Impact of patient and family communication in a pediatric emergency department on likelihood to recommend.

OBJECTIVE: Identify the specific patient experience variables that most strongly predict satisfaction as measured by the likelihood to recommend rating. METHODS: We performed a retrospective analysis of a patient satisfaction survey distributed to patients during their visit to an academic children's hospital emergency department (ED) during a 3-month period. Any incomplete or incorrectly completed surveys were excluded. The associations between staff communication variables and "likelihood to recommend" were assessed while controlling for daily ED flow data. RESULTS: A total of 3135 surveys were completed with 825 (26%) excluded for incomplete or incorrect entry. After controlling for daily census, median daily wait time and median daily length of stay, the communication question that asks if the nurse or physician kept them informed while in the examination room had the strongest association (odds ratio, 12.2; 95% confidence interval, 9.3-16.1; P < 0.001), with the response of "always" likely to recommend this ED. CONCLUSIONS: This study demonstrates that keeping patients and their families informed has a more positive effect on patient satisfaction than any other variable studied even in the setting of increased census and wait times.

Bipolar Disorder and the TCI: Higher Self-Transcendence in Bipolar Disorder Compared to Major Depression.

Personality traits are potential endophenotypes for genetic studies of psychiatric disorders. One personality theory which demonstrates strong heritability is Cloninger's psychobiological model measured using the temperament and character inventory (TCI). 277 individuals who completed the TCI questionnaire as part of the South Island Bipolar Study were also interviewed to assess for lifetime psychiatric diagnoses. Four groups were compared, bipolar disorder (BP), type 1 and 2, MDD (major depressive disorder), and nonaffected relatives of a proband with BP. With correction for mood state, total harm avoidance (HA) was higher than unaffected in both MDD and BP groups, but the mood disorder groups did not differ from each other. However, BP1 individuals had higher self-transcendence (ST) than those with MDD and unaffected relatives. HA may reflect a trait marker of mood disorders whereas high ST may be specific to BP. As ST is heritable, genes that affect ST may be of relevance for vulnerability to BP.

Electronic dispersion pre-compensation for 10.709-Gb/s using a look-up table and a directly modulated laser.

A novel electronic dispersion pre-compensation scheme for a directly modulated laser is described and experimentally demonstrated for transmission distances beyond 200 km using a low-cost laser packaged for 2.5-Gb/s while operated at 10.709-Gb/s. A single look-up-table (LUT) for the drive current is designed to mitigate the effects of fiber dispersion, the intrinsic nonlinear modulation response of the laser, and the laser package. Experimental results show that an 11-bit LUT can compensate the dispersion of 202 km of standard single mode fiber with a required optical-signal-to-noise-ratio of 18.61 dB at a bit error ratio of 3.8 × 10(-3).