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Daudén E, Belinchón I, Colominas-González E, Coto P, de la Cueva P, Gallardo F, Poveda JL, Ramírez E, Ros S, Ruíz-Villaverde R, Comellas M, Lizán L. Defining well-being in psoriasis: A Delphi consensus among healthcare professionals and patients. Sci Rep 2024; 14:14519. [PMID: 38914574 PMCID: PMC11196587 DOI: 10.1038/s41598-024-64738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
Psoriasis is a chronic skin disease that negatively impacts on patient's life. A holistic approach integrating well-being assessment could improve disease management. Since a consensus definition of well-being in psoriasis is not available, we aim to achieve a multidisciplinary consensus on well-being definition and its components. A literature review and consultation with psoriasis patients facilitated the design of a two-round Delphi questionnaire targeting healthcare professionals and psoriasis patients. A total of 261 panellists (65.1% patients with psoriasis, 34.9% healthcare professionals) agreed on the dimensions and components that should integrate the concept of well-being: emotional dimension (78.9%) [stress (83.9%), mood disturbance (85.1%), body image (83.9%), stigma/shame (75.1%), self-esteem (77.4%) and coping/resilience (81.2%)], physical dimension (82.0%) [sleep quality (81.6%), pain/discomfort (80.8%), itching (83.5%), extracutaneous manifestations (82.8%), lesions in visible areas (84.3%), lesions in functional areas (85.8%), and sex life (78.2%)], social dimension (79.5%) [social relationships (80.8%), leisure/recreational activities (80.3%), support from family/friends (76.6%) and work/academic life (76.5%)], and satisfaction with disease management (78.5%) [treatment (78.2%), information received (75.6%) and medical care provided by the dermatologist (80.1%)]. This well-being definition reflects patients' needs and concerns. Therefore, addressing them in psoriasis will optimise management, contributing to better outcomes and restoring normalcy to the patient's life.
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Affiliation(s)
- Esteban Daudén
- Department of Dermatology, Instituto de Investigación Sanitaria de La Princesa (IIS-IP), Hospital Universitario de La Princesa, Diego de León, 62, 28006, Madrid, Spain.
| | - I Belinchón
- Department of Dermatology, Hospital General Universitario Dr Balmis-ISABIAL-UMH, Alicante, Spain
| | | | - P Coto
- Department of Dermatology, Hospital Vital Álvarez Buylla, Mieres, Spain
| | - P de la Cueva
- Department of Dermatology, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - F Gallardo
- Department of Dermatology, Hospital del Mar, Barcelona, Spain
| | - J L Poveda
- Department of Pharmacy, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - E Ramírez
- Department of Pharmacy, Hospital Universitario de La Princesa, Madrid, Spain
| | - S Ros
- Departments of Dermatology and Rheumatology, and Cardiac Transplant Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Ruíz-Villaverde
- Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain
| | - M Comellas
- Outcomes'10, Castellón de la Plana, Spain
| | - Luís Lizán
- Outcomes'10, Universidad Jaume I, Castellón de la Plana, Spain
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Wallnöfer F, Ziehfreund S, Wecker H, Schuster B, Tizek L, Kain A, Biedermann T, Zink A. Disease-Related Internet Use and its Relevance to the Patient-Physician Relationship in Atopic Dermatitis: A Cross-Sectional Study in Germany. Dermatitis 2024. [PMID: 38783509 DOI: 10.1089/derm.2023.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Background: Health-related internet use presents both opportunities and challenges for patients and physicians and requires a comprehensive understanding to improve individual health care in atopic dermatitis (AD). Objective: To explore differences between regular and irregular disease-related internet users, reasons for disease-related internet use, and its relevance to the patient-physician relationship in AD. Methods: This cross-sectional study recruited 221 adults with AD online and from a German university clinic between August 2021 and February 2022. The questionnaire queried sociodemographic and disease-related information, reasons for and against using the internet, types of channels used, and the impact on the patient-physician relationship. Participants were categorized as regular (≥once per month) and irregular (
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Affiliation(s)
- Fabian Wallnöfer
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stefanie Ziehfreund
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Hannah Wecker
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Barbara Schuster
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Linda Tizek
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Alphina Kain
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Tilo Biedermann
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- From the Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Wecker H, Ziehfreund S, Sitaru S, Johansson EK, Elberling J, Doll A, Nicolaidou E, Scala E, Boffa MJ, Schmidt L, Sikora M, Torres T, Chernyshov PV, Zink A. Burden of atopic dermatitis in Europe: A population-centred approach leveraging web search data in 21 European countries. J Eur Acad Dermatol Venereol 2024. [PMID: 38641980 DOI: 10.1111/jdv.19989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/28/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND The complexity, high prevalence, and substantial personal and socioeconomic burden collectively render atopic dermatitis (AD) a major public health concern. Using crowdsourced Internet data has the potential to provide unique insights into this concern, as demonstrated by several previous studies. However, a comprehensive comparison across European countries remains lacking. OBJECTIVES The study aimed to investigate AD-related web searches across Europe to assess spatiotemporal variations and associations between disease-related and external factors. METHODS AD-related web search data were extracted for 21 European countries between February 2019 and January 2023. Descriptive analysis and autocorrelation functions were performed to examine spatiotemporal patterns. Correlations (r) were used to evaluate the associations between web searches and disease-related, socioeconomic and meteorological data. RESULTS Over 241 million AD-related web searches were identified, with search volume varying substantially among European countries (p < 0.001) and correlating with AD prevalence and disease burden (both r = 0.51, p = 0.019). Search volume increased between 2019 and 2023 in all countries and seasonally peaked in January and March. Negative correlations with median population age (r = -0.46, p = 0.039), number of general practitioners (r = -0.29, p = 0.226) and specialists (r = -0.27, p = 0.270) were observed. Moderate to strong correlations were found between search volume and cold, humid and windy weather with fewer sunshine hours, while higher online interest typically occurred 1-3 months after such weather conditions. CONCLUSION The study highlights the great potential of online crowdsourced data analysis, for example, to investigate the impact of climate change or to identify unmet needs at a population level. Furthermore, the growing online interest in AD and the corresponding seasonal peaks emphasize the necessity of adapting treatment plans, intensifying public health campaigns, and disseminating reliable online information by governments and healthcare providers, especially during these periods.
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Affiliation(s)
- Hannah Wecker
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Sebastian Sitaru
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Emma K Johansson
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology and Venereology, Karolinska University Hospital, Stockholm, Sweden
| | - Jesper Elberling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anaïs Doll
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Emanuele Scala
- Department of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Lea Schmidt
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Mariusz Sikora
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Tiago Torres
- Department of Dermatology, Centro Hospitalar Universitário de Santo António, University of Porto, Porto, Portugal
| | - Pavel V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - Alexander Zink
- Department of Dermatology and Allergy, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Mick A, Wecker H, Ziehfreund S, Maul JT, Biedermann T, Zink A. Cracking the code: unveiling the nexus between atopic dermatitis and addictive behavior: a cross-sectional exploration of risk factors. Arch Dermatol Res 2024; 316:102. [PMID: 38485839 PMCID: PMC10940371 DOI: 10.1007/s00403-024-02841-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/18/2024]
Abstract
Atopic dermatitis (AD) stands as a prevalent chronic inflammatory skin disorder with a global reach. Beyond its cutaneous manifestations, AD is accompanied by comorbidities and psychological issues, significantly compromising the overall quality of life for individuals who suffer from AD. Previous research has evidenced a heightened prevalence of addictive disorders among dermatological patients when compared to the general population. Considering these findings, this study endeavors to examine the prevalence of addictive disorders among AD patients and, furthermore, to discern potential risk factors associated with this comorbidity. Therefore, a cross-sectional study was conducted involving patients with AD diagnosed by dermatologists within a large university hospital in Munich, South Germany, between January 2016 and December 2019. Patients received an anonymous paper-based questionnaire comprising standardized and reliable assessment tools concerning disease severity, quality of life, sexual dysfunction, well-being, and anxiety disorder as well as screening tools for various addictive disorders (compulsive internet use, drug abuse, pathological alcohol consumption, and smoking). Data were analyzed descriptively, and a multivariate logistic regression model was conducted. A total of 208 patients participated in the study, comprising 38% males and 62% females with a mean age of 44.8 ± standard deviation:17.9 years. Females showed a higher mean POEM (Patient-Oriented Eczema Measure) score compared to males (female 14.6 ± 7.8; male 12.5 ± 7.7), as well as a higher DLQI (Dermatology Life Quality Index) (female 8.5 ± 6; male 6.5 ± 6.5). Positive addictions were found in 14.9% for daily smoking, 15.4% for critical alcohol consumption, 16.8% for compulsive internet use, and 5.8% for drug abuse. Younger patients were more likely to be affected by one or multiple addictions than older patients. Patients with at least one addiction showed significantly impaired well-being and increased severe anxiety symptoms. Given the notable prevalence of addictive disorders among individuals with AD, it could be useful to implement systematic screening for such conditions as part of patient-centered care, especially focusing on young AD patients or those displaying concurrent indications of depression or anxiety.
