Frontline Forum Part 1: Challenges and Opportunities to Enhance Psoriasis Management – Dermatology Times

As the understanding of psoriasis continues to evolve, the imperative of personalized care has gained prominence, reshaping the traditional paradigms of treatment. In the recentDermatology Timescustom video series Advancements in Psoriasis Care: Navigating Emerging Therapies and Guidelines, experts in the management of skin conditions discussed the latest developments in plaque psoriasis management. The panel discussion included Linda Stein Gold, MD, of Henry Ford Health in Detroit, Michigan; Mona Shahriari, MD, of Yale University School of Medicine in New Haven, Connecticut; Michael Cameron, MD, of Cameron Dermatology in New York, New York; Leon Kircik, MD, of Derm Research, PLLC, in Louisville, Kentucky; and George Han, MD, of Hofstra University in Hempstead, New York. The conversation shed light on the evolving paradigms, evidence-based approaches, and need for individualized care in managing thiscondition (Table).

Stein Gold emphasized the challenges posed by complex treatment regimens and said, The use of complex regimens with multiple topical agents can lead to lower adherence and less effective treatment. This sentiment underscores the critical need to streamline treatment approaches to enhance patient adherence and optimize treatment outcomes.

The panelists also highlighted the impact of treatment complexity on patient adherence, with Cameron noting, The more complex the regimen is, the lower the adherence, which means were less effectively [managing] the disease. This insight underscores the direct correlation between treatment complexity and patient adherence, emphasizing the need for streamlined andpatient-friendly regimens.

Furthermore, Shahriari said, Its really a matter of simplifying the treatment regimen. This sentiment underscores the need to reevaluate treatment approaches and streamline regimens to enhance patient adherence andtreatment efficacy.

In the realm of psoriasis management, the emergence of steroid phobia and evolving patient preferences has sparked critical discussions among health care professionals. Kircik highlighted the growing trend of steroid phobia among patients, stating, There is now this trend that nobody wants to be on steroids. This observation underscores the shifting attitudes toward steroid-based treatments and the impact on patient-provider discussions regarding treatment options.

The panelists also addressed the concerns surrounding patient preferences for nonsteroidal treatment options, with Stein Gold emphasizing the need to consider alternative therapies, stating, I think of steroids as a short-term solution to a long-term problem. Its really a Band-Aid. This sentiment underscores the evolving perspectives on steroid-based treatments and the need to explore nonsteroidal alternatives to address patient preferences and concerns. Additionally, Cameron provided insights into the prevalence of steroid phobia, saying, I find that [for] most of my patients, whether they [have] mild, moderate, or severe [disease], I dont want them using steroidslong term.

Psoriasis management guidelines serve as a critical resource, providing evidence-based recommendations for the management of psoriasis. Stein Gold addressed the limitations of current treatment guidelines and said, The problem is the guidelines are not for psoriasis. Theyre being done for atopic dermatitis right now. This observation sparked a conversation about the need for updated and comprehensive guidelines that align with the evolving landscape ofpsoriasis management.

The panelists also addressed the implications of treatment guidelines on patient care, with Kircik emphasizing the need for individualized treatment approaches, stating, We are looking for new topicals that are steroid freeor nonsteroidal.

Shahriari expressed the importance of defining disease severity in treatment guidelines and noted, I think we need to talk more about the definitions of mild, moderate, [and] severe psoriasis. This perspective highlights the need for clear and comprehensive definitions of disease severity to guide treatment approaches and optimize patient outcomes.

The panel noted that guidelines are often used against providers by attorneys and insurance companies and can be prescriptive rather than informative. The entire panel agreed that guidelines should be based on a review of the literature and provide a comprehensive overview of available treatments rather thanspecific recommendations.

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Frontline Forum Part 1: Challenges and Opportunities to Enhance Psoriasis Management - Dermatology Times

Don’t knock the economic value of majoring in the liberal arts | Brookings – Brookings Institution

For years, economists and more than a few worried parents have argued over whether a liberal arts degree is worth the price. The debate now seems to be over, and the answer is 'no.'

Can we please lighten up on knocking the value of a liberal arts education? With a recent spate of bad press for liberal arts departments on university campuses, many commentators conclude that the writing is on the wall. When it comes to economics, I argue the liberal arts still belong on college campuses: The liberal arts pay.

There are many reasons to be legitimately concerned about the direction the humanities and other liberal arts have taken in recent decades. Course enrollments and declared majors have plummeted across many disciplines since the pandemic, ranging from history to foreign language. This is the continuation of a decades-old pattern: According to the American Academy of Arts and Sciences Humanities Project, the share of humanities degrees out of all bachelors degrees peaked in 1967 at 17.2% and by 2018 had fallen to 4.4%.

Research universities also continue to turn out humanities doctorates for whom job prospects are bleak. Liberal arts colleges have been at risk for decades.

