Appearance in acne: an often-overlooked concept

Acne is one of the most common skin conditions affecting all age groups, especially adolescents and young adults.1 The transition into adulthood is a crucial period of development including many changes and challenges, such as professional progress, making and strengthening relationships and forming one's personal identity.2 Having visible acne impedes these developmental tasks and, in the absence of a cure, affected people must learn to live with their skin condition. Effective treatments are therefore essential. In order to measure efficacy of different treatments, well‐developed and validated patient‐reported outcome measures should be available and capture improvements from the patient's perspective.3 Being an important outcome of acne treatments, appearance should be measured in every clinical trial. What is more important for an affected patient, especially for adolescents and young adults, than how their skin, acne and acne scars look and improve? Because appearance is in the eye of the beholder, a self‐report is needed to capture this concept. There are some acne‐specific measures available, but they often overlook this subjective concept. In this issue of the BJD, Klassen et al. dared to develop a new instrument filling this gap, the ACNE‐Q.4 Addressing the concept appearance comprehensively, this measure is novel. An important criterion to ensure good quality of the development of a measure is a patient‐oriented approach. Patients as well as different healthcare providers were involved in the whole development process. Three top‐level domains with several major and minor themes emerged. Feedback of clinical experts was obtained and cognitive interviews with affected patients were conducted to assess content validity of the scales according to the COSMIN criteria.5 Modern psychometric analyses using the Rasch Measurement Theory were performed to identify items with poor fit and different measurement properties of the ACNE‐Q, such as structural validity, internal consistency, test–retest reliability and construct validity, were assessed. The study is limited to the North American population. However, a large sample size (n = 256) recruited from two countries and different settings, i.e. hospital and community dermatology clinics, was involved in the validation study. Although the ACNE‐Q is quite long, with 73 items in seven scales, it is a comprehensive and promising measure that can be used in clinical practice and research to measure appearance and appearance‐related distress and symptoms. This study lays the ground for future studies on the validation and feasibility of the ACNE‐Q

The 'Chronic Itch Burden Scale' : giving patients with chronic pruritus a voice

Projekt DEAL 202

Are existing quality-of-life instruments in cutaneous T-cell lymphoma of sufficient quality?

Cutaneous T-cell lymphoma (CTCL) is a rare type of non-Hodgkin lymphoma. However, non-Hodgkin lymphoma is ranked as the seventh most common cancer in the USA.1 In CTCL, mutated T cells migrate to the skin, and lesions on the skin tend to appear. Mycosis fungoides (MF) and Sézary syndrome (SS) are the most prevalent forms of CTCL.2 Pruritus, one of the most prominent symptoms of the disease, often leads to scratching, which in turns causes painful skin and can lead to disfigurement of affected patients. This negatively impacts their quality of life (QoL).3 Instruments measuring QoL are of great interest as they capture the patient’s perspective. Their use in clinical trials is increasingly recognized by regulatory authorities, clinicians and patients because they help to indicate whether the impact of an intervention is comprehensively assessed.4 In this issue of the BJD, Bhat et al.5 use qualitative research to assess the impact of CTCL on patients’ daily lives and to identify the most meaningful aspects in assessing QoL in CTCL. This is achieved by evaluating existing QoL instruments (generic, skin specific and disease specific). Generic instruments (e.g. the 36-Item Short-Form Health Survey) and skin-specific instruments (e.g. the Dermatology Life Quality Index) cannot capture CTCL-specific constructs. However, the only existing CTCL-specific measure, the MF/SS-CTCL instrument, did not include patients with advanced-stage disease in either the development or validation.6 In their study, Bhat et al. included patients at all stages of the disease. This assessment across various severity stages is novel. Eighteen semistructured interviews revealed three major themes: clinical symptoms, psychological and social functioning, and the salient treatment burden. Existing QoL instruments were screened for relevant patient concerns identified in the interviews. In particular, individual clinical symptoms, concerns about appearance and problems with sleep were not adequately represented in either generic or skin-specific instruments, or in the only existing CTCL-specific QoL measure. For this reason, there is currently no available QoL instrument of sufficient quality in CTCL. Qualitative research involving affected patients, as performed by the authors, is the gold standard for the development of a promising patient-reported outcome measure. Without patient input, the content validity of a new instrument can be questioned. Only patients are able to judge the impact of their disease, their feelings and their treatment burden. For this reason, this study including interviews with patients with variations in severity represents an excellent starting point for the development of a new, comprehensive, disease-specific QoL instrument of sufficient quality for patients with CTCL.Projekt DEAL 202