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Affiliation(s)
- Antonia Mick
- Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Hannah Wecker
- Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Julia-Tatjana Maul
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zürich, Zurich, Switzerland
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, TUM School of Medicine and Health, Biedersteiner Str. 29, 80802, Munich, Germany.
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Rogner D, Heimerl L, Heyer S, Biedermann T, Sattler E, Zink A. Patients' perspective, quality of life and treatment goals in Hailey-Hailey disease: Lessons learned from the German National Registry. J Eur Acad Dermatol Venereol 2024; 38:419-429. [PMID: 37863661 DOI: 10.1111/jdv.19583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Hailey-Hailey disease (HHD) remains a difficult-to-treat dermatosis and little is known about the patient's perception of the disease activity, the treatment success and its impact on quality-of-life (QoL). OBJECTIVE To obtain better understanding of HHD patients' needs regarding their medical condition, financial burden, QoL, subjective well-being and treatment thereof as well as satisfaction to evaluate common treatments' 'real-life' relevance. METHODS With initiation of the national registry for Darier's disease (DD; Morbus Darier, MD) and Hailey-Hailey disease (HH) MDHHgermany, patients with HHD diagnosis were included starting June 2020. To assess subjective symptoms, patients filled out questionnaires such as the DLQI (dermatological life quality index), numeric rating scale (NRS) for itch, pain and burning sensation, as well as the SWLS (satisfaction with life scale) questionnaire to quantify overall satisfaction in life. Additionally, data on therapies were collected along with the patients' satisfaction of those and their medical care. Furthermore, patients assessed financial aspects and work ability. RESULTS One hundred and two patients were recruited from dermatology clinics, office-based dermatologists and self-help platforms across Germany between June 2020 and February 2023, 90 were eligible and analysed (mean: 49.91 years, 73.33% females, 26.67% males). 39.77% stated according to the DLQI their life is severely/very severely affected. Satisfaction with life was mediocre. Burning sensation was most pronounced among subjective symptoms (NRS 5.85 ± 2.80). Systemic treatments were rated as ineffective according to 56.92%, 25.56% had never received one. Most prescribed systemic treatments were corticosteroids (73.8%), followed by low-dose naltrexone (LDN) (26.2%), retinoids (15.4%) and antibiotics (13.8%). Satisfaction with medical care was generally low. CONCLUSION Our 'real-life' data state a major disease burden and impact on the QoL for affected individuals, as well as limited disease control due to inadequate therapies. MDHHgermany can provide insights into improvement of healthcare support with this debilitating disease and improve QoL. In the long term, it aims to provide basis for further clinical trials, epidemiological studies and immunological investigations.
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Affiliation(s)
- D Rogner
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - L Heimerl
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Pharmacology and Toxicology, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - S Heyer
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - T Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Sattler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - A Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Sommer R, Mrowietz U, Gaarn Du Jardin K, Kasujee I, Martini E, Daudén E, Fabbrocini G, Zink A, Griffiths CEM, Augustin M. Implementing well-being in the management of psoriasis: An expert recommendation. J Eur Acad Dermatol Venereol 2024; 38:302-310. [PMID: 37822008 DOI: 10.1111/jdv.19567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/30/2023] [Indexed: 10/13/2023]
Abstract
Psoriasis causes detriment in a person's physical, mental and social health which impairs their quality of life (QoL). However, the current psoriasis management may not adequately address all relevant health domains. Since the goal of healthcare is to restore or maintain health, health outcomes should include all areas of the patient's overall health. Life satisfaction, QoL and patient well-being are essential to a comprehensive approach to the disease. With the inclusion of more people-centred policies, care of patients with psoriasis should evolve towards a holistic and integrated assessment of the disease impact, including subjective measures of well-being in order to encompass all aspects of health. The main objective of this expert review is to give the concept of well-being a place as an entity within the holistic therapeutic approach for patients with psoriasis. Identifying and defining common goals beyond the skin with the patient and testing them throughout the course of treatment will benefit and enhance treatment success. We propose a series of recommendations for application in clinical practice, providing tangible clinical guidance for implementing well-being in the management of psoriasis. Among the recommendations are the need to initially listen to the patient, to know their level of empowerment or what they want to achieve, their preferences in decision making, the evaluation of not only the physical but also the emotional impact of the disease (well-being), the definition of the aspects that can generate a cumulative deterioration of the disease throughout life, and a continuous assessment of the patient's preferences with the opinion of the expert clinician and the integration of the knowledge of external clinical evidence.
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Affiliation(s)
- Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ulrich Mrowietz
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | | | | | - Esteban Daudén
- La Princesa University Hospital, Instituto de Investigación Sanitaria La Princesa (IIS-IP), Madrid, Spain
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Germany
| | - Christopher E M Griffiths
- The Dermatology Centre, NIHR Manchester Biomedical Research Centre, Salford Royal Hospital, The University of Manchester, Manchester, UK
- Department of Dermatology, King's College Hospital, King's College London, London, UK
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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7
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Kruger D, Samuels N, Lacey J, Keshet Y, Gressel O, Dodiuk-Gad RP, Shulman K, Tapiro Y, Golan M, Ben-Arye E. Exploring a multi-disciplinary model of supportive cancer care for monoclonal antibody treatment-related dermatological symptoms. Support Care Cancer 2023; 31:185. [PMID: 36821054 PMCID: PMC9947431 DOI: 10.1007/s00520-023-07642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
CONTEXT AND OBJECTIVES The present study examined the perspectives of healthcare providers (HCPs) in designing a multi-disciplinary model of supportive cancer care for the relief of dermatology-related symptoms caused by monoclonal antibody therapies. METHODS The study employed a mixed research methodology, with qualitative research embedded within a pragmatic prospective study of a registry protocol study. Patients undergoing oncology therapy with MoAB, anti-HER2, and anti-PD-L1 monoclonal antibodies were identified among a cohort of patients referred to an integrative oncology (IO) consultation for symptom relief and improved quality of life (QoL). Case studies with significant dermatology-related concerns were selected and presented to a panel of 6 HCPs trained in medical oncology, oncology nursing, family medicine, supportive cancer care, and IO. HCP narratives were qualitatively analyzed and assessed using ATLAS.Ti software for systematic coding. RESULTS Of the 924 patients referred to the IO consultation, 208 were treated with monoclonal antibodies, from which 50 were selected for further evaluation. Of these, 7 cases were presented to the HCP team who were asked to identify treatment gaps requiring a multi-disciplinary approach. Qualitative analysis identified 3 major themes: a biophysical perspective; a psycho-social-spiritual perspective; and the implementation of integrated care. DISCUSSION There is a need for a multi-disciplinary approach when treating patients suffering from monoclonal antibody treatment-related skin toxicities. HCP-reported themes highlight the need to identify patients for whom such an approach is warranted; conditions in which a psycho-social-spiritual perspective should be considered, in addition to a bio-physical approach; and considerations of who should be designated as the patient's primary case manager.
