Reduction In Satisfaction Research Articles

Cost-Effectiveness Analysis of Operating Room and In-Office Reconstruction of Skin Cancer Defects.

Reconstruction of skin cancer and Mohs micrographic surgery (MMS) defects of the head and neck is performed in both in-office and operating room (OR). This study intends to understand cost differences between reconstructive surgery for skin cancer defects in the OR and clinic to perform a cost-effectiveness analysis with single-institution patient satisfaction data. Population-based retrospective analysis of cost data and an institutional, prospective survey of patient satisfaction. National insurance database and institutional survey. The Merative® MarketScan database was queried to identify claims involving the reconstruction of skin cancer defects of the head/neck between 2013 and 2020 for cost-analysis by setting (OR vs clinic). Patients undergoing operative and clinic-based reconstruction of MMS defects by 3 different surgeons at a single institution in 2023 were surveyed for satisfaction using a 5-point Likert scale. Data was coupled for cost-benefit analysis. Analysis was performed using propensity-matched samples. Using Marketscan, 1206 patients were analyzed for cost data. OR cases had a higher median baseline cost of $2308 (interquartile range [IQR]: 1484-3889) compared to procedures in the office (median $987, IQR: 784-1454, P < .001). Survey data from 116 patients revealed no significant difference in scores between OR and clinic cases (clinic: 4.57 vs OR: 4.60, P = .8752). Using propensity-matched subsets, providers incur an additional $4744 for a reduction in satisfaction of 0.083 when performing cases in the OR. Lower cost is associated with reconstructive procedures performed in the office. This study is the first cost analysis of head and neck skin cancer reconstruction based on procedural settings and will be valuable to surgeons in considering practice patterns and resource utilization.

Apoio da rede social e cuidados familiares às crianças no contexto de distanciamento social

ABSTRACT Objective to assess family care for children and social network support during the covid-19 pandemic. Method a cross-sectional study, with 57 mothers/guardians of children aged two to ten years in Recife, PE. Data were collected virtually, applying a structured questionnaire on Google Forms® from June ato August 2021. The chi-square test or Fisher’s exact test were used to associate support, difficulties and socioeconomic, housing, care and biological variables. Student’s t-test and Wilcoxon’s test were used to analyze changes in care for continuous variables. Results there was an increase in processed/ultra-processed food consumption (p=0.036) and in the number of meals (p=0.000) and a reduction in satisfaction with the help of teachers (p=0.047). Difficulty in care was associated with help from domestic workers (p=0.011), changes in diet (p=0.026) and not reconciling care with other activities (p=0.039). Support from the social network in care was evident (78.9%). Conclusion and implications for practice there was difficulty in reconciling care with other activities, change in children’s eating patterns and routine, support from the social network in general and reduction in satisfaction with support from teachers. Healthcare and education professionals must provide support to families in care aimed at promoting child health.

Supervision of Surgical Trainees During Operative Procedures: Implementation of a Formal Preoperative Surgical Checklist.

Background Trainers in surgery have an educational obligation to train trainees in performing operative procedures. Objective We hypothesized that poor concordance manifests as discrepancies between the trainee and the trainer, with an associated reduction in satisfaction with the training experience, perception of training quality, and completion of workplace-based assessments (WBAs). This study also aimed to validate the novel Supervised Training Operative Procedure (STOP) online tool. Method We developed an online proforma (STOP online tool) and conducted a prospective, single-blinded study of 53 orthopedic operative procedures with 53 traineesbetween January 19, 2019, and August 27, 2019. Results Forty-four (82%) trainees were listed as the primary surgeon. The overall mean trainee satisfaction (on a 0-10 Likert scale) was 8.25 (range: 3-10), and the mean trainer satisfaction was 8.28 (range: 4-10). A preoperative discussion between the trainee and the trainer occurred in 96.2% of the cases. Forty-eight (91%) trainers preoperatively established trainees' objectives and 91% (n = 48) of the cases showed postoperative completion of objectives. Forty-four (83%) trainers anticipated workplace-based assessment(WBA) completion for trainees, and this translated into 41 (77%) completed WBAs. Overall, 47 (92.9%) trainees felt that the STOP tool would be useful as a surgical training checklist and in the completion of WBAs. Conclusion The STOP checklist is useful in understanding qualitative and quantitative measures of the overall trainee performance of an operative case. This holistic approach will enable us to establish a structured perioperative surgical training checklist, as trainee and trainer requirements are dependent on one another.

