes in situational and dispositional factors as predictors of job satisfaction

Arguably, job satisfaction is one of the most important variables with regard to work. When explaining job satisfaction, research usually focuses on predictor variables in terms of levels but neglects growth rates. Therefore it remains unclear how potential predictors evolve over time and how their development affects job satisfaction. Using multivariate latent growth modeling in a study with 1145 young workers over five years, we analyzed how well job satisfaction is predicted a) by levels of situational (i.e., job control) and dispositional (i.e., Core Self-Evaluations (CSE)) factors and b) by growth per year of these predictors. Results showed both intercepts and slopes to be related to each other, suggesting a joint growth of job control and CSE during early careers. Job satisfaction after five years was best predicted by the slopes of job control (β = .31, p < .001) and CSE (β = .34, p < .01). These findings provide further longitudinal evidence for the role of situational as well as dispositional factors for predicting job satisfaction. In addition, growth rates per year were better predictors than initial levels. Furthermore, a lack of change in job control or CSE went along with a drop in job satisfaction, implying that young workers need to perceive things to be improving in order to increase, or at least maintain, their level of job satisfaction. In terms of theory, the relative importance of levels versus changes deserves more attention. In terms of practical implications, our results suggest a double emphasis on job design (i.e., granting sufficient, and increasing, control) and on personal development (e.g., through training) so that people experience a match between both. Finally, negative associations between initial levels and growth rates suggest that people are quite successful in achieving a reasonable fit between their job characteristics and their needs and goals.

Changes in skill variety predict job satisfaction and psychosomatic complaints

Purpose Skill variety in terms of opportunities for utilizing different skills is an important element of job design; it is associated with well-being and health, but most pertinent research is cross-sectional. Positive associations with well-being, and with intellectual flexibility, have been shown longitudinally, but these studies focus on levels of skill variety at time 1 and do not use changes in skill variety as a predictor. We expect changes in skill variety to be associated with well-being in terms of higher job satisfaction and fewer psychosomatic complaints. Design/Methodology Skill variety, job satisfaction, and psychosomatic complaints were assessed in 2005, 2006, 2007, and 2010 (N = 317 young employees). Data were analyzed using latent growth modeling. Results Skill variety decreased over the first three years after labor market entry. Initial levels of skill variety predicted higher job satisfaction in 2010. Steeper decreases in skill variety from 2005 to 2007 predicted lower levels of job satisfaction and more psychosomatic complaints three years later. Limitations This longitudinal study used only self-report. Research/Practical Implications Our results extend the often found association between challenging work content and job satisfaction in terms of a) showing it for young employees, b) longitudinally, c) not only for initial level but also for changes, and d) for psychosomatic complaints; they underscore the importance of maintaining a high level of challenging work content beyond the initial phase by enriching work as routine increases. Originality/Value Compared to the few existing longitudinal studies, we focus on changes and their relations with well-being.

Envy on Facebook: a hidden threat to users’ life satisfaction?

The wealth of social information presented on Facebook is astound-ing. While these affordances allow users to keep up-to-date, they also produce a basis for social comparison and envy on an unprecedented scale. Even though envy may endanger users’ life satisfaction and lead to platform avoidance, no study exists uncovering this dynamics. To close this gap, we build on responses of 584 Facebook users collected as part of two independent studies. In study 1, we explore the scale, scope, and nature of envy incidents triggered by Face-book. In study 2, the role of envy feelings is examined as a mediator between intensity of passive following on Facebook and users’ life satisfaction. Con-firming full mediation, we demonstrate that passive following exacerbates envy feelings, which decrease life satisfaction. From a provider’s perspective, our findings signal that users frequently perceive Facebook as a stressful environ-ment, which may, in the long-run, endanger platform sustainability.

Longitudinal Relationship of Low Leisure Satisfaction but not Depressive Symptoms With Systemic Low-Grade Inflammation in Dementia Caregivers.

