Psychodermatology in clinical practice: An examination of physician attitudes, beliefs, and interventions toward psychocutaneous disease.

Fifteen days postconception, the embryonic ectoderm simultaneously gives rise to the central nervous system and the epidermis of the integumentary system. The connections between the two organ systems manifests in both the psychiatric and dermatologic setting. To examine the current awareness of psychiatric comorbidity in dermatologic practice and its management in a sample of dermatologists across the United States. A survey was conducted that explored physician perspective on psychiatric comorbidity, clinical practice, and management, that is, use of survey screening measures, employment of psychological interventions, and coordination with mental health services. SPSS v25 was used for descriptive statistical analysis and to calculate Pearson's correlation coefficients between familiarity with dermatologic/psychiatric comorbidity and its management. Ninety-eight percentage of respondents believed a relationship between mental and dermatological health. 61.7% of respondents reported seeing patients with known psychological problems more than once a week. The administration of a psychiatric questionnaires was noted in 23% of practices and only 6.38% administer the questionnaire at every appointment. Management of comorbid disease is best done through the collaboration of dermatology and psychiatry. Implications for streamlining practice include the routine administration of quality of life surveys, utilization of brief psychotherapeutic strategies, and regular interdisciplinary referrals.

Variation in the seasonal germination niche across an elevational gradient: the role of germination cueing in current and future climates.

PREMISE: The timing of germination has profound impacts on fitness, population dynamics, and species ranges. Many plants have evolved responses to seasonal environmental cues to time germination with favorable conditions; these responses interact with temporal variation in local climate to drive the seasonal climate niche and may reflect local adaptation. Here, we examined germination responses to temperature cues in Streptanthus tortuosus populations across an elevational gradient. METHODS: Using common garden experiments, we evaluated differences among populations in response to cold stratification (chilling) and germination temperature and related them to observed germination phenology in the field. We then explored how these responses relate to past climate at each site and the implications of those patterns under future climate change. RESULTS: Populations from high elevations had stronger stratification requirements for germination and narrower temperature ranges for germination without stratification. Differences in germination responses corresponded with elevation and variability in seasonal temperature and precipitation across populations. Further, they corresponded with germination phenology in the field; low-elevation populations germinated in the fall without chilling, whereas high-elevation populations germinated after winter chilling and snowmelt in spring and summer. Climate-change forecasts indicate increasing temperatures and decreasing snowpack, which will likely alter germination cues and timing, particularly for high-elevation populations. CONCLUSIONS: The seasonal germination niche for S. tortuosus is highly influenced by temperature and varies across the elevational gradient. Climate change will likely affect germination timing, which may cascade to influence trait expression, fitness, and population persistence.

Patient satisfaction and total hip arthroplasty: a review.

Primary total hip arthroplasty (THA) has been recognized as a reliable intervention for patients with end-stage osteoarthritis. Despite several notable advances in this procedure, studies have identified at least 7% of patients who remain dissatisfied. There is no general consensus on how to measure patient satisfaction in orthopedic surgery. However, validated tools have been used in multiple studies to further investigate this problem. A comprehensive review was conducted to examine the factors associated with patient satisfaction following THA. Associations in literature included patient expectation, age, sex, pain management, patient comorbidities (medical or psychiatric that existed prior to surgery), and length of stay. The continuous collection of patient satisfaction data using validated and reliable measurement tools is necessary to improve this important patient-reported outcome after THA.