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Daily Archives: October 20, 2019
Posted: October 20, 2019 at 10:40 pm
Recently in The Bulwark, I speculated that President Trumps betrayal of the Kurds would lead to much crazier things happening, or at least to much crazier things seeing the light of day, without responsible adults around to make everything look grown-up and professional.
That result was not long in coming. And yes, Im talking about Trumps crude, childish letter to Turkish strongman Recep Tayyip Erdogan, which had everybody asking whether it could possibly be real.
Lets be clear. Nobody was asking whether this was something Trump would write, because weve all seen his Twitter feed and we know that this sort of thing is his natural style of expression: Dont be a tough guy. Dont be a fool! I will call you later. Thats actually a bit more literate than his average tweet. What was a surprise is that this wasnt coming from his personal Twitter feed but was released by the U.S. government, that it was not scribbled in crayon but typed out neatly on White House stationery.
How did that happen?
* * *
Tom Nichols wonders about the letters we havent seen. But I have no doubt that this is what the first draft of every Trump letter has looked like, before the serious people come in and translate it to adult human. But now were getting Donald Trump unfiltered, as he is, with no help and no enablers. Why?
Maybe his aides had no choice. Maybe the president has finally reached the point at which he feels confident overriding all of his advisors. Maybe he has gotten away with so much and become so fed up at the sense that he is being handled that he has decided to write his own letters and make his own foreign policy without anybody elses involvement. Or maybe he has fired and driven away all of the serious people, so there is nobody left who is willing or even able to make the president look more serious. But the abruptness of the change raises another big possibility: maybe his aides and advisors have gone on strike.
Imagine this situation from the perspective of a highly qualified professional expert, the kind of person who is there to help the president make informed decisions, implement them smoothly, and communicate them in a sober way. Its your job to make sure the president always looks like he knows what hes doing, like he has the relevant facts available, and like he is able to speak to foreign leaders and to his own federal bureaucracy in a way that commands respect. Now imagine that the president has ignored and overridden you repeatedly, and this debacle with the Kurdsa vicious and impulsive decision, made against everybodys adviceis the last straw. Youre tired of the fact that the president never listens to you but does listen to random noisemakers on the Internet. You are ashamed that our allies are paying in blood for it. So at some point, youre going to get fed up, and youre going to stop even trying to make Trump look good.
Youre going to decide that if the president wants to write a letter that makes him sound like a not especially bright toddler, he can go ahead and do it. Youre going to lift up the curtain and let everybody see what he is really like.
* * *
Its not just the letter. There is Trumps shambles of a meeting with congressional leaders to discuss Syria, where he actually boasted about that letter to Erdogan.
Or there is his meeting with the parents of a young British man killed in a car accident by the wife of an American diplomat who fled back to America claiming diplomatic immunity. Trump expressed his sympathythen ambushed them with a harebrained reality-TV scheme to introduce them for the first time to their sons killer in front of a bank of cameras. He was supposed to look sympathetic and conciliatoryand just came across as that much more callous.
Where are the aides who could have nodded their heads gravely, then quietly killed this obviously bad idea? Has he fired them all, or have they simply given up?
* * *
A year ago, when an anonymous senior White House advisor confessed to the New York Times that he and others were only staying on to try to hold things together and repair the damage from Trumps worse impulses, I made an extended analogy to the plot of Ayn Rands Atlas Shrugged. This is partly because I have Atlas Shrugged on the brain a lot these daysbut bear with me, because the analogy is even more relevant now.
In Rands novel, the main character is a competent professional who spends her time cleaning up everybody elses messes and undoing their damage in a desperate attempt to save her familys company and the country from disaster. Its a good motive, but eventually she realizes that shes achieving the opposite of her goal. Every time she bails her brother and his political cronies out of a disaster, they have an excuse to stay in power. Shes helping them evade responsibility so they can keep making all the same stupid mistakes.
Shes not saving the country, as she thinks. Shes serving as an enabler for the people who are destroying it. So what does she eventually do? She goes on strike. She stops trying to solve their problems and clean up their messes. She lets them collapse under the weight of their own viciousness and incompetence.
Im guessing a few more people at the White House, maybe even the author of that anonymous op-ed, have reached this stage.
The point of going on strike is that you have decided that its time for everyone to know the worst and deal with it. You have decided that the short-term disaster of exposing the worst of Trump may be painful, but it will lead to a quicker recovery.
And we need to recover as quickly as possibility. When Erdogan got that letter from Trump, do you know what he did with it? He threw it in the trash. He knows by now that this is just empty bluster from an unserious leader. I shudder when I consider what Trumps successor is going to have to do to make other world leaders take the United States seriously again.