Objectives.This study aimed to further elucidate the biobehavioral mechanisms linking dementia caregiving with an increased cardiovascular disease risk. We hypothesized that both elevated depressive symptoms and a behavioral correlate of depression, low leisure satisfaction, are associated with systemic inflammation.Method.We studied 121 elderly Alzheimer's disease caregivers who underwent 4 annual assessments for depressive symptoms, leisure satisfaction, and circulating levels of inflammatory markers. We used mixed-regression analyses controlling for sociodemographic and health-relevant covariates to examine longitudinal relationships between constructs of interest. RESULTS: There were inverse relationships between total leisure satisfaction and tumor necrosis factor-α (TNF-α; p = .047), interleukin-8 (IL-8; p < .001), and interferon-γ (IFG; p = .020) but not with IL-6 (p = .21) and C-reactive protein (p = .65). Lower enjoyment from leisure activities was related to higher levels of TNF-α (p = .045), IL-8 (p < .001), and IFG (p = .002), whereas lower frequency of leisure activities was related only to higher IL-8 levels (p = .023). Depressive symptoms were not associated with any inflammatory marker (all p values > .17). Depressive symptoms did not mediate the relationship between leisure satisfaction and inflammation.Discussion.Lower satisfaction with leisure activities is related to higher low-grade systemic inflammation. This knowledge may provide a promising way of improving cardiovascular health in dementia caregivers through behavioral activation treatments targeting low leisure satisfaction.

Does the importance of parent and peer relationships for adolescents' life satisfaction vary across cultures?

This study investigated whether the associations between (a) the quality of the parent-child relationship and peer acceptance and (b) early adolescents’ life satisfaction differed depending on the importance of family values in the respective culture. As part of the Value of Children Study, data from a sub-sample of N = 1,034 adolescents (58% female, M age = 13.62 years, SD = 0.60 years) from 11 cultures was analyzed. Multilevel analyses revealed a positive relation between parental admiration and adolescents’ life satisfaction independent of cultural membership. Further, the higher the importance

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).

The Family Preservation Philosophy and Therapy With Lesbian Clients

Family preservation is generally viewed in terms of a rather narrow practice definition. However, it's underlying philosophy offers a strong framework for building a positive, nonbiased helping alliance with lesbian clients in a therapeutic setting. The family preservation philosophy offers a unique heuristic for helping professionals to work with lesbians. Family preservation values teach that the therapist must start with the client's reality, recognize the particular needs of that client, and use the client's strengths in treatment. Also inherent in this perspective is respect and sensitivity to the lesbian client's "cultural context, experience, and history" (Family Preservation Institute, 1995). In other words, in the family preservation philosophy there is no assumption of heterosexuality in the therapeutic relationship; rather there is an assumption of unconditional positive regard. Further, clients are engaged in a dialogue and encouraged to name the challenges they encounter in their own words, from their own perspective. All of these principles will help empower lesbian clients. Lesbians may avoid traditional mental health services in times of need, preferring to depend on alternative services or friendship support networks. The choice not to seek help through mainstream agencies may be based on previous negative experience or on an assumption of the homophobic attitudes which are often inherent in such services. Traditional services are usually based on the medical model. Services based on the family preservation philosophy, however, have the capability of creating therapeutic relationships in which there is no assumption of heterosexuality, where the lesbian client is respected and viewed as a whole, healthy individual.

Measuring Consumer Satisfaction in Family Preservation Services: Identifying Instrument Domains

Measuring consumer satisfaction in the social services has become an important source of feedback for the improvement of service delivery. Consumer satisfaction has recently been incorporated into family preservation evaluation. This article reviews instruments used to measure consumer satisfaction in family preservation services and other related areas. Trends in current practice are examined and instrument dimensions are identified. Finally, some recommendations are made about the application of consumer satisfaction measurement in family preservation services.

A study of patient satisfaction with medical care services in Yanbu al-Sinaiya, Saudi Arabia

This study attempts to provide reliable scientific data that will enable the health services department of the Royal Commission of Yanbu Al Sinaiyah, Saudi Arabia to improve the quality of health care services provided in their facilities. Patient satisfaction and dissatisfaction were investigated along seven dimensions: General satisfaction scale, Communication, Technical quality, Art of care, Continuity of care, Time spent with the doctor, and Access/Convenience/ and availability. Patient satisfaction parameters were compared for Saudi vs. non-Saudi, males vs. females, and for patients seen in the hospital vs. those seen in Al-nawa and Radwa primary care centers. The information was obtained by using a self-administered questionnaire. The results indicate that patients seen in Al-nawa primary care center were more satisfied with care than patients seen in the hospital who in turn were more satisfied than those seen in Radwa primary care center. The non-Saudi patients were more satisfied than the Saudi patients across all three facilities and satisfaction scales. The female patients were more satisfied than the male patients across all three facilities and satisfaction scales. ^