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Dissatisfaction
Kinds of Dissatisfaction Selected AbstractsVerbal Avoidance and Dissatisfaction in Intimate Conflict SituationsHUMAN COMMUNICATION RESEARCH, Issue 3 2009Tamara D. Afifi First page of article [source] Eating problems, body image disturbances, and academic achievement: Preliminary evaluation of the eating and body image disturbances academic interference scaleINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 2 2008Tovah Yanover MA Abstract Objective: To examine the relationships between a new scale, the Eating and Body Image Disturbances Academic Interference Scale (EBIDAIS), and measures of eating disturbance, body image, and academic achievement. Method: One thousand five hundred eighty-four college undergraduates completed the measures in an online survey and were awarded class credit for their participation. Measures included the Eating Disorder Inventory Bulimia, Drive for Thinness, Body Dissatisfaction, and Perfectionism subscales. Grade point average (GPA) was also reported. Results: Academic interference and GPA were significantly correlated, indicating that higher interference scores were related to lower GPA. EBIDAIS was also significantly correlated with drive for thinness, bulimia, and body dissatisfaction, but was not significantly associated with perfectionism. The correlation between interference and GPA was substantially higher for a subsample of individuals who scored in the elevated range on eating and body dissatisfaction. Conclusion: Academic interference may be a relatively unexamined, but potentially important, outcome for individuals who experience eating problems and body image disturbance. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] Body dissatisfaction and drive for thinness in young adult twinsINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2005Anna Keski-Rahkonen MD Abstract Objective We explored correlates of the Eating Disorder Inventory subscales Body Dissatisfaction (BD) and Drive for Thinness (DT) and genetic and environmental influences on these traits. Method In a population-based sample of 4,667 Finnish twins aged 22,27 years, we conducted twin modeling to explore genetic and environmental contributions to body dissatisfaction and drive for thinness. Logistic regression was used for the correlational analysis. Results Various eating and body size-related factors and psychosomatic symptoms were significantly associated with high body dissatisfaction and drive for thinness in both genders. In women, early puberty onset, early initiation of sexual activity, and multiple sex partners were statistically significant risk factors of body dissatisfaction. In gender-specific univariate twin models, additive genes accounted for 59.4% (95% confidence interval [CI] = 53.2,64.7%) of the variance in body dissatisfaction and for 51.0% (95% CI = 43.7,57.5%) of the variance in drive for thinness among females, but for none of the variance among males. Discussion There are very distinct gender differences in the heritability patterns of body dissatisfaction and drive for thinness in young adults. © 2005 by Wiley Periodicals, Inc. [source] Does service failure influence customer loyalty?JOURNAL OF CONSUMER BEHAVIOUR, Issue 3 2002Francis Buttle Abstract There is a general consensus that customer loyalty to service providers is not solely dependent upon their level of satisfaction or dissatisfaction. However, the identified antecedents of loyalty remain, at best, highly speculative. The aim of this extensive literature review is to give some understanding of the nature of customer loyalty and the antecedent effects of service dissatisfaction. The research reviewed suggests that customer loyalty is an attitudinal state, reflecting value, trust and commitment within supplier,customer relationships. Satisfaction is one of several antecedents of loyalty. A key influence on loyalty is the offer of unique value-delivering advantages not provided by competitors. Thus firms need to develop positive value-based exit barriers to achieve loyalty. When service failures occur, the recovery process is likely to have a greater impact on loyalty than the original service failure. The key to successful recoveries was found to be the customer's perception of ,fairness'. Recovery programmes must get it right first time. Customers who remain dissatisfied after a complaint has been handled are more dissatisfied than if no recovery attempt had been made. Dissatisfaction and customer satiation are major causes of a customer's exit. The solution to customer satiation is dynamic value creation. Collection and monitoring of customer data is needed for success and two-way communication is vital. Copyright © 2002 Henry Stewart Publications. [source] Chewing ability and quality of life in an 80-year-old populationJOURNAL OF ORAL REHABILITATION, Issue 5 2006Y. TAKATA summary, As quality of life (QOL) could be influenced by oral status in the elderly, we examined whether chewing ability or number of teeth affected QOL in 80-year olds. A cross-sectional survey included dental examination, chewing self-assessment, and a QOL questionnaire. A total of 823 people who were 80 years old participated in this study. QOL was assessed in terms of satisfaction with physical condition, meals, daily living and social interactions, and with face-scale scores. After adjustment for gender, spouse and activities of daily living, dissatisfaction with social interactions was 3·9 times more prevalent in individuals able to chew four foods or fewer than in those chewing 15. Dissatisfaction with physical condition, meals and daily living, and poor face-scale scores, were 2·7, 2·4, 3·4, and 2·4 times