Perfect Satisfaction Research Articles

Study on Service Quality and Priorities of Pedestrian Path Development in Malioboro Area to Support Sustainable Urban Mobility

This article aims to study the service quality and prioritize the development of pedestrian paths in the Malioboro area to support sustainable urban mobility. Malioboro is one of the commercial and tourist centers in Yogyakarta city, historically known for its pedestrian-friendly pathways. Challenges such as pedestrian circulation issues, inadequate pedestrian facilities, conflicts between pedestrians and motorized vehicles, and problems with drop-off and stop zones for less organized transportation contribute to the low service quality in the Malioboro area. This study adopts a quantitative approach using direct observation and a questionnaire distributed to 132 pedestrian path users. The collected data is analyzed using descriptive analysis techniques and Importance Performance Analysis (IPA) to understand the existing conditions, quality, and priority of pedestrian path services in the Malioboro area. The study results indicate that the service quality of pedestrian paths in Malioboro faces several challenges. Factors such as motor vehicle traffic density, lack of quality pedestrian infrastructure, and pedestrians' unsafe behavior contribute to the low service quality. The pedestrian satisfaction analysis using the Customer Satisfaction Index (CSI) revealed a satisfaction rate of 69.19%, categorizing it as "adequate." However, improvements in pedestrian path services are necessary based on the significance of the Malioboro area and its high appeal to pedestrians. The goal is to achieve good or even perfect satisfaction in terms of service quality. An analysis of interests was conducted, resulting in the identification of four quadrants with distinct characteristics. These quadrants serve as a valuable guide for enhancing the quality of pedestrian path services. Quadrant 1 encompasses attributes such as crossing facilities, CCTV surveillance, protection from weather conditions (rain, heat, cold), and parking convenience. Despite their high importance, these variables received low satisfaction ratings from respondents. Enhancing both the quantity and quality of these variables is crucial. Policymakers should pay special attention to these four variables and implement concrete measures to surpass the "adequate" assessment and attain better pedestrian service satisfaction. By implementing these measures, it is expected that Malioboro can serve as an example in supporting sustainable urban mobility by providing good and safe services for pedestrians. This study can also provide guidance and input for the government and relevant stakeholders in decision-making regarding pedestrian path infrastructure development in similar areas.

Treatment Satisfaction Among Bahraini Patients With Psoriasis: A Single Center Cross-Sectional Study Using the PsoSat Questionnaire.

Psoriasis has a considerable negative impact on a patient's life. However, the treatment prescribed plays a crucial role in their quality of life. Treatment satisfaction is one of the fundamental elements when it comes to patient care for psoriasis (PsO). Dermatologists, just like any other healthcare physician, seek adherence to a specific treatment, and it has been shown that satisfaction influences treatment optimization and thereby the treatment outcome. This was an observational cross-sectional study conducted to determine patient satisfaction with therapy and treatment of psoriasis. The final psoriasis satisfaction (PsoSat) questionnaire consisted of eight affirmations concerning treatment satisfaction. Each affirmation was rated by the patient on a 5-point Likert scale (0-4), indicating poor to perfect satisfaction levels. The study involved patients visiting the outpatient department of a multi-specialty medical complex in Bahrain, or patients contacted via teledermatology, between October 2019 and February. A total of 100 patients who were willing to participate in the survey and fulfilled the inclusion criteria, were considered. Most of the patients (89%) were moderately to very satisfied with their ongoing therapy. One patient was not satisfied with the treatment, and 10 (10%)patients reported that they were very dissatisfied with their treatment. Since psoriasis can negatively impact a patient's quality of life, treatment satisfaction is an essential factor when it comes to patient care. Dermatologists are always on the lookout for specific treatments that provide excellent results and satisfy a patient's needs.

