Global Satisfaction Scale Research Articles

Lip Feminization and Rejuvenation in Patients Assigned Male at Birth With Gender Dysphoria: Our 27-year Experience.

Despite the increasing demand, the combination of lip feminization and rejuvenation in patients assigned male at birth with gender dysphoria is rarely reported in the medical literature. We present our 27 years of experience performing these procedures in this patient population. All patients assigned male at birth with gender dysphoria from 1997 to 2023 were included and grouped into 4 age categories. Combined surgical procedures were performed to achieve lip rejuvenation and feminization, with detailed descriptions of the techniques used. Results were evaluated three months postsurgery using the Global Aesthetic Improvement Scale and the Global Satisfaction Scale. Complications and outcomes were documented, and statistical analysis was conducted to compare the differences between the results obtained. During a 27-year period, 988 patients underwent 1789 procedures. Of these, 79.8% were younger than 50 years, with the largest group being between 20 and 35 years (47.6%). However, patients older than 65 had the highest average number of procedures (2.4 per patient). The results showed a high degree of improvement and satisfaction on both evaluated scales. There were only 2 hematomas, both resolved without incident. The main issues were volume loss after fat infiltration (14.3%) and poorly positioned scars in lip lifts (13.2%). Surgical procedures to feminize and rejuvenate lips can be combined in patients assigned male at birth with gender dysphoria, achieving highly satisfactory results, high patient satisfaction, and few complications.

Pilot Study: Single-depth Superficial Ultrasound with Subdermal Injections of Diluted Calcium Hydroxylapatite for Improving Lower Face Skin Quality.

The lower face can be challenging to treat. We assessed the effectiveness of combining single-depth superficial microfocused ultrasound with visualization (MFU-V, Ultherapy; Merz North America, Inc. Raleigh, N.C.) and subdermal injections of diluted calcium hydroxylapatite (CaHA, Radiesse; Merz North America, Inc. Raleigh, N.C.) in a single session for improving skin quality in the lower face. This study enrolled women with moderate-to-severe fine lines and skin unevenness on the lower face who desired nonsurgical intervention. Single-depth MFU-V treatment (10 MHz/1.5 mm) was followed by subdermal injections of diluted (1:1) CaHA. Subjects were followed up for 24 weeks posttreatment. Objective skin quality assessments (Rv: wrinkle depth; R3z: skin unevenness) were performed using LifeViz Micro (QuantifiCare, Sophia Antipolis, France). Subjective assessments included the modified Fitzpatrick Wrinkle Scale visual analog scale, Global Aesthetic Improvement Scale, and global satisfaction scale. Twelve subjects completed the study. The mean Rv value, mean R3z value, and mean modified Fitzpatrick Wrinkle Scale visual analog scale score improved significantly from baseline to week 24 (mean differences: -0.0321 mm, -0.0684 mm, -1.1667; all P < 0.001). All subjects were rated by the investigators as having demonstrated improvement in their overall aesthetic appearance as early as week 4. All subjects were "very satisfied" or "satisfied" with their treatment from week 12 onwards. No unexpected adverse events were reported. Combination treatment with single-depth superficial MFU-V and diluted CaHA in a single session significantly improved lower facial skin quality, as assessed by both objective and subjective outcome measures.

Subchondroplasty® (SCP) Provides Resolution of Symptoms and Functional Improvements in Mild-to-Moderate Knee Osteoarthritis with Persistent Bone Marrow Lesions: 12-Month Follow-Up Results from a Multicentric Open-Label Prospective Clinical Trial.