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Affiliation(s)
- Dikla Kruger
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,Department of Family Medicine, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | - Noah Samuels
- The Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Clinical School of Medicine, University of Sydney, Camperdown, Australia.,NICM Health Research Institute, Western Sydney University, Sydney, Australia
| | - Yael Keshet
- Department of Sociology and Anthropology, Western Galilee Academic College, Akko, Israel
| | - Orit Gressel
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Roni P Dodiuk-Gad
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.,Department of Dermatology, Emek Medical Center, Afula, Israel.,Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Katerina Shulman
- The Oncology Service, Lin and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,Carmel Medical Center, Haifa, Israel
| | - Yehudit Tapiro
- The Oncology Service, Lin and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel
| | - Miri Golan
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel
| | - Eran Ben-Arye
- Integrative Oncology Program, Oncology Service; Lin, Carmel, and Zebulon Medical Centers, Clalit Health Services, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
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8
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Augustin M, Sommer R, Daudén E, Laws P, de Jong E, Fabbrocini G, Naldi L, Navarini A, Lambert J, Reguiai Z, Gerdes S, Massana E, Obis T, Kasujee I, Mrowietz U. Patient-reported well-being in value-based care using tildrakizumab in a real-world setting: protocol of a multinational, phase IV, 1-cohort prospective observational study (the POSITIVE study). BMJ Open 2023; 13:e060536. [PMID: 36792337 PMCID: PMC9933754 DOI: 10.1136/bmjopen-2021-060536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory skin disease that negatively impacts the quality of life of patients and their families. However, the most commonly used decision-making tools in psoriasis, Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA) and Dermatology Life Quality Index (DLQI), do not fully capture the impact of psoriasis on patients' lives. In contrast, the well-established 5-item WHO Well-being Index (WHO-5) assesses the subjective psychological well-being of patients. Moreover, while drug innovations became available for psoriasis, data on the impact of these therapies on patients' lives and their closest environment (family, physicians) are limited. This study will assess the effect of tildrakizumab, an interleukin-23p19 inhibitor, on the overall well-being of patients with moderate-to-severe psoriasis. Moreover, the long-term benefit of tildrakizumab on physicians' satisfaction and partners' lives of patients with psoriasis will be evaluated. METHODS AND ANALYSIS This non-interventional, prospective, observational, real-world evidence study will involve multiple sites in Europe and approximately 500 adults with moderate-to-severe psoriasis treated with tildrakizumab. Each patient will be followed for 24 months. The primary endpoint is well-being measured by the WHO-5 questionnaire. Key secondary endpoints include Physician's Satisfaction and partner's quality of life (FamilyPso). Other endpoints will evaluate skin-generic quality of life (DLQI-R), Treatment Satisfaction Questionnaire for Medication (TSQM-9), Treatment-related Patient Benefit Index 'Standard', 10 items (PBI-S-10) and work productivity and activity impairment due to psoriasis (WPAI:PSO). Statistical analyses will be based on observed cases. Multiple imputations will be performed as a sensitivity analysis, and adverse events will be reported. ETHICS AND DISSEMINATION The study will be conducted according to the protocol, which received ethics committee approval and applicable regulatory requirements of each participating country. The results will be disseminated through scientific publications and congress presentations. TRAIL REGISTRATION NUMBER ClinicalTrials.gov Identifier: NCT04823247 (Pre-results).
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Affiliation(s)
- Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rachel Sommer
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Esteban Daudén
- Instituto de Investigación Sanitaria La Princesa (IIS-IP), La Princesa University Hospital, Madrid, Spain
| | - Philip Laws
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Elke de Jong
- Department of Dermatology, Radboud University Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luigi Naldi
- Division of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Alexander Navarini
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - Jo Lambert
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Ziad Reguiai
- Department of Dermatology, Polyclinic Courlancy, Reims, France
| | - Sascha Gerdes
- Center for Inflammatory Skin Diseases, Department of Dermatology, Venereology and Allergology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | | | | | - Ulrich Mrowietz
- Psoriasis-Center, Department of Dermatology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Becevic M, Ge B, Braudis K, Cintrón C, Fleming D, Shyu CR, Edison K. Diagnostic and treatment concordance in primary care participants and dermatologists utilizing Extension for Community Health Outcomes (ECHO). J Telemed Telecare 2023:1357633X221147074. [PMID: 36654477 DOI: 10.1177/1357633x221147074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Suboptimal access to dermatologic care is dependent on patient location and insurance type. Although there have been attempts to address access issues, barriers to providing excellent dermatologic care to all patients at the right time still exist. The objective of this study was to investigate the clinical impact of Dermatology Extension for Community Healthcare Outcomes (ECHO) project participation on primary care providers' diagnostic and treatment tendencies and accuracy. METHODS This was a retrospective cohort study constructed using Dermatology Extension for Community Healthcare Outcomes case and recommendation data from November 2015 to June 2021. The University of Missouri-based Dermatology Extension for Community Healthcare Outcomes specialty hub team offers regularly scheduled live interactive tele-mentoring sessions for primary care providers who practice in rural and underserved areas. 524 patient cases presented by 25 primary care providers were included in the analysis. Of those, 449 cases were included in diagnostic concordance, and 451 in treatment concordance analysis. RESULTS Less than 40% of all diagnoses were fully concordant with an expert panel. Over 33% of patients were misdiagnosed, and over 26% received partially correct diagnosis. Only 16% of all treatment recommendations were fully concordant with an expert panel. DISCUSSION Diagnostic and treatment accuracy of participants is low, and Dermatology Extension for Community Healthcare Outcomes platform ensured patients received correct diagnosis and treatment quickly. Although tele-dermatology models are effective, they continue to be underutilized. Dermatologists in practice and training should be encouraged to adopt innovative clinical educational models, like Dermatology ECHO, to expand access to dermatologic expertise for the most marginalized populations.