Evaluating opportunities for improved outpatient satisfaction in an interventional spine clinic: An analysis of Press Ganey® Outpatient Medical Practice Survey responses

ObjectiveThe Press Ganey® Outpatient Medical Practice Survey (PGOMPS) is a frequently used patient satisfaction metric comprised of provider-specific and non-provider-specific questions. The PGOMPS results are used by many administrators to improve the patient experience and are linked to physician reimbursements in some cases. This study aimed to determine the frequency of patient satisfaction for the provider-specific and non-provider-specific PGOMPS questions and their association with the likelihood of a patient recommending their provider's clinic. DesignA retrospective review. MethodsAdult patients attending a university interventional spine clinic between January 2014 and December 2019 were included in this study. We retrospectively reviewed prospectively collected patient satisfaction using PGOMPS. Data was collected within 30 days after an outpatient interventional spine clinic appointment. Satisfaction was defined as receiving a perfect total score. The frequency of perfect scores for each question was calculated. Chi-square (goodness-of-fit) analysis was performed between the number of patients who gave perfect satisfaction on all provider specific questions and the number of patients who gave perfect satisfaction for non-provider scores irrespective of their provider specific scoring. Spearman correlation between individual PGOMPS questions and the likelihood to recommend the practice question were calculated. Results53,118 patients patient encounters were included. 2078 (66.65%) provider-specific questions received perfect satisfaction versus 1121 (35.95%) with perfect satisfaction for non-provider specific questions (p ​< ​0.001). The five questions most likely to receive perfect satisfaction were: physician spoke using clear language (92.90%), physician friendliness/courtesy (82.74%), cleanliness of the practice (82.67%) likelihood to recommend practice (81.27%), and likelihood to recommend physician (80.96%). The 5 least likely were: convenience of office hours (64.30%), wait time (63.00%), ease of getting on phone (60.77%), information about delays (60.19%), and ability to get desired appointment (58.92%). Of the 10 questions that had the strongest correlation with likelihood to recommend the practice 7 were related to the physician. None of the 10 questions with the least correlation were related to the physician. ConclusionsMost interventional spine patients are satisfied with their providers and less satisfied with non-provider-related aspects of their encounters. Provider-specific factors carry the greatest influence in the patient's perceived satisfaction with the experience as a whole and likelihood to recommend the practice.

P86. Evaluating opportunities for improved outpatient satisfaction in a nonoperative spine clinic: an analysis of Press Ganey® outpatient medical practice survey responses