Social connections during physical isolation: How a shift to online interaction explains friendship satisfaction and social well-being

Measures implemented to combat the spread of COVID-19 have included stay-at-home orders, social distancing, and self-isolation, all of which have limited in-person interactions. Given the key role of technology in maintaining social connections during this period, the current study examined the experiences of young adults who shifted from predominantly offline to online interaction with friends during COVID-19. Specifically, we investigated whether changing from interacting predominantly with friends in-person to interacting predominantly with friends online (conceptualized as a major change in context of interaction) was associated with lower social well-being (i.e., greater loneliness and lower social connectedness), and examined whether perceived changes in friendship satisfaction as a result of the pandemic mediated these effects. Participants (N = 329; 68.1% female) were Australian young adults, aged between 17 and 25 years (Mage = 20.05 years, SD = 1.97). Data were collected between April 15th and May 24th, 2020, during the nationwide lockdown in Australia. Results indicated that for young adults who primarily interacted offline with friends prior to COVID-19 (as compared to those who interacted predominantly online or equally online and offline before the pandemic), the shift away from face-to-face interactions was associated with a greater perceived reduction in satisfaction with friendships, which, in turn, was associated with greater loneliness and lower social connectedness. Our results highlight the need to consider how young adults adjust to changes in contexts for engaging with friends and how they maintain meaningful social interactions with others during times of extended physical isolation.

Pet Ownership and Multiple Sclerosis during COVID-19.

Background: Multiple sclerosis (MS) is associated with lower quality of life, reduced social participation, and decreased self-efficacy. The COVID-19 pandemic has had documented effects on the health and wellbeing of people with and without MS. Previous research has demonstrated the positive impact pets can have for people living with long-term conditions. Objectives: To explore the rates of pet ownership and pet attachment in people living with MS and pet ownership associations with quality of life, satisfaction with social roles, and self-efficacy scores; and to explore the effects of the COVID-19 outbreak on people’s perceived relationships with their pets. Materials and Methods: A postal questionnaire was distributed to members of a local MS Register and a control group of people without MS. The questionnaire assessed quality of life, satisfaction with social roles, self-efficacy, the perceived roles of pets, and pet-related concerns experienced during the COVID-19 pandemic. Results: No apparent difference in attachment to pets was found between the patient and control groups. Pet ownership and level of attachment were not associated with differences in quality of life or self-efficacy scores in people living with MS. Using multiple regression analysis, pet ownership was associated with a decrease in satisfaction with participation in social roles, but with the estimated effect being small compared to having a diagnosis of MS or being unemployed. Most participants reported that pets had positive roles during the pandemic, and the most reported pet-related concern was access to veterinary treatment. Conclusion: Pet owners both with and without MS reported subjective benefits to their wellbeing from pet ownership during COVID-19, although analysis suggested that pet ownership was associated with a reduction in satisfaction with social roles. The study had several limitations and suggestions are made for future work.

How Social Assistance Affects Subjective Wellbeing: Lessons from Kyrgyzstan

This paper investigates the effects of social assistance on subjective well-being looking at the case of Kyrgyzstan. For this purpose, we exploit recent changes in the design of social assistance and apply a difference in difference (DiD) method combined with an inverse probability weighting (IPW) technique. In contrast to the existing literature, we find that in the short-term, the receipt of social assistance benefits is associated with lower levels of subjective well-being. Our findings also reveal that participation in social assistance leads to some reduction in satisfaction regarding recipients’ own economic conditions. Moreover, we find that the negative effects on subjective well-being disappear for the oldest generations, which experienced the dissolution of the Soviet Union. By contrast, the effect is negative for the youth, who grew up in a new society where needing help is ultimately the responsibility of the individual citizen. For individuals with high trust in political institutions, the negative effect of state intervention does not hold, while it persists in case of low trust in political institutions.

