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Personal, financial and time burden in inherited ichthyoses: A survey of 144 patients in a university-based setting. J Eur Acad Dermatol Venereol 2024. [PMID: 38523469 DOI: 10.1111/jdv.19804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/14/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patients with inherited ichthyosis suffer from scaling due to mutations affecting the epidermal barrier. Symptomatic treatment with ointments, bathing and mechanical scale removal can alleviate the disease, but therapy is time and cost intensive. OBJECTIVES We investigated costs, time and disease burden of ichthyoses. The study addresses difficulties of the healthcare situation for patients with ichthyoses and reveals potential improvements. MATERIALS AND METHODS We developed a questionnaire addressing time and financial effort for the treatment. Additionally, we collected data of the Dermatology Life Quality Index (DLQI) and the Pruritus Life Quality (5PLQ) questionnaires to determine the impact of ichthyosis and associated pruritus on quality of life (QoL). RESULTS We recruited 144 patients with ichthyosis (median age: 23; 53.5% female) from the Department of Dermatology in Muenster (Germany) and the German patient support group including common, rare and syndromic subtypes. Eighty-seven percent reported applying topical therapeutics at least once per day, 66.4% several times with an overall median duration of 15 min. Highest single expenditure of time was due to balneotherapy (n = 115; median bathing time: 40 min). In 81.9%, the health insurance did not completely cover the costs for topical treatment causing additional financial burden to the patient with a median of 71 € per quarter, herein creams being the largest cost factor (50 €). Patients with Netherton syndrome showed the highest median expenditure (170 €). The QoL impairment under treatment was moderate (median DLQI: 8.5 points). Pruritus was prevalent in 79.9% and showed a distinct impact on QoL (median 5PLQ: 7.5 points) without any significant difference between the subtypes (p = 0.37). CONCLUSION Patients suffering from ichthyoses have a large and lifelong overall burden in mild and severe subtypes. Since continuous topical treatment is required, financial and psychosocial support needs to be considered beyond dermatological care.
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A probabilistic-deterministic approach for assessing climate change effects on infection risks downstream of sewage emissions from CSOs. WATER RESEARCH 2023; 247:120746. [PMID: 37984031 DOI: 10.1016/j.watres.2023.120746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/22/2023]
Abstract
The discharge of pathogens into urban recreational water bodies during combined sewer overflows (CSOs) pose a potential threat for public health which may increase in the future due to climate change. Improved methods are needed for predicting the impact of these effects on the microbiological urban river water quality and infection risks during recreational use. The aim of this study was to develop a novel probabilistic-deterministic modelling approach for this purpose building on physically plausible generated future rainfall time series. The approach consists of disaggregation and validation of daily precipitation time series from 21 regional climate models for a reference period (1971-2000, C20), a near-term future period (2021-2050, NTF) and a long-term future period (2071-2100, LTF) into sub-daily scale, and predicting the concentrations of enterococci and Giardia and Cryptosporidium, and infection risks during recreational use in the river downstream of the sewage emissions from CSOs. The approach was tested for an urban river catchment in Austria which is used for recreational activities (i.e. swimming, playing, wading, hand-to-mouth contact). According to a worst-case scenario (i.e. children bathing in the river), the 95th percentile infection risks for Giardia and Cryptosporidium range from 0.08 % in winter to 8 % per person and exposure event in summer for C20. The infection risk increase in the future is up to 0.8 log10 for individual scenarios. The results imply that measures to prevent CSOs may be needed to ensure sustainable water safety. The approach is promising for predicting the effect of climate change on urban water safety requirements and for supporting the selection of sustainable mitigation measures. Future studies should focus on reducing the uncertainty of the predictions at local scale.
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Patient-physician (dis)agreement on their reports of body surface area affected by psoriasis and its associations with disease burden. J Eur Acad Dermatol Venereol 2022; 36:e995-e997. [PMID: 35788989 PMCID: PMC9796906 DOI: 10.1111/jdv.18400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Pandemiebedingte Transformationsprozesse partizipativer
Forschungsprojekte – Eine qualitative Studie zu vier
Bewegungsförderungsprojekten aus dem Capital4Health
Forschungsverbund. DAS GESUNDHEITSWESEN 2022. [DOI: 10.1055/s-0042-1753675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Resiliente Communities? Eine qualitative Interviewstudie zur
Aufrechterhaltung eines Bewegungsprojektes für Frauen in schwierigen
Lebenslagen (BIG-Projekt) während den ersten beiden Jahren der COVID-19
Pandemie. DAS GESUNDHEITSWESEN 2022. [DOI: 10.1055/s-0042-1753816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Measuring well-being in psoriasis: Psychometric properties of the WHO-5 questionnaire. J Eur Acad Dermatol Venereol 2022; 36:e986-e987. [PMID: 35788987 DOI: 10.1111/jdv.18396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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[Dermatological care of elderly people with psoriasis before and after entering a nursing home : A qualitative analysis from the perspective of medical providers]. Hautarzt 2022; 73:627-633. [PMID: 35482046 PMCID: PMC9047578 DOI: 10.1007/s00105-022-04989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 11/22/2022]
Abstract
Hintergrund Demografische Veränderungen bewirken einen steilen Anstieg der Anzahl der über 65-Jährigen. Damit verbunden ist die Zunahme der Anzahl pflegebedürftiger, multimorbid Erkrankter. National wie auch international gibt es keine Informationen insbesondere zur Versorgung von Psoriasiserkrankten im Setting Pflegeheim und zur Frage, wie diese durch den Eintritt in ein Pflegeheim beeinflusst wird. Fragestellung Ziel war es, anhand von Interviews bzw. Fokusgruppen die Ergebnisse vorausgehender Routinedatenanalysen zur Versorgung Psoriasiserkrankter in Pflegeheimen mit medizinischen Versorgern (Dermatologen, Allgemeinmediziner, Pflegedienstleitungen und Pflegekräfte) zu diskutieren, Schwierigkeiten der Versorgung aufzudecken und abschließend Handlungsempfehlungen für eine zukunftsfähige gerontodermatologische Versorgung abzuleiten. Material und Methoden Durchgeführt wurden qualitative Leitfaden-gestützte Interviews und Fokusgruppen mit Dermatologen (n = 5), Allgemeinmedizinern (n = 7), Pflegekräften (n = 7) und Pflegedienstleitungen (n = 2). Die Daten wurden inhaltsanalytisch ausgewertet. Ergebnisse Die Auswertung ergab insgesamt 344 Aussagen, die insgesamt 14 Hauptkategorien zugeordnet werden konnten. Die Ergebnisse zeigen, dass für die Versorgungsqualität von Menschen mit Hautkrankheiten, insbesondere Psoriasis, in Pflegeinrichtungen ein Verbesserungsbedarf besteht. Dieser zeigt sich sowohl auf ärztlicher als auch auf pflegerischer Ebene. Laut der Versorger (N = 21) kann dies insbesondere durch eine verstärkte digitale Versorgung, dermatologische Schulungen für Hausärzte und Pflegefachkräfte sowie engere Kooperationen zwischen den einzelnen Disziplinen adressiert werden. Schlussfolgerung Digitale Pflegekonsile, aber auch eine spezifische Leitlinie zur „Haut des alternden Menschen“ können von Nutzen sein, um die dermatologische Versorgungssituation im Pflegeheim zu verbessern und somit das Wohlbefinden der Betroffenen zu steigern.