BACKGROUND CONTEXT The Press Ganey® Outpatient Medical Practice Survey (PGOMPS) is a frequently used patient satisfaction metric comprised of provider-specific and nonprovider-specific questions. The PGOMPS results are used by many administrators to improve the patient experience and are linked to physician reimbursements in some cases. PURPOSE This study aimed to determine the frequency of patient satisfaction for the provider-specific and nonprovider-specific PGOMPS questions and their association with the likelihood of a patient recommending their provider's clinic. STUDY DESIGN/SETTING Retrospective. PATIENT SAMPLE Adult patients attending a university nonoperative spine clinic between 1/2014 and 12/2019. OUTCOME MEASURES We retrospectively reviewed prospectively collected patient satisfaction using PGOMPS. Data were collected within 30 days after an outpatient nonoperative spine clinic appointment. METHODS Satisfaction was defined as receiving a perfect total score. The frequency of perfect scores for each question was calculated. Chi-square (goodness-of-fit) analysis was performed between the number of patients who gave perfect satisfaction on all provider specific questions and the number of patients who gave perfect satisfaction for nonprovider scores irrespective of their provider specific scoring. Spearman correlation between individual PGOMPS questions and the likelihood to recommend the practice question were calculated. RESULTS A total of 53,118 patient encounters were included; 2,078 (66.65%) provider-specific questions received perfect satisfaction versus 1,121 (35.95%) with perfect satisfaction for nonprovider specific questions (p < 0.001). The five questions most likely to receive perfect satisfaction were: physician spoke using clear language (92.90), physician friendliness/courtesy (82.74%), cleanliness of the practice (82.67%) likelihood to recommend practice (81.27%), and likelihood to recommend physician (80.96). The 5 least likely were: convenience of office hours (64.30%), wait time (63.00%), ease of getting on phone (60.77%), information about delays (60.19%), and ability to get desired appointment (58.92%). Of the 10 questions that had the strongest correlation with likelihood to recommend the practice 7 were related to the physician. None of the 10 questions with the least correlation were related to the physician. CONCLUSIONS Most non-operative spine patients are satisfied with their providers and less satisfied with non-provider-related aspects of their encounters. Provider-specific factors carry the greatest influence in the patient's perceived satisfaction with the experience as a whole and likelihood to recommend the practice. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. The Press Ganey® Outpatient Medical Practice Survey (PGOMPS) is a frequently used patient satisfaction metric comprised of provider-specific and nonprovider-specific questions. The PGOMPS results are used by many administrators to improve the patient experience and are linked to physician reimbursements in some cases. This study aimed to determine the frequency of patient satisfaction for the provider-specific and nonprovider-specific PGOMPS questions and their association with the likelihood of a patient recommending their provider's clinic. Retrospective. Adult patients attending a university nonoperative spine clinic between 1/2014 and 12/2019. We retrospectively reviewed prospectively collected patient satisfaction using PGOMPS. Data were collected within 30 days after an outpatient nonoperative spine clinic appointment. Satisfaction was defined as receiving a perfect total score. The frequency of perfect scores for each question was calculated. Chi-square (goodness-of-fit) analysis was performed between the number of patients who gave perfect satisfaction on all provider specific questions and the number of patients who gave perfect satisfaction for nonprovider scores irrespective of their provider specific scoring. Spearman correlation between individual PGOMPS questions and the likelihood to recommend the practice question were calculated. A total of 53,118 patient encounters were included; 2,078 (66.65%) provider-specific questions received perfect satisfaction versus 1,121 (35.95%) with perfect satisfaction for nonprovider specific questions (p < 0.001). The five questions most likely to receive perfect satisfaction were: physician spoke using clear language (92.90), physician friendliness/courtesy (82.74%), cleanliness of the practice (82.67%) likelihood to recommend practice (81.27%), and likelihood to recommend physician (80.96). The 5 least likely were: convenience of office hours (64.30%), wait time (63.00%), ease of getting on phone (60.77%), information about delays (60.19%), and ability to get desired appointment (58.92%). Of the 10 questions that had the strongest correlation with likelihood to recommend the practice 7 were related to the physician. None of the 10 questions with the least correlation were related to the physician. Most non-operative spine patients are satisfied with their providers and less satisfied with non-provider-related aspects of their encounters. Provider-specific factors carry the greatest influence in the patient's perceived satisfaction with the experience as a whole and likelihood to recommend the practice.

Cephalic lateral crural advancement flap

BackgroundIn lower lateral cartilage (LLC) surgery, cephalic trimming poses risks for the collapse of the internal and external nasal valves, pinched nose, and drooping deformity. The cephalic lateral crural advancement (CLCA) technique presented herein was aimed at using a flap to increase nasal tip rotation and support the lateral crus, in addition to the internal and external nasal valves, by avoiding grafts without performing excision.MethodsThis study included 32 patients (18 female and 14 male) and the follow-up period for patients having undergone primer open rhinoplasty was 12 months. The LLC was elevated from the vestibular skin using the CLCA flap. A cephalic incision was performed without cephalic trimming. Two independent flaps were formed while preserving the scroll ligament complex. The CLCA flap was advanced onto the lower lateral crus while leaving the scroll area intact. The obtained data were analyzed retrospectively.ResultsThe mean age of the patients was 31.6 years (range, 20–51 years). The Rhinoplasty Outcome Examination scores after 12 months varied from 90 to100 points, and 93% of patients reported perfect satisfaction. At a 1-year follow-up, the patients’ nasal patency (visual analogue scale) rose from 4.56±1.53 (out of 10) to 9.0±0.65 (P<0.001).ConclusionsThe CLCA flap led to better nasal tip definition by protecting the scroll area, increasing tip rotation, and supporting the internal and external nasal valves without cephalic excision.