Patient's evaluations and expectations of primary care medicine in Israel revisited after two decades — Health Service Research

BackgroundThe European Task Force on Patient Evaluations of General Practice's (EUROPEP) internationally-validated questionnaire measures patients' satisfaction with their primary care physicians. A study published in 1999 showed positive evaluations of primary care among patients across Europe and included 1603 Israeli patients. Major changes have taken place during the past 20 years, in Israel's society, in the healthcare system, and particularly in primary care clinics. ObjectivesThe study aims to reevaluate patients' satisfaction with their primary care physicians and care clinics in Israel and compares the results to the 1999 survey. MethodsA survey based on the EUROPEP questionnaire was conducted among 1617 people. Data collection was carried out by an internet panel for the Hebrew speaking population and by a phone questionnaire for the Arabic speaking population. ResultsThe study's results show a significant reduction in satisfaction. Notably, patients' satisfaction with physicians' support relating to emotional problems and physicians' explanations about referrals and workup plans have dramatically deteriorated. ConclusionsThe decrease in patients' satisfaction with primary care physicians and clinics found in the current study is concerning and requires recognition and further exploration. Practice implicationsThe results may be used as a baseline for future assessments of trends in patients' satisfaction.

Identifying Activity Limitation and Decline in Quality of Life in Patients with Knee Osteoarthritis Who Are Scheduled to Undergo Total Knee Arthroplasty.

This study examines factors associated with activity limitation and the decline in quality of life in patients with knee osteoarthritis (OA), and to determine standard values that would be useful for understanding the disease state. We assessed individual factors, the modified version of the Self-Rating Frenchay Activities Index (SR-FAI), and the Japanese Knee Osteoarthritis Measure (JKOM) of 661 participants. Multiple regression analyses were used to examine the relationship between dependent and explanatory variables. Standard values were calculated after stratifying based on factors related to each dependent variable through multiple regression analyses. Among the participants aged 60-74/75-89 years, the standard values for the modified SR-FAI were 23/19 and 20/18 points for K-L grades III and IV in the males, and 29/23 and 26/21 points in the females, respectively. The standard values for the JKOM were 35/49 and 45/59 points for K-L grades III and IV in the males and 41/52 and 47/60 points in the females, respectively. These standard values are a useful index for interpreting the degree of activity limitation and satisfaction reduction in patients with knee OA, and could help in clinical decision making for healthcare providers.

Differences in patient satisfaction with virtual telephone clinics in a tertiary referral centre for otolaryngology during and after lockdown measures during the SARS-Cov2 pandemic.

IntroductionThe SARS-Cov2 pandemic has caused considerable disruption to provision of routine outpatient care. This pandemic has necessitated a more modern and innovative approach to clinics, which could potentially change outpatient organisation and improve efficiency in the long term. Telephone clinics are the most practical way to deliver healthcare at a distance.AimThe purpose of the present study was to assess patient satisfaction with a virtual telephone clinic in a tertiary referral centre for otolaryngology first during the height of the SARS-Cov2 pandemic, and subsequently at a physical follow-up appointment after easing of “lockdown” measures.MethodsPatients were enrolled prospectively via a telephone interview over a 1-week period during the height of the “lockdown” measures, and subsequently at a physical appointment when measures eased.ResultsOverall, patients responded very positively in the anonymised questionnaire at the time of their virtual appointment. However, at a subsequent physical appointment, there was a reduction in overall favourable responses from patients. While patients still thought virtual clinics were a good idea and convenient in the context of SARS-Cov2, we noted a reduction in satisfaction in other key aspects of their care. Notably, patients were less likely to think that virtual clinics were able to properly address their condition.ConclusionWhile virtual clinics remain a useful tool during the height of lockdown measures during the SARS-Cov2 pandemic, we did note a significant reduction in favourable responses to virtual appointments over physical ones upon easing of lockdown measures. Patients remained cautious in suggesting that outpatient appointments may be replaced by virtual clinics.