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Assessment of stigma related to visible skin diseases: a systematic review and evaluation of patient-reported outcome measures. J Eur Acad Dermatol Venereol 2021; 36:499-525. [PMID: 34817889 DOI: 10.1111/jdv.17833] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022]
Abstract
Misconceptions about visible skin diseases are widespread, and patients often face discrimination and stigmatization due to their condition. The associated negative health and psychosocial consequences of stigmatization in skin diseases have prompted an increase in research activity in recent times, resulting in a wide variety of assessment measures. This study aimed at aggregating and evaluating evidence of psychometric properties and methodological quality of published measures to assess stigma in visible skin diseases. Studies assessing stigmatization in visible skin diseases were searched in four databases (Medline, PsycINFO, Web of Science and Embase) until February 2021. The review followed PRISMA guidelines. Papers regarding development and/or validation of measures were identified by two independent researchers. Inclusion criteria were defined as follows: (i) quantitative studies in (ii) populations with skin diseases using (iii) questionnaires explicitly assessing (iv) perceived or public stigmatization or discrimination available in (iv) English or German language. The COnsensus-based Standards of health Measurement INstruments (COSMIN) checklist was used to evaluate their psychometric properties and risk of bias. 35 studies using 21 instruments were identified. Twenty instruments focused on assessing the perceived reality of those affected by visible skin diseases, while public stigma was only assessed by two instruments. Twelve scales could be recommended for use, while nine instruments had the potential to be recommended after further studies have assessed their quality. Some limitations are to be noted. Only studies in English and German were included. Research on self-constructed instruments can lead to new validated instruments, but they were not included in the review at this point. Several validated instruments could be recommended for use. Future research is needed regarding the assessment of stigma across different visible skin diseases, in children and adolescents, and in the general public.
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Author Correction: Global Sequestration Potential of Increased Organic Carbon in Cropland Soils. Sci Rep 2021; 11:18720. [PMID: 34526614 PMCID: PMC8443615 DOI: 10.1038/s41598-021-98375-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Development and validation of an outcome instrument measuring dry skin - the Xerosis Area and Severity Index (XASI). J Eur Acad Dermatol Venereol 2021; 36:e70-e72. [PMID: 34482583 DOI: 10.1111/jdv.17636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
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Secukinumab effects on disease burden, patient needs and benefits, and treatment satisfaction in patients with plaque psoriasis across European regions: patient perspective data from the PROSE study. J Eur Acad Dermatol Venereol 2021; 35:2241-2249. [PMID: 34273904 DOI: 10.1111/jdv.17525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cross-cultural differences in healthcare policies and patient-physician communication may influence the quality of care and patients' perceived benefits and satisfaction with psoriasis treatment. OBJECTIVES To compare the disease burden and patient needs at baseline, and patient benefits and satisfaction with secukinumab treatment across Europe. METHODS PROSE was an open-label, prospective, non-randomized, stratified multicentre study of 52 weeks of secukinumab treatment, in 16 European countries. Secondary analysis of the PROSE study data by European regions was performed to identify cross-cultural differences in disease burden and patient needs at baseline, and in clinical improvement, patient-reported treatment benefits and satisfaction at 52 weeks post-treatment. RESULTS At baseline, Dermatology Life Quality Index impairment was reported to be greater in patients from Eastern Europe (EE: 15.4 ± 7.1) vs. Northern Europe (NE: 13.3 ± 6.7) and Western Europe (WE: 13.6 ± 6.9), but while differences were statistically significant (F-test = 5.5, P < 0.001), their clinical significance is uncertain. There were no significant differences between regions in Psoriasis Area and Severity Index at baseline (F-test = 1.6). There were considerable differences in patients' needs (Patient Need Questionnaire) between geographical regions, with WE focused more on reducing physical impairment [vs. Southern Europe (SE)/EE], EE on reducing social impairment (vs. NE/WE) and SE on reducing impairment due to therapy (vs. NE/WE). At Week 52, patients from EE reported more benefits (Patient Benefit Index) with secukinumab treatment (vs. WE/SE), while patients from NE reported higher global treatment satisfaction (vs. SE). CONCLUSIONS Differences in patients' needs and treatment satisfaction across Europe are likely a result of diverse medical systems, socio-economic status and infrastructural access. A patient-centred approach to treating psoriasis may fulfil patient needs and maximize treatment satisfaction. (NCT02752776).