The sooner we start that process, the better.
Posted: at 10:40 pm
In the months leading up to the 2016 election, conservative writer and director Dinesh DSouza released his polemic Hillarys America, a documentary on the secret history of the Democratic party. While the film did well financially for a documentary (it was the top-grossing doc of 2016), it was almost universally panned by critics as blatant partisan propaganda stuffed with conspiracy theories. As the United States begins to head in another contentious election cycle, it appears that conservatives are again using movies to promote their policies. with R. J. Daniel Hannas film Miss Virginia, the result is a much more milquetoast affair.
Rather than go after a specific candidate, the topic of Hannas film is school vouchers essentially, a system of using public money to send kids to private schools. Its long been a pet cause for many American conservatives, with President Trump appointing voucher advocate Betsy DeVos to lead the Department of Education and even releasing a plan to expand the voucher system this year. With Miss Virginia, we now have a movie on this very subject, the first narrative film from Moving Pictures Institute (MPI), a production company funded in part by the Republican megadonor Mercer family (though MPI asserts that donors do not have control over film content).
Based on the story of Virginia Walden Ford, Miss Virginia is a fictionalized telling of the passing of the D.C. Opportunity Scholarship Program, a program championed by Walden Ford that provides publicly funded scholarships for low-income students in DC to attend privately owned schools. Set in 2003, the film follows Virginia Walden (Uzo Aduba, Orange is the New Black), a poor single mother whose son James (Niles Fitch) is struggling in his neighborhood school. After James is suspended for fighting, Virginia enrolls him in a private academy and takes on a cleaning job for DC Congresswoman Lorraine Townsend (Aunjanue Ellis) to help foot the bill.
James immediately begins to thrive in his new school but is forced to drop out when Virginia cant make enough to pay for tuition. At the end of her rope, Virginia upends one of Townsends townhalls, demanding to know why she cant get money to send her son to the private school. Virginia enlists the help of Congressman Cliff Williams (Matthew Modine) to help pass legislation providing a voucher program for DC residents. While Virginia is leading a grassroots movement, without the stimulation of private school, James begins to work for a local gang.
Ideology aside, Miss Virginia is a pretty by-the-numbers inspirational movie. Hanna presents the well-worn trappings of inner-city poverty: dilapidated public schools, gangs, and drug-addicted parents. We watch a single mother with a troubled child succeed despite the odds posed against them. Aduba brings a strong performance as Virginia, giving the character a wide emotional depth and presence on screen. Honestly, Aduba is too good of an actor for this movie. Virginia is presented too one-dimensionally as a righteous force, and it would have been compelling to see Aduba given the opportunity to bring more nuance to her character.
Through the latter acts of the film, we watch James fall into the gang life his mother is working so hard to give him the opportunities to avoid. When she discovers what her son has been up to, we only see Virginia react to his actions. There is no period of Virginia wondering how she could have not seen her sons struggles while she was wrapped up in her own cause, the type of scenario that would have given Aduba some true internal conflict to work with. As it was, the only personal struggle Virginia is given is a fear of public speaking, which she seems to overcome quite easily.
Ideology aside, Miss Virginia is a pretty by-the-numbers inspirational movie.
Consistent through the film is the idea that government just doesnt work. We watch Virginia be stymied by Townsends endless promise for a better tomorrow if we just give schools more money, and the bureaucracy of government. Ellis portrays Towsend as vengeful and power-hungry, the rights apotheosis of a big-city liberal politician. The film doesnt give Townsend an ideological reason to oppose school vouchers, only that it would be bad for her donor. This leads to one of the most ironic moments in the film, where Virginia decries someone speaking against the program in a meeting as a lobbyist as if a program that gives public funds to private companies wouldnt have lobbyists of its own.
In contrast to Townsends coldness, Modines Williams is an obnoxious politician who hates politicians conservative. Similar to how Townsend wasnt given a substantial reason to be against Virginias cause, Williams isnt given a reason to support it. He takes up the cause seemingly because he did something similar in Milwaukee and he likes to pass legislation. Its an odd omission that he doesnt have a monologue extolling the virtues of school vouchers. Rhetorically, it makes sense for Townsend to oppose the vouchers due to malice or personal gain, but it seems odd they dont have Williams explain why they are a good idea. Even if it would have made the political subtext even more apparent, it would have at least provided the character with an apparent motive.
This is to say nothing of the movies dicey treatment of race, with the story eventually evoking that creakiest of tropes: the white savior. The two primary antagonists for Virginia are women of color: Alongside Townsend, theres talk show host Sally Rae (Vanessa Williams), who brings Virginia on her show for a round of gotcha journalism in order to paint Virginia as Williams pawn.
