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1.
  • Papadopoulos, Nikolaos G, et al. (författare)
  • Research needs in allergy: an EAACI position paper, in collaboration with EFA.
  • 2012
  • Ingår i: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 2:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ABSTRACT: In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century.The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients' Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients' organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels.Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.
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4.
  • Atzendorf, Josefine, et al. (författare)
  • Do smoking, nutrition, alcohol use, and physical activity vary between regions in Germany?-results of a cross-sectional study
  • 2020
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous studies on lifestyle risk factors mainly focused on age- or gender-specific differences. However, lifestyle risk factors also vary across regions. Aim of the present study was to examine the extent to which prevalence rates of SNAP (smoking, nutrition, alcohol consumption, physical activity) vary between East and West Germany or North and South Germany.Methods: Data came from the population-representative 2015 Epidemiological Survey of Substance Abuse (ESA) comprising 9204 subjects aged 18 to 64 years. To assess an east-west or south-north gradient, two binary logistic regression models were carried out for each SNAP factor.Results: The logistic regression models revealed statistically significant differences with higher rates of at-risk alcohol consumption and lower rates of unhealthy nutrition in East Germany compared to West Germany. Significant differences between North and South Germany were found for at-risk alcohol consumption with higher rates of at-risk alcohol consumption in South Germany. Daily smoking and low physical activity were equally distributed across regions.Conclusions: The implementation of measures reducing at-risk alcohol consumption in Germany should take the identified east-west and south-north gradient into account. Since the prevalence of unhealthy nutrition was generally high, prevention and intervention measures should focus on Germany as a whole instead of specific regions.
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5.
  • Atzendorf, Josefine, et al. (författare)
  • Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population : a cross-sectional study
  • 2018
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 8:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Lifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors.Design Cross-sectional study.Setting General German adult population (aged 18–64 years).Participants Participants of the 2015 Epidemiological Survey of Substance Abuse (n=9204).Primary outcome measures Lifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs).Results A latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors.Conclusions Healthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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6.
  • Howells, Laura, et al. (författare)
  • RECAP OF ATOPIC ECZEMA (RECAP) : ASSESSING ECZEMA CONTROL FROM THE PATIENT AND PARENT PERSPECTIVE
  • 2021
  • Ingår i: Acta Dermato-Venereologica. - : Medical journals Sweden AB. - 0001-5555 .- 1651-2057. ; 101:Suppl. 221, s. 29-29
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The Harmonising Outcome Measures for Eczema (HOME) initiative recommend long-term control of eczema is measured in all clinical trials over 3 months in duration, but prior to this work, no instrument had been identified as suitable for inclusion in the core outcome set.Objective: To develop a ques-tionnaire to capture ‘eczema control’ from a patient/caregiver’s perspective.Methods: A mixed-methods approach was used to develop and refine a conceptual framework, generate, refine and select items and initial testing of the items. Questionnaire con-tent was generated and refined via a focus group, expert panel meetings, cognitive interviews and an online survey with people with eczema/caregivers. Impact analysis and multivariable li-near regression were used for item selection. The distribution of scores and construct validity were assessed.Results: Fourteen expert panel members (including patients, caregivers, healthcare professionals and methodologists) co-produced the instrument; with input from people with eczema/caregivers via a focus group (n = 6), cognitive interviews (n = 13) and an online survey (n = 330). Recap of atopic eczema (RECAP) is a seven-item questionnaire with a self-reported and caregiver-reported version. Initial testing suggested no floor or ceiling effects and good construct validity. Positive correlation with the Patient-Oriented Eczema Measure (POEM) was confirmed (r(258)=0.83, p < 0.001).Conclusions: RECAP is appropriate and feasible for measuring eczema control in clinical trials. Testing of measurement properties and translation to other languages is ongoing. RECAP has been recommended for inclusion in the HOME core outcome set for clinical trials and the HOME clinical practice set.
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7.