Introduction. Bone marrow lesions (BMLs) are MRI-visible subchondral bone alterations, highly correlated with symptoms in the knee. Subchondroplasty (SCP) is able to fill the subchondral defects associated with BMLs using an injectable bone substitute material. The aim of the present study is to evaluate the 12-month outcomes of the SCP in the treatment of symptoms of mild-to-moderate knee osteoarthritis (OA) patients with persistent BMLs of the knee. Materials and Methods. Subjects affected by BMLs of the femoral condyle or tibial plateau that were present for >3 months and not responsive to conservative treatments were enrolled in this prospective multicenter trial. All the patients underwent SCP. Follow-up was conducted at 1, 3, 6 and 12 months. All subjects completed Numerical Rating Scale (NRS) for pain, Knee Injury and Osteoarthritis Outcome (KOOS) score, Euro Quality of life-5 dimensions (EQ-5D) score, and a subject global satisfaction scale. Demographic information of the patients was also collected. Results. A total of 79 patients completed the 12-month follow-up. Statistically significant improvements on all clinical scales were registered from baseline to the 12-month follow-up. No severe adverse events were reported. Four patients were considered failed. A 12-month subgroup analysis was performed to evaluate the possible correlation between all the KOOS subscales and age, gender, number of BMLs, location of BMLs, and Kellgren-Lawrence grade: no statistically significant associations were observed. Conclusion. SCP is a safe and effective procedure for the treatment of symptoms related to persisting BMLs in mild-to-moderate osteoarthritic knees, with a low failure rate up to 12 months' evaluation.

Intense Pulsed Light (IPL) for thetreatment of vascular and pigmented lesions.

IPL devices emit a wide range of wavelengths that can be absorbed by different chromophores in the skin. Selective destruction of a specific chromophore with minimal side effects is controlled by wavelength, pulse duration, and fluence. This study aims to evaluate the treatment of vascular and pigmented lesions using narrow-band Intense Pulsed Light (IPL) with Advanced Fluorescence Technology (AFT), which offers more efficient energy usage per pulse to increase safety, and improve clinical outcomes. A retrospective analysis of data from 100 patients treated with narrow-band IPL for vascular and pigmented lesions. Efficacy was measured by the Global Aesthetic Improvement Scale (GAIS) and Patient Satisfaction Scale (0-10). Safety was assessed by evaluating pain levels and adverse events. Mean GAIS scores were 8.02 ± 0.84 for vascular and 8.14 ± 0.9 for pigmented lesions with no significant difference between groups (p=0.49, α=0.05). Patient satisfaction correlated with GAIS scores (correlation coefficient 0.8). No pain was reported and two patients experienced temporary and transient side effects. Overall, the advanced IPL treatments provided favorable outcomes for vascular and pigmented lesions.

Satisfaction and quality of palliative care in patients with outpatient treatment in a level III health care facility Lima

In the field of health, it is closely related to the demand for prompt, timely and responsive care during professional practice. This study seeks to determine the relationship between satisfaction and quality of palliative care in patients with outpatient treatment in a level III health facility in Lima, Lima, 2023. This research has a quantitative approach, non-experimental design, correlational and cross-sectional type. The population will be made up of 100 patients in the oncology area with outpatient treatment over 18 years of age, the type of sampling is non-probabilistic by convenience. The collection instruments were applied 2 instruments. Global satisfaction scale and the palliative care quality scale consisting of 4 dimensions: Physical support, psychological support, social support, spiritual support. The instruments reveal to have a validity evidence between 0.923 and 0.915 which indicates that they are ideal to be applied and collect relevant information for the study report

YOGA, TAI CHI, AND PILATES AND FAMILY CAREGIVERS’ SUBJECTIVE WELL-BEING: FINDINGS FROM MIDUS

Abstract Being an informal caregiver has been associated with stress and lower levels of subjective well-being. Exercise/movement therapy techniques of yoga, tai chi, and Pilates are physical activities that also incorporate stress reducing practices. The current study aimed to examine the association of exercise/movement therapy techniques on family caregivers’ subjective well-being assessed by life satisfaction and mindfulness. Participants were part of the Midlife in the United States (MIDUS) study (wave 2, N = 507 aged 35-86 years; Mage = 56±11, 68% women) who provided informal care in the past 12 months. We recoded the aforementioned exercise/movement therapy activities into three categories, based on the distributions in MIDUS, including regular practice (defined as participating in one or more of them “a lot” or “often”), irregular practice (participating “sometimes” and “rarely”), and no practice (“never”). Subjective well-being was measured using the 5-item global life satisfaction scale and the 9-item mindfulness scale. We considered sociodemographic factors and health as covariates. We used multivariate linear regression models to examine associations between practice and caregivers’ subjective well-being. After controlling for covariates, the findings indicated that regular practice was associated with both better mindfulness-related well-being (b = 2.26, p &amp;lt; .05) and better life satisfaction (b = 0.43, p &amp;lt; .05). Future research should examine whether there is a selection effect of caregivers with higher well-being being more likely to choose these activities, and/or if exercise/movement therapies are effective non-pharmacological interventions to improve family caregivers’ overall quality of life.