Hubungan Persalinan Jampersal Dengan Kepuasan Ibu Bersalin Di Puskesmas

Kepuasan pasien adalah suatu tingkatan perasaan pasien yang timbul sebagai akibat dari kinerja layanan kesehatan yang diperolehnya setelah pasien membandingkannya dengan apa yang diharapkannya. Penelitian ini bertujuan untuk mengetahui hubungan persalinan Jampersal dengan kepuasan ibu bersalin wilayah kerja Puskesmas Curahdami Kabupaten Bondowoso tahun 2013. Desain penelitian yang digunakan adalah studi korelasi dengan pendekatan Cross-Sectional. Populasi pada penelitian ini ibu yang pernah bersalin di wilayah kerja Puskesmas Curahdami pada bulan Januari-Juni tahun 2013 sebanyak 100 orang dengan sampel 80 orang menggunakan teknik Simpel Random Sampling. Dari hasil penelitian menunjukkan bahwa ibu bersalin yang merasa puas dengan persalinan Jampersal sebanyak 49 orang (61,25%) dan yang tidak puas sebanyak 31 orang (38,75%). Data yang diperoleh selanjutnya dianalisis dengan menggunakan Chi Square satu sampel didapatkan χ2 hitung &gt; χ2 tabel yaitu 4,05 &gt; 3,841 dimana KK 0,22. Sehingga Hipotesa nol (Ho) ditolak dan Hipotesis alternatif (Ha) diterima yang artinya ada hubungan persalinan Jampersal dengan kepuasan ibu bersalin wilayah kerja Puskesmas Curahdami Kabupaten Bondowoso tahun 2013. Dengan meningkatkan kualitas pelayanan akan mempengaruhi kepuasan ibu bersalin yang artinya ibu bersalin akan merasa puas karena memperoleh pelayanan yang baik atau sesuai dengan yang diharapkan, semakin baik kualitas pelayanan kesehatan yang diberikan, semakin sempurna kepuasan tersebut

Relationship Of Press Ganey® Satisfaction and Promis Function and Pain in Foot and Ankle Patients

Category:OtherIntroduction/Purpose:Patient satisfaction has garnered interest as a tool to measure healthcare quality. The Press Ganey (PG) instrument was designed to assess outpatient patient satisfaction by probing multiple domains of the patient experience including clinic wait-times and overall assessment of the provider practice. However, orthopaedic studies in total joint arthroplasty, spine, and hand patients have offered conflicting relationships between PG satisfaction metrics and patient-reported outcome (PRO) measures. No prior study has assessed the relationship between PG and PROs in foot and ankle patients. Here, we tested if there was an association between PROMIS outcomes and PG satisfaction scores.Methods:Between 2015 and 2017, new patient visits to orthopedic foot and ankle clinics at a single academic center were retrospectively analyzed. Patients that completed PG satisfaction surveys were included for study. All patients who completed PG surveys had completed either one or both of the PROMIS physical function (PF) or pain interference (PI) metrics administered by computerized adaptive testing. Negative binomial regressions were used to compare PRO scores to PG overall satisfaction and PG satisfaction with care provider, adjusting for patient characteristics. Results were reported as dissatisfaction score ratios along with 95% confidence intervals (CIs) and P-values.Results:Out of 3,984 new patient visits, only 441 completed the PG survey (11.3% response rate). Ceiling effects were seen with PG data as 64% of our patients reported perfect satisfaction with care provider and 27% had perfect overall satisfaction. Higher function on the PROMIS PF was weakly associated with increased overall satisfaction (Ratio=0.82, 95% CI: 0.68-0.99, P=0.039) and increased satisfaction with care provider (Ratio=0.60, 95% CI: 0.40-0.92, P=0.019). However, pain (PROMIS PI) was not associated with overall satisfaction or with satisfaction with care provider.Conclusion:Patient satisfaction was weakly related to patient-reported function but not pain among new foot and ankle clinic patients. It appears from our data that PG and PROMIS measure differing components of patient care. Further, our findings showcase the limitations of the PG tool including low response rates and notable ceiling effects. Until we achieve a broader understanding of the relationship between patient satisfaction and clinical and surgical outcomes, we would caution against the use of PG data in the assessment of quality of care and reimbursement for orthopaedic foot and ankle surgery.

