Validity and reliability of the Rosacea Area and Severity Index: A novel scoring system for clinical assessment of rosacea severity.

BACKGROUND: Rosacea is a common chronic inflammatory facial skin disorder. Standardized evaluation of the severity and extent of rosacea is important for baseline assessment and treatment effect. The currently used Investigator's Global Assessment (IGA) is unspecific and fails to consider subtypes/phenotypes of rosacea and area involvement. The Rosacea Area and Severity Index (RASI) was developed to give a more nuanced evaluation of rosacea features in four facial skin areas adjusted to the relative importance of each area of the face to obtain an overall severity score. OBJECTIVES: To validate RASI against the IGA and to assess the inter- and intraobserver reliability for RASI. METHODS: Sixteen dermatologists evaluated photographs of 60 adult patients with rosacea (3 photographs per patient, one from the front and one from each side). IGA and RASI scores were performed for interobserver reliability assessment. To determine intraobserver reliability, 14 dermatologists evaluated 10 other patients twice with at least 1 week interval. RESULTS: The IGA and RASI correlated well (Spearman correlation coefficient (SCC) = 0.75, 95% confidence interval (CI) = 0.72-0.78). Interobserver reliability was moderate for RASI and poor to moderate for IGA. Reliability was strongest for rhinophyma, followed by papules/pustules and erythema, and rather weak for telangiectasia. For area scores, interobserver reliability was strongest for cheeks, followed by nose, chin and forehead. We found a moderate-to-strong intraobserver agreement both for IGA and RASI. CONCLUSIONS: We have designed a new practical tool to examine clinical severity of rosacea. RASI proved simple and reliable in scoring clinical severity of rosacea with an agreement comparable to the currently used IGA although RASI will provide a more nuanced view of the current rosacea extent and severity. We suggest that RASI is used in the daily clinical setting as well as in clinical studies assessing the efficacy of rosacea therapies.

The Within-Person Effect of Psychological Distress on Social Self-Efficacy: A Random Intercept Cross-Lagged Panel Model.

This study investigated the temporal relationship between social self-efficacy and psychological distress during 3 years in middle to late adolescence. The sample comprised 1508 participants (60.7% female; baseline mean age = 16.33, SD = .62; 52.9% high perceived family wealth; 70.6% born in Norway). We used a random intercept cross-lagged panel model to investigate the concurrent and subsequent associations between the two constructs. The results indicated (1) small to moderate and negative associations between the trait-like components and within-person fluctuations of social self-efficacy and psychological distress, (2) positive and significant carry-over stability effects on both constructs across time, and (3) that psychological distress predicted subsequent social self-efficacy more consistently across four time points, than social self-efficacy predicted later psychological distress.

Basic psychological need satisfaction in leisure activities and adolescents' life satisfaction.

Participation in leisure activities is an important arena for the positive psychological development of adolescents. The present study set out to examine the relationship between adolescents' satisfaction of the psychological needs for competence, relatedness, and autonomy in their participation in leisure activities and their perceived life satisfaction. The aim was to identify the extent to which satisfaction of the three needs explained the relationship between participation in leisure activities and life satisfaction. These proposed mechanisms were based on previous empirical work and the theoretical frameworks of self-determination theory, and were tested in a nationally representative sample of Norwegian adolescents (N = 3,273) aged 15 and 16 years (51.8 % boys). The structural equation analysis showed that competence and relatedness satisfaction fully mediated the association between participation in activities and life satisfaction. Autonomy satisfaction had a direct positive effect on life satisfaction but did not show any mediation effect. The positive processes of psychological need satisfaction, and especially the need for competence and relatedness, experienced in the leisure activity domain thus seem to be beneficial for adolescents' well-being. These findings add to previous research investigating the positive impact of need satisfaction in other important domains in the lives of children and adolescents.

Perceived support provided by teachers and classmates and students' self-reported academic initiative.

The aim of this study was to examine how perceived support provided by teachers and classmates in the school class environment related to students' academic initiative. Data were from a stratified sample of 13-year-old students (n=1591) from the Norwegian part of the World Health Organization's survey of Health Behaviour in School-aged Children (HBSC). Self-reported academic initiative varied across school classes with a difference (unexplained school class-level variance) of 12%. Perceived teacher support, defined as the provision of fairness and friendliness, varied substantially between classes. In two-level SEM analysis, a latent factor comprising pedagogical caring and autonomy support was substantially related to students' academic initiative at the class level. Perceived classmate support was significantly but moderately associated with academic initiative at the individual level.