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

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

Visible-light activation of Ti02 photocatalysts: advances in theory and experiments

The remarkable achievement by Fujishima and Honda (1972) in the photo-electrochemical water splitting\ud results in the extensive use of TiO2 nanomaterials for environmental purification and energy\ud storage/conversion applications. Though there are many advantages for the TiO2 compared to other\ud semiconductor photocatalysts, its band gap of 3.2 eV restrains application to the UV-region of the electromagnetic\ud spectrum ( \ud ≤\ud 387.5 nm). As a result, development of visible-light active titanium dioxide\ud is one of the key challenges in the field of semiconductor photocatalysis. In this review, advances in\ud the strategies for the visible light activation, origin of visible-light activity, and electronic structure of\ud various visible-light active TiO2 photocatalysts are discussed in detail. It has also been shown that if\ud appropriate models are used, the theoretical insights can successfully be employed to develop novel\ud catalysts to enhance the photocatalytic performance in the visible region. Recent developments in theory\ud and experiments in visible-light induced water splitting, degradation of environmental pollutants,\ud water and air purification and antibacterial applications are also reviewed. Various strategies to identify\ud appropriate dopants for improved visible-light absorption and electron–hole separation to enhance the\ud photocatalytic activity are discussed in detail, and a number of recommendations are also presented

EAACI Molecular Allergology User's Guide

none65siThe availability of allergen molecules ('components') from several protein families has advanced our understanding of immunoglobulin E (IgE)-mediated responses and enabled 'component-resolved diagnosis' (CRD). The European Academy of Allergy and Clinical Immunology (EAACI) Molecular Allergology User's Guide (MAUG) provides comprehensive information on important allergens and describes the diagnostic options using CRD. Part A of the EAACI MAUG introduces allergen molecules, families, composition of extracts, databases, and diagnostic IgE, skin, and basophil tests. Singleplex and multiplex IgE assays with components improve both sensitivity for low-abundance allergens and analytical specificity; IgE to individual allergens can yield information on clinical risks and distinguish cross-reactivity from true primary sensitization. Part B discusses the clinical and molecular aspects of IgE-mediated allergies to foods (including nuts, seeds, legumes, fruits, vegetables, cereal grains, milk, egg, meat, fish, and shellfish), inhalants (pollen, mold spores, mites, and animal dander), and Hymenoptera venom. Diagnostic algorithms and short case histories provide useful information for the clinical workup of allergic individuals targeted for CRD. Part C covers protein families containing ubiquitous, highly cross-reactive panallergens from plant (lipid transfer proteins, polcalcins, PR-10, profilins) and animal sources (lipocalins, parvalbumins, serum albumins, tropomyosins) and explains their diagnostic and clinical utility. Part D lists 100 important allergen molecules. In conclusion, IgE-mediated reactions and allergic diseases, including allergic rhinoconjunctivitis, asthma, food reactions, and insect sting reactions, are discussed from a novel molecular perspective. The EAACI MAUG documents the rapid progression of molecular allergology from basic research to its integration into clinical practice, a quantum leap in the management of allergic patients.restrictedMatricardi, P M; Kleine-Tebbe, J; Hoffmann, H J; Valenta, R; Hilger, C; Hofmaier, S; Aalberse, R C; Agache, I; Asero, R; Ballmer-Weber, B; Barber, D; Beyer, K; Biedermann, T; Bilò, M B; Blank, S; Bohle, B; Bosshard, P P; Breiteneder, H; Brough, H A; Caraballo, L; Caubet, J C; Crameri, R; Davies, J M; Douladiris, N; Ebisawa, M; EIgenmann, P A; Fernandez-Rivas, M; Ferreira, F; Gadermaier, G; Glatz, M; Hamilton, R G; Hawranek, T; Hellings, P; Hoffmann-Sommergruber, K; Jakob, T; Jappe, U; Jutel, M; Kamath, S D; Knol, E F; Korosec, P; Kuehn, A; Lack, G; Lopata, A L; Mäkelä, M; Morisset, M; Niederberger, V; Nowak-Węgrzyn, A H; Papadopoulos, N G; Pastorello, E A; Pauli, G; Platts-Mills, T; Posa, D; Poulsen, L K; Raulf, M; Sastre, J; Scala, E; Schmid, J M; Schmid-Grendelmeier, P; van Hage, M; van Ree, R; Vieths, S; Weber, R; Wickman, M; Muraro, A; Ollert, MMatricardi, P M; Kleine-Tebbe, J; Hoffmann, H J; Valenta, R; Hilger, C; Hofmaier, S; Aalberse, R C; Agache, I; Asero, R; Ballmer-Weber, B; Barber, D; Beyer, K; Biedermann, T; Bilò, M B; Blank, S; Bohle, B; Bosshard, P P; Breiteneder, H; Brough, H A; Caraballo, L; Caubet, J C; Crameri, R; Davies, J M; Douladiris, N; Ebisawa, M; Eigenmann, P A; Fernandez-Rivas, M; Ferreira, F; Gadermaier, G; Glatz, M; Hamilton, R G; Hawranek, T; Hellings, P; Hoffmann-Sommergruber, K; Jakob, T; Jappe, U; Jutel, M; Kamath, S D; Knol, E F; Korosec, P; Kuehn, A; Lack, G; Lopata, A L; Mäkelä, M; Morisset, M; Niederberger, V; Nowak-Węgrzyn, A H; Papadopoulos, N G; Pastorello, E A; Pauli', Gabriella; Platts-Mills, T; Posa, D; Poulsen, L K; Raulf, M; Sastre, J; Scala, E; Schmid, J M; Schmid-Grendelmeier, P; van Hage, M; van Ree, R; Vieths, S; Weber, R; Wickman, M; Muraro, A; Ollert,