Relationship of Press Ganey Satisfaction and PROMIS Function and Pain in Foot and Ankle Patients.

Patient satisfaction has garnered interest as a tool to measure health care quality. However, orthopedic studies in total joint arthroplasty, spine, and hand patients have offered conflicting relationships between Press Ganey (PG) satisfaction metrics and patient-reported outcome (PRO) measures. No prior study has assessed the relationship between PG and PROs in foot and ankle patients. Whether satisfaction and outcomes instruments, though, measure similar or differing aspects of the patient experience is unclear. Here, we tested if there was an association between Patient-Reported Outcomes Measurement Information System (PROMIS) outcomes and PG satisfaction scores. PG and PROMIS outcomes data for new patient visits to an orthopedic foot and ankle clinic between 2015 and 2017 were retrospectively analyzed. Patients that completed PG satisfaction surveys were included for study. All patients who completed PG surveys and completed one or both PROMIS physical function (PF) or pain interference (PI) metrics administered by computerized adaptive testing were included. Negative binomial regressions were used to compare PRO scores to PG overall satisfaction and PG satisfaction with care provider, adjusting for patient characteristics. Results were reported as dissatisfaction score ratios, which represented the amount of PG dissatisfaction associated with a 10-point increase in PROMIS PF or PI. Of the 3984 new patient visits, only 441 completed the PG survey (11.3% response rate). Ceiling effects were seen with PG data: 64% of patients reported perfect satisfaction with care provider and 27% had perfect overall satisfaction. Higher function on the PROMIS PF was weakly associated with increased overall satisfaction (ratio = 0.82, 95% CI: 0.68-0.99, P = .039) and increased satisfaction with care provider (ratio = 0.60, 95% CI: 0.40-0.92, P = .019). However, pain (PROMIS PI) was not associated with overall satisfaction or with satisfaction with care provider. Based on our data here, patient satisfaction was weakly related to patient-reported function but not pain interference among this subset of new patients presenting to a foot and ankle clinic. Given our essentially negative findings, further study is needed to determine which aspects of the PG satisfaction and PROMIS scores track similarly. Further, our findings add to the growing literature showcasing limitations of the PG tool, including low response rates and notable ceiling effects. If satisfaction metrics and patient-reported outcomes capture differing aspects of the patient experience, we need to better understand how that influences the measurement of health care quality and value. Level III, comparative study.

Evaluating opportunities for improved orthopedics outpatient satisfaction: an analysis of Press Ganey\xae Outpatient Medical Practice Survey responses

IntroductionThe Press Ganey® Outpatient Medical Practice Survey (PGOMPS) is composed of 10 provider-specific and 15 non-provider-specific questions. Some healthcare systems link PGOMS overall scores to physician reimbursements. The aim of this study was to determine the frequency of patient satisfaction across individual PGOMPS question, the null hypothesis being that there was no variability between the frequency of satisfaction and similar questions.MethodsWe reviewed all new patient orthopedic PGOMPS scores between January 2014 and December 2017. Due to the large ceiling effect, satisfaction was defined as a perfect total score. The frequency of perfect scores for each question was calculated.ResultsFive thousand one hundred sixty-three patients met the inclusion criteria. Two thousand two hundred sixty-six (43.89%) provider-specific questions received perfect satisfaction versus 986 (19.10%) with perfect satisfaction for non-provider-specific questions (p < 0.001). The five questions most likely to receive perfect satisfaction were MD friendliness/courtesy (80.36), MD spoke using clear language (80.35%), likelihood to recommend practice (79.11%), likelihood to recommend MD (78.8%), and MD confidence (78.74%). The five least likely were convenience of office hours (60.44%), ease of getting on phone (59.72%), ability to get desired appointment (59.50%), wait time (54.63%), and information about delays (53.80%).ConclusionsOur results suggest that the majority of orthopedic patients are satisfied with their provider, demonstrating that room for improvement is limited with provider-specific areas. Leaders of health care teams should consider these results when seeking to improve patient satisfaction scores and determining how and if scores should be linked to reimbursements.

