Skin hyperpigmentation disorders: associations and impact on health-related quality of life

Hyperpigmentation is a common dermatological complaint that can have profound effect on appearance and quality of life.  Disorders of hyperpigmentation comprise a large group of skin conditions characterized by an increase of melanin production, increase in density of active melanocytes, abnormal melanin distribution, and/or deposition of exogenous pigments. This cross-sectional study was conducted to evaluate the impact hyperpigmentation disorders on health-related quality of life and to better understand patient knowledge, approaches, and experiences. The study was conducted on 298 consenting adult patients with a skin related disorder of hyperpigmentation who sought dermatological care at Boston Medical Center (BMC) or East Boston Neighborhood Health Center (EBNHC) from February of 2015 to March of 2016. Patients were anonymously surveyed in order to collect an assortment of information including demographic characteristics, skin condition, health practices, knowledge base, and health-related quality of life (HRQoL) measured with the Dermatology Life Quality Index (DLQI) (Finlay and Khan 1994) and SDIEQ, a five-item , non-validated, brief health-related quality of life questionnaire (A. Taylor et al. 2008). Disease severity was assessed by Melasma Area Severity Index (MASI), Post Acne Hyperpigmentation Index (PAHPI) and body surface area when appropriate. The mean overall DLQI was 6.56 (SD 5.35). In sub-analysis, the mean DLQI in those diagnosed with post-inflammatory hyperpigmentation was 7.89 (SD 0.61), melasma 6.75 (SD 0.45), and other hyperpigmentation disorders 4.5 (SD 0.55). The disease type and duration were both factors associated with a change in DLQI scores. The factors associated with a higher likelihood of patients’ knowledge of their diagnosis included a higher level of formal education, younger age, longer duration of having the condition, and current use of sunscreen, which were found to have 2.4, 2, 3.7, and 2.4 significantly higher odds of knowing their diagnosis, respectively. This study found that the overall impact of hyperpigmentation on health-related quality of life (HRQoL) was small to moderate; however, about 22% reported a very large affect on quality of life. Patients with post-inflammatory hyperpigmentation (PIH) and melasma have significantly lower quality of life when compared with other hyperpigmentation disorders. MASI had a significantly weak correlation with DLQI and SDIEQ, demonstrating that disease severity does not predict patient perception and impact on quality of life

Causas, efectos socioeconómicos, medidas de mitigación y adaptación al cambio climático en el turismo rural comunitario del departamento de Matagalpa

Esta investigación se realizó a familias campesinas trabajadoras de turismo rural comunitario en los municipios de San Ramón y Sébaco del departamento de Matagalpa, para determinar las causas, efectos, y medidas de mitigación y adaptación ante el fenómeno cada vez más acelerado como es el cambio climático en el que vemos ante todo la mano del hombre como principal causante, pero también es una de las víctimas más vulnerable a estos cambios. Las comunidades campesinas seleccionadas para realizar la investigación de campo fueron: Finca Esperanza Verde, cooperativas asociadas a la UCA San Ramón de La Pita, La Reyna, El Roblar y familias organizadas en el Museo Precolombino de Chagüitillo, estas cooperativas o grupos organizados, le brindan asistencia técnica para enfrentar los efectos del cambio climático, con medidas de mitigación y adaptación, de tal forma que se logre una mejor vida amigable con el medio ambient

LA INFLUENCIA DE LA NUEVA GESTIÓN PÚBLICA, EN EL MARCO DE LA REFORMA EDUCATIVA DE 2013

Por tanto, partimos de tres temas vinculados a la Administración Pública, su estudio e investigación: la Reforma Administrativa, la Nueva Gestión Pública y la profesionalizacióny evaluación del servicio público. Considerando las interrelaciones existentes entre estos temas, se buscó relacionarlos con un asunto de gran relevancia, como lo es la educació

Tejiendo territorios: prácticas de apropiación territorial en el mercado de Santa Marta.

El objetivo general de esta investigación es la apropiación del espacio en el mercado, de incorporarse en la cotidianidad del vendedor, de ver, como el vendedor, como dice Montañés (2001), lo convierte en su territorio, en espacio de tránsito y habitad, como establece lógicas de inclusión y exclusión en temporalidades definidas, de ahí la pregunta que guía la investigación ¿Cuáles son las prácticas de apropiación territorial que configuran los vendedores del mercado de Santa Marta sobre su espacio laboral, a partir de su reubicación en el sector de El Pueblito?. Esta monografía está organizada en tres apartados. El primero expone las transformaciones que la plaza de mercado de Santa Marta ha tenido en el tiempo y en el espacio a partir de la revisión bibliográfica, entre otros viajeros del siglo XIX, datos históricos y prensa local. El segundo explica la consolidación territorial del mercado entre el 2002 y el 2015

Melasma pathogenesis: a review of the latest research, pathological findings, and investigational therapies