Treatment satisfaction of patients with psoriasis with topical therapy in a real-world setting: unmet need for higher effectiveness

BackgroundTopical medication is the mainstay for treatment of mild psoriasis. However, dissatisfaction with topicals is common and rates of non-adherence are high. Assessing patients’ perspectives can help to identify unmet needs.ObjectiveOur aim was to investigate satisfaction of patients with psoriasis with topical therapy and to determine influencing factors.MethodsPatients were recruited from the Department of Dermatology, University Medical Center Mannheim, Germany. Satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication version 1.4 with the domains effectiveness, side effects, convenience, and global satisfaction (scale 0–100 each). The impact of sociodemographic and disease characteristics was determined by multivariate regression.ResultsAveraged across the cohort (n = 122, mean age 52.5 years, 58.2% male), the side effects domain had the highest mean satisfaction score (89.7), followed by convenience (72.5), global satisfaction (60.8), and effectiveness (55.0). Comparing specific medications, combinations of corticosteroids and vitamin D analogues were rated best in effectiveness. Treatment satisfaction was influenced by age, partnership, ability to apply topicals independently, disease-related quality-of-life impairment, sole or adjunctive use of topicals and pruritus.ConclusionsParticipants were particularly satisfied with safety but rather dissatisfied with effectiveness of topicals. Topical therapy should be adapted to individual needs with special attention to effectiveness.

Efficacy and safety evaluation of Shatavari Gudam and Triphala Kashaya in leucorrhoea (Shwetapradara) – A study protocol of an open-label, multicenter, interventional, single-arm trial

BACKGROUND: In the classical text of Ayurveda, formulations Shatavari Gudam (SG) and Triphala Kashaya (TK) are indicated to treat Shwetapradara. The disease Shwetapradara can be correlated to leucorrhoea based on the similar symptom, painless, white-colored discharge from the vagina. SG is a formulation containing Shatavari (Asparagus racemosus) as a main ingredient. Several studies indicate Shatavari as a tonic for reproductive tract-related diseases. The external use of Triphala has anti-inflammatory, antiseptic, and anti-bacterial actions. The present article is a clinical study protocol on the efficacy and safety evaluation of SG and TK in leucorrhoea (Shwetapradara). MATERIALS AND METHODS: It will be a multicenter, prospective single-arm study planned to be conducted at Regional Ayurveda Research Institute, Thiruvananthapuram, Regional Ayurveda Research Institute Nagpur, National Ayurveda Research Institute for Panchakarma, Cheruturthy and Regional Ayurveda Research Institute Vijayawada. One hundred sixty participants will be recruited for the trial (40 from each center). In the dose of 6gm, SG will be administered twice daily with lukewarm water after food. Vaginal douche will be done with TK for seven days in two consecutive cycles. The primary outcome will be change in the quantity of white discharge using visual analog scale. The secondary outcome will be change in other associated symptoms like pruritis vulva, lower abdominal pain, low back ache, burning micturition, and dyspareunia using the Visual Analogue Scale; change in the Quality of life and well-being by PGWBI score; change in Score of Investigator’s Global Satisfaction Scale, and changes in Patient’s Global Satisfaction Scale from baseline to final visit. Clinical/biochemical assessments will determine the safety and tolerability of the formulation during the follow-ups. Compared with the baseline, the efficacy of interventions on the 84th and 98th day, will be assessed with Paired t-test. Data will be analyzed using SPSS 15.0 software. ETHICS AND DISSEMINATION: The IEC clearance has been obtained from each participating institute. After completion of the trial, the outcome will be disseminated through peer-reviewed journals for publication.