Adapting clinical pharmacy staffing models during the COVID‐19 pandemic: Lessons learned and considerations for future disaster planning

AbstractIntroductionIn response to the coronavirus disease 2019 (COVID‐19) pandemic, health care institutions have faced challenges necessitating operational agility to facilitate provision of optimal patient care. This research was performed to elucidate how pharmacy departments adapted their staffing models, and the impact on frontline staff satisfaction.MethodsCritical care pharmacists in the American College of Clinical Pharmacy (ACCP) and the American Society of Health‐System Pharmacists list‐serves were electronically invited to participate in a 28‐question survey between April and May 2020. Likert‐like questions used a 1 to 5 (strongly agree to strongly disagree) scale, and responses were compared based on the degree of satisfaction with implemented pharmacy leadership strategies. Practice model changes were compared before and during the COVID‐19 pandemic. Multivariate logistic regression was used to assess the effects of independent variables on the primary outcome ‐ satisfaction with pharmacy leadership response.ResultsRespondents (N = 168) representing 40 states in the United States participated. Forty percent of respondents experienced a surge, 68% experienced a staffing model change, and 65% were satisfied overall with their pharmacy leadership's response to the COVID‐19 pandemic. Both specialists (50% vs 21%, P = .013) and unit‐based generalists (65% vs 35%, P &lt; .001) rounded less frequently in response to the COVID‐19 pandemic. Disagreement with “Satisfied with leadership efforts to protect staff (limiting in‐person meetings, changing code response)” decreased the odds of satisfaction by 96% (odds ratio [OR] 0.043 [95% confidence interval (CI) 0.005‐0.336], P = .003). Disagreement with “Satisfied with voice of front‐line staff” was associated with an 84% reduction in satisfaction (OR 0.165 [95% CI 0.049‐0.549], P = .003). Eliminating in‐person rounds was associated with a 95% decrease in satisfaction with pharmacy leadership (OR 0.053 [95% CI 0.007‐0.392], P = .004). Disagreement with “I believe I am at increased risk for COVID‐19 due to departmental staffing decisions” increased satisfaction (OR 3.8, 95% CI [1.06‐13.91], P = .041).ConclusionFrontline staff perceptions can inform practice model changes to improve employee satisfaction while providing safe, reliable, and responsible patient care.

The Impact of Gradual and Immediate Nicotine Reduction on Subjective Cigarette Ratings.

BackgroundA recent clinical trial showed that an immediate transition to very low nicotine content (VLNC) cigarettes, compared with a gradual transition, produced greater reductions in smoking behavior, smoke exposure, and dependence. However, there was less compliance with the instruction to smoke only VLNC cigarettes in the immediate versus gradual reduction condition. The goal of this study was to test whether nicotine reduction method alters subjective ratings of VLNC cigarettes, and whether subjective ratings mediate effects of nicotine reduction method on smoking behavior, smoke exposure, dependence, and compliance.MethodsThis is a secondary analysis of a randomized trial conducted across 10 sites in the United States. Smokers (n = 1250) were randomized to either a control condition, or to have the nicotine content of their cigarettes reduced immediately or gradually to 0.04 mg nicotine/g of tobacco during a 20-week study period. Participants completed the modified Cigarette Evaluation Questionnaire (mCEQ).ResultsAfter Week 20, the immediate reduction group scored significantly lower than the gradual reduction group on multiple subscales of the mCEQ (ps < .001). The Satisfaction subscale of the mCEQ mediated the impact of nicotine reduction method on smoke exposure, smoking behavior, dependence, compliance, and abstinence. Other subscales also mediated a subset of these outcomes.ConclusionsAn immediate reduction in nicotine content resulted in lower product satisfaction than a gradual reduction, suggesting that immediate reduction further reduces cigarette reward value. This study will provide the Food and Drug Administration with information about the impact of nicotine reduction method on cigarette reward value.ImplicationsThese data suggest that an immediate reduction in nicotine content will result in greater reductions in cigarette satisfaction than a gradual reduction, and this reduction in satisfaction is related to changes in smoking behavior and dependence.

Testing Statebuilding’s ‘Missing Link’: Effects of Government Communications in Colombia

Research from developed countries indicates that improving how government communicates with the public can increase trust in government and satisfaction with public services. In countries affected by violent conflict, communication has even been described as the ‘missing link’ necessary to rebuild a positive relationship between citizen and state. Does this approach work? This paper presents a field experiment implemented in partnership with a Colombian government agency, to test two communication interventions in statebuilding areas. The results suggest limits to these programmes. One treatment – provision of information on service delivery via text messages – led to a reduction in satisfaction with services. For the second treatment – an invitation for citizens to vote on service provision priorities – we can detect no effect. We find evidence that people’s prior beliefs are strong drivers of these results: both treatments had negative effects among people with low political interest and knowledge, suggesting that informational interventions may backfire among precisely the sub-populations that statebuilders seek to engage. Instead of improving perceptions of service delivery, they may have raised expectations among this otherwise apathetic population.

