Skin Distress Screening: Validation of an Efficient One-question Tool.

Skin diseases are often accompanied by physical, emotional and social problems, which may negatively impact health-related quality of life and result in skin-related distress. It is essential to identify patients with skin-related distress within the short time-window of an outpatient dermatological visit. Therefore the one-question screening tool, the Distress Thermometer adjusted for skin conditions, was validated in a cross-sectional questionnaire study. In 2 medical centres in Amsterdam, 214 patients with a chronic skin disease were invited to complete the Distress Thermometer and additional health-related quality of life questionnaires. To validate the Distress Thermometer, the Skindex29 was used as gold standard. To test test-retest reliability, the questionnaires were answered at 2 different time-points. Severely impaired health-related quality of life was present in 30% of respondents according to the Skindex29 using a cut-off score of 44. Receiver operating characteristic curve analyses yielded an area under the curve of 0.813 (standard error 0.04, 95% confidence interval 0.74-0.89). A cut-off score ≥ 4 on the Distress Thermometer provided the optimal ratio of sensitivity (90.7%) to specificity (56.1%). Therefore, for general practice, a cut-off score of ≥ 4 on the Distress Thermometer is advised. The Distress Thermometer seems to be a rapid, valid and reliable screening tool for identifying skin-related distress in patients with a chronic skin disease in the outpatient dermatology setting.

Peristomal Skin Itch: An Integrative Review.

Survey data from the United Stated, the United Kingdom, and the Netherlands indicate peristomal itch is prevalant among ostomy patients. Pruritus has a significant negative impact on health-related quality of life, resulting in discomfort and interrupted sleep. In ostomy patients, peristomal skin scratching also may interfere with adherence of the ostomy pouching system. This article reviews the classification and pathophysiology of itch in the peristomal skin, along with options for its management.

Stabilization of the obesity epidemic and increasing thinness in children in Caribbean Bonaire.

BACKGROUND: In 2008, the prevalence of overweight and obesity among children in Bonaire was twice as high as the prevalence in northern Europe but comparable to that of other Caribbean islands and the United States. The aim of this study was to examine change in the body mass index status of children in Bonaire and report children's energy balance-related behaviours (EBRB) in 2015. METHODS: Two school-based cross sectional surveys of children age 4-14 years were conducted in 2008 and 2015. Height (m) and weight (kg) were measured, body mass index (BMI) calculated and children's BMI categorised according to the International Obesity Task Force criteria. In 2015, children age 10-14 years completed a questionnaire on EBRB and responses were compared between non-overweight/obese children and overweight/obese children. RESULTS: In total 2117 children age 4-14 years participated (92.4% response rate). The prevalence of thinness significantly increased between 2008 and 2015 (adjusted OR 1.5 95% CI: 1.2-1.8). There were no other significant differences in children's weight status between survey years. One quarter of children (25.4%) were overweight/obese in 2015. There were no significant differences in EBRB between non-overweight/obese and overweight/obese children in 2015. Few children met recommendations for EBRB. CONCLUSIONS: The prevalence of overweight/obesity in children in Bonaire did not significantly change between 2008 and 2015 and remained high. However, the prevalence of thinness has significantly increased. Interventions to improve children's current EBRB are required.

Body image: a survey of children in Caribbean Bonaire.

BACKGROUND: In Bonaire, the prevalence of overweight and obesity is twice as high compared with Northern Europe but similar to other Caribbean Islands and the USA. Having a realistic body image may be an important tool in the battle against childhood obesity. Previous studies have demonstrated associations between having a realistic body image and efforts to control weight. The aim of the study was to explore the body image of children in Bonaire. METHODS: In a cross-sectional study from March to May 2015 in Bonaire, weight and height were measured in all children aged 10-14 years attending school. Body mass index (kg/m2) was classified according to the International Obesity Task Force. The children were asked about their body image using a validated questionnaire. RESULTS: Body mass index was measured in 939 of 1029 (91.3%) children aged 10-14 years (51.5% boys) in Bonaire. Of all children, 9.7% was underweight, 57.6% was normal weight, 32.7% was overweight (including obesity) and 11.6% was obese. The question pertaining to body image was completed by 750 of 939 (79.9%) children. Having a realistic perception of body image varied per weight category from 65% in underweight girls to 13% in obese boys. The percentage of obese children who underestimate their weight is high (boys 87%, girls 77%). CONCLUSIONS: In many children in Caribbean Bonaire, perceived body image is not in agreement with actual weight status. This applies especially to obese children. Disagreement between perceived body image and actual weight status may prevent weight management in overweight children. Future research is needed to elucidate determinants of disagreement between body image and actual weight status.