While Virginia draws on support from the Black community in activism for the voucher program, there is an undercurrent of White paternalism from Williams being the one to actually get the legislation passed. When Virginia finds legislation drafted by Williams in Townsends trash, Townsend tells Virginia that Williams doesnt want people like us to do better. Similarly, when Virginia introduces Williams to her community, they wonder if he can represent people like us, and Williams assures them that, even despite his considerably higher amount of wealth and Ivy League education, he can. In the end, by pitting a White male politician against a Black female politician, it gives the air of old White guys will do whats best for you, trust us, especially by making Townsend seem so conniving.
The praise for, or vitriol against, Miss Virginia will inevitably be mostly based on the viewers feelings towards the films politics. This is no Atlas Shrugged: while far from spectacular, the filmmaking and script are of decent quality, and Adubas acting has enough pathos to pull you through Virginias journey. Moreover, by wearing its ideology so openly on its sleeve, the politics of the film will inevitably color the viewers appreciation of it.
Miss Virginia is currently available in theaters.
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Posted: at 10:37 pm
It's been nearly two months since Polish developer CD Projekt Red shared with us its latest vision for Cyberpunk 2077. A 15 minute slice of gameplay impressed many thanks to the employment of various play styles that allowed you to get the job done in different manners, but there was more to that quarter of an hour than meets the eye. Carefully pieced together to get some of its most important points across, the footage is actually three times as long when left uninterrupted. At EGX 2019 this past weekend, we watched that full 45 minute demo being played in real-time, and we came away more impressed than ever.
Kicking things off with a quick bit of character creation, you'll be able to choose between a male or female protagonist V, adjust their eye colour and facial characteristics, and then select a hairstyle from a limited amount along with its colour. But then you're on your way. A set of red pupils and various surface wiring seems to be about as creative as you can get, but with another six months to go before launch, let's hope this is a feature which is fleshed out at least a little bit more.
Back to the action and we're doing a job for Placide. After asking of his whereabouts throughout the rundown, law-free district of Pacifica, V tracks his location down to a Butcher's shop. Hidden in the back is a makeshift office and the choice of whether to trust him or not. Jacking in and allowing him access to your chip-set basically gives the suspicious character a killswitch, but since the job on offer is an essential one, it's a necessary evil you'll have to deal with. Of course, you can always deny his help in your own playthrough.
It's time to make our way to the Animal gang's hideout, which forms the crux of our next operation, but we'll need some transport to get us there in sufficient time. A motorbike nearby is the answer to that, which appears to be a complete joy to control. The playtester was able to gracefully weave their way between debris, the pavement, and other cars as a booming, original soundtrack played in the background. From the hip-hop station to the selection of dance tracks, there'll be something for every sort of musical taste.
You'll want to scout out the building before entering, though, because while going all guns blazing through the front door might be your first thought, it's probably also going to be your last. The demo finds a back entrance to sneak through, and thus begins the life of a Netrunner. Sticking to the shadows, the playstyle favours hacking and stealth above all else. When used in tandem, those two skills can produce some deadly, but silent, results: turn off security cameras to mask your presence, force an AI bot into overdrive so that it leaves an enemy with a bloody nose, or render a bench press so heavy that its user drops the weight onto their neck. They're grisly demises indeed, but then that's just the cogs of creativity at work.
Alternatively, with a Strong Solo build, you'll be able to bypass those encounters altogether by employing a high strength stat to rip a locked door off its hinges, thus getting you to the centrepiece of the action faster. You're definitely in the thick of it as soon as the gang is alerted, but with a turret nearby that's thirsting for blood, it becomes more of a deadly playground than anything else. The playtester grabs an enemy to form a human shield as they bridge the gap between protagonist and weaponry before ripping the turret from its very foundations and going to town on the rest of the Animals.
It is abundantly clear that Cyberpunk 2077 is going to let you play it however you want to. With a Life Path that helps to form your backstory, dialogue options are affected by your core stats, abilities and how much of an upgrade they're packing, and the relationship you hold with that particular character. On the other hand, combat can be as gritty and intense as you want. Complete the game without killing a soul, tear Night City apart by testing the limits of your ammunition stocks, or fall in-between the two extremes as you forge your own path through what looks set to be the next great PS4 RPG.
But it's not perfect. The 45 minute stretch of gameplay featured some incredibly rare, minor texture issues and two examples of NPCs T-posing as they went about their lives. It's something which highlights the fact that after its proper reveal back at E3 2018 and the aura that came with it, Cyberpunk 2077 is starting to look more and more like an actual video game and an incredibly impressive one at that.
How hyped are you for Cyberpunk 2077? Did you check out its 45 minute gameplay presentation at EGX 2019 too? Hack into the comments below.