more prevalent, respectively, in subjects chewing four foods or fewer. The number of teeth showed little effect. In conclusion, self-assessed chewing ability but not number of teeth was associated with QOL in 80-year-old subjects. [source] A survey of treatment outcomes with removable partial denturesJOURNAL OF ORAL REHABILITATION, Issue 8 2003D. Knezovi, Zlatari summary The patient's satisfaction with removable partial denture (RPD) therapy has become an increasingly important factor in prosthetic treatment. This study examined patients' satisfaction with RPDs in relation to some socio-economic variables, patients' habits of wearing and cleaning RPDs, comfort of wearing RPDs and different RPDs characteristics. A questionnaire was devised for the purpose. Two hundred and five patients were required to assess satisfaction with RPDs. They graded RPDs, depending on the level of satisfaction, on scale ranging from 1 to 5. A dentist determined Kennedy classification, material and denture support, denture base shape, number of missing teeth and evaluated denture construction. Majority of the patients were satisfied with the prosthesis. The patients of a higher education level gave lower grades (P < 0·05) to aesthetics of maxillary RPDs. Almost half of the patients were wearing RPDs during the day. Most of the patients cleaned RPDs three times a day. A significant difference was found between the patients' grades for comfort of wearing mandibular RPDs and number of missing teeth and between hygiene of mandibular RPDs and habits of cleaning them. Majority of the patients treated with RPDs were satisfied with the prosthesis. Dissatisfaction was related to mastication, esthetics, number of missing teeth and maintenance of oral hygiene. [source] Overactive Bladder in Female Patients with Chronic Diseases Visiting Primary Care Doctors: Effect of Age on Prevalence and BothersomenessLUTS, Issue 1 2009Masaki YOSHIDA Objectives: We evaluated the effects of age on the prevalence and bothersomeness of overactive bladder (OAB) in female patients with chronic diseases visiting primary care doctors. Methods: We used the pooled data of the SURPRISE survey in which 121 doctors and 1388 female patients aged 40 years or older responded to questionnaires. Results: The OAB prevalence rate in patients was estimated by doctors to be 9.5%. However, the OAB prevalence rate according to patients, as defined by the OAB symptom score, was 22.3%. The rate was increased with age. The number of patients with OAB was much higher than estimated by doctors. Approximately 25% of patients were dissatisfied with their present urinary condition. The rate was increased with age. Dissatisfaction with present urinary condition was strongly correlated with severe urgency score in all age groups. In elderly patients, contribution of urgency incontinence and nocturia to dissatisfaction was also increased. Thirteen percent of patients were receiving treatment for their OAB. However, 15.8% were untreated, regardless of having OAB, suggesting that treated patients comprise less than half of all OAB patients. This tendency was observed in all age groups. In the correlation between satisfaction with pharmacological treatment and each OAB symptom, contribution of urgency to satisfaction with pharmacological treatment was the highest. Conclusion: Urgency is the most bothersome symptom and shows the highest contribution to treatment satisfaction. In elderly patients, urgency incontinence and nocturia are proportionally greater problems. Management of urgency is essential for improving quality of life and satisfaction with treatment in OAB patients. [source] Older peoples' satisfaction with home-based dialysisNEPHROLOGY, Issue 4 2010SARAH DERRETT ABSTRACT: Background: The proportion of older people receiving dialysis is rapidly increasing. The typical choice for older patients is between home-based peritoneal dialysis (PD) and clinic-based haemodialysis (HD). Some centres have been successful in encouraging all patients , including older patients , to have home-based self-administered PD or HD. Aim: To (i) describe the overall satisfaction with renal services among older patients dialysing, or in training, with HD or PD at home; and (ii) examine the relationship between residential distance from the nephrology unit and satisfaction with home-based dialysis. Methods: Participants were aged 60 years or more; and were either dialysing at home or training for dialysis at home. Two methods of cross-sectional data collection were used: (i) structured quantitative interviews with all participants; and (ii) qualitative interviews with a selected subgroup. Results: Participants comprised 45 patients on dialysis (94% of 48 eligible). Their average age was 68 years. Duration of dialysis averaged 28 months (range 3,150 months). Ratings of ,very good or excellent' were reported for dialysis treatment by 40 (89%) patients. Patients on dialysis, despite experiencing frustration with dialysis itself, expressed satisfaction across four categories: staff, information provision, involvement in decision-making and confidence in managing dialysis. Dissatisfaction was infrequent. Conclusion: This pilot study suggests that older patients trained to dialyse at home using PD or HD are highly satisfied with the nephrology service , even when living remote from the nephrology unit. Home-based dialysis is possible in older patients with levels of comorbidity and disease severity as serious as elsewhere. [source] Prevalence of overweight, obesity, and associated psychological problems in Qatari's female populationOBESITY REVIEWS, Issue 2 2006A. Bener Summary Dissatisfaction with body weight and the use of unhealthy weight reduction practices