Decreasing No-Show Rates in an Outpatient Specialty Clinic

Decreasing Patient No-Show Rates in an Outpatient Specialty Clinic Abstract Problem: Non-attendance or no-shows of patients in an outpatient clinic is a prevalent occurrence that impacts the quality of patient care and cost utilization in the clinic. Context: A collaborative effort was undertaken with the clinic nurse manager to implement a quality improvement intervention to reduce patient no-shows in the optometry and otolaryngology clinics. The electronic health record EPIC data analysis revealed language variability in the occurrence of no-shows, indicating the need for improvements. Interventions: Tools were employed to gather comprehensive information regarding the factors contributing to patient no-shows and identify potential strategies for enhancing communication within the clinic, thereby reducing instances of missed appointments. In addition, patients who did not attend their appointments offered suggestions on communication strategies that could effectively reduce the number of missed appointments in the future. Measures: The data collection encompassed the patient reasons for no-shows. Individuals who failed to attend their appointments provided recommendations regarding communication strategies that could effectively discourage future instances of missed appointments. Results: The data analysis indicated that the most common reason for no-shows was the patients\u27 failure to recall their scheduled appointments. To minimize the occurrence of missed appointments, patients commonly recommended receiving text messages one to two days before their scheduled appointment. A positive correlation was identified between patients who did not have access to MyChart, a platform that enables the transmission of appointment reminders via text messaging, and an increased frequency of missed appointments. Conclusion: The optimal approach for reducing patient no-show rates entails providing patients with comprehensive education on the utilization of MyChart, a platform that offers text messaging in advance of their scheduled appointments. Empowering patients by equipping them with the necessary tools to access MyChart ensures they can effectively manage their healthcare. Keywords: no-show rates, outpatient clinic, patient perceptio

Cholesterol provides nonsacrificial protection of membrane lipids from chemical damage at air–water interface

The role of cholesterol in bilayer and monolayer lipid membranes has been of great interest. On the biophysical front, cholesterol significantly increases the order of the lipid packing, lowers the membrane permeability, and maintains membrane fluidity by forming liquid-ordered–phase lipid rafts. However, direct observation of any influence on membrane chemistry related to these cholesterol-induced physical properties has been absent. Here we report that the addition of 30 mol % cholesterol to 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) or 1-palmitoyl-2-oleoyl-sn-glycero-3-phospho-(1′-rac-glycerol) (POPG) monolayers at the air–water interface greatly reduces the oxidation and ester linkage cleavage chemistries initiated by potent chemicals such as OH radicals and HCl vapor, respectively. These results shed light on the indispensable chemoprotective function of cholesterol in lipid membranes. Another significant finding is that OH oxidation of unsaturated lipids generates Criegee intermediate, which is an important radical involved in many atmospheric processes

Education to gain sustainability : analysis and approach from the experience obtained from two high school systems in mexican rural communities

The decade &ldquo;Education for Sustainability&rdquo; is just emerging and one of its goals emphasized the importance of considering the curr&iacute;cula in a transdisciplinary and community based programs. This includes recognizing local and regional interests as relevant topics into the curr&iacute;cula. &ldquo;Education for sustainability&rdquo; does not appear to have a strong basis on their actions as its theoretical discourse does. The study we present here about content analysis in the curricula of two high schools systems in rural Mexican communities is an example. In this research we analyzed: 1) how the curricula is oriented towards forest management and the way is connected to the social reality of the communities; 2) how does the learning process develops in the classroom and its dynamics with teachers and students and 3) how does the environmental learning take place. Results revealed that more research is needed with adolescents in order to change the educational structure in rural Mexican high schools.<br /

Reproductive Morphology of Male Black Perch (Embiotoca jacksoni)

Black perch (Embiotoca jacksoni) are a common southern California fish that exhibits internal fertilization. During copulation, males transfer a spermatozeugmata to the female via an intromittent organ. Relatively little is known about the reproductive morphology of male black perch and the spermatozeugmata. The objective of our study was to describe the development of spermatocytes and the spermatozeugmata. We also used histology to examine the anal fin and describe the tissues of the intromittent organs. Black perch \u3c 90 mm SL had testes that were composed of spermatocytes at all developmental stages. All stages of spermatocytes in addition to spermatozeugmata were present in males ³ 90 mm SL. On both sides of the anal fin at the anterior end, an intromittent organ was housed in a sheath composed of smooth muscle. Our research note is the first to document the formation of black perch spermatozeugmata within the testis. We also characterized the tissues of the intromittent organs and its muscular sheath which reside on an unmodified anal fin. The copulatory structures of embiotocid species have not been fully investigated, thus our work contributes to understanding the reproductive biology of surfperches

An Analysis of Cases in Financial Accounting

The following thesis consists of solutions to a series of case studies in financial accounting that were completed in fulfillment of the requirements of the ACCY 420 course at the University of Mississippi for the fall and spring semester for the 2015/2016 academic year. The thirteen case studies each focus on a separate area of financial accounting and aid in the comprehension and analysis of different accounting topics, such as revenue recognition and depreciation expense. The cases were formatted as a series of questions to a specific scenario. Included are answers consisting of accounting financial statements, journal entries, calculations, and financial analysis

Evaluating the impact of an environmental education programme; an empirical study in Mexico.

This study draws on information from 11 in-depth interviews, two focus groups and 72 written questionnaires to evaluate an extra-curricular environmental education programme on forestry designed for preparatory school students from a small rural community in Mexico. Specifically, the study assessed the impact of the programme on the ecological knowledge of 72 students. Qualitative feedback suggests that students learnt about forestry, acquired greater awareness of the importance of conservation for the local environment and enjoyed the participatory teaching methods used in the programme. Quantitative results show a positive and significant association between the number of times a student participated in the programme and the student&rsquo;s ecological knowledge. Students who participated in the programme once had a 16.3% higher knowledge on ecological concepts and knew, on average, 1.5 more local forest plants than students who never attended it (p&lt;.001). Findings suggest that the inclusion of participatory environmental education programmes in preparatory schools would improve the acquisition of ecological knowledge. Further research could consider the consistency of the findings by replicating participatory methods presented here and by using an experimental research design.<br /

Structural phase transition and material properties of few-layer monochalcogenides

GeSe and SnSe monochalcogenide monolayers and bilayers undergo a two-dimensional phase transition from a rectangular unit cell to a square unit cell at a temperature $T_c$ well below the melting point. Its consequences on material properties are studied within the framework of Car-Parrinello molecular dynamics and density-functional theory. No in-gap states develop as the structural transition takes place, so that these phase-change materials remain semiconducting below and above $T_c$. As the in-plane lattice transforms from a rectangle onto a square at $T_c$, the electronic, spin, optical, and piezo-electric properties dramatically depart from earlier predictions. Indeed, the $Y-$ and $X-$points in the Brillouin zone become effectively equivalent at $T_c$, leading to a symmetric electronic structure. The spin polarization at the conduction valley edge vanishes, and the hole conductivity must display an anomalous thermal increase at $T_c$. The linear optical absorption band edge must change its polarization as well, making this structural and electronic evolution verifiable by optical means. Much excitement has been drawn by theoretical predictions of giant piezo-electricity and ferroelectricity in these materials, and we estimate a pyroelectric response of about $3\times 10^{-12}$ $C/K m$ here. These results uncover the fundamental role of temperature as a control knob for the physical properties of few-layer group-IV monochalcogenidesComment: Supplementary information included. Published versio