Esta historia no me la contaron : producción dramatúrgica desde la sistematización de experiencias

El presente trabajo de investigación tiene como propósito contribuir al ámbito de la gestión y producción de la comunicación organizacional, mediante la sistematización de experiencias, en la que se presenta al guión radiofónico "Refundación de la utopía". El objetivo es conocer la realidad institucional de la cooperativa de trabajo artístico "La hormiga circular".Fil: Gabes, Ana. Universidad Nacional del Comahue. Facultad de Derecho y Ciencias Sociales. Departamento de Comunicación Social; Argentina

Validation of the German Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire in Peri- and Postmenopausal Women.

BACKGROUND The Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire is a validated patient-reported outcome measure (PROM) capturing the impacts of vaginal symptoms in postmenopausal women. AIM We aimed to psychometrically validate the German version of the DIVA questionnaire. METHODS Data was collected online and by paper-pencil. We ran confirmatory factor analyses to confirm the a priori four-factor structure of the DIVA. Internal consistency was calculated using Cronbach's alpha. Correlations with other outcome measures such as the Patient Health Questionnaire-4 (PHQ-4), the SF-12 SOEP (socio-economic panel) version and self-created anchor questions were calculated regarding convergent validity. Known groups regarding age, home country and disease severity were analyzed. Test-retest reliability after 1 week and responsiveness after 4 weeks were only descriptively assessed due to low sample sizes. MAIN OUTCOME MEASURES The DIVA questionnaire, the Menopause Rating Scale (MRS II), the PHQ-4 and the SF-12 SOEP version were the main outcome measures. RESULTS 185 postmenopausal women reporting vaginal complaints participated in the survey. The mode of administration did not influence the severity of vaginal symptoms. The four-factor structure of the DIVA could be confirmed and the model fit indicated sufficient structural validity. Furthermore, strong internal consistency in all of the DIVA domains was found. Regarding convergent validity, no hypothesis has failed completely. The results regarding known-groups validity were mostly in line with our a priori hypotheses. Descriptive evidence for sufficient test-retest reliability and responsiveness was given, however, the sample size for the assessment of those two measurement properties was low. CONCLUSION This study supports the excellent structural validity, internal consistency and construct validity of the German version of the DIVA questionnaire. It can be recommended for the assessment of the impacts of vaginal symptoms in postmenopausal women in future clinical GSM trials. Gabes M, Stute P, Apfelbacher C. Validation of the German Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire in Peri- and Postmenopausal Women. Sex Med 2021;9:100382

„Stell dir vor, alle deine Ferien werden gestrichen …“ - Sprachbewusstheitsförderung beim Modellieren

In diesem Beitrag wird das Forschungsvorhaben mamola (mathematical modelling and language awareness) vorgestellt. Indem Sprachfördermaßnahmen ein Potenzial für das mathematische Modellieren in der Grundschule bieten (Specht & Tokarski, 2019), beschäftigt sich das Projekt mit der Frage, wie sich ein Arbeitssetting mit unterschiedlich hohem Grad an Sprachbewusstheitsförderung auf die mathematische Modellierungskompetenz von Grundschulkindern auswirkt

Measurement properties of quality-of-life outcome measures for children and adults with eczema: an updated systematic review