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Affiliation(s)
- Mirna Becevic
- Department of Dermatology, 14716University of Missouri, Columbia, MO, USA
- Missouri Telehealth Network, 14716University of Missouri, Columbia, MO, USA
- Institute for Data Science and Informatics, 14716University of Missouri, Columbia, MO, USA
| | - Bin Ge
- Family and Community Medicine, 14716University of Missouri, Columbia, MO, USA
| | - Kara Braudis
- Department of Dermatology, 14716University of Missouri, Columbia, MO, USA
| | - Coralys Cintrón
- Calle San Antonio Rosales, 7165Universidad del Sagrado Corazón, San Juan, Puerto Rico
| | - David Fleming
- Department of Medicine and Center for Health Ethics, 14716University of Missouri, Columbia, MO, USA
| | - Chi-Ren Shyu
- Institute for Data Science and Informatics, 14716University of Missouri, Columbia, MO, USA
- Department of Electrical Engineering and Computer Science, 14716University of Missouri, Columbia, MO, USA
| | - Karen Edison
- Department of Dermatology, 14716University of Missouri, Columbia, MO, USA
- Missouri Telehealth Network, 14716University of Missouri, Columbia, MO, USA
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Li C, Xia Y, Zhang Y. Relationship between subjective well-being and depressive disorders: Novel findings of cohort variations and demographic heterogeneities. Front Psychol 2023; 13:1022643. [PMID: 36704672 PMCID: PMC9872016 DOI: 10.3389/fpsyg.2022.1022643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
This paper uses a large-scale nationally representative dataset, the Chinese General Social Survey, to examine the relationship between subjective well-being and depressive disorders. Statistical results indicate that higher levels of subjective well-being help decrease perceived depression. Robustness checks are carried out using different types of explanatory and dependent variables, various regression models, penalized machine learning methods, instrumental variable approaches, and placebo tests, all of which lend further credence to the above findings. Based on it, heterogeneities in the relationship between subjective well-being and self-rated mental disorders are explored. In respect of variations in age cohorts, it is found that the absolute values of happiness's estimated coefficients are smaller in the 20-30 and 30-40 age groups, while that in the 40-50 age group increase substantially. In older cohorts, the estimates remain at higher levels while fluctuating to some degree. Furthermore, the significantly negative interaction between happiness and age proves that age amplifies subjective well-being's effect on perceived depressive disorders. With age increasing, the impact of happiness on reducing perceived depression tends to be stronger. Therefore, for older people, subjective well-being plays a more important role in suppressing self-rated depression. Heterogeneities of the relationship between happiness and perceived depressive disorders in subgroups with different demographic characteristics are also investigated. It is found that the negative correlation between subjective well-being and self-rated depression is stronger among those with higher educational levels, living in urban areas, being members of the Communist Party of China, having pensions, and owning more housing assets. However, gender, ethnic identity, religious belief, and marital status exert no significant moderating effects.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, Weihai, China,*Correspondence: Chao Li, ✉
| | - Yuxin Xia
- HSBC Business School, Peking University, Shenzhen, China
| | - Yuhan Zhang
- HSBC Business School, Peking University, Shenzhen, China
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11
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Heim‐Ohmayer P, Freiberger A, Gedik M, Beckmann J, Ziehfreund S, Zink A, Hähl W, Schielein MC. The impact of stigmatization of psoriasis, atopic dermatitis and mastocytosis in different areas of life-A qualitative interview study. SKIN HEALTH AND DISEASE 2022; 2:e62. [PMID: 36479263 PMCID: PMC9720196 DOI: 10.1002/ski2.62] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 06/07/2023]
Abstract
BACKGROUND Stereotypes and false assumptions about chronic and visible skin diseases can determine the behaviour towards affected individuals and result in stigmatization or discrimination. OBJECTIVE The aim of this study was to analyze the perceived disease-related stigmatization of individuals with psoriasis, atopic dermatitis (AD) or mastocytosis. The study also aims to broaden people-centred knowledge of the effects of stigmatization in different areas of life, namely in everyday life, at work, in sports and in relationships. METHODS Qualitative in-depth semi-structured interviews were conducted among individuals with either psoriasis, AD or mastocytosis. Participants were recruited via self-help networks and were asked to express their experience of stigmatization in different areas of life. All interviews were audio recorded, transcribed verbatim and evaluated based on Mayring's content analysis. RESULTS In total, 24 individuals aged 19-79 years and living in Germany were included in the study-eight for each disease. Stigmatization was experienced in all three diseases in all mentioned areas of life as well as in interaction with medical professionals. Self-exclusion, negative self-perception and negative behaviour of others were the most frequent experiences with stigmatization. CONCLUSION Stigmatization, both internal and external, is an important factor contributing to the mental burden of people with chronic skin diseases. More research is needed to gain deeper insight into stigmatization and its psychological burden in various contexts to enhance people-centred care in chronic skin diseases.
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Affiliation(s)
- P. Heim‐Ohmayer
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - A. Freiberger
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - M. Gedik
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - J. Beckmann
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
- School of Human Movement and Nutrition SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | - S. Ziehfreund
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
| | - A. Zink
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
- Unit of Dermatology and VenereologyDepartment of MedicineKarolinska University HospitalKarolinska InstitutetSolnaSweden
| | - W. Hähl
- Department of Sport and Health SciencesTechnical University of MunichMunichGermany
| | - M. C. Schielein
- Department of Dermatology and AllergySchool of MedicineTechnical University of MunichMunichGermany
- Unit of Dermatology and VenereologyDepartment of MedicineKarolinska University HospitalKarolinska InstitutetSolnaSweden
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12
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Shi Y, Bi D, Wang Y, Li R, Wu L, Zhao C, Wu Z, Duan X, Xu J, Zhan F, Yang M, Liu S, Li Q, Zhang S, Liu L, Zhao J, Tian X, Li X, Wang Q, Zeng X. Chinese SLE Treatment and Research Group Registry (CSTAR) XIV: the subjective well-being of patients with systemic lupus erythematosus. Front Med (Lausanne) 2022; 9:984183. [PMID: 36203761 PMCID: PMC9531862 DOI: 10.3389/fmed.2022.984183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Systemic lupus erythematosus (SLE) can significantly influence patients’ quality of life and subjective well-being (SWB), but the relationships between clinical characteristics, SWB, and related psychological factors have been little studied. Objective To measure SWB in patients with SLE and examine how major clinical determinants, emotional variables, and related positive factors affect SWB. Methods Overall, 1,110 patients with SLE from the Chinese SLE Treatment and Research Group (CSTAR) and 198 age and gender-matched individuals from the general population without self-reported SLE were invited to complete questionnaires of SWB evaluated by the satisfaction with life scale (SWLS), emotional variables assessed by the patient health questionnaire-9 (PHQ-9), and general anxiety disorder-7 (GAD-7) and related positive factors assessed by the self-esteem scale (SES), general self-efficacy scale (GESE), and Connor-Davidson resilience scale (CD-RISC). The multivariate linear regression was used to examine the relationship between clinical manifestations and SWB. Results Life satisfaction was significantly lower (p < 0.001) in patients with SLE than in the general population. Active skin involvement (OR = 0.923, 95% CI = 0.868–0.981, p < 0.05) was negatively associated with life satisfaction scores, and age at enrollment (OR = 1.160, 95% CI = 1.092–1.230, p < 0.001) were positively associated with life satisfaction scores in the multivariate regression model. The cumulative organ damage was significantly associated with depression (OR = 1.085, 95% CI = 1.022–1.153, p < 0.01) and the loss of self-esteem (OR = 1.067, 95% CI = 1.004–1.133, p < 0.05). Conclusion SWB provides useful insight into the impact of SLE on psychological health and opportunities to improve quality of life and clinical care.
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Affiliation(s)
- Yue Shi
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Dandan Bi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yanhong Wang
- Department of Epidemiology and Biostatistics, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
| | - Ruofan Li
- Department of International Education, The Experimental High School Attached to Beijing Normal University, Beijing, China
| | - Lijun Wu
- Department of Rheumatology, The People’s Hospital of Xinjiang Autonomous, Urumqi, China
| | - Cheng Zhao
- Department of Rheumatology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhenbiao Wu
- Department of Clinical Immunology and Rheumatology, Xijing Hospital Affiliated with The Fourth Military Medical University, Xi’an, China
| | - Xinwang Duan
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jian Xu
- Department of Rheumatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Feng Zhan
- Department of Rheumatology, Hainan Provincial People’s Hospital, Haikou, China
| | - Min Yang
- Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shengyun Liu
- Department of Rheumatology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qin Li
- Department of Rheumatology, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Shuo Zhang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Lingshan Liu
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Jiuliang Zhao
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xinping Tian
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Xinying Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Xinying Li,
| | - Qian Wang
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
- Qian Wang,
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science and Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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13
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A Green Tea Containing Skincare System Improves Skin Health and Beauty in Adults: An Exploratory Controlled Clinical Study. COSMETICS 2022. [DOI: 10.3390/cosmetics9050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Skin dryness, fine lines and wrinkles, red spots, red vasculature, and porphyrin count are common indicators of skin health and beauty. The skincare system in this study contains scientifically validated ingredients such as fermented green tea (Camellia sinensis) water, niacinamide, antioxidants, and a variety of natural plant extracts. The purpose of this study was to evaluate the effectiveness of this skincare system in improving facial-skin health and beauty. Twenty-six healthy adults, both female and male, aged 18–54 and of all skin types and tones, were included in the study and participated as either the active or the control group (competitor product) using designated topical products for 30 days. Skin moisture, fine lines and wrinkles, porphyrin count, red spots, and red vasculature count were measured through high-quality photography, Visia® complexion analysis, FitSkin® skin analysis, and survey questions on day 0, day 8, and day 30. Significant improvements were observed in facial moisture, red-spot count, red vasculature count, and porphyrin count on day 30 in comparison with the control group. Non-significant improvements were observed in pores, skin texture, and wrinkles. With extensive well-documented functional ingredients, the studied skincare system used daily may significantly improve key areas of skin health and beauty.