have been reported among adolescents. It is important to conduct rigorous studies using large representative samples of female adolescents to assess accurately the frequency of dieting, overweight and eating disorders and accompanying attitudes. The aim of the present study was to examine the severity of dieting and its association with obesity, body satisfaction and psychological problems in female adolescents. A representative sample of 800 girls aged 14,19 years were approached during the period of October to December 2004, and 566 girls gave consent and participated in the study, thus giving a response rate of 70.8%. Self-reports were obtained from 566 teenage girls using the Adolescent Dieting Scale and the Self-Reporting Questionnaire (SRQ-20) for psychopathology. Subjects were classified into three categories: acceptable weight (BMI < 25 kg m,2); overweight (BMI 25,29.9 kg m,2); and obese (BMI > 30 kg m,2). The prevalence of overweight and obesity for female adolescents were 13.4% vs. 1.8%; 39.9% were intermediate dieters, and 8.3% were extreme dieters. Dieting was not associated with age but was significantly associated with body mass index (BMI) (P = 0.045). Extreme dieting was strongly associated with peer perception of respondent's figure (P < 0.001) and self-perception of figure (P = 0.016). Additionally, in adult Qatari population overweight and obesity for males were (34.4% vs. 34.6%) and for females were (33.0% vs. 45.3%). This is significantly higher than adolescent girls. (P < 0.01). The SRQ score was significantly highest in the extreme dieters group (P = 0.005). The extreme dieters get most of their education about dieting from school (14.0%) and TV (43.6%). The present study revealed strong evidence for the association between frequent dieting and overweight, body image dissatisfaction and psychological problems among adolescent females. [source] Front and Back Covers, Volume 25, Number 2.ANTHROPOLOGY TODAY, Issue 2 2009April 200 Front cover caption, volume 25 issue 2 Front cover Ethnicity, Race and the Limits of Human Identity The front and back covers show artist Sean Weisgerber's interpretation of the theme of this issue, the problem of classifying human identity in a world of fusion and change. Articles address biometric security, the use of the concept of ,tribe' in US army counter-insurgency programmes, and human identity as constituted in and through debate among Afghani refugees recently returned from northern Pakistan to Afghanistan. The difficulty of fitting human diversity into strictly defined categories is most acutely evident in questions asked on census forms. In this issue, Peter Aspinall considers the broad range of terms proposed and debated for the ,mixed race' population. Many have complex histories and have been used to subsume individuals of varied and sometimes disparate ethnic and racial origins. Dissatisfaction with the widely used term ,mixed race', contested by anthropologists and sociologists among others on the grounds that it references the now discredited concept of ,race', has led to the search for an alternative. In 1994 the Royal Anthropological Institute advanced ,mixed origins', although such advocacy has gained little momentum. ,Mixed race' now competes with terms such as ,mixed heritage', ,dual heritage' and ,mixed parentage' amongst data users, and UK government usage also reflects this diversity in terminology. However, research indicates that the term of choice of most respondents in general and student samples of this population is ,mixed race'. Terms invoking just two groups , such as ,mixed parentage', ,dual heritage', and ,biracial', are preferred by few. While ,mixed origins' is likely to have a continuing niche role in professional practice, such as legal usage and assessment of health risks, it is premature to argue that the umbrella term ,mixed race' should be replaced by candidates that are not self-descriptors. Bruno Latour's editorial places such questions in a broader context as he draws attention to a lively debate on the biggest question of all, the essence of nature itself. In the context of an emergent multi-naturalism, has anthropological theory itself been ,decolonizing enough'? [source] ,Mixed race', ,mixed origins' or what?ANTHROPOLOGY TODAY, Issue 2 2009Generic terminology for the multiple racial/ethnic group population A broad range of terms have been proposed and debated for the ,mixed race' population. Dissatisfaction with ,mixed race', the term most widely used but contested on the grounds that it references the now discredited concept of ,race', has led to the search for an alternative. In 1994 the Royal Anthropological Institute advocated ,mixed origins'; despite subsequent further efforts, this alternative has gained little momentum. ,Mixed race' now competes with terms such as ,mixed heritage', ,dual heritage', and ,mixed parentage' amongst data users. However, research indicates that the term of choice of most respondents in general population and student samples of this population group is ,mixed race', other terms - including ,mixed origins' - attracting little support. Given its dominance, it is premature to argue that the term ,mixed race' should be replaced by candidates that are not self-descriptors. [source] Women as Consumers of Maternity Care: Measuring "Satisfaction" or "Dissatisfaction"?BIRTH, Issue 1 2008Maggie Redshaw BA ABSTRACT: The measurement of "satisfaction" has been intrinsic to the models of evaluation of health care. However, a thoughtful approach to its use has not always been evident in which this concept is understood to represent a complex group of theoretical constructs involving attitudes, expectations, and perceptions that may be both