Objective The aim of this updated systematic review was to systematically assess the measurement properties of previously discussed and new quality‐of‐life patient‐reported outcome measures (PROMs) in children and adults with eczema using the new COSMIN guideline. Methods A systematic literature search was conducted in PubMed and EMBASE. Eligible studies reported on measurement properties of quality‐of‐life PROMs for children and adults with eczema. The methodological quality of selected already known PROMs and new evidence identified through the literature search was assessed with the COSMIN Risk of Bias checklist. The adequacy of included PROMs was judged with updated quality criteria, and the quality of evidence of the summarized results was graded. Finally, PROMs were placed in a recommendation category (A‐C). Results In total, 133 measurement properties of nine different PROMs were assessed. No PROM could be placed in category A due to a lack of validation studies. Only the DLQI fulfilled the criteria for category C and therefore should not be recommended for use. All other PROMs were placed in category B, that is, they still have the opportunity to be recommended, but need further validation. Conclusions Currently, no PROM for quality of life can be recommended for use in children and adults with eczema. Further validation is needed. The DLQI cannot be recommended for future use

Motivation und digitale Medien am Beispiel des Sachunterrichts

Der folgende Beitrag versucht zu klären, wie sich der Einsatz digitaler Medien auf die Motivation der Schülerinnen und Schüler im Sachunterricht auswirkt. Dabei werden aus den Forschungsergebnissen Potenziale abgeleitet, wie sich ein motivationsförderlicher Sachunterricht mit digitalen Medien in der Grundschule verwirklichen lässt. (DIPF/Orig.

Driving simulation: the effects of interactivity and presentation setting

Background: Driving simulators are established tools used for different research purposes. Either head-mounted displays (HMDs) or monitors are applied. However, the extent to which the setting (HMD vs monitors) or the interactivity in driving (active behaviour as a driver or passive behaviour as a co-driver) influences the experience of presence, realism or simulator sickness is not yet entirely clear. Objective: We aimed to compare different conditions to assess the influence of interactivity and presentation setting on the experience of presence, realism, and simulator sickness. Further, different driving performance parameters (e.g., speed perception or sign detection) were aimed to be assessed between the two settings. Methods: Ninety participants were recruited. This was an experimental study (2 × 2 within-between-subject design) with interactivity as within-subject factor (2 levels: active vs passive) and setting as between-subject factor (2 levels: HMD vs monitors). As driving scenarios, we selected four specific driving maneuvers that we assume would affect driving behaviour differently depending on the setting. Differences in the experience of presence as well as in the development of simulator sickness were assessed using standardised questionnaires. Results: There was no difference between the two settings regarding presence, realism or simulator sickness. Regarding interactivity, presence was significantly higher in the active compared to the passive condition. The most prominent difference between the two settings was found in the sign detection task where participants wearing an HMD performed worse. Conclusion: The choice of interactivity appears to have a stronger effect on the experience of presence than the setting. Sign detection was worse in the HMD setting probably due to the lower display resolution. These results are relevant for the interpretation of driving simulator studies and the implementation of future studies

Refinement and validation of the ItchyQoL using classical test theory and item response theory resulted in a reduction of the response categories from a 5-point to a 3-point scale

Background The ItchyQoL is an itch-specific patient-reported outcome measure used to assess quality of life in patients with chronic pruritus (CP). Objectives We aimed to assess and extend the psychometric properties of the Itchy- QoL using classical test theory (CTT) and item response theory (IRT). Methods Item characteristic curves were analysed to investigate whether the response categories were functioning optimally. Confirmatory factor analyses were carried out on the ItchyQoL prior to and after rescoring of the response categories. We conducted a Rasch analysis for the ItchyQoL with revised response options and assessed the mean fit residuals in addition to the assumptions of unidimensionality and local independence. Results In total, 551 patients with CP from nine European countries completed the 22 items of the ItchyQoL. IRT analysis supported the revision of response options from five points to three. This revision was supported by excellent structural validity using CTT. The overall fit to the Rasch model was adequate. Unidimensionality was supported by the ItchyQoL overall scale and by the single subscales; however, local independence was violated in eight cases. Conclusions We suggest a revision of the response categories of the ItchyQoL from a 5-point to a 3-point scale. When this revision was applied, the ItchyQoL showed excellent structural validity according to CTT and IRT/Rasch. The calculation of an overall ItchyQoL sum score is allowed.Projekt DEAL 202