5 The impact of outpatient partial booking on dermatology clinic activity

2003 ◽  
Vol 148 (3) ◽  
pp. 619-619 ◽  
Author(s):  
C.R. Charman ◽  
J.S. English
Keyword(s):  
Dermatology Clinic ◽  
The Impact ◽  
Clinic Activity

scholarly journals Analysis of the effects of EHR implementation on timeliness of care in a dermatology clinic: a simulation study

2018 ◽  
Vol 25 (7) ◽  
pp. 827-832 ◽  
Author(s):  
Vahab Vahdat ◽  
Jacqueline A Griffin ◽  
James E Stahl ◽  
F Clarissa Yang
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Discrete Event ◽  
Wait Time ◽  
Simulation Models ◽  
Event Simulation ◽  
Dermatology Clinic ◽  
Average Patient ◽  
Encounter Time ◽  
The Impact

Abstract Objective Quantify the downstream impact on patient wait times and overall length of stay due to small increases in encounter times caused by the implementation of a new electronic health record (EHR) system. Methods A discrete-event simulation model was created to examine the effects of increasing the provider-patient encounter time by 1, 2, 5, or 10 min, due to an increase in in-room documentation as part of an EHR implementation. Simulation parameters were constructed from an analysis of 52 000 visits from a scheduling database and direct observation of 93 randomly selected patients to collect all the steps involved in an outpatient dermatology patient care visit. Results Analysis of the simulation results demonstrates that for a clinic session with an average booking appointment length of 15 min, the addition of 1, 2, 5, and 10 min for in-room physician documentation with an EHR system would result in a 5.2 (22%), 9.8 (41%), 31.8 (136%), and 87.2 (373%) minute increase in average patient wait time, and a 6.2 (12%), 11.7 (23%), 36.7 (73%), and 96.9 (193%) minute increase in length of stay, respectively. To offset the additional 1, 2, 5, or 10 min, patient volume would need to decrease by 10%, 20%, 40%, and >50%, respectively. Conclusions Small changes to processes, such as the addition of a few minutes of extra documentation time in the exam room, can cause significant delays in the timeliness of patient care. Simulation models can assist in quantifying the downstream effects and help analyze the impact of these operational changes.

scholarly journals The Impact of Female Pattern Hair Loss on Quality of Life

2019 ◽  
Vol 4 (3) ◽  
Keyword(s):  
Quality Of Life ◽  
Hair Loss ◽  
Statistical Tests ◽  
Large Impact ◽  
Life Questionnaire ◽  
Dermatology Clinic ◽  
Female Pattern Hair Loss ◽  
Co Morbidity ◽  
The Impact

Background: Female pattern hair loss (FPHL) is a non-scarring alopecia characterised by the progressive thinning of hair. Hair has an important role in determining one’s self-esteem, confidence and attractiveness. Hence, hair loss can heavily affect patients’ quality of life (QoL). This study aims to assess the impact FPHL has on QoL in order to help improve patient management. Methods: Twenty-two patients presenting to an outpatient dermatology clinic in Wolverhampton, UK, took part in this study. The impact of FPHL on QoL was measured using two questionnaires: the women’s androgenic alopecia quality of life questionnaire (Waa-QoL) and the dermatology life quality index (DLQI). Participants were screened for psychological co-morbidity using the hospital anxiety and depression scale (HADS). Statistical tests used were Spearman’s rank correlation, Mann-Whitney U and Kruskal Wallis tests. Results: FPHL had a large impact on QoL. Patients who were younger or had a longer duration of disease had a significantly lower QoL (p<0.05). Furthermore, patient with a diagnosed mental health illness had a significantly lower QoL than those without (p<0.05). Conclusions: FPHL has a significant and detrimental effect on patients’ QoL. This study identifies several factors that are associated with a worse QoL outcome. This recognises groups of patients which could be targeted for more intensive intervention. Recognising the large impact on QoL, FPHL patients may benefit from a more holistic management with psychological interventions and a greater emphasis on improving QoL.

scholarly journals The impact of vitamin D deficiency and microbiome in psoriasis versus non immune-mediated diseases

2020 ◽  
Vol 4 (6) ◽  
pp. 162-165
Author(s):  
Fernanda Soares Simoneti
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Serum Vitamin ◽  
Chronic Inflammatory Disease ◽  
Control Group ◽  
Serum Vitamin D ◽  
Dermatology Clinic ◽  
Immune Mediated ◽  
Vitamin D Levels ◽  
The Impact