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Estimating spatially distributed SOC sequestration potentials of sustainable land management practices in Ethiopia. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 286:112191. [PMID: 33667822 DOI: 10.1016/j.jenvman.2021.112191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
The sustainable land management program (SLMP) of Ethiopia aims to improve livelihoods and create resilient communities and landscape to climate change. Soil organic carbon (SOC) sequestration is one of the key co-benefits of the SLMP. The objective of this study was to estimate the spatial dynamics of SOC in 2010 and 2018 (before and after SLMP) and identify the SOC sequestration hotspots at landscape scale in four selected SLMP watersheds in the Ethiopian highlands. The specific objectives were to: 1) comparatively evaluate SOC sequestration estimation model building strategies using either a single watershed, a combined dataset from all watersheds, and leave-one-watershed-out using Random Forest (RF) model; 2) map SOC stock of 2010 and 2018 to estimate amount of SOC sequestration and potential; 3) evaluate the impacts of SLM practices on SOC in four SLMP watersheds. A total of 397 auger composite samples from the topsoil (0-20 cm depth) were collected in 2010, and the same number of samples were collected from the same locations in 2018. We used simple statistics to assess the SOC change between the two periods, and machine learning models to predict SOC stock spatially. The study showed that statistically significant variation (P < 0.05) of SOC was observed between the two years in two watersheds (Gafera and Adi Tsegora) whereas the differences were not significant in the other two watersheds (Yesir and Azugashuba). Comparative analysis of model-setups shows that a combined dataset from all the four watersheds to train and test RF outperform the other two strategies (a single watershed alone and a leave-one-watershed-out to train and test RF) during the testing dataset. Thus, this approach was used to predict SOC stock before (2010) and after (2018) land management interventions and to derive the SOC sequestration maps. We estimated the sequestrated, achievable and target level of SOC stock spatially in the four watersheds. We assessed the impact of SLM practices, specifically bunds, terraces, biological and various forms of tillage practices on SOC using partial dependency algorithms of prediction models. No tillage (NT) increased SOC in all watersheds. The combination of physical and biological interventions ("bunds + vegetations" or "terraces + vegetations") resulted in the highest SOC stock, followed by the biological intervention. The achievable SOC stock analysis showed that further SOC stock sequestration of up to 13.7 Mg C ha--1 may be possible in the Adi Tsegora, 15.8 Mg C ha-1 in Gafera, 33.2 Mg C ha-1 in Azuga suba and 34.7 Mg C ha-1 in Yesir watersheds.
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Mapping risk factors for cumulative life course impairment in patients with chronic skin diseases - a systematic review. J Eur Acad Dermatol Venereol 2021; 35:2166-2184. [PMID: 33988873 DOI: 10.1111/jdv.17348] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/27/2021] [Indexed: 02/01/2023]
Abstract
Patients with chronic skin diseases suffer from physical and psychosocial impairments which can lead to a cumulative life-long burden. Therefore, the concept of cumulative life course impairment (CLCI) was introduced, referring to the non-reversible damage due to the persistent life-long burden. This systematic review (PROSPERO registry number: CRD42020179141) aimed at mapping the risk factors and the associated burden over time in patients with psoriasis, atopic dermatitis (AD) and hidradenitis suppurativa (HS). Three electronic databases were searched (date of the last search: December 2019). Studies with a longitudinal study design that assessed the association between a risk factor and the associated burden over time in patients with psoriasis, AD and HS were included. Quality assessment of the included studies was done using Critical Appraisal Skills Programme (CASP) checklists. In total, 40 publications reflecting 25 different studies were included: nine studies addressed patients with psoriasis, 13 patients with AD, two studies included patients with HS and one study enrolled patients with psoriasis and AD, respectively. Twenty-two potential risk factors with underlying evidence were found in this review. These risk factors include mainly sociodemographic (such as age or gender) and clinical (such as disease severity or comorbidities) variables. Disease severity and comorbidities were the most often studied risk factors, while only a few studies evaluated psychosocial risk factors over time. Patients with chronic skin diseases are at high risk to develop a life-long negative impact from the disease. However, there is a lack of data that evaluates the psychosocial burden and its influence on the patients' life course over time. The risk factors found in this review help to identify patients at risk, to treat them adequately and, ultimately, to prevent CLCI. These results can be the basis to develop a highly needed tool to assess the risk for CLCI in the future.
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Significance of chronic pruritus for intrapersonal burden and interpersonal experiences of stigmatization and sexuality in patients with psoriasis. J Eur Acad Dermatol Venereol 2021; 35:1553-1561. [DOI: 10.1111/jdv.17188] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/14/2021] [Indexed: 01/07/2023]
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Stigma in visible skin diseases - a literature review and development of a conceptual model. J Eur Acad Dermatol Venereol 2021; 35:1493-1504. [PMID: 33428316 DOI: 10.1111/jdv.17110] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
The burden of visible skin diseases (VSDs) includes not only physical symptoms but also psychosocial consequences such as depression, anxiety, impaired quality of life and low self-esteem. Stigmatization was shown to play a major role in people with skin diseases. The aim of the study was to review the evidence for the components, drivers and impacts of (self-)stigma, and to organize the data into a series of conceptual models. A targeted literature search was conducted to identify studies on (self-)stigma in relation to VSD. Conceptual models of stigma in VSDs were developed from existing generic conceptual models for VSD and of generic conceptual models of stigma and were refined after discussion with a board of experts, patient advocacy groups, clinicians and researchers. A total of 580 references were identified, of which 56 references were analysed and summarized. Two conceptual models of stigma were identified: one with external stigma and self-stigma dimensions, the other for self-stigma in mental health. These models were adapted to allow a complete description of stigma in VSDs. For this, a distinction was made between 'discrimination' and 'impact'. Finally, five models were developed: macro-overview; stigma, impact and socio-demographics; stigma, impact and disease characteristics; stigma, impact and quality of life; and stigma, impact and coping. Gaps were identified in available quantitative evidence. To our knowledge, this is the first conceptual model of stigma in VSDs. The model will help to standardize evaluation of stigma and to enhance empirical evaluation of anti-stigma interventions in VSDs. Further research should be conducted to develop a more complete model in stigma due to significant gaps in existing evidence, particularly including the stigma in others (external stigma) and also to cover a broader range of VSDs as their impact on particular dimensions of stigma differs.
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Validation of the Spanish Wound-QoL Questionnaire. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:44-51. [PMID: 33137321 DOI: 10.1016/j.ad.2020.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND AND AIMS The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German. The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version. MATERIALS AND METHODS Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N=10 patients and then used in the validation study. RESULTS A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha>0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation. CONCLUSIONS The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials.