positive and critical. These constructs require investigation and evaluation using recognized and developed methodologies. At the same time the importance of listening to patients and to women and their partners in evaluating and carrying out research on maternity care cannot be underestimated if the instruments used are to have construct and face validity. Qualitative data of this kind have a dual function of contributing to a more complex picture of women's experience and of suggesting that researchers need to explore the issues related to "dissatisfaction" at least as much as those arising from a positive overall view of care. (BIRTH 35:1 March 2008) [source] The family impact of skin diseases: the Greater Patient conceptBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2007M.K.A. Basra Summary Background, Although the impact of skin disease on patients' health-related quality of life (HRQoL) is well known, little work has been carried out to determine the secondary impact of a patient's skin disease on the patient's family or partner. Objectives, The aim of this study was to identify the different aspects of a family member's QoL that may be affected by having a family member with skin disease. Methods, Qualitative interviews were conducted with 50 family members/partners of patients attending the outpatient clinic of a university hospital, with a wide range of dermatological conditions (n = 21). Subjects were invited to discuss in detail all the ways that their lives were affected by living with a patient with skin disease. Results, The mean age of subjects (M = 19; F = 31) was 48·1 years (SD = 15·7) most were either parents (44%) or spouses/partners (44%) of the patients. Patients' ages (M = 16; F = 34) ranged from 5 months to 84 years. Fifty-nine aspects of QoL of family members were identified that were adversely affected by the patients' skin disease. These were categorized into 18 main topic areas: Emotional distress (98%), Burden of care (54%), Effect on housework (42%), Social life (48%), Holidays (46%), Financial aspect (30%), Physical well-being (22%), Job/study (40%), Leisure activities (26%), Sleep (20%), Food/drink (12%), Restriction of liked activities (14%), Need for support (12%), People's attitude (10%), Dissatisfaction with medical care (14%), Effect on sex life (8%), Role of religious faith (8%) and Miscellaneous (16%). There was no significant difference between male and female subjects regarding main QoL areas affected. The median number of main topic areas reported per family member was five (mean = 5·2, range = 1,10, SD = 2·64). Conclusions, This study has demonstrated that skin diseases can significantly impair the HRQoL of the patient's family in very diverse ways. Asking family members about this impact is greatly appreciated by them. We propose the ,Greater Patient' concept to describe the immediate close social group affected by a person having skin disease. [source] Physician professionalism for a new centuryCLINICAL ANATOMY, Issue 5 2006James W. Holsinger Jr. Abstract During the past 50 years, physicians have become increasingly dissatisfied with certain aspects of their profession. Dissatisfaction has intensified with the advent of managed care in the late 20th century, the medical liability crisis, and the growing divergence between the professional and personal expectations placed upon physicians and their practical ability to meet these expectations. These and other factors have encroached on physician autonomy, the formerly ascendant professional value within medicine. As the underlying values and practical realities of the broader American health care system have changed, the professional values and practices of physicians have failed to adapt correspondingly, resulting in a "professionalism gap" that contributes to physician dissatisfaction. To improve the outlook and efficacy of modern American physicians, the profession must adopt a new values framework that conforms to today's health care system. This means foregoing the 20th century's preferred "independent physician" model in favor of a new professional structure based on teamwork and collaboration. Convincing established physicians to embrace such a model will be difficult, but opportunities exist for significant progress among a new generation of physicians accustomed to the realities of managed care, flexible practice models, and health information technology. The teaching of clinical anatomy, given its incorporation of student collaboration at the earliest stages of medical education, offers a prime opportunity to introduce this generation to a reinvigorated code of professionalism that should reduce physician dissatisfaction and benefit society. Clin. Anat. 19:473,479, 2006. © 2006 Wiley-Liss, Inc. [source] The Sieve Model: An innovative process for identifying alternatives to custody evaluationsCONFLICT RESOLUTION QUARTERLY, Issue 3 2009Robert B. Silver This article reviews the development of the Sieve Model, conceived from dissatisfaction with adversarial processes that encouraged endless destructive fighting and depletion of financial and emotional family resources. Adversarial approaches discourage constructive problem solving and cooperation and are very hard on children. Rather than a piecemeal approach toward divorce, a systemic model was conceived. The Sieve Model is being implemented in the 20th Judicial Circuit of the State of Florida through differentiated case management, after a study revealed that protracted cases primarily involved disputes over children. Families are invited to use pertinent elements in an individualized fashion. Family law professionals are challenged to develop other solution-based efforts akin to mediation to