Evaluation of acute mesenteric ischemia: accuracy of biphasic mesenteric multi-detector CT angiography.

The purpose of this study was to explore the accuracy of multi-detector row helical CT (MDCT), using a biphasic mesenteric angiography protocol for evaluation of acute mesenteric ischemia (AMI). In total, 79 consecutive patients with clinical signs of AMI underwent contrast enhanced 16- or 40-channel MDCT. MDCT findings were correlated with surgery, endoscopy and clinical outcome. Sensitivity, specificity, and positive and negative predictive values were calculated using the patients in which AMI had been excluded as a control group. In 28 patients the final diagnosis was AMI. In 27 patients (96.4%) MDCT correctly diagnosed AMI (specificity of 97.9%). A sensitivity of 93%, specificity of 100%, and positive and negative predictive values of 100% and 94%, respectively were achieved for the CT findings of visceral artery occlusion, intestinal pneumatosis, portomesenteric venous gas or bowel wall thickening in combination with either portomesenteric thrombosis or solid organ infarction. Our findings suggest that mesenteric MDCT angiography is an accurate tool for fast diagnostic work-up of patients with suspected AMI.

Factors influencing the recommendation of nursing homes.

This article reviews and compares the perceptions of nursing homes by residents and their proxies (family, friends, etc.) and reports that residents tended to give higher ratings to services than do their proxies. The analysis attempts to determine why residents give higher marks, which group the facility should look to for feedback, and whether the ratings will help organize the strengths and weaknesses in the facility to produce positive word of mouth within the community.

Evaluations of care by ambulatory surgery patients.

As medical care increasingly moves from inpatient to outpatient delivery settings, attention must be paid to patient assessments of the care received in these ambulatory medical centers. This study of patients in ambulatory surgery centers (N = 275) across the United States reports on the ratings given to the varied attributes of the ambulatory surgery experience. The respondents (N = 36,078) gave highest ratings to those items which evaluated the nurses and physicians and lower marks to items related to registration and access. The article concludes with an illustration of a quadrant analysis technique that managers can use to identify the specific care issues that should be addressed to increase positive word-of-mouth referrals.

Identifying service quality strengths and weaknesses using SERVQUAL: a study of dental services.

The goal of this study was to examine responses among dental patients to the most recent version of SERVQUAL, and to evaluate that instrument as a tool for measuring satisfaction in a dental practice. Items on the reliability and responsiveness dimensions produced the lowest satisfaction ratings, while improvements in providing services as promised and instilling confidence have the greatest potential for producing higher satisfaction among patients. Finally, using open-ended questions, we identified a number of patient events or experiences which caused either high or low scores on individual SERVQUAL items.

Dentists' personal values: an exploratory investigation.

A sample of 367 dentists, all licensed to practice in Oregon, provided data for an investigation of the personal values of dentists. The authors found that the dentists' values differed in several particulars from those of the general population. On the other hand, they found that the values of younger and older dentists were highly similar, as were the values of male and female dentists.

Positioning health care services: yellow pages advertising and dental practice performance.

The authors empirically explored the relationship between positioning strategies and financial performance in dental practices. They analyzed data collected from a random sample mail survey of Oregon dentists in conjunction with data obtained in a content analysis of yellow pages advertising. The authors' analysis of usable responses from 264 general dentists in private practice reveals that they use a variety of positioning strategies and that the selection of a positioning strategy correlates significantly with financial performance.

Advertising and the dental profession. Retrospective and prospective.

"Advertising" has become a very controversial topic, not just among dentists, but among all professionals. That controversy focuses on three questions. First, what are the legal issues surrounding dental advertising and how are these issues being resolved? Second, what are the attitudes toward advertising among practicing dentists and how are these attitudes changing? Finally, how many dentists advertise and what are those advertising dentists actually doing? The purpose of this paper is to neither praise nor excoriate advertising, but to refer to the law and to published research in order to provide dental practitioners with a broader understanding of this topic.

Test of the Korman hypothesis: performance, self-esteem, and job satisfaction among dentists.

Contrary to the Korman hypothesis, this study of 416 dentists showed positive relationships between job satisfaction and productivity-based measures of performance for individuals of both low and high self-esteem.

Determination of fees by professionals: an exploratory investigation of dentists.

Previous research has attempted to infer dentists' pricing practices from aggregate data, such as those derived from insurance claims. In a disaggregated analysis based on a mail survey of 327 dentists in private practice, the authors find the most important influence on dental fees to be cost, followed by fees charged by other dentists and perceptions of patient sensitivity to prices. The relative importance of the various influences on dentists' fees is related to several practice characteristics, including location and gross income.