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Perception and determinants of stigmatization of people with psoriasis in the German population. J Eur Acad Dermatol Venereol 2020; 34:2846-2855. [PMID: 32277524 DOI: 10.1111/jdv.16436] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/10/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Perception of psoriasis in the general population is characterized by knowledge deficits and prejudice against those affected. The extent and possible predictors of stigmatizing attitudes remain unclear. OBJECTIVES The aim was to assess prejudices and stigmatization of people with psoriasis and to identify sociodemographic and attitude-related variables accounting for stigmatization. METHODS Representative telephone surveys of 2004 (in 2017) and 2001 (in 2018) adults using a standardized questionnaire. Descriptive analyses were applied to living area, age, gender, educational status, general knowledge and attitudes about psoriasis. Logistic regression analyses were carried out to determine which variables are associated with the assessment of prejudices of 'others' against people with psoriasis. Those prejudices were specified by the following statements: 'they should take better care of themselves', 'don't want to touch people with psoriasis' and 'disgusted by psoriasis'. RESULTS The majority of those surveyed (74%) believe that people with psoriasis are disadvantaged. Similarly, a majority (69%) said that most people find psoriasis disgusting, do not want to touch people with psoriasis (59%) and think that people with psoriasis need to take better care of themselves (45%). 'Willing to enter a relationship with an affected person' (OR = 0.330, P = 0.029), higher age (OR = 1.027, P <0.001) and male gender (OR = 1.263, P = 0.034) proved to be significantly associated with 'psoriasis is disgusting'. Education (OR = 1.648, P = 0.016) and lower age (OR = 0.847, P <0.001) are significantly associated with 'they need to take better care of themselves'. CONCLUSIONS Data suggest that stigmatization of skin diseases is still entrenched. This overview shows the need for interventions against stigmatization of those affected. Results imply that gender, age and education level and related health literacy of the target groups of respective interventions should be taken into account.
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Hypoxemia and brain atrophy in older adults with sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Heart rate variability and cognitive decline in older adults with sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Disease burden and patient needs and benefits in anogenital psoriasis: developmental specificities for person-centred healthcare of emerging adults and adults. J Eur Acad Dermatol Venereol 2019; 34:1010-1018. [PMID: 31715033 DOI: 10.1111/jdv.16076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/24/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Establishing romantic relationships involving cohabitation and/or sexual intercourse is an overriding task for many people during emerging adulthood, i.e. from their late teens through the twenties. The diagnosis of anogenital psoriasis may hinder social/intimate relationships, resulting in higher disease burden in this age group. OBJECTIVES To compare the disease burden and patient needs/benefits between emerging adults (18-30 years) and adults (>30 years) with psoriasis, with and without anogenital involvement; and to identify sociodemographic/clinical variables accounting for better patient-reported outcomes. METHODS Patients aged ≥18 years with psoriasis vulgaris were recruited within a cross-sectional nationwide survey randomly assigning 157 dermatology practices/clinics in Germany. Anogenital involvement was established based on a high-resolution grid on the topology of psoriasis. The main outcome measures were the Psoriasis Area and Severity Index (PASI), the EuroQoL visual analogue scale (EQ-VAS), the Dermatology Life Quality Index (DLQI) and the Patient Benefit Index (PBI). RESULTS Participants were 1921 patients: 173 emerging adults and 1749 adults >30 years. Anogenital involvement was observed in 621 patients (32.3%). Patient with anogenital psoriasis reported decreased health and more QoL impairments compared with those without anogenital lesions. Emerging adults presented more QoL impairments and less treatment benefits than older patients, and they were more prone to underrate a wide range of needs, except when the anogenital area was affected. Beyond anogenital involvement and higher disease severity, less treatment benefits were associated with more QoL impairments, particularly for emerging adults. CONCLUSIONS The developmental instability of many emerging adults may result in difficulties to establish/adhere to treatment goals and thus in decreased perception of treatment benefit and more QoL impairments. Anogenital involvement is a risk factor for increased disease burden regardless of age. Assessing anogenital involvement in all patients and helping younger patients to define/adhere to treatment goals should be prioritized in patient-centred healthcare for psoriasis.
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Characterizing treatment-related patient needs in atopic eczema: insights for personalized goal orientation. J Eur Acad Dermatol Venereol 2019; 34:142-152. [PMID: 31465587 DOI: 10.1111/jdv.15919] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/08/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Atopic eczema (AE) is a common and burdensome chronic skin disease. Clinical guidelines suggest an evidence-based, personalized and stepwise treatment approach. Only few studies have so far focused on the specific patient needs in treatment. OBJECTIVES To characterize therapeutic needs of patients with AE in routine care. METHODS Nationwide cross-sectional study in 91 dermatology practices and outpatient clinics. Descriptive statistics were used for valuation. Comparisons of HRQoL and general health status were performed including subgroups (age, gender and disease duration). Group comparisons of patient needs were performed for age groups, gender and disease duration. Correlations between patients' needs (PNQ) and HRQoL, generic health status and severity were tested. In addition, a hierarchical regression analysis was performed to determine which variables contribute to explain the variance in patient needs. RESULTS Analysis of 1678 patients (60.5% female, mean age 38.35 ± 15.92 years) revealed a high disease burden with mean SCORAD of 42.26 ± 18.63, mean DLQI of 8.49 ± 6.45 and mean EQ VAS of 63.62 ± 21.98. Among the patient needs that were most frequently rated as 'quite important'/'very important' were as follows: 'to be free of itching' (96.0%), 'to get better skin quickly' (87.7%) and 'to be healed of all skin defects' (85.7%). In general, older people, women and patients who had been diagnosed with AE for 1 year or less rated the treatment needs as more important than younger patients, men and patients who had been diagnosed with AE for more than 1 year. Major determinants of higher needs were skin-related quality of life impairments, higher disease severity and higher age. CONCLUSIONS Patients with AE show a high number and variety of therapeutic needs related to disease signs and symptoms, which are associated with individual disease burden. The patient needs vary substantially according to patient characteristics. Identification of patient-specific needs may support personalized, patient-centred care and shared decision-making.
