GEOSAT Altimeter Observations of Kelvin Waves and the 1986-87 El Nino.

Two years of GEOSAT altimeter observations are used to investigate the response of sea level to anomalous westerly wind bursts in the tropical Pacific Ocean before and during the 1986-87 El Niño. Sea level time series along the equator show examples of both positive and negative anomalies of 10-centimeter amplitude and 2- to 4-week time scale propagating across the Pacific with phase speeds of 2.4 to 2.8 meters per second, suggesting downwelling and upwelling Kelvin waves, respectively. A comparison of island wind observations with sea level indicates one instance (May 1986) in which a positive sea level anomaly can be related to westerly winds caused by a cross-equatorial cyclone pair in the western Pacific. This episode was followed by additional wind bursts later in the year, and finally by sustained westerlies in the western Pacific during November-December 1986, at the height of El Niño. The GEOSAT observations reveal the sea level response to these meteorological events and provide a synoptic description of the El Niño oceanographic phenomenon.

Seasat altimeter calibration: initial results.

Preliminary analysis of radar altimeter data indicates that the instrument has met its specifications for measuring spacecraft height above the ocean surface (+/- 10 centimeters) and significant wave height (+/- 0.5 meter). There is ample evidence that the radar altimeter, having undergone development through three earth orbit missions [Skylab, Geodynamics Experimental Ocean Satellite 3 (GEOS-3), and Seasat], has reached a level of precision that now makes possible its use for important quantitative oceanographic investigations and practical applications.

What do patients expect of psychiatric services? A systematic and critical review of empirical studies.

The article reviews literature concerning patients' expectations of psychiatric care. Early research (pre-1980) is outlined, followed by a systematic review of 21 studies fulfilling specific inclusion criteria from 1980 onwards. Overall, patients expected to improve as a result of psychiatric treatment, and had higher expectations of the helpfulness of psychological and combined treatments than other interventions. Few studies considered expectations of the process of psychiatric care or determinants of expectations. The majority of studies focused on examining the relation between expectations and outcomes. There were indications that expectations of improvement were linked to clinical outcomes, although the relationship appeared to be complex. There was also some evidence that when expectations of the process of care were incongruent with the service provided, outcomes were poorer. The findings of studies in the systematic review were generally congruent with earlier work (pre-1980), although expectations of improvement appeared to be higher in the later studies. Interventions to prepare patients for what to expect were found to have beneficial effects on attendance, satisfaction and the accuracy of expectations about the process of psychiatric care. Future research should focus on developing valid and reliable measures for use in different settings, and on determining the mechanism by which expectations may relate to outcomes, including clinical outcomes, attendance and satisfaction.

Dickens' characters on the couch: an example of teaching psychiatry using literature.

The value of literature in medical education is widely accepted by medical teachers. There are examples of psychopathology in the characters of novels that provide illustrations of particular psychiatric diagnoses. Characters created by Charles Dickens, often eccentric, have been deemed to suffer from mental disorders. This may be because Dickens could draw on his extensive contact with Victorian psychiatry and interest in psychopathology to create authentic characters. He is widely acknowledged to have described many other medical conditions in his fiction and his writing is already used to teach medical students. This article reviews Dickens' contact with psychiatry and outlines the mental disorders possibly suffered by the characters under ICD 10 diagnostic headings. These descriptions, while interesting in their own right, may also prove useful to clinicians and teachers.

What do patients want and do we want to know? A review of patients' requests of psychiatric services.

OBJECTIVE: A systematic review was conducted of the literature concerning patients' requests of psychiatric care in order to identify the types of requests patients make, psychiatrists' perceptions of their patients' requests, and the relationship between requests and the outcome of care. METHOD: A total of 28 published original articles which fulfilled specific inclusion criteria were reviewed. RESULTS: The studies showed that there are certain core requests that patients make irrespective of the type of service attended. Patients mainly request psychological approaches, and the most common requests are for 'clarification', 'psychological expertise' and 'psychodynamic insight'. There is evidence that patients normally feel inhibited about making requests, and that psychiatrists often fail to identify what their patients want. CONCLUSION: The majority of patients attending psychiatric services have requests which they will express when encouraged to do so, but little is known about the relationship between patients' requests and the outcome of care. Recommendations are made for future research.