Analysis of Minnesota Multiphasic Personality Inventory-2 profiles of prospective anonymous oocyte donors in relation to the outcome of the donor selection process

Objective: To examine the scores of prospective anonymous oocyte donors on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in four outcome groups.

Design: Chart review.

Setting: Academic medical center.

Patient(s): One hundred fifty prospective anonymous oocyte donors who underwent a preliminary screening and a 1-hour structured psychological interview and who completed the MMPI-2.

Intervention(s): Psychological evaluation prior to donation.

Main Outcome Measure(s): Scores on the MMPI-2 and outcomes of the donor selection process.

Result(s): Seventy (47%) women were accepted as donors and completed one donation cycle; 30 (20%) were accepted as donors but did not donate because of medical reasons or relocation; 18 (12%) were accepted as donors but were noncompliant; and 32 (21%) were rejected as donors because of psychological concerns. Statistically significant differences were found between outcome groups on scales F, K, 1, 2, 7, 8, and 0. Although these differences were statistically significant, all group subscale mean scores were in the average to low-average range and differences between group means were small.

Conclusion(s): The MMPI-2 differentiates between prospective donor outcome groups, but psychologists need to interpret the results of the MMPI-2 carefully in the context of clinical interview information.     

New areas for psychological assessment in general health care settings: what to do today to prepare for tomorrow

Unique roles of the professional psychologist are outlined with respect to increasingly restrictive utilization practices of managed care. Suggestions of how to develop less traditional venues of practice, the types of instruments to use, and report formats, along with ways to persuade primary care physicians (PCPs), managed care organizations, and facilities to utilize psychological assessment services are provided. Medical cost offsets, cost-efficient quality of care, and models of practice are also discussed.     

Lineal occlusion concepts for complete dentures

A rationale for using lineal occlusal-contact teeth in complete dentures was discussed. The vectors of occlusal force for anatomic, nonanatomic, and lineal occlusal-contact teeth were compared. Four combinations of plastic and porcelain occlusal tooth forms, which can be used or modified for lineal occlusal contact, were described. Rules for positioning of the teeth and methods for occlusal adjustment of each combination were considered.     

Risk factors for ineffective therapy in patients with bloodstream infection

BACKGROUND: Infections occurring among outpatients having recent contact with the health care system have been termed health care-associated infections. The objective of this study was to analyze the impact of health care-associated status on effectiveness of initial therapy in hospitalized patients with bloodstream infections. METHODS: Prospective cohort study of adults with bloodstream infections at 3 North Carolina hospitals. Bloodstream infection was defined as health care-associated if it occurred within the first 48 hours after hospitalization and if patients had 1 of the following characteristics: had received home health services, outpatient intravenous therapy, or outpatient renal dialysis in the 30 days prior to hospital admission; had been hospitalized within 90 days prior to admission; or lived in a long-term care facility. RESULTS: Of 466 bloodstream infections, 132 (28%) were community-acquired, 178 (38%) were health care-associated, and 156 (33%) were nosocomial. Multivariable logistic regression using community-acquired status as a reference identified health care-associated status (odds ratio, 3.1; 95% confidence interval, 1.6-6.1) and nosocomial status (odds ratio, 4.3; 95% confidence interval, 2.2-8.3) as independent predictors of ineffective initial antibiotic therapy. Among health care-associated characteristics, hospitalization in the 90 days prior to admission was independently associated with ineffective initial therapy (odds ratio, 2.4; 95% confidence interval, 1.4-4.2). CONCLUSIONS: Among patients treated in the hospital for bloodstream infection, health care-associated status was an independent predictor of ineffective initial antibiotic therapy. Hospitalization within 90 days prior to hospital admission was the component of health care-associated status most strongly associated with ineffective initial therapy.