Despite arguments that a liberal arts education may be exactly the right preparation for a world in which routine tasks are taken over by AI, students are apparently not yet persuaded. Thus, humanities departments in colleges face very real budget pressures, including sometimes the risk of being eliminated. Indeed, West Virginia University is eliminating all foreign language degrees, and the University of Nebraska at Kearney has also proposed cutting its theater and philosophy programs.

I suspect that part of the political push to eliminate the humanities, especially from off-campus sources, is connected to the myth that the price of college has skyrocketed. In fact, the real price of college attendance has been falling modestly in recent years. Consequently, the share of undergraduates taking out student loans and the loan values are also down slightly.

Since Im an economist, in what follows Im going to stick to earnings numbers. But I also recognize there is more to a career than earnings. The American Academy of Arts and Sciences reports that responses to the statement I am deeply interested in the work I do are about the same for majors in the arts, humanities, engineering, and social sciences, although responses were a little higher in education and the natural sciences. And for a good reminder that careers are not all there is to life, see this article by a former poet laureate of Mississippi who writes, Students who master written and spoken communication can change the world.

Angst notwithstanding, here are two facts that are both true:

Heres a picture that illustrates why both are true.

Using data from the American Community Survey (ACS) collected between 2017 and 2021, Ive looked at graduates falling into one of four categories: education ended with a high school diploma, education ended with an associate degree, education ended with a bachelors degree in a liberal arts field, and education ended with a bachelors degree in a field other than liberal arts. Using the categories provided in the ACS, Ive defined liberal arts majors as Area, Ethnic, and Civilization Studies, Linguistics and Foreign Languages, English Language, Literature, and Composition, Liberal Arts and Humanities, Fine Arts, and History. Everything else Im categorizing as not liberal arts. The figure above gives average annual wage and salary income for each kind of degree. (The latest data is for 2021, so all the figures are in 2021 dollars. The sample is for ages 23 through 65. For a similar analysis with slightly older data but a broader listing of majors, see The College Payoff.)

For fact number one, compare the dark blue liberal arts bachelors bar to the orange bar for other majors. The latter is considerably higher. On average, people with a liberal arts degree earned only $50,000 a year while those with other degrees earned $65,000. Thats a big difference. (Median earnings are lower than average earnings of course, but the gap isnt much different$37,000 versus $50,000.)

For fact number two, compare the dark blue liberal arts bar to the light blue bar for those earning only a high school diploma. The liberal arts bar is much highergetting a liberal arts degree is a good investment compared to not going to college at all. On average, the liberal arts degree led to a $50,000 annual income compared to $28,000 for those stopping at the end of high school. (Median earnings are $37,000 versus $21,000 for high school only.) A $12,000 annual difference in earnings will, over a lifetime, more than pay for a college education. Suppose one worked for 35 years after graduation. The lifetime difference would be $420,000 (ignoring inflation). That way, way more than makes up the cost of tuition plus and foregone earnings from a student not working while in college. Unsurprisingly, pay associated with an associate degree falls in between what liberal arts bachelors degrees earn and what one gets with a high school diploma. Its worth noting that employment rates in the data also follow a similar pattern: strongest for non-liberal-arts bachelors holders (81.9%), followed by liberal arts bachelors holders (78.5%), then associate degree holders (77%), then high school graduates only (64.4%).

An important part of the story is that right out of college, liberal arts majors do not earn much more than high school graduates, though this understates earnings potential over the long term. Earnings for all college graduates rise rapidly after graduation and continue to rise for decades. In contrast, the age-earnings profile of high school graduates is relatively flat. One hidden advantage of majoring in non-STEM fields is that students learn general skills that last a lifetime, where the specific skills in more technical subjects often have a shorter shelf life and differences between majors eventually narrow later down the career path.

The picture above shows average earnings for holders of each credential across different survey respondents ages; this provides a plausible pathway for earnings over the course of ones career (though its possible nobodys career path looks exactly like this). At age 22, the liberal arts line is not much higher than either the high school or associate degree lines. But the liberal arts bachelors line rises very rapidlymuch more so than is true for either high school graduates or those whove earned an associate degree. You can also see that graduates with bachelors degrees outside the liberal arts do begin their careers earning noticeably more than either liberal arts majors or high school graduates, and the gap grows over time. For example, at age 50, the average earnings with a liberal arts degree are $67,000 a year. Thats not as good as a non-liberal arts degree at $81,000, but its quite a bit better than an associate degree at $49,000 or a high school diploma at $33,000.

One hopes that students go to college for more than just the financial value of the degreenot just for their own sake but also because society needs a citizenry equipped to think broadly. But that hope aside, liberal arts degrees do pay. They dont pay as well as other college degrees, but they do pay and policymakers need to be clear-eyed about that before running roughshod across humanities departments. The humanities are indeed in trouble, but its silly to say that a liberal arts degree is not worth the price.

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Don't knock the economic value of majoring in the liberal arts | Brookings - Brookings Institution