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How surveys are changing at the U.S. Bureau of the Census.
"This article describes the survey activities of the U.S. Census Bureau and recent efforts by the bureau to move toward a more fully automated environment....[It] focuses on four areas in which the Census Bureau is changing its approach to surveys: (1) redesigning the questionnaire for the Current Population Survey to better reflect current labor force conditions; (2) redesigning the same questionnaire to gain advantages from computer-assisted interviewing; (3) redesigning the samples for household surveys to be used during the next decade, a task undertaken after every decennial census; and (4) progress in changing to a computer-assisted survey information collection (CASIC) system and developing a data management network for all Census Bureau surveys."
Diet-induced mood changes in normal populations.
Using an 11-item questionnaire and a double-blind experimental design, changes in mood, hunger and food preference after taking caffeine (100 mg), tryptophan (500 mg), tyrosine (500 mg) or placebo, were investigated in 60 volunteers. At the end of the study, volunteers also ranked the four treatments on a sedation/stimulation scale. Caffeine significantly increased scores for wakefulness, vigor, clarity of mind, energy, feeling full of ideas, feeling full of go and feeling efficient. Caffeine was also ranked as the most stimulating treatment (p less than 0.001). Tyrosine produced no changes, while tryptophan shifted mean scores towards somnolent and lethargic, and was ranked most sedating (p less than 0.05). None of the treatments changed hunger ratings or carbohydrate/protein preference.
A Dutch study of the effects of primary nursing on job characteristics and organizational processes.
In an 850-bed Dutch hospital a study was carried out to evaluate the effects of the implementation of a Dutch form of primary nursing on five job characteristics (viz. autonomy, responsibility, feedback/clarity, complexity/difficulty and job demands) and on the communication and power processes in the organization of the nursing unit. The study consisted of three measuring moments: one pre-intervention (t1, March 1992) and two post-intervention moments (t2, November 1992 & t3, May 1993). Primary nursing was introduced in the two experimental units (the experimental group) after t1. No changes were made to the control group. After t2, this quasi-experimental design changed, because primary nursing was also implemented in the three original control units (the control group) after this moment. The research variables were measured by means of questionnaires. No significant effects were found for the five job characteristics. Only the improvement in the communication with the team head and the decrease in the influence of physicians on patient care in the experimental group and the improved communication with physicians in the control group were in line with expectations. Changes in the amount of influence of different groups on patient care were inconsistent with what had been expected: according to the nurses the influence of the nursing management increased, whereas the influence of the nurses decreased and the influence of the patients did not change. In other words, the shift of power was not in the expected direction.
Patient reported quality of care before vs. after the implementation of a diagnosis related groups (DRG) classification and payment system in one Swedish county.
Patient reported quality of care before vs. after the implementation of a diagnosis related groups (DRG) classification and payment system in one Swedish county. The purpose was to evaluate the effects of a diagnosis related groups (DRG)-intervention on the quality of care as perceived by patients at two surgical clinics in the County Council of Gävleborg, Sweden. The study was planned as a nonequivalent control groups design, but external factors turned it into a prospective longitudinal design. Changes in patient experiences of received care were evaluated for the period 1992-1996. Of the 40 included consecutive patients per year from each hospital, > 85% completed the questionnaire. The selection of patients was defined by diagnoses and surgical treatments, and by geographical area. The results demonstrated a decrease of the quality of care as seen from the patient perspective, especially with respect to treatment by staff. Previously stated DRG goals were partially fulfilled and the DRG-intervention was gradually implemented. Other presumed causal variables were: other reforms, restrained resources, quality assurance activities, organizational and structural changes within the county council. Further studies of the effects of health care reforms would yield more distinct conclusions, provided it would be possible to evaluate interventions prior to full-scale implementation.
Practice visits: a pilot study.
OBJECTIVE: The aim of the paper is to report a pilot study of practice visits. METHOD: The study involved 35 psychiatrists as hosts and/or visitors, as well as four non-psychiatrist visitors, with the model and subsequent design changes described. RESULTS: The Quality Assurance Committee's rationale for practice visits is detailed, together with several focal concerns raised by committee members and other Fellows of the College. CONCLUSIONS: Feedback was highly positive, with visitors being generally more positive and enthusiastic than hosts. A follow-up questionnaire indicated ongoing enthusiasm for such an activity and provided evidence of participants making changes to their practices. Identified concerns and some suggested modifications to the pilot study design are noted.
Intermediate term assessment of the reliability, function and patient satisfaction with the AMS700 Ultrex penile prosthesis.
PURPOSE: The AMS700 Ultrex penile prosthesis is an example of the design changes that penile prostheses have undergone to improve mechanical reliability. Few studies have reviewed an overall experience with the AMS700 Ultrex prosthesis. We review patient outcomes, surgical complications, and Ultrex cylinder intermediate term mechanical reliability and function. MATERIALS AND METHODS: Between March 1990 and November 1994, 145 patients 32 to 79 years old (mean age 58) underwent insertion of an AMS700 Ultrex penile prosthesis. At a followup of 6 to 62 months (mean 42) patients were evaluated with a retrospective clinical record review, and patient and partner questionnaires. RESULTS: From the clinical record review of 145 patients our malfunction, reoperation, infection, erosion, major complication and minor complication rates were 8, 13, 2, 3, 13 and 7%, respectively. Patient responses to our questionnaire showed that 85% were satisfied overall, 85% had durable and reliable implant function, 86% had a sustained level of satisfaction with the implant and 83% remained satisfied after a revision for malfunction. Overall, partner satisfaction with the implant was 76%, and 42% reported maintenance of a good or improved nonsexual relationship after prosthesis implantation. CONCLUSIONS: Our data demonstrate the intermediate term mechanical reliability and function of the AMS700 Ultrex penile prosthesis, and high patient and partner satisfaction with this implant.