Melasma is an acquired hyperpigmentation disorder most commonly affecting females with darker skin types. It is triggered by several factors including sun exposure, genetic influences, and female sex hormones. The pathology of melasma extends beyond melanocytes and recent literature points to interactions between keratinocytes, mast cells, gene regulation abnormalities, neovascularization, and disruption of basement membrane. This complex pathogenesis makes melasma difficult to target and likely to recur post treatment. A better understanding of the latest pathological findings is key to developing novel and successful treatment options. This review aims to provide a summary of the more novel pathological findings and latest investigational therapies

Alternative conductive coatings based on multi-walled carbon nanotubes

The aim of this work was to develop coatings as possible replacements for tin-doped indium oxide (ITO) systems. The alternative material of choice was carbon nanotubes, due to their flexibility, the abundance of carbon element in nature, their high aspect ratio and high electrical conductivity. Focusing on cost benefits, very thin multi-walled carbon nanotubes (MWNTs) were investigated rather than single-walled nanotubes (SWNTs) normally presented in the literature. Moreover, spin coating sol-gel technique was performed as a less expensive alternative to sputtering techniques used in the production of ITO films. MWNTs were studied both as pure networks as well as embedded in conductive and insulating matrixes. As networks, MWNTs presented sheet resistances as low as 20 kΩ/sq with transparency in the visible range of 87%, values comparable to some of SWNT networks presented in the literature. MWNTs were investigated as additional conductive elements in antimony-doped tin oxide (ATO) matrix. The results showed that the addition of concentrations as low as 0.1 wt.-% MWNTs is sufficient to decrease the resistivity of conducting ATO films by a factor of 16, with preserved transparency (90%) in the visible range. Less ATO nanoparticles and lower temperatures of sintering are required in order to obtain films with comparable resistivities and even higher transparency than that presented by ATO films reported in the literature. MWNTs have also provided resistivities in the order of 10 Ω.cm^-1 to an initially insulating TiO₂ matrix. The transparency of these films was, however, affected by the concentration of MWNTs necessary in order to reach the percolation threshold. Although the studied coatings did not meet the requirements necessary for a proper substitution of ITO in opto-electronic devices, their optical and electrical response as well as their low cost and simplicity of preparation allow them to be used in other applications where the high conductivity of ITO is not a requirement. The structural, optical, mechanical and electrical properties of all coatings were studied using different techniques and are demonstrated in this work.Das Ziel dieser Arbeit bestand in der Entwicklung von Schichten als Ersatz für Zinndotiertes Indiumoxid (ITO). Das Material der Wahl waren Kohlenstoff-Nanoröhren aufgrund ihrer Flexibilität, des häufigen Vorkommens von Kohlenstoff in der Natur, ihres hohen Aspektverhältnisses und vor allem ihrer hohen elektrischen Leitfähigkeit. Während normalerweiser in der Literatur einwandige Nanoröhren (SWNTs) beschrieben werden, standen in dieser Arbeit aus Kostengründen die mehrwandigen Kohlenstoff-Nanoröhren (MWNTs) im Vordergrund. Außerdem wurde in dieser Arbeit die Rotationsbeschichtungstechnik in Verbindung mit Sol-Gel-Verfahren eingesetzt. Diese ist eine günstigere Alternative zur Sputtertechnik, welche zum Herzustellen von ITO-Schichten verwendet wird. MWNTs wurden sowohl als Netzwerke, als auch eingebunden in leitfähige und isolierende Matrices untersucht. In Netzwerken zeigten MWNTs Schichtwiderstände von 20 kΩ/sq und eine Transparenz von 87% im sichtbaren Bereich des Lichtes, was durchaus vergleichbar mit den Werten von SWNT-Netzwerken in der Literatur ist. Ferner wurden MWNTs als leitfähige Additive in Antimon-dotierten Zinnoxid (ATO) Matrices untersucht. Die Ergebnisse zeigten, dass bereits die Zugabe von 0.1 Gew.-% MWNTs ausreichend ist, um den Widerstand einer leitfähigen ATO-Schicht unter Beibehaltung von 90% Transparenz im Sichtbaren, um den Faktor 16 zu senken. Dadurch werden weniger ATO-Nanopartikel und niedrigere Sintertemperaturen benötigt, um Schichten mit vergleichbarem Widerstand und sogar höherer Transparenz als in der Literatur zu erhalten. Mit MWNTs ließen sich auch in einer zuvor isolierenden TiO₂-Matrix Widerstände in der Größenordnung von 10 Ω.cm^-1erreichen. Die Transparenz dieser Schichten wurde jedoch durch die Konzentration der MWNTs, die für ein Erreichen der Perkolationsschwelle nötig waren, negativ beeinflusst. Obwohl die in dieser Arbeit untersuchten Schichten die Spezifikationen, die für einen Ersatz von ITO in opto-elektronischen Elementen nötig wären, noch nicht erreicht haben, erlauben ihre optischen und elektrischen Eigenschaften, wie auch ihre niedrigen Herstellungskosten und die Einfachheit ihrer Herstellung, sie in anderen Anwendungen einzusetzen, in denen die hohe Leitfähigkeit von ITO nicht erforderlich ist. Die strukturellen, optischen, mechanischen und elektrischen Eigenschaften aller Schichten wurden mit verschiedenen Techniken untersucht