Happily Ever After or Not? Marital Quality among Culturally Diverse Older-Aged Canadian Parents

The quality of partnered relationships is integral to individual and family health and well-being over the life span. Significant shifts in ethno-cultural diversity, parental roles, and family life contribute to more complex partnership experiences in North American society. Drawing from a socio-cultural life course lens, we examine parental marital satisfaction/quality in later life in terms of ethnicity, socio-demographic variables (e.g., ethnic identity, gender, age, health status) and family context (e.g., presence of children at home, intergenerational relations, retirement status). Data are drawn from a sample of 454 married/partnered adults aged 50+ with a least one child aged 19–35 who reside in Metro Vancouver, British Columbia, from four cultural groups: British, Chinese, Persian/Iranian, and South Asian. Using Ordinary Linear Regression, we model predictors of three dependent variables: global marital satisfaction and two sub-scales, including positive and negative emotional/cognitive appraisals of relationship quality. Several ethnic group contrasts were supported, with Chinese reporting lower global marital satisfaction than the South Asians and Persian/Iranians reporting lower levels of positive marital appraisals than the South Asians. In addition, these associations were nuanced by interactions between ethnicity and gender, revealing distinct relationships with the dependent variables. Results also support associations for several covariates. In particular, greater income satisfaction and those reporting lower conflict with their children had higher marital quality; and males and those reporting better health only had positive associations with the global marital satisfaction scale. Implications for theorizing relationship quality in later life and recommendations for those who work with culturally diverse older adults (e.g., mental health care professionals, community service providers) are discussed.

Spinal cord epidural stimulation for motor and autonomic function recovery after chronic spinal cord injury: A case series and technical note.

Traumatic spinal cord injury (tSCI) is a debilitating condition, leading to chronic morbidity and mortality. In recent peer-reviewed studies, spinal cord epidural stimulation (scES) enabled voluntary movement and return of over-ground walking in a small number of patients with motor complete SCI. Using the most extensive case series (n = 25) for chronic SCI, the present report describes our motor and cardiovascular and functional outcomes, surgical and training complication rates, quality of life (QOL) improvements, and patient satisfaction results after scES. This prospective study occurred at the University of Louisville from 2009 to 2020. scES interventions began 2-3 weeks after surgical implantation of the scES device. Perioperative complications were recorded as well as long-term complications during training and device related events. QOL outcomes and patient satisfaction were evaluated using the impairment domains model and a global patient satisfaction scale, respectively. Twenty-five patients (80% male, mean age of 30.9 ± 9.4 years) with chronic motor complete tSCI underwent scES using an epidural paddle electrode and internal pulse generator. The interval from SCI to scES implantation was 5.9 ± 3.4 years. Two participants (8%) developed infections, and three additional patients required washouts (12%). All participants achieved voluntary movement after implantation. A total of 17 research participants (85%) reported that the procedure either met (n = 9) or exceeded (n = 8) their expectations, and 100% would undergo the operation again. scES in this series was safe and achieved numerous benefits on motor and cardiovascular regulation and improved patient-reported QOL in multiple domains, with a high degree of patient satisfaction. The multiple previously unreported benefits beyond improvements in motor function render scES a promising option for improving QOL after motor complete SCI. Further studies may quantify these other benefits and clarify scES's role in SCI patients.

A National Survey of Job Satisfaction and Workload Among Emergency Medicine (EM) Residency Faculty.

