Assessing Patient Experience and Healthcare Quality of Dental Care Using Patient Online Reviews in the United States: Mixed Methods Study.

BACKGROUND: Over the last two decades, patient review websites have emerged as an essential online platform for doctor ratings and reviews. Recent studies suggested the significance of such websites as a data source for patients to choose doctors for healthcare providers to learn and improve from patient feedback and to foster a culture of trust and transparency between patients and healthcare providers. However, as compared to other medical specialties, studies of online patient reviews that focus on dentists in the United States remain absent. OBJECTIVE: This study sought to understand to what extent online patient reviews can provide performance feedbacks that reflect dental care quality and patient experience. METHODS: Using mixed informatics methods incorporating statistics, natural language processing, and domain expert evaluation, we analyzed the online patient reviews of 204,751 dentists extracted from HealthGrades with two specific aims. First, we examined the associations between patient ratings and a variety of dentist characteristics. Second, we identified topics from patient reviews that can be mapped to the national assessment of dental patient experience measured by the Patient Experience Measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey. RESULTS: Higher ratings were associated with female dentists (t71881=2.45, P<.01, g=0.01), dentists at a younger age (F7, 107128=246.97, P<.001, g=0.11), and those whose patients experienced a short wait time (F4, 150055=10417.77, P<0.001, g=0.18). We also identified several topics that corresponded to CAHPS measures, including discomfort (eg, painful/painless root canal or deep cleaning), and ethics (eg, high-pressure sales, and unnecessary dental work). CONCLUSIONS: These findings suggest that online patient reviews could be used as a data source for understanding the patient experience and healthcare quality in dentistry.

Spirocyclic systems derived from pyroglutamic acid.

The synthesis and likely conformational structure of rigid spirocyclic bislactams and lactam-lactones derived from pyroglutamic acid, and their suitability as lead structures for applications in drug development programmes using cheminformatic analysis, has been investgated.

Temperature regulation and microhabitat choice by free-ranging Galapagos fur seal pups (Arctocephalus galapagoensis).

Behavioural activity, and core and surface temperatures of 4 unrestrained Galapagos fur seals were recorded in the natural habitat during their first weeks of life. Climatic variables were registered simultaneously. Pup behaviours were divided into bouts of resting (55% of total time), sucking (23%) and other activities (22%). Pups maintained a constant body temperature from their first day. Core temperature (T e ) was 37.7° C±0.3° C (x ± SD) over 39 pup-days and 8 pup-nights. Skin temperature was correlated with T c , but flipper temperature was not. No daily T c rhythm was detected. Microclimate data were used to calculate operative temperature T e . Environmental temperatures can be very high, with T e above T c 6-9 h a day for animals exposed to the sun, but below it in the shade. T c is about 22° C at night. Pups avoid overheating mainly by withdrawing into the shade and reducing activity to a minimum during the hot hours of the day. Sun-exposed pups could be active at any time during the day if they had access to water, which was usually around high tide.

Ecophysiology and conservation: The contribution of energetics--introduction to the symposium.

Animal physiologists have begun making contributions to conservation biology based on their knowledge of endocrinology, immunology, and sensory biology. Contributions to this symposium use the perspective of energy and mass balance to examine questions about habitat usage, activity times, competition, foraging, reproduction, and body condition. Physiological constraints or requirements sculpt the behavioral and life history choices of individuals and provide mechanistic linkages with population processes and conservation policies.

Honeybee flight metabolic rate: does it depend upon air temperature?

Differing conclusions have been reached as to how or whether varying heat production has a thermoregulatory function in flying honeybees Apis mellifera. We investigated the effects of air temperature on flight metabolic rate, water loss, wingbeat frequency, body segment temperatures and behavior of honeybees flying in transparent containment outdoors. For periods of voluntary, uninterrupted, self-sustaining flight, metabolic rate was independent of air temperature between 19 and 37 degrees C. Thorax temperatures (T(th)) were very stable, with a slope of thorax temperature on air temperature of 0.18. Evaporative heat loss increased from 51 mW g(-1) at 25 degrees C to 158 mW g(-1) at 37 degrees C and appeared to account for head and abdomen temperature excess falling sharply over the same air temperature range. As air temperature increased from 19 to 37 degrees C, wingbeat frequency showed a slight but significant increase, and metabolic expenditure per wingbeat showed a corresponding slight but significant decrease. Bees spent an average of 52% of the measurement period in flight, with 19 of 78 bees sustaining uninterrupted voluntary flight for periods of >1 min. The fraction of time spent flying declined as air temperature increased. As the fraction of time spent flying decreased, the slope of metabolic rate on air temperature became more steeply negative, and was significant for bees flying less than 80% of the time. In a separate experiment, there was a significant inverse relationship of metabolic rate and air temperature for bees requiring frequent or constant agitation to remain airborne, but no dependence for bees that flew with little or no agitation; bees were less likely to require agitation during outdoor than indoor measurements. A recent hypothesis explaining differences between studies in the slope of flight metabolic rate on air temperature in terms of differences in metabolic capacity and thorax temperature is supported for honeybees in voluntary flight, but not under agitation.