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脂溢性皮炎的流行病学特征. Br J Dermatol 2019. [DOI: 10.1111/bjd.18399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Potential Benefits and Trade-Offs of Using Sub-surface Water Retention Technology on Coarse-Textured Soils: Impacts of Water and Nutrient Saving on Maize Production and Soil Carbon Sequestration. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2019. [DOI: 10.3389/fsufs.2019.00071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Strategies to reduce stigma related to visible chronic skin diseases: a systematic review. J Eur Acad Dermatol Venereol 2019; 33:2029-2038. [PMID: 31177601 DOI: 10.1111/jdv.15734] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 05/27/2019] [Indexed: 12/14/2022]
Abstract
Many patients with a visible chronic skin disease experience discrimination and stigmatization. This results in psychosocial impairments in addition to the burden of disease and emphasizes the urgency to implement effective stigma-reduction strategies. To synthesize what is known globally about effective interventions to reduce stigma associated with visible chronic skin diseases, a systematic review was conducted. Four electronic databases were searched until May 2018. Studies evaluating interventions to reduce stigmatization in patients with visible chronic skin diseases and applying at least one stigma-related outcome measure were included. Data were extracted on study design, country, study population, outcome measures and main findings. Results were subsequently synthesized in a narrative review. Critical Appraisal Skills Programme tools were used to assess study quality. Nineteen studies were included in the review. Study design was very heterogeneous and study quality rather poor. Thirteen studies addresses patients with leprosy in low- and middle-income countries, and one study each targeted patients with onychomycosis, leg ulcer, facial disfigurement, atopic dermatitis, vitiligo and alopecia. Evaluated interventions were mainly multi-faceted incorporating more than one type of intervention. While 10 studies focused on the reduction in self-stigma and 4 on the reduction in public stigma, another 5 studies aimed at reducing both. The present review revealed a lack of high-quality studies on effective approaches to reduce stigmatization of patients with visible chronic skin diseases. Development and evaluation of intervention formats to adequately address stigma is essential to promote patients' health and well-being.
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Epidemiology and dermatological comorbidity of seborrhoeic dermatitis: population‐based study in 161 269 employees. Br J Dermatol 2019; 181:743-748. [DOI: 10.1111/bjd.17826] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2019] [Indexed: 01/05/2023]
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Translating the WHA resolution in a member state: towards a German programme on 'Destigmatization' for individuals with visible chronic skin diseases. J Eur Acad Dermatol Venereol 2019; 33:2202-2208. [PMID: 31087405 DOI: 10.1111/jdv.15682] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/23/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Even today, a substantial number of individuals with visible skin diseases still suffer from incomprehension and stigmatization. About 10 million people are affected by such diseases in Germany. The WHO strongly urges member states to take measures against stigmatization in skin diseases. OBJECTIVES Objectives are the development of an action programme to raise awareness and address stigmatization. Therefore, conception, development and testing of interventions for the destigmatization of persons with skin diseases in Germany will be carried out. METHODS A series of actions addressing decision makers, politicians and the Federal Ministry of Health were initiated, all based on the World Health Assembly (WHA). Argumentation was largely based on data from health services research. Supported by the Federal Ministry of Health, a concept against stigmatization was developed by an expert consortium of researchers, dermatologists and patients. Specific strategies of structured destigmatization between those affected and those not will be developed and scientifically evaluated. RESULTS The activities addressed to politics were - to a large extent - successfully and financially supported by a 3-year programme (2018-2020), designed to develop interventions against stigma. It was funded by the Federal Ministry of Health. The project includes conception and development, intervention and evaluation, data analyses and development of a long-term concept. CONCLUSIONS The WHO's call against stigmatization in psoriasis (resolution WHA67.9 and global report on psoriasis 2016) was taken into account and developed into a destigmatization programme supported by the German government and German politicians. This has been achieved by successful collaborations between dermatologists, researchers, patients and policymakers. Next step will be the testing of interventions in situations and surroundings, where stigmatization usually occurs. The data will be used for the implementation of a long-term concept that can be used to continue destigmatization in Germany far beyond the project's initial phase.
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Topology of psoriasis in routine care: results from high‐resolution analysis of 2009 patients. Br J Dermatol 2019; 181:358-365. [DOI: 10.1111/bjd.17403] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/08/2023]
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Gender and age significantly determine patient needs and treatment goals in psoriasis – a lesson for practice. J Eur Acad Dermatol Venereol 2019; 33:700-708. [DOI: 10.1111/jdv.15324] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/04/2018] [Indexed: 11/28/2022]
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The psychometric evaluation of the quality of life in short stature youth (QoLISSY) instrument for German children born small for gestational age. J Endocrinol Invest 2018; 41:1185-1191. [PMID: 29455392 DOI: 10.1007/s40618-018-0850-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 02/06/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to validate the disease-specific "quality of life in short stature youth (QoLISSY)-instrument" that assessesQuery the health-related quality of life (HrQoL) in German children and adolescents diagnosed as small for gestational age (SGA) in a patient and parent report. METHODS The psychometric performance of the German version of the QoLISSY questionnaire was examined in terms of reliability and validity in 65 SGA families (17 child reports/64 parent reports) and compared to the psychometric performance of the original European QoLISSY dataset of over 200 children with growth hormone deficiency and idiopathic short stature (ISS). RESULTS The analysis yielded psychometrically favorable results with excellent reliability and acceptable discriminant validity. The instrument's operating characteristics were comparable to the results of the original European QoLISSY data. In the parent- as well as child report, children with SGA had lower HrQoL scores than children with ISS. Convergent validity was demonstrated by significant correlations between the QoLISSY scales and the generic KIDSCREEN-10 Index. CONCLUSION Psychometric testing suggests that QoLISSY is a promising instrument to assess the HrQoL of young German people with SGA. Both versions (parent- and child report) appear to detect differences between SGA and other conditions (e.g. ISS). QoLISSY can be used in clinical studies, health service research, as well as in practice in children with SGA and their parents. For a cross-cultural application of the instrument in SGA, the tool needs be validated in sufficiently large SGA samples within respective countries.
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[Healthcare research in dermatology 2018 - power of the factual : What healthcare research is and who it serves]. Hautarzt 2018; 69:794-800. [PMID: 30215114 DOI: 10.1007/s00105-018-4274-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In the dermatology practiced in Germany, healthcare research is an established and highly differentiated discipline. In many university dermatological institutions and private practices, studies are carried out on the processes of healthcare research for skin diseases. Commissioned by the German Society of Dermatology and the Professional Association of German Dermatologists, a significant number of the studies and projects are conducted by the German Center for Health Services Research in Dermatology (CVderm) as a nationwide reference center. Important projects include the implementation of patient registers and national care studies, research with secondary data and carrying out methodological studies for the further development of scientific questions. Important results are the national healthcare conferences for psoriasis, skin cancer, wounds and atopic dermatitis, the regional care networks as well as projects and cooperation with health insurance companies, local government and public institutions. In the interests of improved patient care, important factors of care are continuously improved. Future health services research in dermatology will be able to contribute even more efficiently for better care planning and management. Patient registers will facilitate the transfer of innovations into care and help to ensure that new treatment approaches can be implemented. Registers also support the optimization of therapy approaches, which can no longer be carried out on the basis of clinical studies alone, for example in the case of psoriasis, due to the large number of drugs available. In the era of digital medicine, healthcare research has an even more important function.