ORGANIZATIONAL STRUCTURES BASED ON INFORMATION TECHNOLOGY

&amp;lt;jats:p&amp;gt;New organizational structures which are based on informatics, are new organizational models that use technology to dynamically connect people, resources and ideas. That is, the core of the enterprise network, which creates the opportunities and risks of products and services, and such a commitment to a virtual organization has no boundaries. For the success of the concept it is necessary: mutual trust, high technology, as well as the pursuit of excellent performance and perfect satisfaction of customers&amp;#039; needs. Today, companies can not afford to work for themselves, and in this way they get the opportunity to orient themselves to their basic strategy, ie. its realization and its combination with the basic strategies of other companies. A system that should support state structures in the Republic of North Macedonia, especially in the legal regulation of the conclusion of agreements and monitoring the implementation of the agreement in a virtual organization, which is its most important part. With the efficiency and speed of the Macedonian judiciary, one should be cautious in implementing the organization.&amp;lt;/jats:p&amp;gt;

Posterior-Only Vertebral Column Resection for Fused Spondyloptosis

Study DesignRetrospective review. ObjectivesTo describe 3 cases of a posterior-only vertebral column resection (pVCR) for the treatment of spondyloptosis in the setting of prior spinal fusions. Summary of Background DataLumbosacral spondyloptosis is a rare spinal deformity with a number of surgical options, none of which demonstrate clear superiority. The use of an L5 vertebral column resection, via combined anterior and posterior approaches, to restore lumbosacral alignment has been described though is accompanied by high rates of neurological deficit. MethodsReview of 3 cases of spondyloptosis with prior spinal fusions in which a staged pVCR was used for deformity reconstruction. ResultsThree females, ages 39, 54, and 28, developed spondyloptosis with progressive lumbosacral kyphosis and sagittal malalignment after prior in-situ posterolateral spinal fusions. All were treated with staged pVCRs. At ultimate follow-up, imaging revealed improvement in sagittal balance of 6.1 cm (56%) in the 39-year-old and 12 cm (67%) in the 54-year-old, 21.1 cm (92%) in the 28-year-old. All patients had improvement in outcome scores with perfect satisfaction scores despite the 54-year-old having a persistent right foot drop. ConclusionPosterior-only VCR for spondyloptosis is a technically demanding surgical option offering significant radiographic and clinical improvement, but carries a risk for L5 nerve root deficit as in any spondyloptosis treatment.

On preservation of symmetry in r–z staggered Lagrangian schemes

In the focus of this work are symmetry preservation, conservation of energy and volume, and other important properties of staggered Lagrangian hydrodynamic schemes in cylindrical (r–z) geometry. It is well known that on quadrilateral cells in r–z, preservation of spherical symmetry, perfect satisfaction of the Geometrical Conservation Law (GCL), and total energy conservation are incompatible even on conforming grids. This paper suggests a novel staggered grid approach that preserves symmetry, conserves total energy by construction and tries to do its best by diminishing the GCL error to the order of entropy error. In particular, the forces from an existing volume consistent scheme are corrected so that spherical symmetry is preserved. The incorporation of subcell pressure mechanism to reduce spurious grid deformations is described and the relation of the new scheme to popular area-weighted and control volume approaches studied.

An integer programming model for assigning students to elective courses

This paper deals with the problem of assigning students to elective courses according to their preferences. This process of assigning students to elective courses according to their preferences often places before academic institutions numerous obstacles, the most typical being a limited number of students who can be assigned to any particular class. Furthermore, due to financial or technical reasons, the maximum number of the elective courses is determined in advance, meaning that the institution decides which courses to conduct. Therefore, the expectation that all the students will be assigned to their first choice of courses is not realistic (perfect satisfaction). This paper presents an integer programming model that maximizes the total student satisfaction in line with a number of different constraints. The measure of student satisfaction is based on a student’s order of preference according to the principle: the more a choice is met the higher the satisfaction. Following the basic model, several versions of the models are generated to cover possible real-life situations, while taking into consideration the manner student satisfaction is measured, as well as the preference of academic institution within set technical and financial constraints. The main contribution of the paper is introducing the concept of the minimal student satisfaction level that reduces the number of students dissatisfied with the courses to which they were assigned.