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How important is subjective well-being for patients? A qualitative interview study of people with psoriasis. Qual Life Res 2022; 31:3355-3363. [PMID: 35948788 PMCID: PMC9587968 DOI: 10.1007/s11136-022-03189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE This qualitative study aimed to investigate the importance of subjective well-being (SWB) as an outcome of psoriasis treatment from patient's perspective. We focused on the affective component of SWB as assessed with the Daily Experience Sampling Questionnaire (DESQ), a validated daily diary. METHODS Semi-structured qualitative telephone interviews were conducted with in-patients of a dermatological rehabilitation clinic, after participants had completed the DESQ for up to seven days to get familiar with the concept of SWB. Patients were asked to reflect on the importance of SWB as treatment goal and on its relative importance as compared with other treatment outcomes. We also addressed whether SWB could be an indirect measure of benefit in that it reflects other important outcomes. Transcripts were analyzed using content analysis. RESULTS Eleven patients participated (24-63 years, mean 53 years, 8 male, 3 female). Participants uniformly confirmed that changes in SWB reflected treatment benefit. All but one considered SWB to be a central aspect of treatment benefit-either as the most important treatment goal or as an indirect benefit indicator. In particular, participants described positive associations of SWB with other outcomes, such as symptoms. They reported that both the disease and the medical treatment had an impact on their SWB, which was reflected in the DESQ. CONCLUSION Our findings suggest that SWB is a relevant indicator of treatment benefit for patients with psoriasis. Therefore, SWB measures, such as the DESQ, could be used to operationalize patient-relevant benefit of psoriasis treatment, complementing outcome measures currently used.
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15
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A hierarchy-based machine learning model for happiness prediction. APPL INTELL 2022. [DOI: 10.1007/s10489-022-03811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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16
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Scala E, Kaczmarczyk R, Zink A, Balato A, Amerio P, Argenziano G, Babino G, Bardazzi F, Bianchi L, Caldarola G, Campanati A, Chiricozzi A, Conti A, Damiani G, Dapavo P, De Simone C, Esposito M, Fabbrocini G, Fargnoli MC, Ferrara F, Fidanza R, Gualdi G, Guarneri C, Hansel K, Malagoli P, Malara G, Megna M, Micali G, Mugheddu C, Musumeci ML, Odorici G, Offidani A, Papaianni V, Pescitelli L, Prignano F, Raimondo A, Ribero S, Rongioletti F, Stingeni L, Trifirò C, Zanframundo S. Sociodemographic, clinical and therapeutic factors as predictors of life quality impairment in psoriasis: a cross‐sectional study in Italy. Dermatol Ther 2022; 35:e15622. [DOI: 10.1111/dth.15622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/25/2022] [Accepted: 06/03/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Emanuele Scala
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
| | - Robert Kaczmarczyk
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy Munich Germany
| | - Alexander Zink
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy Munich Germany
- Dermatology and Venerology Unit, Department of Medicine Solna Karolinska University Hospital Stockholm Sweden
| | - Anna Balato
- Dermatology Unit University of Campania “Luigi Vanvitelli” Naples Italy
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Tizek L, Schielein MC, Tizek L, Zink A. [Atopic dermatitis-identifying needs in the German population by internet search queries]. Hautarzt 2022; 73:475-484. [PMID: 35294564 PMCID: PMC8925291 DOI: 10.1007/s00105-022-04974-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 12/27/2022]
Abstract
Hintergrund Das Internet ist eine der wichtigsten Informationsquellen für gesundheitliche Themen für die Allgemeinbevölkerung. Deshalb kann die Analyse von Internetsuchmaschinen dabei helfen, die gesellschaftlichen Interessen und Bedürfnisse bezüglich Erkrankungen zu erfassen. Ziel Ziel dieser Studie war es, die Suchanfragen zu atopischer Dermatitis (AD) in Bezug auf Häufigkeit, Interessenschwerpunkt und zeitliches Auftreten in allen deutschen Bundesländern zu untersuchen, um mögliche regionale Unterschiede zu identifizieren. Material und Methoden Mithilfe des Google Ads Keyword Planner wurden AD relevante Keywords inklusive deren monatlichen Suchvolumens zwischen Januar 2017 und Dezember 2020 identifiziert, die in Interessenschwerpunkte unterteilt wurden. Ergebnisse Es wurden 1419 Keywords gefunden, die ein Suchvolumen von 14.817.610 Anfragen hatten. Das größte Suchvolumen hatte die Kategorie Allgemein (n = 5.970.840), jedoch wurden der Kategorie Lokalisation die meisten Keywords zugeordnet (n = 348). Rund 60 % der Keywords zu Lokalisation bezogen sich auf AD im Gesicht. Von allen Bundesländern hatten Bremen und Hamburg das größte Suchvolumen pro 100.000 Einwohner. Mit über 70 % war ein enormer Anstieg im Suchvolumen zu beobachten, der v. a. 2020 sichtbar wurde. Diskussion Durch diese Internetsuchmaschinenanalyse konnte verdeutlicht werden, welche AD-relevanten Aspekte von besonderer Bedeutung für die Bevölkerung waren, was dabei helfen kann, Informationskampagnen zielgerichtet anzupassen. Zudem unterstreicht die Studie die immer größer werdende Relevanz des Internets als Informationsquelle für gesundheitliche Themen. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00105-022-04974-x) enthält zusätzliche Tabellen. Beitrag und Zusatzmaterial stehen Ihnen im elektronischen Volltextarchiv auf https://www.springermedizin.de/der-hautarzt zur Verfügung. Sie finden das Zusatzmaterial am Beitragsende unter „Supplementary Information“.
