A review of non-pharmacologic approaches to enhance the patient experience in dermatologic surgery

Efforts to increase patient comfort by minimizing pain and anxiety have been shown to improve clinical outcomes, reduce pain thresholds, decrease analgesic requirements and complication risk, strengthen the physician-patient relationship, and increase overall patient satisfaction. Patients also have a strong preference for patient-centered communication and educational discussion with physicians. In recent years, the increasing emphasis on patient experience scores as a metric for quality care has had significant implications for physician practice and has reinforced attempts to provide more patient-centered care. Though different pharmacologic agents and techniques have been extensively reviewed in the dermatologic literature, there have been few studies of non-pharmacologic strategies for improving patient-centered care. This evidence-based review describes alternative techniques that have been suggested for use in dermatologic surgery. Mechanoanesthesia, cold therapy, verbal and audiovisual distraction, music, optimal needle insertion methods, hypnosis and guided-imagery, perioperative communication, and educational strategies have been reported to improve the patient experience in dermatologic surgery. These interventions are often cost-effective and easy to implement, avoid medication side effects, and serve as adjunct approaches to enhance patient comfort. This review examines the corresponding evidence for these nonpharmacologic strategies to provide a clinical resource for the dermatologic surgeon seeking to optimize the patient experience

Exotic galilean symmetry and the Hall effect

The ``Laughlin'' picture of the Fractional Quantum Hall effect can be derived using the ``exotic'' model based on the two-fold centrally-extended planar Galilei group. When coupled to a planar magnetic field of critical strength determined by the extension parameters, the system becomes singular, and ``Faddeev-Jackiw'' reduction yields the ``Chern-Simons'' mechanics of Dunne, Jackiw, and Trugenberger. The reduced system moves according to the Hall law.Comment: Talk given by P. A. Horvathy at the Joint APCTP- Nankai Symposium. Tianjin (China), Oct.2001. To appear in the Proceedings, to be published by Int. Journ. Mod. Phys. B. 7 pages, LaTex, IJMPB format. no figure

Motion and Trajectories of Particles Around Three-Dimensional Black Holes

The motion of relativistic particles around three dimensional black holes following the Hamilton-Jacobi formalism is studied. It follows that the Hamilton-Jacobi equation can be separated and reduced to quadratures in analogy with the four dimensional case. It is shown that: a) particles are trapped by the black hole independently of their energy and angular momentum, b) matter alway falls to the centre of the black hole and cannot understake a motion with stables orbits as in four dimensions. For the extreme values of the angular momentum of the black hole, we were able to find exact solutions of the equations of motion and trajectories of a test particle.Comment: Plain TeX, 9pp, IPNO-TH 93/06, DFTUZ 93/0

On the Initial Singularity Problem in Two Dimensional Quantum Cosmology

The problem of how to put interactions in two-dimensional quantum gravity in the strong coupling regime is studied. It shows that the most general interaction consistent with this symmetry is a Liouville term that contain two parameters $(\alpha, \beta)$ satisfying the algebraic relation $2\beta - \alpha =2$ in order to assure the closure of the diffeomorphism algebra. The model is classically soluble and it contains as general solution the temporal singularity. The theory is quantized and we show that the propagation amplitude fall tozero in $\tau =0$. This result shows that the classical singularities are smoothed by quantum effects and the bing-bang concept could be considered as a classical extrapolation instead of a physical concept.Comment: 9pp, Revtex 3.0. New references added. To appear in Phys. Rev.

El uso de BITNET para acceder a las bases de datos de la Biblioteca Nacional de Medicina

This article describes a project developed using GRATEFUL MED, a software of the National Library of Medicine (NLM) in BITNET Network to access to data bases of NLM

Radiative processes as a condensation phenomenon and the physical meaning of deformed canonical structures

Working with well known models in $(2+1)D$ we discuss the physics behind the deformation of the canonical structure of these theories. A new deformation is constructed linking the massless scalar field theory with the self-dual theory. This is the exact dual of the known deformation connecting the Maxwell theory with the Maxwell-Chern-Simons theory. Duality is used to establish a web of relations between the mentioned theories and a physical picture of the deformation procedure is suggested.Comment: revtex4 file, 16 page