Urban-rural difference in satisfaction with primary healthcare services in Ghana

BackgroundUnderstanding regional variation in patient satisfaction about healthcare systems (PHCs) on the quality of services provided is instrumental to improving quality and developing a patient-centered healthcare system by making it more responsive especially to the cultural aspects of health demands of a population. Reaching to the innovative National Health Insurance Scheme (NHIS) in Ghana, surpassing several reforms in healthcare financing has been a milestone. However, the focus of NHIS is on the demand side of healthcare delivery. Studies focusing on the supply side of healthcare delivery, particularly the quality of service as perceived by the consumers are required. A growing number of studies have focused on regional differences of patient satisfaction in developed countries, however little research has been conducted concerning patient satisfaction in resource-poor settings like in Ghana. This study was therefore dedicated to examining the variation in satisfaction across rural and urban women in Ghana.MethodsData for the present study were obtained from the latest demographic and health survey in Ghana (GDHS 2014). Participants were 3576 women aged between 15 and 49 years living in non-institutional settings in Ghana. Summary statistics in percentages was used to present respondents’ demographic, socioeconomic characteristics. Chi-square test was used to find association between urban-rural differentials with socio-economic variables. Multiple logistic regression was performed to measure the association of being satisfied with primary healthcare services with study variables. Model fitness was tested by pseudo R2. Statistical significance was set at p < 0.05.ResultsThe findings in this study revealed that about 57.1% were satisfied with primary health care services. The urban and rural areas reported 57.6 and 56.6% respectively which showed no statistically significant difference (z = 0.64; p = 0.523; 95%CI: -0.022, 0.043). Bivariate analysis showed that region, highest level of education, wealth index and type of facility were significantly associated with location of residence (urban-rural areas). After adjusting for confounding variables using logistic regression, geographical location became a key factor of satisfaction with primary healthcare services by location of residence. In urban areas, respondents from Greater Accra had 64% increase in the level of satisfaction when compared to those in Western region (OR = 1.64; 95CI: 1.09–2.47), Upper East had 75% increase in satisfaction compared to Western region (OR = 1.75; 95%CI: 1.08–2.84), Northern had an estimated 44% reduction in satisfaction when compared to Western region (OR = 0.56; 95%CI: 0.34–0.92). However, rural areas in Central, Volta, Eastern, Ashanti, Brong Aghafo, Northern and Upper West region had 51, 81, 69, 46, 62, 75 and 61% reduction respectively in the level of satisfaction when compared to Western region.ConclusionsPatient satisfaction is an important indicator of health outcomes. Quality of care and measuring level of patient satisfaction has been found to be the most useful tool to predict utilization and compliance. In fact, satisfied patients are more likely than unsatisfied ones to continue using health care services. Our results suggest that policymakers need to better understand the determinants of satisfaction with the health system and how different socio-demographic groups perceive satisfaction with healthcare services so as to address health inequalities between urban and rural areas within the same country.

Smoking concordance during pregnancy: Are there relationship benefits?

ObjectiveCouples often engage in similar patterns of behavior, including substance use, and similarity may benefit relationship quality. Such relationship benefits may be especially salient for adolescent and young couples, whose relationships are often unstable and prone to breakups. This study examined the effect of mutual smoking during pregnancy on relationship quality in pregnant adolescent and young adult couples. MethodsCouples (N = 228; MAgeFemale = 18.69; MAgeMale = 21.12) were recruited from obstetrics/gynecology clinics in Connecticut from July 2007 to February 2011. Couples completed measures of recent smoking and relationship quality (i.e. satisfaction, affectional expression, cohesion, and consensus) during pregnancy and at six months postpartum. Data were analyzed using multilevel models to account for interdependence within dyads. ResultsDiscrepant smoking patterns were associated with a reduction in satisfaction and cohesion over time (B = −1.14, p = 0.03, and, B = −2.74, p = 0.03, respectively), and a reduction in consensus over time for female participants, B = −1.98, p = 0.07, but not for male participants, p = 0.51. Discrepant smoking was not related to affectional expression, p = 0.11. ConclusionsResults suggest relationship benefits concordant smoking patterns during pregnancy. Interventions should consider potential unintended relationship consequences of changing individual health behavior and instead work to develop couple-level health interventions.