  • Ofenloch, Robert F., et al. (författare)
  • Cross-Cultural Validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ)
  • 2017
  • Ingår i: Journal of Investigative Dermatology. - : Elsevier BV. - 0022-202X. ; 137:7, s. 1454-1460
  • Tidskriftsartikel (refereegranskat)abstract
    • The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is the only instrument assessing disease-specific health-related quality of life in patients with hand eczema. It is available in eight language versions. In this study we assessed if the items of different language versions of the QOLHEQ yield comparable values across countries. An international multicenter study was conducted with participating centers in Finland, Germany, Japan, The Netherlands, Sweden, and Turkey. Methods of item response theory were applied to each subscale to assess differential item functioning for items among countries. Overall, 662 hand eczema patients were recruited into the study. Single items were removed or split according to the item response theory model by country to resolve differential item functioning. After this adjustment, none of the four subscales of the QOLHEQ showed significant misfit to the item response theory model (P < 0.01), and a Person Separation Index of greater than 0.7 showed good internal consistency for each subscale. By adapting the scoring of the QOLHEQ using the methods of item response theory, it was possible to obtain QOLHEQ values that are comparable across countries. Cross-cultural variations in the interpretation of single items were resolved. The QOLHEQ is now ready to be used in international studies assessing the health-related quality of life impact of hand eczema.
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8.
  • Prinsen, Cecilia A C, et al. (författare)
  • Navigating the landscape of core outcome set development in dermatology.
  • 2019
  • Ingår i: The Journal of American Academy of Dermatology. - : Elsevier. - 0190-9622 .- 1097-6787. ; 81:1, s. 297-305
  • Tidskriftsartikel (refereegranskat)abstract
    • The development of core outcome sets (COSs; ie, a minimum set of core outcomes that should be measured and reported in all trials or in clinical practice for a specific condition) in dermatology is increasing in pace. A total of 44 dermatology-related COS projects have been registered in the online Core Outcome Measures in Effectiveness Trials database (http://www.comet-initiative.org/studies/search) and include studies on 26 different skin diseases. With the increasing number of COSs in dermatology, care is needed to ensure the delivery of high-quality COSs that meet quality standards when using state-of-the-art methods. In 2015, the Cochrane Skin-Core Outcome Set Initiative (CS-COUSIN) was established. CS-COUSIN is an international, multidisciplinary working group aiming to improve the development and implementation of COSs in dermatology. CS-COUSIN has developed guidance on how to develop high-quality COSs for skin diseases and supports dermatology-specific COS initiatives. Currently, 17 COS development groups are affiliated with CS-COUSIN and following standardized COS development processes. To ensure successful uptake of COSs in dermatology, researchers, clinicians, systematic reviewers, guideline developers, and other stakeholders should use existing COSs in their work.
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9.
  • Schmitt, Jochen, et al. (författare)
  • Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting
  • 2012
  • Ingår i: Allergy. - : Wiley. - 1398-9995 .- 0105-4538. ; 67:9, s. 1111-1117
  • Tidskriftsartikel (refereegranskat)abstract
    • The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research.
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10.
  • von Kobyletzki, Laura, et al. (författare)
  • Factors That Predict Remission of Infant Atopic Dermatitis: A Systematic Review.
  • 2015
  • Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 1651-2057 .- 0001-5555. ; 95:4, s. 389-394
  • Forskningsöversikt (refereegranskat)abstract
    • The individual prognosis of infants with atopic dermatitis (AD) is important for parents, healthcare professionals, and society. The aim of this study was to investigate predictors for remission of infant AD until school age. A systematic review was carried out of clinical and epidemiological studies investigating the effect of filaggrin gene (FLG) loss-of-function mutations, sex, exposure to pets, topical anti-inflammatory treatment, disease severity, and atopic sensitization during infancy on complete remission of infant-onset AD until 6-7 years of age. Systematic electronic searches until September 2013, data abstraction, and study quality assessment (Newcastle-Ottawa Scale) were performed. From 3316 abstracts identified, 2 studies of good study quality were included. Parental allergies and sex did not significantly affect remission. For non-remission of AD, the included articles reported an association with any atopic sensitization at 2 years old (adjusted odds ratio [aOR] 2.76; 95% confidence interval (CI) 1.29-5.91), frequent scratching with early AD (aOR 5.86; 95% CI 3.04-11.29), severity score at 2 years old (aOR 1.10; 95% CI 1.07-1.14), and exposure to pets (cat OR 2.33; 95% CI 0.85-6.38). It is largely unknown which factors predict remission of infant AD. This is a highly relevant research gap that hinders patient information on the prognosis of infant-onset AD.
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