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Global Sequestration Potential of Increased Organic Carbon in Cropland Soils. Sci Rep 2017; 7:15554. [PMID: 29138460 PMCID: PMC5686149 DOI: 10.1038/s41598-017-15794-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/02/2017] [Indexed: 11/24/2022] Open
Abstract
The role of soil organic carbon in global carbon cycles is receiving increasing attention both as a potentially large and uncertain source of CO2 emissions in response to predicted global temperature rises, and as a natural sink for carbon able to reduce atmospheric CO2. There is general agreement that the technical potential for sequestration of carbon in soil is significant, and some consensus on the magnitude of that potential. Croplands worldwide could sequester between 0.90 and 1.85 Pg C/yr, i.e. 26–53% of the target of the “4p1000 Initiative: Soils for Food Security and Climate”. The importance of intensively cultivated regions such as North America, Europe, India and intensively cultivated areas in Africa, such as Ethiopia, is highlighted. Soil carbon sequestration and the conservation of existing soil carbon stocks, given its multiple benefits including improved food production, is an important mitigation pathway to achieve the less than 2 °C global target of the Paris Climate Agreement.
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Multiparametric monitoring of microbial faecal pollution reveals the dominance of human contamination along the whole Danube River. WATER RESEARCH 2017; 124:543-555. [PMID: 28806705 PMCID: PMC5718294 DOI: 10.1016/j.watres.2017.07.052] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 05/22/2023]
Abstract
The microbial faecal pollution of rivers has wide-ranging impacts on a variety of human activities that rely on appropriate river water quality. Thus, detailed knowledge of the extent and origin of microbial faecal pollution is crucial for watershed management activities to maintain safe water use. In this study, the microbial faecal pollution levels were monitored by standard faecal indicator bacteria (SFIB) along a 2580 km stretch of the Danube, the world's most international river, as well as the Danube's most important tributaries. To track the origin of faecal pollution, host-associated Bacteroidetes genetic faecal marker qPCR assays for different host groups were applied in concert with SFIB. The spatial resolution analysis was followed by a time resolution analysis of faecal pollution patterns over 1 year at three selected sites. In this way, a comprehensive faecal pollution map of the total length of the Danube was created, combining substantiated information on both the extent and origin of microbial faecal pollution. Within the environmental data matrix for the river, microbial faecal pollution constituted an independent component and did not cluster with any other measured environmental parameters. Generally, midstream samples representatively depicted the microbial pollution levels at the respective river sites. However, at a few, somewhat unexpected sites, high pollution levels occurred in the lateral zones of the river while the midstream zone had good water quality. Human faecal pollution was demonstrated as the primary pollution source along the whole river, while animal faecal pollution was of minor importance. This study demonstrates that the application of host-associated genetic microbial source tracking markers in concert with the traditional concept of microbial faecal pollution monitoring based on SFIB significantly enhances the knowledge of the extent and origin of microbial faecal pollution patterns in large rivers. It constitutes a powerful tool to guide target-oriented water quality management in large river basins.
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Validation of the Italian Quality of Life in Short Stature Youth (QoLISSY) questionnaire. J Endocrinol Invest 2017; 40:1077-1084. [PMID: 28397185 DOI: 10.1007/s40618-017-0667-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 03/25/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE The Quality of Life in Short Stature Youth (QoLISSY) questionnaire is a disease-specific instrument developed to assess health-related quality of life (HrQoL) in children with short stature. While the original instrument was simultaneously developed in five European countries, this study describes the results of the Italian QoLISSY translation, cultural adaptation, and validation. METHODS Focus group discussions and a cognitive debriefing process with children (N = 12) diagnosed with growth hormone deficiency or idiopathic short stature and one parent each, as well as parents of younger children (N = 20) were conducted to examine the linguistic and content validity of the Italian version. Psychometric testing was performed using data from the subsequent field- and re-test (N = 32). RESULTS The results of the qualitative testing of the Italian sample revealed comparability of content to data of the original five European countries. The following field- and re-test results were psychometrically satisfactory including good item and scale operating characteristics, sufficient evidence of reliability, and acceptable evidence of construct validity. CONCLUSION In conclusion, the Italian QoLISSY HrQoL-dimensions are comparable to other European countries. The psychometric quality of the Italian QoLISSY version is satisfactory and the instrument is ready for use in Italian patients and their parents.
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Development and pilot-testing of a condition-specific instrument to assess the quality-of-life in children and adolescents born with esophageal atresia. Dis Esophagus 2017; 30:1-9. [PMID: 28475726 DOI: 10.1093/dote/dox017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/10/2017] [Indexed: 12/11/2022]
Abstract
The survival rate of children with esophageal atresia has today reached 95%. However, children are at risk of chronic morbidity related to esophageal and respiratory dysfunction, and associated anomalies. This study describes the pilot testing of a condition-specific health-related quality-of-life instrument for children with esophageal atresia in Sweden and Germany, using a patient-derived development approach consistent with international guidelines. Following a literature review, standardized focus groups were conducted with 30 Swedish families of children with esophageal atresia aged 2-17 years. The results were used for item generation of two age-specific pilot questionnaire versions. These were then translated from Swedish into German with considerations of linguistic and semantical perspectives. The 30-item pilot questionnaire for children aged 2-7 years was completed by 34 families (parent report), and the 50-item pilot questionnaire for children aged 8-17 years was completed by 52 families (51 child report, 52 parent report), with an overall response rate of 96% in the total sample. Based on predefined psychometric criteria, poorly performing items were removed, resulting in an 18-item version with three domains (Eating, Physical health and treatment, Social isolation and stress,) for children aged 2-7 years and a 26-item version with four domains (Eating, Social relationships, Body perception, and Health and well-being) for children aged 8-17 years. Both versions demonstrated good internal consistency reliability and acceptable convergent and known-groups validity for the total scores. The study identified specific health-related quality-of-life domains for pediatric patients with esophageal atresia, highlighting issues that are important for follow-up care. After field testing in a larger patient sample, this instrument can be used to enhance the evaluation of pediatric surgical care.