Psoriasis consists of a chronic inflammatory disease with systemic character and may be associated with several comorbidities. Although its etiopathogenesis has not yet been fully elucidated, it is known that it is an immune-mediated pathology, especially by T cells. Like other inflammatory and autoimmune disorders, psoriasis is also related to changes in the cutaneous microbiome. Vitamin D deficiency is one of the conditions associated with pathologies whose microbiome is altered, although the causal relationship between these events is not precisely determined. Thus, the objective of this study was to estimate the prevalence of vitamin D deficiency in patients with psoriasis who attended the Dermatology Clinic of ABC Medical School (FMABC) and compare it to the prevalence of vitamin D deficiency among patients with non-inflammatory pathologies. 88 patients with psoriasis and 91 patients with non-inflammatory diseases (Control Group) were evaluated and had their serum vitamin D measured. It was observed that the Psoriasis Group had lower serum vitamin D levels compared to the Control Group (p<0.001) and It was observed that the chance of a person with psoriasis present low vitamin D levels is about seven times higher.

scholarly journals The Impact of Aeroallergens on Military Readiness: A Case Report

2019 ◽  
Vol 184 (11-12) ◽  
pp. e945-e947
Author(s):  
Kevin A Fajardo ◽  
Wendi E Wohltmann
Keyword(s):  
Case Report ◽  
Skin Disease ◽  
Military Service ◽  
Clinical Symptoms ◽  
Type I ◽  
Laboratory Findings ◽  
Type Iv ◽  
Dermatology Clinic ◽  
The Impact ◽  
Mountain Cedar

Abstract Seasonal aeroallergens commonly cause allergic conjunctivitis, rhinorrhea, sinusitis, and cough in sensitized individuals. These clinical symptoms are the result of IgE-mediated type I hypersensitivity reactions, which trigger the degranulaton of mast cells and basophils. In contrast, aeroallergens are not common precipitants of urticarial dermatitis, which is driven by a cell-mediated type IV hypersensitivity reaction. In this case report, we describe an Active Duty Air Force member stationed in San Antonio, TX, who presented to the dermatology clinic with a three year history of recalcitrant urticarial dermatitis found to be directly related to exposure to the pollen from the Juniperus ashei tree, also referred to as Mountain Cedar. While laboratory findings confirmed a high level of circulating IgE antibody to Mountain Cedar, the patient had no upper respiratory symptoms consistent with a typical allergic reaction. Further, his skin disease rapidly cleared within 24 hours of leaving southern Texas. Because of the recalcitrant nature of his condition upon returning home, he was considered unfit for further military service. This case not only highlights the growing link between IgE and chronic skin disease, but also the impact aeroallergens can have on the medical readiness and world-wide deployability of Airmen, Sailors, Soldiers, and Marines.

Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

1962 ◽  
Vol 14 ◽  
pp. 415-418
Author(s):  
K. P. Stanyukovich ◽  
V. A. Bronshten
Keyword(s):  
Explosive Charge ◽  
The Moon ◽  
Meteorite Impacts ◽  
The Earth ◽  
Lunar Craters ◽  
The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

The Geosciences Applied to Lunar Exploration

1962 ◽  
Vol 14 ◽  
pp. 169-257 ◽  
Author(s):  
J. Green
Keyword(s):  
Lunar Surface ◽  
Probable Mechanism ◽  
Point Of View ◽  
Lunar Exploration ◽  
Geological Model ◽  
Apply Geophysics ◽  
Surface Features ◽  
The Impact

The term geo-sciences has been used here to include the disciplines geology, geophysics and geochemistry. However, in order to apply geophysics and geochemistry effectively one must begin with a geological model. Therefore, the science of geology should be used as the basis for lunar exploration. From an astronomical point of view, a lunar terrain heavily impacted with meteors appears the more reasonable; although from a geological standpoint, volcanism seems the more probable mechanism. A surface liberally marked with volcanic features has been advocated by such geologists as Bülow, Dana, Suess, von Wolff, Shaler, Spurr, and Kuno. In this paper, both the impact and volcanic hypotheses are considered in the application of the geo-sciences to manned lunar exploration. However, more emphasis is placed on the volcanic, or more correctly the defluidization, hypothesis to account for lunar surface features.