Faculty workload, and its relation to job satisfaction, has not been well studied in Emergency Medicine (EM). Methods:A cross-sectional survey was conducted among EM physician faculty at 49 residency programs across the United States. We collected information on clinical and non-clinical (education, administration, and research) workload, demographics, and EM department characteristics, as well as job satisfaction measured using the Global Job Satisfaction (GJS) scale. Comparisons were made using Wilcox signed rank tests. Multivariable associations with job satisfaction were assessed in a regression model. Of 1,791 surveys sent, 265 were completed.The quantity of contracted clinical and non-clinical hours was lower than the actual clinical (difference (95% confidence interval (CI)): 2.7 (1.5-4.1)) and non-clinical hours (6.0 (3.8-8.8)) worked.Respondents preferred a distribution of 50% clinical work. However, the actual percentage was 62% (difference (95% CI): 14.4% (10.8%-17.6%)).Identifying as core faculty and required logging of non-clinical hours were associated with improved job satisfaction while increased percentage of time spent in the clinical and administrative domains were associated with significant declines. The estimated actual work performed by EM physician faculty is greater than contracted and misaligned with their preferred type of work, the latter of which is associated with decreased job satisfaction. Improved job satisfaction and faculty retention might be achieved by increasing the percentage of time devoted to education and research, by increasing the core faculty contingent and by implementing tracking of non-clinical efforts.

Mind-Body Practice and Family Caregivers' Subjective Well-Being: Findings From the Midlife in the United States (MIDUS) Study.

Objectives: Informal caregiving has been associated with higher stress and lower levels of subjective well-being. Mind-body practices including yoga, tai chi, and Pilates also incorporate stress reducing activities. The current study aimed to examine the association between mind-body practice and subjective well-being among informal family caregivers. Methods: A sample of informal caregivers were identified in the Midlife in the United States study (N = 506, M ± SDage = 56 ± 11, 67% women). We coded mind-body practice into three categories, including regular practice (participating in one or more of them "a lot" or "often"), irregular (participating "sometimes" and "rarely") and no practice ("never"). Subjective well-being was measured using the 5-item global life satisfaction scale and the 9-item mindfulness scale. We used multiple linear regression models to examine associations between mind-body practice and caregivers' subjective well-being, controlling for covariates of sociodemographic factors, health, functional status, and caregiving characteristics. Results: Regular practice was associated with both better mindfulness-related well-being (b = 2.26, p < .05) and better life satisfaction (b = 0.43, p < .05), after controlling for covariates. Discussion: Future research should examine whether there is a selection effect of caregivers with higher well-being being more likely to choose these activities, and/or if mind-body practices are effective non-pharmacological interventions to improve family caregivers' quality of life.

Job characteristics that enrich clinician-educators’ career: a theory-informed exploratory survey

ABSTRACT Clinician educators (CEs) play a vital role in helping academic institutions achieve the missions of patient care, education and research. The driving forces that motivate pediatric CEs in professional growth and personal satisfaction remain unexplored. An exploratory survey research to investigate the job characteristics and factors that motivate CEs to pursue professional growth with personal satisfaction. Using the Job Characteristics Model (JCM) as a framework, we developed a 22-item survey comprised of the JCM derived Job Diagnostic Survey, Global Job Satisfaction scales and demographics. We collected data from January 2020 to March 2020 from self-identified pediatric CEs (with and without educational leadership roles) through a survey recruitment service. Given no data on total number of CEs in the survey pool, response rate was unknown. Job characteristics in the core job dimensions of meaningfulness, autonomy, and performance feedback, as well as, the derived Motivating Potential Score (MPS), were analyzed using descriptive statistics and regression models. From 201 respondents, including 55 education leaders, >70% were satisfied with patient care, teaching, and mentoring while <40% were satisfied with administrative and scholarly activities. Meaningfulness (in some areas), autonomy (patient care/teaching), and internal feedback (all areas) had significant effects on job satisfaction. In regression analysis, skill variety, feedback, and years of experience were associated with higher job satisfaction, and the MPS was a predictor of total job satisfaction. The JCM can be utilized to understand CE’s motivations and needs within their workplace and guide professional development via job enrichment efforts.