assist families of divorce. The Sieve Model encourages participants to practice solving problems rather than creating them, decreasing divorce brutality and postjudgment conflicts. [source] Quality of life of male outpatients with personality disorders or psychotic disorders: a comparisonCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2008Yvonne HA Bouman Background,Quality of life (QoL) has become increasingly important as an outcome measure in community-based psychiatry. QoL refers to an individual's sense of well-being and satisfaction with his current life conditions. It is measured both through objective social indicators and life domain-specific subjective indicators. People with a personality disorder (PD) or a major mental disorder (MMD) tend to show poor social adjustment, but their relative subjective QoL is not known. Aim,To compare the QoL of male outpatients in treatment for PD or MMD overall and by means of specific social and subjective indicators. Methods,A sample of 135 men under treatment for PD in Dutch forensic outpatient facilities were compared with 79 men with MMD using the extended Dutch version of the Lancashire Quality of Life Profile (LQoLP). Results,Almost all of the objective indicators of QoL were significantly poorer among men with MMD than those with PD, but the groups did not differ on domain-specific subjective ratings of QoL. Indeed, global subjective QoL was lower in the PD than in the MMD patient group. PD outpatients seemed to have a more complex concept of QoL than the MMD outpatients for whom almost half of the variance in subjective QoL rating was related to their everyday activities and their objective sense of safety. Conclusions and implications for practice,Further study of QoL among PD patients would be warranted to test the extent to which subjective dissatisfaction is intrinsic to PD and to explore the possibility of improving it with targeted treatments. Copyright © 2008 John Wiley & Sons, Ltd. [source] UNITED STATES V. BOOKER AS A NATURAL EXPERIMENT: USING EMPIRICAL RESEARCH TO INFORM THE FEDERAL SENTENCING POLICY DEBATE,CRIMINOLOGY AND PUBLIC POLICY, Issue 3 2007PAUL J. HOFER Research Summary: In United States v. Booker, the U.S. Supreme Court held that the federal sentencing guidelines must be considered advisory, rather than mandatory, if they are to remain constitutional under the Sixth Amendment. Since the decision, the U.S. Sentencing Commission has provided policy makers with accurate and current data on changes and continuity in federal sentencing practices. Unlike previous changes in legal doctrine, Booker immediately increased the rates of upward and downward departures from the guideline range. Government-sponsored downward departures remain the leading category of outside,the-range sentences. The rate of within-range sentences, although lower than in the period immediately preceding Booker, remains near rates observed earlier in the guidelines era. Despite the increase in departures, average sentence lengths for the overall caseload remain stable, because of offsetting increases in the seriousness of the crimes being sentenced and in the severity of penalties for those crimes. Analyses of the reasons that judges reported for downward departures suggest that treatment of criminal history and offender characteristics are the two leading areas of dissatisfaction with the guidelines. Policy Implications: Assessment of changes in sentencing practices following Booker by different observers depends partly on competing institutional perspectives and on different degrees of trust in the judgment of judges, prosecutors, the Sentencing Commission, and Congress. No agreement on whether Booker has bettered or worsened the system can be achieved until agreement exists on priorities among the purposes of sentencing and the goals of sentencing reform. Both this lack of agreement and an absence of needed data make consensus on Booker's effects on important sentencing goals, such as reduction of unwarranted disparity, unlikely in the near future. Similarly, lack of baseline data before Booker on the effectiveness of federal sentencing at crime control makes before-after comparisons impossible. Despite these limitations, research provides a sounder framework for policy making than do anecdotes or speculation and sets valuable empirical parameters for the federal sentencing policy debate. [source] Using Quality Management Tools to Enhance Feedback from Student EvaluationsDECISION SCIENCES JOURNAL OF INNOVATIVE EDUCATION, Issue 1 2005John B. Jensen ABSTRACT Statistical tools found in the service quality assessment literature,the T2 statistic combined with factor analysis,can enhance the feedback instructors receive from student ratings. T2 examines variability across multiple sets of ratings to isolate individual respondents with aberrant response patterns (i.e., outliers). Analyzing student responses that are outside the "normal" range of responses can identify aspects of the course that cause pockets of students to be dissatisfied. This fresh insight into sources of student dissatisfaction is particularly valuable for instructors willing to make tactical classroom changes that accommodate individual students rather than the traditional approach of using student ratings to develop systemwide changes in course delivery. A case study is presented to demonstrate how the recommended procedure minimizes data overload, allows for valid schoolwide and longitudinal comparisons of correlated survey responses, and helps instructors identify priority areas for instructional improvement. [source] The esthetic outcome of autotransplanted premolars replacing maxillary incisorsDENTAL TRAUMATOLOGY, Issue 5 2002Ewa Monika