Asteroid and Comet Impact Speeds upon Mars: Significance for Panspermia and the Supply of Organics

1997 ◽  
Vol 161 ◽  
pp. 197-201 ◽  
Author(s):  
Duncan Steel
Keyword(s):  
Probability Distributions ◽  
Regions Of Interest ◽  
Significant Fraction ◽  
Organic Chemicals ◽  
Impact Speed ◽  
The Mean ◽  
The Impact

AbstractWhilst lithopanspermia depends upon massive impacts occurring at a speed above some limit, the intact delivery of organic chemicals or other volatiles to a planet requires the impact speed to be below some other limit such that a significant fraction of that material escapes destruction. Thus the two opposite ends of the impact speed distributions are the regions of interest in the bioastronomical context, whereas much modelling work on impacts delivers, or makes use of, only the mean speed. Here the probability distributions of impact speeds upon Mars are calculated for (i) the orbital distribution of known asteroids; and (ii) the expected distribution of near-parabolic cometary orbits. It is found that cometary impacts are far more likely to eject rocks from Mars (over 99 percent of the cometary impacts are at speeds above 20 km/sec, but at most 5 percent of the asteroidal impacts); paradoxically, the objects impacting at speeds low enough to make organic/volatile survival possible (the asteroids) are those which are depleted in such species.

Organic Syntheses During the Impact of a Comet with a Gaseous Planet

1997 ◽  
Vol 161 ◽  
pp. 189-195
Author(s):  
Cesare Guaita ◽  
Roberto Crippa ◽  
Federico Manzini
Keyword(s):  
Polymeric Material ◽  
Molecular Form ◽  
Parent Compound ◽  
Blue Filter ◽  
Organic Syntheses ◽  
The Impact

AbstractA large amount of CO has been detected above many SL9/Jupiter impacts. This gas was never detected before the collision. So, in our opinion, CO was released from a parent compound during the collision. We identify this compound as POM (polyoxymethylene), a formaldehyde (HCHO) polymer that, when suddenly heated, reformes monomeric HCHO. At temperatures higher than 1200°K HCHO cannot exist in molecular form and the most probable result of its decomposition is the formation of CO. At lower temperatures, HCHO can react with NH3 and/or HCN to form high UV-absorbing polymeric material. In our opinion, this kind of material has also to be taken in to account to explain the complex evolution of some SL9 impacts that we observed in CCD images taken with a blue filter.

Hydrogen Cyanide Polymers from the Impact of Comet P/Shoemaker-Levy 9 on Jupiter

1997 ◽  
Vol 161 ◽  
pp. 179-187
Author(s):  
Clifford N. Matthews ◽  
Rose A. Pesce-Rodriguez ◽  
Shirley A. Liebman
Keyword(s):  
Amino Acids ◽  
Solar System ◽  
Hydrogen Cyanide ◽  
Nitrogen Heterocycles ◽  
Laboratory Studies ◽  
Heterogeneous Solids ◽  
The Many ◽  
Comet Halley ◽  
The Impact ◽  
By Products

AbstractHydrogen cyanide polymers – heterogeneous solids ranging in color from yellow to orange to brown to black – may be among the organic macromolecules most readily formed within the Solar System. The non-volatile black crust of comet Halley, for example, as well as the extensive orangebrown streaks in the atmosphere of Jupiter, might consist largely of such polymers synthesized from HCN formed by photolysis of methane and ammonia, the color observed depending on the concentration of HCN involved. Laboratory studies of these ubiquitous compounds point to the presence of polyamidine structures synthesized directly from hydrogen cyanide. These would be converted by water to polypeptides which can be further hydrolyzed to α-amino acids. Black polymers and multimers with conjugated ladder structures derived from HCN could also be formed and might well be the source of the many nitrogen heterocycles, adenine included, observed after pyrolysis. The dark brown color arising from the impacts of comet P/Shoemaker-Levy 9 on Jupiter might therefore be mainly caused by the presence of HCN polymers, whether originally present, deposited by the impactor or synthesized directly from HCN. Spectroscopic detection of these predicted macromolecules and their hydrolytic and pyrolytic by-products would strengthen significantly the hypothesis that cyanide polymerization is a preferred pathway for prebiotic and extraterrestrial chemistry.

Unusual Microstructure in Shock-Compacted Graphite

1970 ◽  
Vol 28 ◽  
pp. 474-475
Author(s):  
Lucien F. Trueb
Keyword(s):  
Mechanical Characteristic ◽  
Compression Wave ◽  
Gray Zone ◽  
Flyer Plate ◽  
Compacted Graphite ◽  
The Impact

Crushed and statically compressed Madagascar graphite that was explosively shocked at 425 kb by means of a planar flyer-plate is characterized by a black zone extending for 2 to 3 nun below the impact plane of the driver. Beyond this point, the material assumes the normal gray color of graphite. The thickness of the black zone is identical with the distance taken by the relaxation wave to overtake the compression wave.The main mechanical characteristic of the black material is its great hardness; steel scalpels and razor blades are readily blunted during attempts to cut it. An average microhardness value of 95-3 DPHN was obtained with a 10 kg load. This figure is a minimum because the indentations were usually cracked; 14.8 DPHN was measured in the gray zone.

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