Circular Directed Suction Technique for Ablative Laser Treatments

The use of ablative laser treatments is steadily increasing. A side-effect is plume, which can potentially transmit infectious material. Insufficient plume removal may lead to transmission of infectious diseases. To introduce a newly developed circular suction technique for ablative interventions. The new plume removal system consists of a circular master tube and four smaller suction tubes. This design guarantees plume removal around the whole treatment area. This system can be connected in principle to any common aspiration device. The suction system worked effectively with perfect satisfaction in daily routine. Its effect on skin surface temperature was evaluated using thermography and surface temperature measurements. The circular system removed the laser-associated plume much better than ordinary single-point plume-removal systems. Split-face investigations confirm additional benefits in terms of better skin surface cooling. The combination of providing a cool air flow during laser treatment and circular suction is a new approach for directed cooling air streams and streamed plume evacuation without obstructing the physician because of its architecture.

Sound, Space and Moral Soundscapes in Ruyijun zhuan and Chipozi zhuan

AbstractThis paper employs methods from phenomenology, anthropology and literary criticism to theorise the deployment of sound in two early works of erotic fiction from sixteenth-century China: Ruyijun zhuan ([The tale of ] The Lord of Perfect Satisfaction) and Chipozi zhuan (A tale of an infatuated woman). After assessing the significance of the two novels in relation to problems of gender ideology in the period, as well as the treatment of sound, noisiness and gender in two Tang dynasty works, the paper demonstrates how almost all occurrences of non-verbal or involuntary sounds in the novels are attached to the moral positioning of their women protagonists in relation to gender norms. While not performing a full content analysis of the novels' soundscapes, moral or otherwise, a select number of examples are used to illustrate how a focus on sound, as a sign of both external moral threat and the inner person, adds to our understanding of erotic fiction from the late Ming (1520-1644). While they employ aurality in radically different ways, the two novels show how aural events share a similar function in governing women's sexuality.

Assessment of Patient Opinions of Different Clinical Tests Used in the Management of Glaucoma

To compare different tests used in the clinical management of glaucoma, with respect to the testing experience for patients undergoing each test. Evaluation of diagnostic tests. A total of 101 subjects with high-risk ocular hypertension or early glaucoma. Subjects were asked to give their opinion on 7 tests used clinically in glaucoma management by assigning each a score between 0 (absolute dislike) and 10 (perfect satisfaction). Tests were ranked for each subject from 1 (favorite test) to 7 (least favorite test) on the basis of patient-assigned scores. Goldmann applanation tonometry for measurement of intraocular pressure was ranked significantly better than any other test (median rank 2.5, P<or=0.01). This was followed by confocal scanning laser ophthalmoscopy using a Heidelberg Retina Tomograph (median rank 3.3); frequency doubling technology perimetry (4.0); multifocal visual evoked potential (4.0); optic nerve photography (4.3); and standard automated perimetry (4.8). Short-wavelength automated perimetry was ranked significantly worse than any other test (median rank 5.3, P</=0.04). In many cases, statistically significant differences were found between the patients' opinions of the tests. Information on this issue has to date largely been anecdotal or subjective. To our knowledge, this is the most comprehensive study to assess and compare the patient experience when undergoing these tests. The authors have no proprietary or commercial interest in any materials discussed in this article.

The Adolescent and Child Health Initiative to Encourage Vision Empowerment (ACHIEVE) Study Design and Baseline Data