Czochrowska Abstract ,,,Autotransplantation of developing premolars to replace maxillary incisors has been documented to provide physiologically sound results, but comprehensive studies of the esthetic outcome have not been made previously. In order to assess the applicability of this approach and to identify factors important for planning of treatment, 22 autotransplanted premolars reshaped to incisor morphology were compared to their natural, contralateral maxillary incisors by scoring of features considered important for esthetics (color, soft tissue appearance, tooth morphology, and position). The sum of scores for each feature was used to place the reshaped transplant in one of three categories , Match, Deviate, Mismatch. The 22 patients were asked to fill in a questionnaire which addressed the same features that were examined professionally, and the responses were categorized as either Satisfied, Acceptable, or Dissatisfied. Eleven of the 22 patients had received orthodontic treatment with fixed appliances following the transplantation. Most of the transplanted premolars matched the contralateral incisor, and the majority of patients were satisfied with the appearance of the transplant. Fourteen percentage of the transplants were categorized as Mismatch and 18% of patients reported dissatisfaction. The distribution in categories assessed professionally and by the patients was not significantly different. The color and gingival width of the transplanted tooth were scored as different from the natural incisor in about half of the bilateral comparisons. For those teeth categorized professionally as Mismatch and by patients as Dissatisfied, a potential for esthetic improvement could be identified, as allocation to these categories was primarily due to suboptimal positioning and restorative build-up of the transplant. Inter-disciplinary planning is important for successful esthetic results. [source] Use of Hyaluronidase in the Treatment of Granulomatous Hyaluronic Acid Reactions or Unwanted Hyaluronic Acid MisplacementDERMATOLOGIC SURGERY, Issue 8 2005Harold J. Brody MD Background. In the past, reactions or misplacement of soft tissue fillers has been fraught with anxiety because time has been the main thrust for improvement in spite of ancillary treatments. Hyaluronidase is an enzyme that dissolves hyaluronic acid in the skin and also assists in the management of granulomatous foreign-body reactions to hyaluronic acid. These reactions may be caused by allergy to the material or immunologic response to the protein contaminants in the hyaluronic acid preparations. Dissolution of material in erroneous placement of material and in allergic reactions can be a time saver and a deterrent to patient dissatisfaction. Objective. To evaluate the use of hyaluronidase in the treatment of both allergic reactions and the erroneous misplacement of hyaluronic acid in the skin. Methods. A case of persistent granulomatous reaction to injectable hyaluronic acid and a case of hyaluronic acid erroneous misplacement with their successful subsequent treatments using intracutaneous hyaluronidase are reported, along with illustrative examples of hyaluronidase use. Results. The use of hyaluronidase reduced the patient discomfort within 24 to 48 hours, deterring any patient anxiety or patient dissatisfaction. Conclusions. Hyaluronidase has a place in the treatment of allergic reactions to hyaluronidase and in the erroneous misplacement of the material. [source] Body Dysmorphic Disorder and the Liposuction PatientDERMATOLOGIC SURGERY, Issue 5 2005Dee Anna Glaser MD background. Body dysmorphic disorder (BDD) is an under-recognized disorder that affects a sizeable number of patients who seek cosmetic enhancement, in particular liposuction. Understanding and recognizing BDD can positively impact the care delivered to patients. objective. To familiarize physicians with the presenting signs of BDD and present strategies for caring for BDD patients in a liposuction and/or cosmetic surgery practice. methods. Review of currently available literature and diagnostic criteria. results. BDD affects approximately 1% of patients in the United States, but as many as 7 to 15% of patients seeking cosmetic surgery. Patients with BDD will usually demonstrate an obsession with the area they seek treatment of. In addition, patients with BDD present a unique challenge to the liposuction surgeon. conclusions. Physicians who care for patients seeking liposuction or other cosmetic procedures should learn to recognize those who have BDD. Proper recognition and counseling of BDD patients can have a significant positive impact on not only their care but also on the patient-physician relationship. Failure to recognize BDD can, and often does, lead to patient dissatisfaction, as well as difficult future interactions with the BDD patient. [source] BUDDHISM AND NEUROETHICS: THE ETHICS OF PHARMACEUTICAL COGNITIVE ENHANCEMENTDEVELOPING WORLD BIOETHICS, Issue 2 2009ANDREW FENTON ABSTRACT This paper integrates some Buddhist moral values, attitudes and self-cultivation techniques into a discussion of the ethics of cognitive enhancement technologies , in particular, pharmaceutical enhancements. Many Buddhists utilize meditation techniques that are both integral to their practice and are believed to enhance the cognitive and affective states of experienced practitioners. Additionally, Mah,y,na Buddhism's teaching on skillful means permits a liberal use of methods or techniques in Buddhist practice that yield insight into our selfnature or aid in alleviating or eliminating dukha (i.e. dissatisfaction). These features of many, if not most, Buddhist traditions will inform much of the Buddhist assessment of pharmaceutical