Association between competencies of biopsychosocial approach and job satisfaction of rehabilitation professionals in Ukraine

BackgroundThe Biopsychosocial (BPS) model is recognized and widely accepted in the field of health care, particularly in rehabilitation. However, in clinical practice the applicability of the BPS model is a challenge for many professionals.MethodThis study aimed to explore the factors that impact the perception of rehabilitation professionals about the BPS model in Ukraine. In addition, the job satisfaction assessment was done to measure whether rehabilitation specialists in Ukraine fulfil their professional roles according to their expectations and values. Participants were 346 rehabilitation specialists from Ukraine who completed the Bio-Psycho-Social Scale (BPS) for Use in Healthcare and the Global Job Satisfaction Scale (GJSS). The ANOVA was used to investigate the outcome differences between the two scales.ResultsThe highest proportion of responders in this study represented state health services. The BPS subscale outcomes on “assessment and reporting” and “professional knowledge and skills” were significantly higher for specialists from a private sector. The global job satisfaction scale outcomes did not differ between responders from the private and state health sector. The perception of professionals networks was associated with greater job satisfaction.ConclusionsThe findings suggest that conception of the BPS approach in rehabilitation system of Ukraine varies across the private and state settings. The professional network plays important role in job satisfaction of rehabilitation professionals in Ukraine. Future research focusing on education strategies to effectively train professionals to apply biopsychosocial approach to practice is of critical importance to prepare rehabilitation specialists in Ukraine.

216 Impact of Proposed Core Faculty Protected Time Requirements: National Survey of Emergency Medicine Faculty on Work Hours and Associated Job Satisfaction

216 Impact of Proposed Core Faculty Protected Time Requirements: National Survey of Emergency Medicine Faculty on Work Hours and Associated Job Satisfaction

A New Complex Minimally Invasive Thread Lift Method for One-Time Three-Step Fixation of the Face and Neck Soft Tissues

Background In recent years thread lift has become widespread; however, existing methods need to improve their long-term outcome, which requires considering topographic anatomy of face and neck, especially the ligamentous apparatus. This study aims to assess the effectiveness and safety of an innovative method of one-time three-step thread facelift, which provides an additional support to the ligamentous structures of the upper, middle, and lower thirds of the face and neck. Methods The study included 357 patients aged 32 to 67 years with various morphotypes of aging. The original method of thread lift was applied, and its effectiveness was followed up for to 2 years. The Wrinkle Severity Rating Score (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores were used for assessment by investigators, independent observers, and patients. Statistical significance was determined using paired t -test and chi-square test. Results The mean WSRS score was 3.88 ± 0.88 before the thread lift, 1.93 ± 0.81 one month after the procedure, and 2.36 ± 0.85 after 2 years of follow-up. The mean GAIS was 4.80 ± 0.04 one month after thread lift, and 4.01 ± 0.04 after 2 years, while in the patients' assessment Global Satisfaction Scale was 4.86 ± 0.02 and 4.10 ± 0.02, respectively. There were no clinically significant complications throughout the observation period. Conclusion The new method of one-time three-step thread fixation of the soft tissues of the face and neck demonstrated a high degree of satisfaction by both experts and patients after 2 years of follow-up. It showed high efficacy and safety, including in the group of patients with pronounced age-related changes of the skin of face and neck.

Association between work situation and life satisfaction during the COVID-19 pandemic: prospective cohort study in Norway

ObjectivesTo estimate the impact of being laid off from work, having to work from home or having been diagnosed with COVID-19 on self-reported satisfaction with life.DesignNationwide population-based cohort study.SettingNorway.ParticipantsWe followed...

Measuring General Job Satisfaction: Which Is More Construct Valid—Global Scales or Facet-Composite Scales?

In order to assess general job satisfaction, researchers often use composites formed by summing scores from multiple satisfaction facets. The appropriateness of composites, however, is a matter of contention: some researchers have argued that composites provide an effective means of assessing general job satisfaction (e.g., Spector, American Journal of Community Psychology, 13, 693-713. 1985), whereas others have argued that composites are inappropriate and should be replaced with global job satisfaction scales (e.g., Ironson et al., Journal of Applied Psychology, 74, 193-200. 1989). To address this debate, we compared the construct validities of composite job satisfaction scales with those of global job satisfaction scales. We first created a nomological network that specifies a hypothetical pattern of relationships that exists between general job satisfaction and several external variables. Using this network as a guide, we conducted two studies (total N = 676) that examined the construct validities of four global scales and five composite scales. Within both studies, we found that composite satisfaction scales and global satisfaction scales generally yielded similar relationships with the external variables included in the nomological network. This suggests that the two types of scales are equally effective at assessing general job satisfaction. Researchers, therefore, should not summarily disregard previous studies that have used composite measures. These findings also suggest that it is appropriate to use composite measures in instances where global satisfaction data are unavailable, a situation that can occur when working with archival or organizational datasets.