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Review of lattice results concerning low-energy particle physics: Flavour Lattice Averaging Group (FLAG). THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2017; 77:112. [PMID: 29033670 PMCID: PMC5588406 DOI: 10.1140/epjc/s10052-016-4509-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 11/11/2016] [Indexed: 06/07/2023]
Abstract
We review lattice results related to pion, kaon, D- and B-meson physics with the aim of making them easily accessible to the particle-physics community. More specifically, we report on the determination of the light-quark masses, the form factor [Formula: see text], arising in the semileptonic [Formula: see text] transition at zero momentum transfer, as well as the decay constant ratio [Formula: see text] and its consequences for the CKM matrix elements [Formula: see text] and [Formula: see text]. Furthermore, we describe the results obtained on the lattice for some of the low-energy constants of [Formula: see text] and [Formula: see text] Chiral Perturbation Theory. We review the determination of the [Formula: see text] parameter of neutral kaon mixing as well as the additional four B parameters that arise in theories of physics beyond the Standard Model. The latter quantities are an addition compared to the previous review. For the heavy-quark sector, we provide results for [Formula: see text] and [Formula: see text] (also new compared to the previous review), as well as those for D- and B-meson-decay constants, form factors, and mixing parameters. These are the heavy-quark quantities most relevant for the determination of CKM matrix elements and the global CKM unitarity-triangle fit. Finally, we review the status of lattice determinations of the strong coupling constant [Formula: see text].
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Reducing emissions from agriculture to meet the 2 °C target. GLOBAL CHANGE BIOLOGY 2016; 22:3859-3864. [PMID: 27185416 DOI: 10.1111/gcb.13340] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 04/21/2016] [Indexed: 05/03/2023]
Abstract
More than 100 countries pledged to reduce agricultural greenhouse gas (GHG) emissions in the 2015 Paris Agreement of the United Nations Framework Convention on Climate Change. Yet technical information about how much mitigation is needed in the sector vs. how much is feasible remains poor. We identify a preliminary global target for reducing emissions from agriculture of ~1 GtCO2 e yr-1 by 2030 to limit warming in 2100 to 2 °C above pre-industrial levels. Yet plausible agricultural development pathways with mitigation cobenefits deliver only 21-40% of needed mitigation. The target indicates that more transformative technical and policy options will be needed, such as methane inhibitors and finance for new practices. A more comprehensive target for the 2 °C limit should be developed to include soil carbon and agriculture-related mitigation options. Excluding agricultural emissions from mitigation targets and plans will increase the cost of mitigation in other sectors or reduce the feasibility of meeting the 2 °C limit.
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Abstract
While optical cameras or laser systems are widely used for mobile mapping low attention was payed for radar systems. Due to new semiconductor technologies, compact and leight weight SAR systems based on the Frequency Modulated Continuous Wave (FMCW) principle in the millimeter wave domain can serve for mobile radar mapping on cars. For mapping of long stripes along roads in close range a special strategy for focusing of SAR images was developed. Hereby local adapted planes for processing are used considering the IMU data of the sensor. An experimental system was designed for high resolution radar mapping of urban scenes in close range geometry. This small and leight weighted system has a bandwidth of 30 GHz (5 mm resolution) and operates with 300 GHz in the lower terahertz domain. Experiments with a van in an urban scenario were carried out for proof of applicability of an operating SAR system resolving objects in the subcentimeter domain. The results show that narrow cracks in the asphalt of the road are visible and the measuring of small metallic objects placed in the scene is possible. Based on this mobile mapping techniques a first result from an acquisition of vertical facade structure is shown.
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Occurrence of human-associated Bacteroidetes genetic source tracking markers in raw and treated wastewater of municipal and domestic origin and comparison to standard and alternative indicators of faecal pollution. WATER RESEARCH 2016; 90:265-276. [PMID: 26745175 PMCID: PMC4884448 DOI: 10.1016/j.watres.2015.12.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/13/2015] [Accepted: 12/17/2015] [Indexed: 05/19/2023]
Abstract
This was a detailed investigation of the seasonal occurrence, dynamics, removal and resistance of human-associated genetic Bacteroidetes faecal markers (GeBaM) compared with ISO-based standard faecal indicator bacteria (SFIB), human-specific viral faecal markers and one human-associated Bacteroidetes phage in raw and treated wastewater of municipal and domestic origin. Characteristics of the selected activated sludge wastewater treatment plants (WWTPs) from Austria and Germany were studied in detail (WWTPs, n = 13, connected populations from 3 to 49000 individuals), supported by volume-proportional automated 24-h sampling and chemical water quality analysis. GeBaM were consistently detected in high concentrations in raw (median log10 8.6 marker equivalents (ME) 100 ml(-1)) and biologically treated wastewater samples (median log10 6.2-6.5 ME 100 ml(-1)), irrespective of plant size, type and time of the season (n = 53-65). GeBaM, Escherichia coli, and enterococci concentrations revealed the same range of statistical variability for raw (multiplicative standard deviations s* = 2.3-3.0) and treated wastewater (s* = 3.7-4.5), with increased variability after treatment. Clostridium perfringens spores revealed the lowest variability for raw wastewater (s* = 1.5). In raw wastewater correlations among microbiological parameters were only detectable between GeBaM, C. perfringens and JC polyomaviruses. Statistical associations amongst microbial parameters increased during wastewater treatment. Two plants with advanced treatment were also investigated, revealing a minimum log10 5.0 (10th percentile) reduction of GeBaM in the activated sludge membrane bioreactor, but no reduction of the genetic markers during UV irradiation (254 nm). This study highlights the potential of human-associated GeBaM to complement wastewater impact monitoring based on the determination of SFIB. In addition, human-specific JC polyomaviruses and adenoviruses seem to be a valuable support if highly specific markers are needed.