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Affiliation(s)
- Linda Tizek
- Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland.
| | - Maximilian C Schielein
- Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland
| | - Lucas Tizek
- Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland
| | - Alexander Zink
- Fakultät für Medizin, Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland
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Singleton H, Hodder A, Boyers D, Doney L, Almilaji O, Heaslip V, Thompson AR, Boyle RJ, Axon E, Van Onselen J, O'Meara S, Roberts A, Ersser SJ. Psychological and educational interventions for managing eczema. Hippokratia 2021. [DOI: 10.1002/14651858.cd014932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Heidi Singleton
- Department of Nursing Science; Bournemouth University; Bournemouth UK
| | - Andrew Hodder
- Department of Dermatology; Royal Cornwall Hospitals NHS Trust; Truro UK
- Department of Dermatology; University Hospitals Dorset; Christchurch UK
| | - Dwayne Boyers
- Health Economics Research Unit; University of Aberdeen; Aberdeen UK
| | - Liz Doney
- Cochrane Skin, Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | - Orouba Almilaji
- Department of Medical Science and Public Health; Bournemouth University; Bournemouth UK
| | - Vanessa Heaslip
- Department of Nursing Science; Bournemouth University; Bournemouth UK
| | - Andrew R Thompson
- South Wales Clinical Psychology Training Programme; Cardiff and Vale University Health Board & Cardiff University; Cardiff UK
| | - Robert J Boyle
- Cochrane Skin, Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
- National Heart & Lung Institute, Section of Inflammation and Repair; Imperial College London; London UK
| | - Emma Axon
- Cochrane Skin, Centre of Evidence Based Dermatology; University of Nottingham; Nottingham UK
| | | | | | - Amanda Roberts
- Nottingham Support Group for Carers of Children with Eczema; Nottingham UK
| | - Steven J Ersser
- Department of Nursing Science; Bournemouth University; Bournemouth UK
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Schuster B, Peifer C, Ziehfreund S, Tizek L, Biedermann T, Zink A, Schielein MC. Happiness and depression in psoriasis: a cross-sectional study in Germany. Qual Life Res 2021; 31:1761-1773. [PMID: 34532835 PMCID: PMC9098583 DOI: 10.1007/s11136-021-02991-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/21/2022]
Abstract
Purpose Prior research on the psychological consequences of skin diseases has focused on assessing mental comorbidities. The aim of this study was to investigate subjective well-being in a large sample of individuals affected by psoriasis, a chronic inflammatory skin disease, and to explore the associations with depression and disease-related parameters such as disease severity. Methods A cross-sectional online survey was conducted from March to June 2019. The link to the questionnaire was shared on websites and Facebook pages of psoriasis patient organizations and campaigns. Participants filled in validated scales measuring subjective well-being—operationalized as positive affect (PA), negative affect (NA) and satisfaction with life (SWL); and depression. Results The data of 722 participants were analyzed. Exploratory factor analysis supported the differentiation of PA, NA, SWL, and depression as four different constructs. The respondents reported lower levels of PA than healthy individuals and judged themselves to be less happy and were less satisfied with their lives than the general population (except age group 65 + years). 40.3% of respondents were screened positive for depression. More severe psoriasis was associated with lower affective well-being and a higher risk for depression. Conclusion The results of this study empirically supported the differentiation of subjective well-being and depression as different constructs in individuals with psoriasis, and underline the large mental burden of the disease which goes beyond a higher risk for depression. Measures of well-being should thus be incorporated in both research and clinical practice in patients with psoriasis in order to achieve a more comprehensive picture of the mental burden of this disease.
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Affiliation(s)
- Barbara Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany. .,Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Corinna Peifer
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, LMU Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Pettenkofer School of Public Health, LMU Munich, Munich, Germany.,Division of Dermatology and Venereology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
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Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients. Qual Life Res 2021; 31:903-915. [PMID: 34370186 PMCID: PMC8921030 DOI: 10.1007/s11136-021-02967-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Capability well-being captures well-being based on people's ability to do the things they value in life. So far, no capability well-being measures have been validated in dermatological patients. OBJECTIVES To validate the adult version of the ICEpop CAPability measure (ICECAP-A) in patients with dermatological conditions. We aimed to test floor and ceiling effects, structural, convergent and known-group validity, and measurement invariance. METHODS In 2020, an online, cross-sectional survey was carried out in Hungary. Respondents with self-reported physician-diagnosed dermatological conditions completed the ICECAP-A, Satisfaction with Life Scale (SWLS), WHO-5 Well-Being Index and two dermatology-specific measures, Dermatology Life Quality Index (DLQI) and Skindex-16. RESULTS 618 respondents (mean age 51 years) self-reported a physician-diagnosed dermatological condition, with warts, eczema, onychomycosis, acne and psoriasis being the most common. ICECAP-A performed well with no floor and mild ceiling effects. The violation of local independence assumption was found between the attributes of 'attachment' and 'enjoyment'. ICECAP-A index scores correlated strongly with SWLS and WHO-5 (rs = 0.597-0.644) and weakly with DLQI and Skindex-16 (rs = - 0.233 to - 0.292). ICECAP-A was able to distinguish between subsets of patients defined by education and income level, marital, employment and health status. Multigroup confirmatory factor analysis indicated measurement invariance across most of these subgroups. CONCLUSIONS This is the first study to validate a capability well-being measure in patients with dermatological conditions. The ICECAP-A was found to be a valid tool to assess capability well-being in dermatological patients. Future work is recommended to test measurement properties of ICECAP-A in chronic inflammatory skin conditions.
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Trotz einer großen Auswahl wirksame Medikamente: Psoriatiker scheinen immer noch untertherapiert zu sein. J Dtsch Dermatol Ges 2021; 19:1003-1012. [PMID: 34288484 DOI: 10.1111/ddg.14387_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
HINTERGRUND UND ZIELE Durch die Entwicklung neuer anti-psoriatischer Medikamente und verbesserte Strukturen zu deren flächendeckender Einführung hat sich die medizinische Versorgung von Psoriasis-Patienten deutlich verbessert. In dieser Studie haben wir die tatsächliche Inanspruchnahme des Gesundheitswesens untersucht und Gründe für die Unzufriedenheit der Betroffenen ermittelt. PATIENTEN UND METHODIK Diese nicht-interventionelle Querschnittsstudie wurde als anonyme Online-Befragung von 12/2018 bis 01/2019 in Deutschland durchgeführt. Teilnehmer mit einer selbstberichteten, von einem Arzt gestellten Psoriasis-Diagnose und Symptomen beantworteten Fragen zu ihrer Erkrankung, deren Einfluss auf das tägliche Leben und ihrer medizinischen Versorgung. ERGEBNISSE 649 Teilnehmer mit einem mittleren Alter von 42,5 ± 13,7 Jahren und ausgewogener Geschlechterverteilung (männlich: 50,2 %) wurden ausgewertet. 54,1 % waren zum Zeitpunkt der Studie in ärztlicher Behandlung, 45,9 % nicht. Von den Teilnehmern mit medizinischer Versorgung waren 59,3 % nur mäßig oder weniger zufrieden mit ihrer Behandlung. Gründe für die Unzufriedenheit mit der Medikation waren unter anderem mangelnde Wirksamkeit und Nebenwirkungen. Von den nicht in ärztlicher Behandlung befindlichen Teilnehmern wurde "Zeitmangel des Arztes" als Hauptgrund für die Nichtinanspruchnahme ärztlicher Hilfe angegeben. SCHLUSSFOLGERUNGEN Trotz der Verfügbarkeit effizienter Therapieoptionen in Deutschland sind viele Betroffene mit Psoriasis unzufrieden. Diese unterbehandelte Gruppe wurde als neue Zielgruppe identifiziert.
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Affiliation(s)
- Anna Caroline Pilz
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Alexander Zink
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Maximilian C Schielein
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | - Katharina Hell
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | | | | | | | | | - Nicola Wagner
- Hautklinik, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
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Pulfer S, Ziehfreund S, Gebhard J, Hindelang B, Biedermann T, Brockow K, Zink A. Health-Related Quality of Life and Influencing Factors in Adults with Nonadvanced Mastocytosis-A Cross-Sectional Study and Qualitative Approach. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3166-3175.e2. [PMID: 33965596 DOI: 10.1016/j.jaip.2021.04.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/14/2021] [Accepted: 04/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Mastocytosis comprises a heterogeneous group of disorders characterized by an accumulation of mast cells in 1 or more organs. Symptoms range from mild complaints to severe and life-threatening events. Impact on quality of life seems to vary widely, but influencing factors are poorly understood so far. OBJECTIVE To examine impairments, psychological burden, health-related quality of life (HRQOL), and possible influencing factors in patients with mastocytosis. METHODS In semistructured telephone interviews, patients provided information on impairments in everyday life and psychological burden caused by mastocytosis. HRQOL was measured using the Mastocytosis Quality of Life (MC-QoL) questionnaire. Clinical data were collected from patient files. RESULTS A total of 101 adult patients with mastocytosis (74.3% women; mean age, 47.7 ± 13.5 years) were included. Half of the interviewed patients (50.6%) reported disease-related impairments in everyday life, and 42.4% stated a psychological burden. MC-QoL questionnaire scores showed a broad distribution, with a mean total score at a "mild" impairment level (mean total score, 34.7 ± 22.5). One-third of patients felt moderately (22.8%) or severely (13.9%) impaired, whereas one-third reported no impairment at all (30.7%). Symptoms of mast cell activation and perceived food intolerance had the highest impact on HRQOL. Higher age, higher body mass index, higher tryptase level, and longer duration of symptoms, as well as current drug therapy and pathological bone density, were each associated with reduced HRQOL. CONCLUSIONS A high level of suffering and strong associations between impairments and symptom-related factors indicate the importance of addressing patients' concerns and adequate symptom management in mastocytosis.