Infrequent Walks down Memory Lane: People Overestimate How Much They Will Retrospect about Experiences

People value experiences in part because of the memories they create. Yet, we find that people systematically overestimate how much they will retrospect about their experiences. This overestimation is driven by (a) a desire to retrospect about experiences and (b) an erroneous belief that this desire will necessarily lead to actual retrospection. We find that desirability is a significantly weaker predictor of actual retrospection than it is of predicted retrospection, resulting in more overestimation when the desirability of retrospection is greater. Importantly, people do not lose interest in retrospecting over time, but, instead, simply forget to remember. Furthermore, this overestimation of retrospection has consequences, as the degree of overestimation reliably predicts declining satisfaction with the experience over time. However, buying physical reminders (e.g., merchandise) mitigates this reduction in satisfaction by increasing how much people actually retrospect, bringing their realized retrospection more in line with their forecasts (and aspirations).

Recruiting to Clinical Trials on the Telephone - a randomized controlled trial.

BackgroundInformed consent is an essential element of clinical research. Obtaining consent, however, may be challenging. The use of the telephone for giving information and obtaining consent may be practical but little formal research has been done.MethodsWe examined the use of the telephone for the purpose of informing expectant mothers about The Danish Calmette Study; a randomized clinical trial assessing neonatal Bacille Calmette-Guérin vaccination. Expectant mothers received an invitation letter with a Participant Information Sheet about The Danish Calmette Study, the present trial, and a Consent Form. Two to 4 weeks later we contacted the mothers to discuss potential participation in the present trial. At this initial telephone contact, and after consent from the mothers, we randomized expectant mothers to receive the verbal information about The Danish Calmette Study by telephone, or at a face-to-face consultation. The primary outcome was a communication score, consisting of comprehension of information about The Danish Calmette Study and satisfaction with the information process. The outcome was measured using a questionnaire 2 days after the information was provided, and 2.5 months after the birth of the child.ResultsThe communication score obtained 2 days after information was given was significantly reduced in the telephone group, effect size −0.74 (95% confidence interval (CI), −1.11 to −0.36). The effect sizes of the subscores were −0.87 (95% CI, −1.25 to −0.49) for satisfaction and −0.22 (95% CI, −0.58 to 0.14) for comprehension. The effect sizes were slightly reduced when assessed 2.5 months after the birth.ConclusionThe communication score was reduced in the telephone group. This was due to a reduction in satisfaction, while no difference in the comprehension could be found in comparison to the control group. This may be ethically acceptable as both groups had high satisfaction scores.Trial registrationClinicalTrials.gov, registered on 5 October 2015 with trial registration number NCT02570061.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1680-y) contains supplementary material, which is available to authorized users.

Comparison of Quality of Life, Sexual Satisfaction and Marital Satisfaction between Fertile and Infertile Couples.

Fertility plays an important role in sexual and psychological function in families. Infertility can result in major emotional, social, and mental disorders, including a reduction in satisfaction with marital life and quality of life. The present study aimed to compare the quality of life and marital satisfaction and sexual satisfaction between fertile and infertile couples. This analytical cross-sectional study was conducted on 250 couples at the Fatemiyeh Educational Research Center affiliated to Hamadan University of Medical Sciences, Hamadan, Iran, from May to August in 2014. The subjects were randomly selected from the patients referred to this center using a table of random numbers. They were then allocated into two groups of infertile group (n=125) and fertile group (n=125). The study participants completed World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, Linda Berg's Sexual Satisfaction Scale, and Enrich Marital Satisfaction Scale. Then, the data were entered into the SPSS version16 for statistical analysis. The Chi-square and Mann-Whitney tests were also applied to compare the data between the groups. The results revealed no significant difference between the two groups regarding demographic and general health variables. The mean scores of sexual satisfaction were 63.67 ± 13.13 and 46.37 ± 7.72 in the fertile and infertile couples, respectively. Furthermore, the mean scores of marital satisfaction were also 44.03 ± 9.36 and 36.20 ± 4.03 in the fertile and infertile groups, respectively. Our finding demonstrated that the fertile couples obtained significantly higher mean scores of quality of life as well as lower mean scores of sexual satisfaction and marital satisfaction as compared to the infertile ones (P<0.001). According to the results, the fertile couples obtained significantly higher quality of life and lower sexual satisfaction and marital satisfaction as compared to the infertile ones. Therefore, holding consultation programs and conducting more studies are necessary for improving the quality of life and promoting sexual and marital satisfaction in infertile couples.

