The impact of anonymity on psychiatric patients' ratings of satisfaction with the initial evaluation.

BACKGROUND: Preserving anonymity is believed to yield more honest appraisals of patient satisfaction, although the data addressing this issue are sparse. The goal of this study from the Rhode Island Methods to Improve Diagnostic Assessment and Services project was to determine the impact of anonymity on patient satisfaction ratings after the initial evaluation. METHODS: The Clinically Useful Patient Satisfaction Scale (CUPSS) is a brief, self-administered questionnaire assessing patients' satisfaction with the initial evaluation. Every 2 to 3 months, we switched from anonymous to non-anonymous completion of the CUPSS. More than 1,300 patients completed the scale (729 anonymous, 603 non-anonymous). RESULTS: Anonymity was not associated with scores on the scale. In both the anonymous and non-anonymous conditions, the CUPSS had high internal consistency, all item-scale correlations were significant, and all items were significantly correlated with global satisfaction ratings. There was sufficient variability in satisfaction ratings to detect differences among clinicians. CONCLUSIONS: Anonymity was not associated with patient satisfaction ratings, did not affect the psychometric properties of the scale, and did not compromise the scale's ability to discriminate among clinicians. That is, anonymity did not affect the reliability or validity of satisfaction ratings.

A clinically useful self-report measure of psychiatric patients' satisfaction with the initial evaluation.

Patient satisfaction is one component of the quality of care. Studies of satisfaction in samples of established patients are biased because dissatisfied patients are more likely to have dropped out of treatment. We, therefore, sought to develop a new instrument assessing patients' satisfaction with the initial psychiatric evaluation. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project we describe the development, reliability, and validity of the Clinically Useful Patient Satisfaction Scale (CUPSS). The CUPSS is a brief, self-administered questionnaire covering 3 areas: clinician's attitude and behavior, office environment and staff, and overall satisfaction. A sample of psychiatric outpatients (n=412) and partial hospital patients (n=500) completed the measure immediately after their initial meeting with the psychiatrist. The scale had high internal consistency, and all item-scale correlations were significant. All items were significantly correlated with each of the indicators of global satisfaction. There was sufficient variability in satisfaction ratings to detect differences amongst clinicians. The results of the present study of psychiatric outpatients and partial hospital patients indicate that the CUPSS was minimally to not at all burdensome to complete, it had good psychometric properties, and it can discriminate amongst clinicians.

An acetylated polysaccharide-PTFE membrane-covered stent for the delivery of gemcitabine for treatment of gastrointestinal cancer and related stenosis.

Gemcitabine (Gem) eluting metal stents were prepared for potential application as drug delivery systems for localized treatment of malignant tumors. Pullulan, a natural polysaccharide, was chemically acetylated (pullulan acetate; PA) by different degrees (1.18, 1.71, and 2.10 acetyl groups per glucose unit of pullulan), layered on polytetrafluoroethylene (PTFE), and applied as part of a Gem-loaded controlled-release membrane for drug-eluting non-vascular stents. PA with a higher degree of acetylation had greater drug-loading capacity with more extended release of Gem over 30 days. The released Gem accumulated in CT-26 colon cancer without systemic exposure inducing total regression of tumors. The long-term biological activity of the released Gem and apoptosis of tumor tissues following localized delivery were confirmed by annexin V binding assays and histology. The controlled release of Gem from PA-PTFE covered drug-eluting stents (DES) may increase the patency of these stents for the treatment of malignant gastrointestinal cancer as well as cancer-related stenosis.

Bone morphogenic protein-2 (BMP-2) loaded nanoparticles mixed with human mesenchymal stem cell in fibrin hydrogel for bone tissue engineering.

Recent tissue engineering efforts have been focused on the use of natural or synthetic matrices which combine the characteristics of biodegradable properties with those of protein delivery vehicles, allowing for implanted cell actions and enhanced tissue regeneration. The principal objective of this study was to assess the feasibility of ectopic bone formation in a three-dimensional fibrin construct mixed with bone morphogenic protein-2 (BMP-2) loaded in nano-carriers for the osteogenic differentiation of human mesenchymal stem cells (hMSCs). The results of our evaluation showed that the osteogenic differentiation of hMSCs embedded in the fibrin construct was affected significantly by the stimulation of growth factors loaded in nanoparticles. When the osteoinduction activity of hMSCs in fibrin construct was evaluated in an in vitro test followed by RT-PCR, real time-QPCR, Western blotting, histological and immunohistochemical examinations, significant homogeneous bone formation was observed histologically throughout the fibrin construct containing the growth factor (BMP-2) loaded into the nanoparticles. With the above detection techniques, the BMP-2-loaded nanoparticles encapsulated in fibrin constructs evidenced more potent effects of hMSCs on bone regeneration as compared to the control or BMP-2 loaded fibrin constructs without nanoparticles. In the current study, we conclude that fibrin constructs containing BMP-2 loaded nanoparticles will be a promising method by which bone regeneration can be enhanced.