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Affiliation(s)
- Stephanie Pulfer
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Julia Gebhard
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Benedikt Hindelang
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
| | - Knut Brockow
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany.
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Munich, Germany
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated. J Dtsch Dermatol Ges 2021; 19:1003-1011. [PMID: 33955676 DOI: 10.1111/ddg.14387] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Due to the development of new anti-psoriatic drugs in combination with improved structures for implementation throughout Germany, the medical care of psoriasis patients has markedly improved. In this study we investigated the real-life utilization of the health care system and identified reasons for dissatisfaction in affected individuals. PATIENTS AND METHODS This non-interventional cross-sectional study was conducted as an anonymous online survey from 12/2018 to 01/2019 in Germany. Participants with a self-reported physician-confirmed diagnosis of psoriasis and symptoms answered questions about their disease, its influence on daily life and their medical care. RESULTS 649 participants with a mean age of 42.5 ± 13.7 years and equal gender distribution (male: 50.2 %) were evaluated. 54.1 % received medical treatment at the time of the study, 45.9 % did not. Among the participants with medical care, 59.3 % were only moderately or less satisfied with their treatment. Reasons for dissatisfaction with the medication included lack of efficacy and side effects. Participants without medical treatment specified a physician's lack of time as a main reason for not seeking medical help. CONCLUSIONS Despite the availability of efficient therapeutic options in Germany, many individuals with psoriasis are not satisfied. This under-treated group was identified as a new target population.
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Affiliation(s)
- Anna Caroline Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | | | | | | | | | - Nicola Wagner
- Department of Dermatology, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg (FAU), Erlangen, Germany
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Atopic Dermatitis Is Associated With Lower Patient Satisfaction in US Adults. Dermatitis 2021; 33:323-331. [PMID: 33675329 DOI: 10.1097/der.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is complex with unmet needs and management challenges in clinical practice. Little is known about patient satisfaction among adults with AD. OBJECTIVE The aim of the study was to determine patterns and predictors of patient satisfaction among adults with AD. METHODS Data were analyzed from the 2000-2015 Medical Expenditure Panel Survey. Patient satisfaction was assessed by the Consumer Assessment of Healthcare Providers and Systems survey. RESULTS Atopic dermatitis (linear regression; adjusted β [95% confidence interval {95% CI}] = -0.75 [-1.25 to -0.25]) was associated with lower patient satisfaction compared with no AD. Adults with 1 or more office-based visits had increased odds of high satisfaction (>75th percentile; logistic regression; adjusted odds ratio [95% CI] = 1.81 [1.30-2.52]). Adults who saw an outpatient dermatologist or allergist had lower satisfaction (adjusted β [95% CI] = -0.65 [-1.27 to -0.03]). Patient satisfaction among adults with AD was associated with older age (adjusted β [95% CI] = 40-59 years, 1.85 [0.90-2.80]; ≥60 years, 6.13 [5.18-7.09]) and inversely associated with lower income (-1.82 [-2.68 to -0.96]) or middle income (-0.85 [-1.59 to -0.12]), race/ethnicity (Hispanic, -1.40 [-2.42 to -0.38]; other/multiracial, -2.34 [-3.53 to -1.15]), public (-4.50 [-6.43 to -2.58]) or no insurance (-4.53 [-6.47 to -2.59]), and multimorbidity (-0.48 [-0.61 to -0.35]). CONCLUSIONS Adults with AD in the United States had decreased patient satisfaction, particularly those with lower income, fewer outpatient visits, and multimorbidity. There are substantial unmet needs in patient satisfaction for AD.
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Ring J. Dermato-venereology in the year of coronavirus - Hot topics in research and patient care. J Eur Acad Dermatol Venereol 2021; 35:8-10. [PMID: 33617054 PMCID: PMC8014214 DOI: 10.1111/jdv.17087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Ring
- Department Dermatology and Allergy Biederstein, Technical University, Munich, Germany
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Leung AK, Lam JM, Leong KF, Leung AA, Wong AH, Hon KL. Nummular Eczema: An Updated Review. ACTA ACUST UNITED AC 2021; 14:146-155. [DOI: 10.2174/1872213x14666200810152246] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022]
Abstract
Background:
Nummular eczema may mimic diseases that present with annular configuration
and the differential diagnosis is broad.
Objective:
This article aimed to provide an update on the evaluation, diagnosis, and treatment of
nummular eczema.
Methods:
A PubMed search was performed in using the key terms “nummular eczema”, “discoid
eczema”, OR “nummular dermatitis”. The search strategy included meta-analyses, randomized controlled
trials, clinical trials, observational studies, and reviews. The search was restricted to English
literature. The information retrieved from the above search was used in the compilation of the present
article. Patents were searched using the key terms “nummular eczema”, “discoid eczema”, OR
“nummular dermatitis” in www.google.com/patents and www.freepatentsonline.com.
Results:
Nummular eczema is characterized by sharply defined, oval or coin-shaped, erythematous,
eczematous plaques. Typically, the size of the lesion varies from 1 to 10cm in diameter. The
lesions are usually multiple and symmetrically distributed. Sites of predilection include the lower
limbs followed by the upper limbs. The lesions are usually intensely pruritic. The diagnosis is mainly
clinical based on the characteristic round to oval erythematous plaques in a patient with diffusely
dry skin. Nummular eczema should be distinguished from other annular lesions. Dermoscopy
can reveal additional features that can be valuable for correct diagnosis. Biopsy or laboratory tests
are generally not necessary. However, a potassium hydroxide wet-mount examination of skin scrapings
should be performed if tinea corporis is suspected. Because contact allergy is common with
nummular eczema, patch testing should be considered in patients with chronic, recalcitrant nummular
eczema. Avoidance of precipitating factors, optimal skin care, and high or ultra-high potency
topical corticosteroids are the mainstay of therapy. Recent patents related to the management of
nummular eczema are also discussed.
Conclusion:
With proper treatment, nummular eczema can be cleared over a few weeks, although
the course can be chronic and characterized by relapses and remissions. Moisturizing of the skin
and avoidance of identifiable exacerbating factors, such as hot water baths and harsh soaps may reduce
the frequency of recurrence. Diseases that present with annular lesions may mimic nummular
eczema and the differential diagnosis is broad. As such, physicians must be familiar with this condition
so that an accurate diagnosis can be made, and appropriate treatment initiated.