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[Evaluation of a Self-Help Supported Counseling Concept for Children and Adolescents with Disproportional Short Stature]. KLINISCHE PADIATRIE 2015; 228:17-23. [PMID: 26466200 DOI: 10.1055/s-0035-1564106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Disproportionate short stature may impair the quality of life (QoL) of patients and their families. This study aimed to evaluate a self-help supported counseling concept to increase the QoL of the participants. METHODS QoL data from 58 children/adolescents (8-17 years) with a diagnosis of achondroplasia was collected at 2 measurement points during one year using the the QoLISSY questionnaire (self-/parental report). Differences before and after participation vs. non-participation in the intervention were evaluated using a linear mixed model. RESULTS The longitudinal results show a greater increase of QoL in the active intervention group compared to a passive control group (p=0,005). The increase in the self-reported QoL of affected patients was significantly higher than for the parent-report (p=0,048). CONCLUSIONS The study shows that patients with achondroplasia benefit from a self-help supported counseling concept. However, this should be tested in a randomized trial.
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Response to the discussion letter of Lassaletta and Aguilera "soil carbon sequestration is a climate stabilization wedge: comments on Sommer and Bossio (2014)". JOURNAL OF ENVIRONMENTAL MANAGEMENT 2015; 153:132-133. [PMID: 25659939 DOI: 10.1016/j.jenvman.2015.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 01/21/2015] [Indexed: 06/04/2023]
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Gesundheitsbezogene Lebensqualität – ein zentraler patientenrelevanter Endpunkt in der Nutzenbewertung medizinischer Maßnahmen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 58:283-90. [DOI: 10.1007/s00103-014-2107-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Dynamics and climate change mitigation potential of soil organic carbon sequestration. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2014; 144:83-7. [PMID: 24929498 DOI: 10.1016/j.jenvman.2014.05.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 05/12/2014] [Accepted: 05/20/2014] [Indexed: 05/08/2023]
Abstract
When assessing soil organic carbon (SOC) sequestration and its climate change (CC) mitigation potential at global scale, the dynamic nature of soil carbon storage and interventions to foster it should be taken into account. Firstly, adoption of SOC-sequestration measures will take time, and reasonably such schemes could only be implemented gradually at large-scale. Secondly, if soils are managed as carbon sinks, then SOC will increase only over a limited time, up to the point when a new SOC equilibrium is reached. This paper combines these two processes and predicts potential SOC sequestration dynamics in agricultural land at global scale and the corresponding CC mitigation potential. Assuming that global governments would agree on a worldwide effort to gradually change land use practices towards turning agricultural soils into carbon sinks starting 2014, the projected 87-year (2014-2100) global SOC sequestration potential of agricultural land ranged between 31 and 64 Gt. This is equal to 1.9-3.9% of the SRES-A2 projected 87-year anthropogenic emissions. SOC sequestration would peak 2032-33, at that time reaching 4.3-8.9% of the projected annual SRES-A2 emission. About 30 years later the sequestration rate would have reduced by half. Thus, SOC sequestration is not a C wedge that could contribute increasingly to mitigating CC. Rather, the mitigation potential is limited, contributing very little to solving the climate problem of the coming decades. However, we deliberately did not elaborate on the importance of maintaining or increasing SOC for sustaining soil health, agro-ecosystem functioning and productivity; an issue of global significance that deserves proper consideration irrespectively of any potential additional sequestration of SOC.
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Review of lattice results concerning low-energy particle physics. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2014; 74:2890. [PMID: 25972762 PMCID: PMC4410391 DOI: 10.1140/epjc/s10052-014-2890-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 05/05/2014] [Indexed: 05/28/2023]
Abstract
We review lattice results related to pion, kaon, [Formula: see text]- and [Formula: see text]-meson physics with the aim of making them easily accessible to the particle-physics community. More specifically, we report on the determination of the light-quark masses, the form factor [Formula: see text], arising in semileptonic [Formula: see text] transition at zero momentum transfer, as well as the decay-constant ratio [Formula: see text] of decay constants and its consequences for the CKM matrix elements [Formula: see text] and [Formula: see text]. Furthermore, we describe the results obtained on the lattice for some of the low-energy constants of [Formula: see text] and [Formula: see text] Chiral Perturbation Theory and review the determination of the [Formula: see text] parameter of neutral kaon mixing. The inclusion of heavy-quark quantities significantly expands the FLAG scope with respect to the previous review. Therefore, we focus here on [Formula: see text]- and [Formula: see text]-meson decay constants, form factors, and mixing parameters, since these are most relevant for the determination of CKM matrix elements and the global CKM unitarity-triangle fit. In addition we review the status of lattice determinations of the strong coupling constant [Formula: see text].
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Effects of Zero Tillage and Residue Retention on Soil Quality in the Mediterranean Region of Northern Syria. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ojss.2014.43015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Microorganism inactivation by an ozonation step optimized for micropollutant removal from tertiary effluent. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2013; 68:311-318. [PMID: 23863422 DOI: 10.2166/wst.2013.212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This paper demonstrates the additional benefit of the microbicidal efficacy of an ozonation plant implemented for micropollutant removal from tertiary effluent. Due to the low amount of viruses and protozoa in the tertiary effluent, bacteriophage MS2 and spores of Bacillus subtilis were dosed as surrogates. At specific ozone consumptions of 0.6 and 0.9 g O3/g dissolved organic carbon (DOC) a 2-log colony forming unit (CFU) reduction was achieved for indigenous Escherichia coli and enterococci, and the limits of the European bathing water directive for the excellent quality of inland waters were met. Higher removal was impeded by the shielding effect of suspended solids in the effluent, which implies the combination of ozonation with a preceding filtration step if higher microbicidal performances are required. The surrogate virus MS2 was reduced by 4-5 log while no significant inactivation was detected for B. subtilis spores. Additionally, the impact of ozonation on the biochemical oxygen demand (BOD) was studied. The BOD5 measurement was not adversely affected despite the reduced concentration of microorganisms after ozonation. The intrinsic increase in BOD5 averaged 15% at 0.6-0.7 g O3/g DOC. The impact of the projected increase on the surface water quality is generally not considered a problem but has to be assessed on a case-by-case approach.
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Development of a new CARD-FISH protocol for quantification of Legionella pneumophila and its application in two hospital cooling towers. J Appl Microbiol 2012; 112:1244-56. [DOI: 10.1111/j.1365-2672.2012.05289.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Promovieren in den Therapieberufen. PHYSIOSCIENCE 2012. [DOI: 10.1055/s-0031-1299238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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