The impact on quality-of-life following treatment of surgical facial scars with laser-based therapy: a scoping review.

Post-surgical scarring impacts quality of life (QOL) and is a significant source of morbidity. Existing treatments targeted at improving the appearance and morbidity of scarring include laser-based therapies. Although lasers are frequently used to improve scar appearance, the effects on QOL are unclear. A scoping review was conducted to assess the impact of laser-based therapy for patients with surgical facial scarring on QOL. Throughout literature review was conducted with the guidance of a medical librarian. Relevant articles underwent two rounds of screening by two, independent reviewers. Data were extracted from each article and later analyzed. Of the four articles analyzed, laser-based therapies were demonstrated as effective in improving QOL for patients with facial scars resultant from surgical intervention. Laser-based therapy should be considered when treating facial scarring resultant from surgical intervention, as it has been shown to improve patient QOL. Standardization of QOL assessment and further studies expanding scar inclusion should be pursued given the paucity of information found through this review.

Representation of Fitzpatrick skin phototype in dermatology surgical textbooks.

Given the importance of skin of color (SoC) representation in dermatologic education and training, this study quantified representation of Fitzpatrick skin phototypes (FST) in core dermatology surgery textbooks. Images within Surgery of the Skin: Procedural Dermatology, Dermatologic Surgery, and Facial Reconstruction after Mohs Surgery were categorized according to the Fitzpatrick skin phototype (FST) depicted and the dermatologic surgery topic addressed. 1501 images were analyzed, with only 5.6% of the images categorized as FST IV-VI representing SoC. Several topics (11/29, 37.9%) identified did not include images with SoC. Increasing access to high-quality images of SoC can enhance appreciation of various skin conditions, especially those predominant in SoC, by dermatologic trainees and clinicians.

Skin of Color Representation in Clinical Trials: An Analysis of Clinicaltrials.gov From 2008-2022.

There is a plethora of dermatologic clinical trials; however, little is known regarding the representation of skin of color (SOC) populations. We evaluated the 15 most prevalent skin conditions in SOC patients and their representation in clinical trials over 14 years (2008-2022) to address the lack of research regarding dermatologic clinical trials and SOC inclusion. There have been 1,419 clinical trials conducted over the last 14 years regarding the 15 dermatologic conditions most commonly affecting SOC. Despite the prevalence of these conditions in SOC, Black/African American participation was greater than 50% in clinical trials for two conditions, keloids (77.9%) and seborrheic dermatitis (55.3%). Due to the disparities in inclusion, clinical trial data is difficult to extrapolate the results to SOC patients, limiting therapeutic options and potentially contributing to worse outcomes for such patients. Our study confirms that there is limited data available in clinical trials with respect to race, ethnicity, and FST. Further, it highlights how essential it is for SOC to be both adequately represented and reported in research regarding dermatologic skin conditions to ensure equality and equity in dermatologic care. J Drugs Dermatol. 2023;22(3) doi:10.36849/JDD.7087.

Physical Activity and Social Behaviors of Incarcerated Youth Participating in a Sport-Leadership Program.

Research illustrates that participation in physical activity is advantageous to overall health. Incarcerated populations are one subset that would benefit most from consistent engagement in physical activity, yet little is known about programs created to fulfill this need. The purpose of this study was to determine activity levels and social behaviors of incarcerated adolescent males during a structured sport-leadership program. Participants were 23 incarcerated males. The System for Observing Children's Activity and Relationships during Play was employed to evaluate activity and social behaviors. A major finding of this study demonstrated that incarcerated youth engaged in moderate to vigorous physical activity for a large portion of the sport-leadership programming time (50.6%). In this study, prosocial (11.7%) and antisocial (7.1%) interactions mirrored those observed in residential summer camps, on playgrounds, and during recess.

Exploring physical activity trends and lesson context of incarcerated youth in a sport-leadership program.