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Affiliation(s)
- Alexander K.C. Leung
- Department of Pediatrics, The University of Calgary, Alberta Children’s Hospital, Calgary, Alberta, Canada
| | - Joseph M. Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, The University of British Columbia, Vancouver, Canada
| | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Amy A.M. Leung
- Department of Family Medicine, The University of Alberta, Edmonton, Alberta, Canada
| | - Alex H.C. Wong
- Department of Family Medicine, The University of Calgary, Calgary, Alberta, Canada
| | - Kam L. Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin and Department of Paediatrics and Adolescent Medicine, The Hong Kong Children’s Hospital, Kowloon Bay, Kowloon, Hong Kong
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Blome C, Kirsten N, Nergiz I, Schiffner U, Otten M, Augustin M. New method of measuring subjective well-being: prospective validation study of the 'Daily Experience Sampling Questionnaire' (DESQ) in patients with psoriasis and healthy subjects in Germany. BMJ Open 2020; 10:e039227. [PMID: 33262188 PMCID: PMC7709519 DOI: 10.1136/bmjopen-2020-039227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To validate the newly developed Daily Experience Sampling Questionnaire (DESQ) that measures affective subjective well-being (SWB). The DESQ is an end-of-day diary in which respondents retrospectively rate their SWB at six different, randomly determined moments; it is completed over 1 week. The DESQ shall provide an alternative or complementary approach to existing methods of near-time SWB measurement (experience sampling, Day Reconstruction Method). The primary research objective was to determine criterion validity of the DESQ. DESIGN Prospective, non-interventional study. SETTING Participants were recruited in Hamburg, Germany, at a specialised outpatient clinic (patients) and via different channels (healthy participants). PARTICIPANTS 101 adults with diagnosed and stable psoriasis (46 women, 55 men); 105 adults without psoriasis (49 women, 56 men). PRIMARY AND SECONDARY OUTCOME MEASURES Participants completed the DESQ for 3 weeks. In weeks 2 and 3, they also performed experience sampling. Criterion validity was determined by weekwise intraclass correlations (ICC) between both methods. Sensitivity to change was determined by the correlation between changes in both methods from weeks 2 to 3. For convergent validity, related concepts such as life satisfaction were measured. Retest reliability was determined using DESQ values of weeks 2 and 3. RESULTS Criterion validity was excellent (ICC: patients=0.86, 95% CI 0.81 to 0.91; healthy participants=0.86, 95% CI 0.79 to 0.91). Sensitivity to change was r=0.57 and r=0.56, respectively. Correlations with convergent criteria were mostly significant and higher in constructs more proximal to SWB. The ICC indicating retest reliability was 0.77 in patients (95% CI 0.68 to 0.84) and 0.81 in healthy participants (95% CI 0.73 to 0.86). CONCLUSIONS The DESQ is a valid, reliable and feasible instrument for SWB measurement in people with psoriasis and healthy people. Its approach of end-of-day evaluations of single moments may also lend itself to the measurement of other highly time-variant constructs such as pain, fatigue or depression.
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Affiliation(s)
- Christine Blome
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ibrahim Nergiz
- Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Ulrich Schiffner
- Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Marina Otten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Deep learning based classification of facial dermatological disorders. Comput Biol Med 2020; 128:104118. [PMID: 33221639 DOI: 10.1016/j.compbiomed.2020.104118] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 11/03/2020] [Accepted: 11/07/2020] [Indexed: 01/11/2023]
Abstract
Common properties of dermatological diseases are mostly lesions with abnormal pattern and skin color (usually redness). Therefore, dermatology is one of the most appropriate areas in medicine for automated diagnosis from images using pattern recognition techniques to provide accurate, objective, early diagnosis and interventions. Also, automated techniques provide diagnosis without depending on location and time. In addition, the number of patients in dermatology departments and costs of dermatologist visits can be reduced. Therefore, in this work, an automated method is proposed to classify dermatological diseases from color digital photographs. Efficiency of the proposed approach is provided by 2 stages. In the 1st stage, lesions are detected and extracted by using a variational level set technique after noise reduction and intensity normalization steps. In the 2nd stage, lesions are classified using a pre-trained DenseNet201 architecture with an efficient loss function. In this study, five common facial dermatological diseases are handled since they also cause anxiety, depression and even suicide death. The main contributions provided by this work can be identified as follows: (i) A comprehensive survey about the state-of-the-art works on classifications of dermatological diseases using deep learning; (ii) A new fully automated lesion detection and segmentation based on level sets; (iii) A new adaptive, hybrid and non-symmetric loss function; (iv) Using a pre-trained DenseNet201 structure with the new loss function to classify skin lesions; (v) Comparative evaluations of ten convolutional networks for skin lesion classification. Experimental results indicate that the proposed approach can classify lesions with high performance (95.24% accuracy).
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Tizek L, Schielein MC, Zink A. PeakPASI: A new measurement tool in psoriasis care. J Am Acad Dermatol 2020; 84:1730-1732. [PMID: 32861712 DOI: 10.1016/j.jaad.2020.08.096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Linda Tizek
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
| | - Maximilian Christian Schielein
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany; Karolinska Institutet, Department of Medicine, Karolinska University Hospital, Unit of Dermatology and Venerology, Solna, Sweden
| | - Alexander Zink
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany.
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Schielein MC, Tizek L, Schuster B, Ziehfreund S, Liebram C, Eyerich K, Zink A. Always Online? Internet Addiction and Social Impairment in Psoriasis across Germany. J Clin Med 2020; 9:E1818. [PMID: 32545234 PMCID: PMC7355796 DOI: 10.3390/jcm9061818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 01/11/2023] Open
Abstract
With the World Health Organization (WHO) demanding further investigation of the social impairment and psychosocial burden of psoriasis, a first study identified a high prevalence of Internet addiction. The aim of this study was to assess social impairment and estimate the occurrence of Internet addiction along with depression, cigarette smoking, and alcohol dependency in individuals with psoriasis recruited online in a people-centered care approach. A cross-sectional online survey was carried out across Germany between March 2019 and June 2019. The questionnaire contained information on social impairment, smoking habits, as well as validated questionnaires on Internet addiction, depression, and alcohol dependency. Overall, 460 individuals (62.4% female; mean age: 45.9 ± 13.7 years) with psoriasis were included. Of those, 406 (88.3%) stated to be at least rarely socially impaired. The positive screening rate for Internet addiction was 8.5%. Furthermore, 40.0% had positive screenings for depression, 17.1% for alcohol dependency, and 32.6% for daily smoking. Positive screenings for Internet addiction and alcohol dependency were substantially more frequent in individuals with psoriasis than in the German general population. In order to meet the demands of the WHO, Internet addiction could be considered as a potential comorbidity in psoriasis and a focus on people-centered care is advisable for further research.
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Affiliation(s)
- Maximilian Christian Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Barbara Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
| | | | - Kilian Eyerich
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Karolinska Institutet, Department of Medicine, Unit of Dermatology and Venerology, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
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Dong L, Yang L, Li Y, Yang J, An X, Yang L, Zhou N, Zhang Y, Du H, Lan J, Song Z, Miao X, Zhu J, Tao J. Efficacy of hydrogel patches in preventing facial skin damage caused by mask compression in fighting against coronavirus disease 2019: a short-term, self-controlled study. J Eur Acad Dermatol Venereol 2020; 34:e441-e443. [PMID: 32421878 PMCID: PMC7276886 DOI: 10.1111/jdv.16638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- L Dong
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - L Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,School of Medicine, Hunan Normal University, Changsha, China
| | - Y Li
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - J Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - X An
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - L Yang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - N Zhou
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - Y Zhang
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - H Du
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - J Lan
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
| | - Z Song
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,The Second Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - X Miao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, HUST, Wuhan, China
| | - J Zhu
- School of Chemistry and Chemical Engineering, HUST, Wuhan, China
| | - J Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China.,Hubei Engineering Research Center for Skin Repair and Theranostics, Wuhan, China
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Editor’s Picks June 2020. J Eur Acad Dermatol Venereol 2020; 34:1129. [DOI: 10.1111/jdv.16594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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