enhancements offered in this paper. Some Buddhist concerns about the effects and context of the use of pharmaceutical enhancements will be canvassed in the discussion. Also, the author will consider Buddhist views of the possible harms that may befall human and nonhuman research subjects, interference with a recipient's karma, the artificiality of pharmaceutical enhancements, and the possible motivations or intentions of healthy individuals pursuing pharmacological enhancement. Perhaps surprisingly, none of these concerns will adequately ground a reflective Buddhist opposition to the further development and continued use of pharmaceutical enhancements, either in principle or in practice. The author argues that Buddhists, from at least certain traditions , particularly Mah,y,na Buddhist traditions , should advocate the development or use of pharmaceutical enhancements if a consequence of their use is further insight into our self-nature or the reduction or alleviation of dukha. [source] Closer to the Shifting Ground: The Rise of Relationship in God-TalkDIALOG, Issue 3 2005By Paul R. Sponheim Abstract:, The article argues that God-talk has changed significantly over the last fifty years and identifies the rise of the notion of relationship (reflecting postmodern dissatisfaction with modernity) as a key factor in this change. That factor is cited in Trinitarian studies, the Creator's relationship with and to the creatures, the science and religion conversation, the connection with context, and the increasing recognition of the adjectival character of theology. In closing the author looks ahead to further relational work in soteriology, anthropology and metaphysics. [source] ASIA PACIFIC COLUMN: New challenges and opportunities in managing substance abuse in MalaysiaDRUG AND ALCOHOL REVIEW, Issue 5 2006MAHMUD MAZLAN MD Abstract Until recently, Malaysia has lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. By the end of 2004, 234 000 heroin users or heroin-dependent individuals had been registered in the official government registry, but other estimates exceed 500 000 for heroin abusers in the country. Amphetamine-type stimulant abuse is also increasing and of considerable public and government concern. Among the population of drug users, HIV and other infectious diseases rates are very high. In the Western Pacific regions, Malaysia has the second highest HIV prevalence (after Vietnam) among adult populations (0.62%) and the highest proportion of HIV cases resulting from injection drug use (76.3%). Drug use and related disorders exert a heavy burden on the country's health care and legal systems. Historically, drug abusers were rehabilitated involuntarily in correctional, rather than health-care, facilities. This primarily criminal treatment approach had limited effectiveness which led to widespread public dissatisfaction and the recent introduction of medical treatments for addiction. Naltrexone was introduced in 1999; buprenorphine was introduced in 2001 and methadone in 2003. Agonist maintenance programmes were embraced rapidly by the medical community in Malaysia. Currently, over 30 000 opiate-dependent patients are treated with agonist maintenance treatments by more than 500 medical practitioners in Malaysia. Despite these recent advances, treatments for amphetamine-type stimulant abuse or dependence are underdeveloped, and diversion of agonist medications is an emerging concern. [source] The longitudinal association between multiple substance use discrepancies and marital satisfactionADDICTION, Issue 7 2009Gregory G. Homish ABSTRACT Aims The objective of this work was to examine the relation between patterns of substance use among newly married couples and marital satisfaction over time. In particular, this work examined if differences between husbands' and wives' heavy alcohol use and cigarette smoking, rather than simply use per se, predicted decreases in marital satisfaction over the first 7 years of marriage. Methods Married couples (n = 634 couples) were assessed on a variety of substance use and relationship variables at the time of marriage and again at the first, second, fourth and seventh years of marriage. Results After controlling for key socio-demographic variables, discrepancies in husband and wife cigarette smoking and heavy alcohol use were related to significant reductions in marital satisfaction. Importantly, couples who were discrepant on both substances experienced the greatest declines in marital satisfaction over time. Conclusions Patterns of substance use among newly married couples are important predictors of changes in marital functioning over time. It was not simply the heavy alcohol use or cigarette smoking that predicted dissatisfaction but, rather, differences between husbands' and wives' substance use that impacted the relationship. [source] Responding to formal complaints about the emergency department: Lessons from the service marketing literatureEMERGENCY MEDICINE AUSTRALASIA, Issue 4 2004Gavan Doig Abstract The ability to respond to formal complaints is a necessary part of emergency medicine practice. In spite of the significance of formal complaints there is little guidance within the medical literature to understand why patients complain or how to provide satisfaction to individuals who complain. Practitioners are usually left to their own devices in the style and substance of complaint responses even when working within a defined complaint management system. This article draws on relatively abundant literature in the service marketing field to provide an understanding of dissatisfaction, complaining and complaint handling. Having developed an appropriate theoretical framework the article provides guidance for