Real-World Treatment Patterns of Disease Modifying Therapy (DMT) for Patients with Relapse-Remitting Multiple Sclerosis and Patient Satisfaction with Therapy: Results of the Non-Interventional SKARLET Study in Slovakia.

BackgroundDuring long-term multiple sclerosis therapy, patient satisfaction with received treatment has considerable impact on treatment outcomes. Here we report the results of a non-interventional real-world study that mapped the treatment patterns of disease-modifying therapy (DMT) and assessed treatment satisfaction with DMT.Patients and MethodsThe SKARLET study was a non-interventional, cross-sectional study in Slovakia running from May 2016 to March 2017. Patients with relapsing-remitting multiple sclerosis on DMT for ≥3 months and ≤2 years (per local labelling) from 10 multiple sclerosis centers across Slovakia were included. The primary objective was to collect the Treatment Satisfaction Questionnaire for Medication version 9 (TSQM 9) score regarding perceived effectiveness, convenience and overall satisfaction with DMT.ResultsThe following TSQM 9 scores (mean; 95% confidence interval) were reported from 415 patients: convenience (75.05; 73.49–76.61), effectiveness (68.15; 66.56–69.75) and global satisfaction scale (66.94; 65.26–68.62). All three parameters of the TSQM 9 were analyzed by the route of DMT administration, with infusions best rated for effectiveness and global satisfaction in comparison to oral dosage and injections. For convenience, however, oral dosage forms were appraised highly (82.66; 80.59–84.73) followed by infusions (74.40; 70.12–78.69), while injections were rated as the worst (66.92; 64.81–69.04). The difference of TSQM 9 scores according to the route of DMT administration is statistically significant for convenience (p < 0.001) and global satisfaction (p = 0.004), but not for effectiveness (p = 0.185).ConclusionIn the present study, it was confirmed that patients find oral DMTs as most convenient; however, the infusion form of treatment outweighs oral DMTs in global satisfaction and effectiveness. The differences of TSQM 9 scores among DMT dosage forms were significant for convenience and global satisfaction. In conclusion, the results of this detailed survey increase our understanding of RRMS patient population characteristics and patient satisfaction with DMT treatment.

Facial Rejuvenation Using a Mixture of Calcium Hydroxylapatite Filler and Hyaluronic Acid Filler.

Calcium hydroxylapatite filler is a popular dermal filler, as it provides long-lasting results. However, it sometimes undergoes unexpected early volume loss, due to rapid gel absorption before neocollagenesis. To compensate for this phenomenon, hyaluronic acid filler was added to calcium hydroxylapatite filler for injection as a mixture. Twenty-five patients who scored 1 or 2 on the Merz 5-point scale for the nasolabial fold and jawline were injected with 3.0 mL of the mixture. The mixture was prepared with 1.0 mL of hyaluronic acid filler, 0.5 mL of lidocaine, and 1.5 mL of calcium hydroxylapatite filler. A visual analog scale (VAS) and the 5-point global satisfaction scale (GSS) were used for objective and subjective assessments. In a subset of patients, for histologic analysis, 0.1 mL of the mixture and 0.1 mL of only calcium hydroxylapatite filler were injected into the right and left postauricular areas, respectively. The histologic analysis was performed 6 months after implantation. The mean VAS and GSS scores for both sets of wrinkles were above "fair" at every follow-up, including at short-term and long-term periods. The skin biopsies from both postauricular areas from selected patients showed increased dermal collagen bundles without inflammation. The mixture of calcium hydroxylapatite filler and hyaluronic acid filler maintained constant volume with high satisfaction, as hyaluronic acid filler compensated for the unexpected early volume loss of calcium hydroxylapatite filler. This procedure can be applied safely, and it is also convenient, because no retouching procedure is needed.