Incarcerated youth are one subset of the population in dire need of physical activity interventions. As inactivity within incarcerated populations has become a mounting public health concern, several sport-based physical activity and fitness programs within prisons have emerged. The purpose of this study is to explore physical activity levels and lesson context of a sport-leadership program in one juvenile detention center. Participants in this study were 27 incarcerated males (Mage = 19.3), imprisoned in one juvenile detention center. Participants participated in 20, 40-min sport-leadership lessons over the course of 3 months. Each lesson was live coded using the System for Observing Instructional Time (SOFIT) to examine physical activity levels and lesson context. Over the course of 20 lessons, participants engaged in moderate to vigorous physical activity (MVPA) for 61% of lesson time (24.5 min). Further, over 23% of lesson time was spent vigorously (9.5 min). Specific to lesson context, 18% of total lesson time (7.5 min) was spent in management whereas 7.96% (3.1 min) was consumed by knowledge acquisition. Furthermore, a vast majority of each session (70%) was spent in gameplay (28.04 min). This study is the first to adopt the SOFIT systematic observation instrument to evaluate and quantify MVPA and lesson context during a sport-leadership program within a juvenile detention center. Results from this study indicate incarcerated youth who participated in this program engaged in MVPA for more than 60% of lesson time. It was reported that overall MVPA of participants within programming slightly decreased across the 20 total lessons.

Undesignated Glucagon in Illinois: An Issue of Access and Equity.

School nurses must identify and advocate for change when student safety is at risk. Using a population-focused approach (one that addresses the needs of a whole group rather than an individual), one Illinois nurse successfully sought legislation to address the need for undesignated glucagon in all Illinois schools. This article will tell her story and describe the steps all school nurses can take to make a population-level change through legislative advocacy.

Students' Perceptions of Learning Life Skills Through the Teaching Personal and Social Responsibility Model: An Exploratory Study.

Purpose: Physical education (PE) lags behind community-based sport and physical activity programs in the integration of positive youth development (PYD) principles and practices such as teaching transferable life skills. However, research and educational policy indicates this can and should be part of the PE curriculum. Therefore, there is a significant need to explore students' perceptions and experiences about learning life skills within the PE context. In the current study, an intervention based in a wellestablished PYD approach called Teaching Personal and Social Responsibility (TPSR), was delivered to assess these issues. Methods: The current study was conducted in the mid-western U.S. Participants were 122 adolescent students (m = 60, f = 62; M = 12.48 years, SD = 0.97 years) in intervention and control classes. For the intervention, a PE teacher received training on the TPSR approach to promote life skills, while the control teacher received no training and participated in usual practices. Pre- and post-surveys were distributed that examined student perceptions about learning life skills, and supplemental systematic observations were recorded to capture the intervention teacher's fidelity to the TPSR model. Results: Results indicated that the intervention group students' perceptions of in-class experiences with life skills such as problem solving, emotional regulation, effort, goal setting, identity experiences, time management, and promoting social norms were enhanced overtime, compared to the control group. Conclusion: PE is in a unique position to promote PYD in the school curriculum by teaching of life skills. In this case, participants in the intervention group demonstrated learning personally and socially responsible behaviors across the course of 15 PE lessons. Future research should examine if changed in-class perceptions about life skills can foster use of these skills outside of the PE setting.

Analysis of the Long-term Visual Outcomes of ForeseeHome Remote Telemonitoring: The ALOFT Study.

PURPOSE: To evaluate long-term visual acuity (VA) and performance of a monitoring strategy with a self-operated artificial-intelligence-enabled home monitoring system in conjunction with standard care for early detection of neovascular age-related macular degeneration (nAMD). DESIGN: Retrospective review. SUBJECTS: Patients with dry-age-related macular degeneration from 5 referral clinics. METHODS: Clinical data of patients monitored with ForeseeHome (FSH) device from August 2010 to July 2020 were reviewed. MAIN OUTCOME MEASURES: Visual acuity at baseline, VA at diagnosis of nAMD for eyes that converted while monitored, and VA from the final study follow-up, weekly frequency of use, duration of monitoring, modality of conversion diagnosis (system alert vs. detection by other standard care means), and duration and number of treatments since conversion to final study follow-up were collected. RESULTS: We reviewed 3334 eyes of 2123 patients with a mean (standard deviation [SD]) age of 74(8) years, monitored for a mean (SD) duration of 3.1 (2.4) years, with a total of 1 706 433 tests in 10 474 eye-monitoring years. The mean (SD) weekly use per patient was 5.2 (3.4), and it was persistent over the usage period. Two hundred eighty-five eyes converted while monitored at an annual rate of 2.72% and were treated with a mean (SD) 17.3 (16.5) injections over a mean (SD) 2.7 (2.0) years, with 6.4 (3.1) injections per year for eyes treated for > 1 year. The median VAs at baseline and at final follow-up for eyes that did not convert were 20/27 and 20/34 with a median change of 0.0 letters. The median VAs at baseline, conversion, and final follow-up for eyes that converted during the monitoring period were 20/30, 20/39, and 20/32 with a median change from baseline to conversion, baseline to recent, and conversion to recent of -4, -4, and 0 letters, respectively. Fifty-two percent of conversions detected had a system alert before conversion. Forty-eight percent of patients were detected by symptoms or routine visit. Patients experienced a non-nAMD alert on average every 4.6 years. At conversion and at final follow-up, the proportion (95% CI) of eyes that maintained ≥ 20/40 was 84% (78% to 88%) and 82% (76% to 86%), respectively. CONCLUSIONS: Patients in the FSH monitoring program showed excellent long-term VA years after conversion to nAMD.