Sexuality in Surgically Treated Carcinoma Penis Patients and Their Partners.

Most common treatment offered to carcinoma penis patients is surgery. This results in not only mutilation of the genitals but also affects their sexuality. The treating physician fails to address the issue due to the paucity of the data in this regard. Hence, we decided to evaluate sexuality in these patients after surgical treatment for penile cancer. Most of the times, their partners also face problems of sex and sexuality, regarding which there is no literature. Hence, we decided to include their partners also in the study. We retrieved records of the patients who underwent surgical treatment for carcinoma penis at our institute. After obtaining ethical committee approval, they were invited along with their partners for personal interview. After obtaining written informed consent from each of them, they were administered sexual functioning questionnaire (SFQ). Sexuality was evaluated based on the scores obtained. Performance anxiety was reported by majority of these patients. Their sexual interest, arousal and desire remained almost intact with reduction in satisfaction more so in total penectomised patients. Though the partners had accepted the global reduction in sexuality as their fate, their interpersonal relationship remained little disturbed. The study reveals that sexuality is more than the sexual intercourse alone. Proper pre-operative counselling of these patients and their partners by the treating urologist helps better post-treatment adjustment with regards to sexuality in these patients as well as their partners.

Inequity Leads to Distress and a Reduction in Satisfaction: Evidence From a Priming Experiment

Considerable research has shown that perceptions of inequity in relationships are associated with distress and relationship dissatisfaction, thus providing support for equity theory’s predictions. The evidence, however, is based primarily on correlational data, making it difficult to determine causality. The reverse causal direction could also explain the correlational findings—dissatisfaction could lead to perceptions of inequity. This study employed experimental priming, in which participants wrote a narrative about a past situation in their relationship, either an underbenefiting situation, an overbenefiting situation, or an equity situation (randomly assigned). Participants who were primed to think about a past underbenefiting inequity reported more distress than those who were primed to think about a past overbenefiting inequity; those who were primed for equity were the least distressed. In addition, the equity/inequity prime affected participants’ score on a satisfaction scale completed in regard to their current relationship. Those who wrote about a past underbenefiting inequity reported lower relationship satisfaction than those who wrote about either an equity or an overbenefiting inequity. The results of this study suggest that making salient inequity situations from one’s relationship may have negative effects on the relationship.

Effect of SKy bone expander system by percutaneous osteoplasty in treatment calcaneal fracture

Objective To explore the clinical effect of percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture.Methods 63 feet of 55 patients with calcaneal fractures were involved in this study.According to Sanders fracture classification including 38 feet of Sanders Ⅱ,18 feet of Sanders Ⅲ,7 feet of Sanders Ⅳ.There were 6 to 16 days interval between the injuries and the surgeries.The patients were treated by percutaneous osteoplasty with the SKy bone expander system.The standard of operation was the satisfaction of reduction and Bohler's and Gissane's angles under X-ray.Results All of 63 feet of 55 patients were followed up for average 22 months.According to the criterion of therapeutic effect,the results were as follows:excellent in 30 cases,good in 26 cases,fair in 7cases,and no poor case.The excellent and good rate was 88.9％.Conclusion Percutaneous osteoplasty with SKy bone expander system in the treatment of calcaneal fracture,especially in reduction and fixation of Sanders type Ⅱ and Sanders type Ⅲ,can recover Bohler's and Gissane's angles,significantly shorten the duration of illness,and has fast recovery and can possess satisfactory curative effect,and it is worth popularizing. Key words: Calcaneus; Fracture fixation; SKy bone expander system