The purpose of this study was to describe the baseline characteristics of subjects and methods for a multicenter, randomized clinical trial to compare the effects of contact lens wear and spectacle wear on children's self-perception. Eligible subjects are randomly assigned to wear glasses or contact lenses throughout the 3-year study. Self-perceptions are measured 1 month after randomization and every 6 months using the Self-Perception Profile for Children (SPPC). Children's satisfaction with spectacles and refractive error-related visual quality of life are also measured using surveys developed for the study. Visual acuity, cycloplegic autorefraction, corneal curvature, and axial dimensions are measured annually. Five clinical sites enrolled 484 subjects with a mean (+/- standard deviation [SD]) age of 10.4 +/- 1.1 years. Approximately three-fifths of the subjects are girls, 47.1% of the subjects are white, 21.5% are black, and 21.5% are Hispanic. The mean (+/- SD) cycloplegic spherical equivalent autorefraction of the right eye is -2.38 +/- 1.04 D, and the average (+/- SD) axial length of the right eye is 24.32 +/- 0.77 mm. The average (+/- SD) Global Self-Worth score on the SPPC is 3.20 +/- 0.62 on a scale from one (low perceived competence) to 4 (high perceived competence). The average (+/- SD) spectacle satisfaction is 59.1 +/- 26.6 on a scale from zero (no satisfaction) to 100 (perfect satisfaction). The average refractive error-related quality of life score is 63.5 +/- 12.8 on a scale from zero (poor quality of life) to 100 (excellent quality of life). Subjects enrolling in the ACHIEVE Study are an ethnically diverse group of young myopic children. Ocular characteristics of the sample are consistent with data presented in other randomized clinical trials evaluating treatments for myopic children. The data reported here represent the baseline data for a 3-year randomized clinical trial to investigate the effects of contact lens vs. spectacle wear on children's self-perceptions.

Charles r. stone: the fountainhead of chinese erotica: the lord of perfect satisfaction (ruyijun zhuan), with a translation and critical edition. viii, 271 pp. honolulu: university of hawai‘i press, 2003.

charles r. stone: the fountainhead of chinese erotica: the lord of perfect satisfaction (ruyijun zhuan), with a translation and critical edition. viii, 271 pp. honolulu: university of hawai‘i press, 2003. - Volume 68 Issue 2

The Effects of Additional Alfentanil for Sedation during the Endoscopic Retrograde Cholangiopancreatography

Background: Propofol can be used as a sedative. And, opioids are also frequently used to relieve pain or to induce sedation during monitored anesthetic care. The objectives of this study were to evaluate the effects of additional alfentanil for sedation. Methods: Forty-four patients scheduled for ERCP (endoscopic retrograde pancreatocholangiography) were allocated to one of two groups (group 1: propofol without alfentanil, group 2: propofol with alfentanil). In group 2, we mixed propofol with 1,000g alfentanil, and administered propofol using a target controlled infusion (TCI). During ERCP, we checked oxygen saturation, systolic blood pressure, heart rate, complications (hypoxemia, agitation, bradycardia, tachycardia). After the procedure, we also checked recovery characteristics; complications (nausea/vomiting, itching, urinary retention, soar throat), and satisfaction scores by using the VAS system (0-100 mm, 0 mm: no satisfaction at all, 100 mm: perfect satisfaction). Results: There were no significant differences between the two groups in terms of the recovery characteristics, incidence of complications and the satisfaction score of endoscopist or patients. And the total amounts of propofol used were not significantly different. Only , systolic blood pressure and heart rate showed slight differences, but these were not clinically significant. Conclusions: We concluded that the sedation using propofol mixed with 1,000g alfentanil has no merit compared with plain propofol.

The Fountainhead of Chinese erotica: The lord of perfect satisfaction (Ruyijun zhuan)

The Lord of Perfect Satisfaction (Ruyijun zhuan), a short work of fiction from the early sixteenth century, tells the story of the Tang dynasty's notorious Wu Zetian, the only woman to rule as emperor of China. It is famous not for the history it relates, but for its graphic sexual descriptions - the first ever in a Chinese novel - purportedly given from a woman's point of view. Despite its renown and unmistakable influence on later writing, the origins and significance of the Ruyijun zhuan have never been explored, in any language, and until now it has never been translated. Its date of composition is unknown, its author unidentified. One of its earliest appraisals, written by a contemporary scholar known for his conservatism, maintains that the Ruyijun zhuan is a moral work notwithstanding its sexual content. Combining a careful textual study with a complete translation and a detailed and far-ranging study of the text and its various contexts. The Fountainhead of Chinese Erotica places this important cultural document into historical context and offers possibilities on its meaning.