applying these concepts in dealing with formal complaints. [source] Tensions between Scottish National Policies for onshore wind energy and local dissatisfaction , insights from regulation theoryENVIRONMENTAL POLICY AND GOVERNANCE, Issue 5 2007Karen Parkhill Abstract Although best described as a ,meta' theory addressing the endurance of capitalism, regulation theory can successfully be used to explore not only the economic dimensions, but also the political, socio-cultural and environmental dimensions of particular developmental strategies. Thus, it offers a framework for embedding abstract debates about social attitudes to new technologies within debates about ,real regulation' , the economic, social and cultural relationships operating through particular places. This paper uses regulation theory and qualitative, interview-based data to analyse Scotland's drive for onshore wind energy. This approach teases out how responses to wind farms are bound up with wider debates about how rural spaces are, and should be, regulated; the tensions within and between national political objectives, local political objectives and local communities' dissatisfaction; and the connections between local actors and more formal dimensions of renewable energy policy. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source] Understanding herb and dietary supplement use in patients with epilepsyEPILEPSIA, Issue 8 2009Kitti Kaiboriboon Summary Objective:, To determine the prevalence of herb and dietary supplement use and to provide a comprehensive analysis of factors influencing the use of these products in patients with epilepsy. Methods:, We performed a cross-sectional study using self-administered questionnaires in a selected group of patients who were receiving care at a tertiary epilepsy center. Logistic regression was used to measure the association between the demographic variables and herb and dietary supplement use. In addition, we performed a MEDLINE search for each of the herb and dietary products used by our patients to determine the effect of these products on seizures and on their potential for interactions with other drugs metabolized by the liver. Results:, One hundred eighty-seven patients completed the survey. Fifty-six percent of this group of patients with epilepsy used herbs and dietary supplements at the time of the survey. A considerable portion (71%) of these patients reported the use of these products to their physician, and most of them relied on their physicians as the primary source of information. Most of the patients used dietary supplement for health promotion rather than to specifically benefit their epilepsy condition. Approximately one-third of patients used herb or dietary supplements that had the potential to increase seizures (16%) or to interact with hepatically metabolized drugs (19%). The most powerful independent predictors of herb and dietary supplement use were partial epilepsy [odds ratio (OR) 3.36; 95% confidence interval (CI) 1.27,8.88] and Caucasian race (OR 3.55; 95% CI 1.11,11.34). Conclusion:, Patients with epilepsy commonly used dietary supplements along with their antiepileptic medications. The majority of these patients used herb and dietary supplements for health promotion rather than because of dissatisfaction with conventional treatment. It is important that physicians involved in the care of patients with epilepsy routinely inquire about the use of dietary supplements and that they make use of reliable resources to assess the safety of these products with regard to modification of seizure risk and the potential for interactions with antiepileptic drugs. [source] Quality of equine veterinary care: Where can it go wrong?EQUINE VETERINARY EDUCATION, Issue 3 2008A conceptual framework for the quality of equine healthcare, based on court cases against equine practitioners in The Netherlands Summary Quality control and client satisfaction are topics of considerable current interest in both human and veterinary healthcare. Crucial to this discussion is a proper definition of ,quality of care'. This study applied, to (equine) veterinary care, a conceptual framework designed for assessing the quality of human healthcare and featuring structural deficiency, procedural inadequacy and disappointing outcome as key elements. This was done using court cases against equine practitioners as a yardstick for client dissatisfaction. Applying a system for evaluating the quality of healthcare may be a good way of monitoring and improving (equine) veterinary services, particularly once reliable indices for client satisfaction have been validated. [source] The effect of attentional training on body dissatisfaction and dietary restrictionEUROPEAN EATING DISORDERS REVIEW, Issue 3 2009Evelyn Smith Abstract The aim of the present study is to investigate the effect of attentional training towards shape, weight and food related information on body dissatisfaction and dietary restriction. A total of 98 female participants were trained to attend to negative shape/weight words, positive shape/weight words, negative (high calorie) food words, positive (low calorie) food words or neutral words. Subsequently, a body image challenge was presented and participants' body dissatisfaction and dietary restriction were measured. Results indicated that negative shape/weight attentional biases exacerbated body dissatisfaction and a bias towards negative food words intensified dietary restriction. The study provides evidence for specificity in the effects of attentional biases and supports the notion that attentional training may be a useful component in interventions to improve body image and reduce dieting. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||