Acne vulgaris is considered one of the most common medical skin conditions globally, affecting approximately 85% of individuals worldwide. While acne is most prevalent among adolescents between 15 to 24 years old, it is not uncommon in adults either. Acne addresses a number of different challenges, causing a multidimensional disease burden. These challenges include clinical sequelae, such as post inflammatory hyperpigmentation (PIH) and the chance of developing lifelong disfiguring scars, psychological aspects such as deficits in health related quality of life, chronicity of acne, economic factors, and treatment-related issues, such as antimicrobial resistance. The multidimensionality of the disease burden stipulates the importance of an effective and timely treatment in a well organised care system. Within the Netherlands, acne care provision is managed by several types of professional care givers, each approaching acne care from different angles: (I) general practitioners (GPs) who serve as ‘gatekeepers’ of healthcare within primary care; (II) dermatologists providing specialist medical care within secondary care; (III) dermal therapists, a non-physician medical professional with a bachelor’s degree, exclusively operating within the Australian and Dutch primary and secondary health care; and (IV) beauticians, mainly working within the cosmetology or wellness domain. However, despite the large variety in acne care services, many patients experience a delay between the onset of acne and receiving an effective treatment, or a prolonged use of care, which raises the question whether acne related care resources are being used in the most effective and (cost)efficient way. It is therefore necessary to gain insights into the organization and quality of Dutch acne health care beyond conventional guidelines and protocols. Exploring areas of care that may need improvement allow Dutch acne healthcare services to develop and improve the quality of acne care services in harmony with patient needs.
1. We assessed the hypothesized negative correlation between the influence of multiple predators and body condition and fecundity of the European hare, from 13 areas in the Netherlands. 2. Year-round abundance of predators was estimated by hunters. We quantified predator influence as the sum of their field metabolic rates, as this sum reflects the daily food requirements of multiple individuals. We determined the ratio between body mass and hindfoot length of hares as an index of body condition and the weight of their adrenal gland as a measure of chronic exposure to stress, and we counted the number of placental scars to estimate fecundity of hares. 3. As hypothesized, we found that the sum of field metabolic rate of predators was negatively correlated with body condition and the number of placental scars, whereas it was positively related to the weight of the adrenal glands. In contrast to the sum of the field metabolic rate, the total number of predators did not or weakly affect the investigated risk responses. 4. The sum of the field metabolic rate can be a useful proxy for the influence of multiple predators and takes into account predator abundance, type, body weight, and food requirements of multiple predators. 5. With our findings, our paper contributes to a better understanding of the risk effects of multiple predators on prey fitness. Additionally, we identify a potential contributor to the decline of European hare populations.
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In Nederland krijgt één op de zeven vrouwen borstkanker. Paramedici, waaronder huidtherapeuten, krijgen te maken met vrouwen die last hebben van hun littekens na een borstoperatie. Welke klachten hebben deze vrouwen en hoe kunnen we ze verminderen of voorkomen?Doel We willen de effectiviteit onderzoeken van niet-chirurgische behandelingen bij het voorkomen en herstellen van littekens na borstoperaties. Het gaat hierbij om borstoperaties ten gevolge van borstkanker. Het doel hiervan is de kwaliteit van het litteken verbeteren en daarmee de levenskwaliteit van de vrouwen. Resultaten Dit onderzoek loopt nog. Na afronding vind je hier een samenvatting van de resultaten. Looptijd 01 december 2017 - 01 december 2021 Aanpak We hebben inmiddels 26 vrouwen geïnterviewd die een borstoperatie hebben gehad ten gevolge van borstkanker. We vroegen ze naar hun ervaringen met littekens na de borstoperatie. We onderzoeken hoeveel invloed de littekens hebben op hun kwaliteit van leven. In een tweede studie gebruiken we vragenlijsten om deze inzichten verder te onderzoeken. Tegelijkertijd voeren we een literatuuronderzoek uit naar mogelijke niet- chirurgische behandelingen om littekens te voorkomen of herstellen. Vervolgens ontwikkelen we een behandelprogramma en testen dit in de beroepspraktijk.