Research Brief: Physical Activity Trends Among Incarcerated Youth During a Sport Leadership Program.

Research indicates that engagement in physical activity is advantageous to adolescents' overall health. One subset of the population that is not provided with ample opportunities to be physically active includes incarcerated youth. To date, sport leadership programs have been designed to target this population; yet, little is known about physical activity opportunities for participants. The purpose of this study was to explore physical activity during a sport leadership program within a juvenile detention center. The participants were 27 incarcerated male youth (Mage = 18.7 years), all of whom participated in a sport leadership program. Physical activity was assessed during 32 sessions using Yamax DigiWalker SW 701 pedometers. Youth who participated in the sport leadership program accumulated an average of 3232 steps per session, with average standard deviation of 1245.5. As youth attended more sessions, overall physical activity levels during programming increased with a drastic reduction in variance among participants. This study is the first to closely examine and provide insights into youths' physical activity trends across programming and demonstrates a noticeable uptrend in activity and deceleration of variability among participants. Findings suggest that participation in a structured sport leadership program within juvenile detention centers can provide participants a critical opportunity to engage in physical activity.

Real-World Performance of a Self-Operated Home Monitoring System for Early Detection of Neovascular Age-Related Macular Degeneration.

The real-world performance of a home telemonitoring strategy (ForeseeHome AMD Monitoring System®, Notal Vision, Inc.,Manassas VA, USA) was evaluated and compared to the device arm of the AREDS2-HOME study among patients with intermediate AMD (iAMD) who converted to neovascular AMD (nAMD). All patients with confirmed conversion to nAMD who used the home monitoring system from 10/2009 through 9/2018 were identified by Notal Vision Diagnostic Clinic's medical records. Selected outcome variables were evaluated, including visual acuity (VA) at baseline and at conversion, and change in visual acuity (VA) from baseline to time of conversion. In total, 8991 patients performed 3,200,999 tests at a frequency of 5.6 ± 3.2 times/week. The 306 eyes that converted from iAMD to nAMD over the study period (a 2.7% annual rate) were included in the analyses. There was a median (interquartile range) change of -3.0 (0.0-(-10.0)) letters among converted eyes, 81% [95% confidence interval (72-88%)] maintained a VA ≥ 20/40 at the time of conversion, while 69% of the conversion detections were triggered by system alerts. The real-world performance of an at-home testing strategy was similar to that reported for the device arm of the AREDS2-HOME study. The home telemonitoring system can markedly increase early detection of conversion to nAMD.

Mere Nuisance or Growing Threat? The Physical and Economic Impact of High Tide Flooding on US Road Networks.

High tide flooding (HTF) already affects traffic in many US coastal areas, but the issue will worsen significantly in the future. While studies show that large storm surge events threaten to be ever more costly, less damaging, but more frequent HTF events remain understudied and potentially carry a comparable economic impact. This study advances our understanding of the risks and impacts of HTF on vulnerable traffic corridors using hourly tide gauge water levels, sea-level rise projections, and link-level spatial analysis. It is the first study to estimate HTF economic impacts for varying levels of intervention, including reasonably anticipated driver-initiated rerouting and ancillary protection of adjacent property. The 2020 annual national-level costs of $1.3 to $1.5 billion will increase to $28 to $37 billion in 2050 and $220 to $260 billion in 2100 for medium to high greenhouse gas (GHG) emissions scenarios, respectively. Total costs over the century are $1.0 to $1.3 trillion (discounted 3%). Additional cost-effective protection by building sea walls or raising road surfaces could significantly reduce 2100 costs to $61 to $78 billion, but there remain many barriers to adopting least-cost adaptation decisions, and these gains may only be realized with careful planning and information sharing.