Psychodermatology is the crossover discipline between Dermatology and Clinical Psychology and/or Psychiatry. It encompasses both Psychiatric diseases that present with cutaneous manifestations (such as delusional infestation) or more commonly, the psychiatric or psychological problems associated with skin disease, such as depression associated with psoriasis. These problems may be the result either of imbalance in or be the consequence of alteration in the homoeostatic endocrine mechanisms found in the systemic hypothalamic‐pituitary‐adrenal axis or in the local cutaneous corticotrophin‐releasing factor‐proopiomelanocortin‐corticosteroid axis. Alteration in either of these systems can lead to immune disruption and worsening of immune dermatoses and vice‐versa. These include diseases such as psoriasis, atopic eczema, acne, alopecia areata, vitiligo and melasma, all of which are known to be linked to stress. Similarly, stress and illnesses such as depression are linked with many immunodermatoses and may reflect alterations in the body's central and peripheral neuroendocrine stress pathways. It is important to consider issues pertaining to skin of colour, particularly with pigmentary disorders.
Introduction
Virtual clinics were implemented during COVID-19 to reduce patient contact. We identified the need to seek feedback from patients relating to their perceptions on care received at a virtual clinic compared to a face-to-face clinics.
Method
Patients who attended a virtual clinic in General Surgery were selected at random from a database of 627 patients. They were called and asked to complete a google survey which was sent via email. A shorter survey was also conducted over the phone for patients who did not have an email address.
Results
79.6% (n = 43) of patients felt their care did not suffer because of non-face-to-face contact. 63% (n = 34) reported that their symptoms were fully assessed during the virtual clinic. 77.8% (n = 42) did not feel rushed by the virtual clinic, 92.6% (n = 50) answered that they had the opportunity to ask questions. 68.5% (n = 35) answered their care did not suffer by not being examined. 72.2% (n = 39) felt that the outcome of the clinic was not changed because of non face-to-face contact.
Conclusions
Patient feedback on the care received in the virtual clinic was positive. This may suggest that virtual clinics could be utilised in outpatients care with good reception from patients.
Introduction
During the COVID-19 pandemic many hospitals adopted the use of virtual clinics to reduce in-person contact. We identified the need to assess patient’s opinion of the disruption caused to their lives by attending a virtual clinic appointment compared to a face-to-face appointment at a General Surgery department of a UK hospital.
Method
627 patients attended a virtual clinic in General Surgery between 25th March 2020 and 30th April 2020. Patients were selected using a random number generator; they were called and asked to complete a google survey which was sent via email. A shorter survey was also conducted over the phone for patients who did not have an email address.
Results
73 patients completed the online or telephone survey. 77.8% (n = 42) reported that they had no problems accessing the virtual clinic. 74.1% of patients (n = 40) agreed that virtual clinics caused less disruption to their daily life. 87.7% (n = 64) saved time by attending the virtual clinic. 67.1% (n = 49) saved two or more hours. 65.8% made a financial saving.
Conclusions
Patients found the clinic easy to access. Overall, the virtual clinics cause less disruption to patients’ lives than a face-to-face clinic appointment with notifiable savings in both time and money.
participants agreed that video-conferencing improved accessibility, with 80% stating they would access recorded sessions if unable to attend. 41 consultants completed the survey. 67% had never used video-conferencing to teach doctors. 40% were not confident in sharing presentations and 92% in managing break-out sessions. 34 consultants would deliver CME virtually with 82% having no objections to recording of sessions. Conclusions Virtual teaching is an appropriate method to provide the necessary volume and quality of postgraduate medical education. Consultants are keen to provide virtual teaching but would benefit from focused training.
were readmitted in the postpartum period due to a hypertension-related diagnosis. Random forest method achieved a sensitivity of 85%, specificity of 79%, and balanced accuracy of 82% for predicting readmission. The most important variables for predicting readmission included systolic blood pressure at 48 hours postpartum and systolic blood pressure in labor. Overall, Fifteen variables were included in the final model and resulting user-friendly online clinical calculator.CONCLUSION: This validated model predicts the risk of hypertension related postpartum readmission. In contrast to prior known predictors of readmission this model uses distinct clinical variables that are easily identifiable in the medical chart. This user-friendly online clinical calculator may be used as an individualized objective tool during discharge planning, outpatient management, and perhaps those who may most benefit from daily remote patient monitoring or closer outpatient surveillance to prevent readmission.
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