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Posted: at 10:37 pm
With the sheer scope and the detail of its world, Cyberpunk 2077 is going to push current gaming tech to its limit. Between the open-ended gameplay and dynamic setting, CD Projekt Red believes the expansive sci-fi RPG will be something of a benchmark for this generation of games.
Speaking to AusGamers at PAX Australia,John Mamais, the head of CD Projekt Reds Krakow studio, discussed the ambition of Cyberpunk 2077, saying the team had to rapidly expand to keep up. We grew alongside the design as it was developing. And really, you dont know how many cinematic animators youre going to need until you have a scope for the number of scenes youre going to have in the game, He said. We didnt have that in the beginning, we just knew we wanted to have cool cinematics and we knew that we were going to be at least as big as The Witcher 3. We ended up hiring a lot more people than what we needed for The Witcher because the fidelity and overall requirements of 2077 crept up on us.
Mamais went on to talk about the technological challenges of Cyberpunk 2077, mentioning that CD Projekt is still knee-deep in the process. You need crowds of people moving around or it wont look right. It was very technically challenging, and still is. Were still working on it in fact, He explained. Last time I talked to the Technical Director, he talked its current status as a real achievement, where weve got all these people in the same space moving around. In Cyberpunk these are all, in a way, unique characters moving around the space. And its a combination of AI, tech, and art. I dont know even know how to explain how it exactly works but I can say that it was fucking hard and that were still working on it.
In other interviews, Mamais has talked quite a bit about the studios current standing. CD Projekt will soon have enough staff to work on two games at once, opening up the possibility of multiplayer-only projects, and hes doubled-down on the teams flat rejection of micro-transactions.
For Cyberpunk 2077, Mamais believes CD Projekt hascultivated the last word on what this generation is capable of. As the technology changes, were expected to use it too and we want to use it cause that stuff keeps looking cooler and cooler, all the time, He said. Well always keep pushing the envelope on the way a game can look, and thats one of the most exciting things about working at CD Projekt Red; getting to do just that. I think Cyberpunk is going to be a real show piece in terms of tech. Especially as this generation of consoles is fading out. I think were going to be that one last, big, exceptional looking title on this current generation of hardware.
Cyberpunk 2077 will beavailable April 16, 2020.
Posted: at 10:36 pm
By the time Mary Elizabeth Bretz was 15, her mother, Christina, thought shed exhausted treatment options for her eczema. We tried everything thats on the counter and more, Christina says. We would go to the doctor constantly with her flare-ups, and they would prescribe a steroidal cream and say it may work, it may not. She says if it did work, it would only work for a short time, leaving them back at square one.
Mary Elizabeth, now 16, had her first flare-up with atopic dermatitis (a term used interchangeably with eczema) at 6 months old, and the symptoms exacerbated when she was in seventh grade. She felt the effects both physically, in the form of cuts and blisters on her skin, and emotionally. It caused me to be very self-conscious, and people would make fun of me, Mary Elizabeth says.
Christina adds that Mary Elizabeth had anxiety and depression because of her physical features. Christina noticed her daughters grades slipping, and she says Mary Elizabeth had trouble concentrating in school and on the soccer field because she was scratching her skin constantly. Soccer was taken away from me because I was in constant pain, Mary Elizabeth says. Sweating hurt so bad.
RELATED: Eczema Triggers and How to Target Them
Thats when Mary Elizabeths dermatologist suggested traveling from their home in Lexington, Kentucky, to Denver, for an intensive two-week wet wrap therapy program.
Photo Courtesy of National Jewish Health and Mary Elizabeth Bretz
Wet wrap therapy is a treatment option for intense eczema flares that are accompanied by itching or pain. Wet wraps work for moderate to severe atopic dermatitis, says Kanwaljit Brar, MD, a pediatric allergist and immunologist at National Jewish Health in Denver, where Mary Elizabeth received her treatment. (Dr. Brar didnt treat her, however.) The therapy isnt designed for mild cases. Its considered a rescue therapy, so its something we do to rescue the skin, Brar says. I like to think of it as a skin reset.
The therapy involves wrapping the affected areas of skin with damp fabric, either for a couple of hours during the day or overnight, which Brar says is the most effective and the most convenient for busy families. The therapy is generally used for a couple of days, according to Seattle Childrens, though Brar says it could be used for up to two weeks for severe cases.
During the first week of Mary Elizabeths visit to National Jewish Health, the wet wraps were applied for two hours in the morning, two hours in the afternoon, and overnight.
RELATED: A Detailed Guide to Eczema Treatment
The goal of the treatment, according to the National Eczema Association, is to rehydrate the skin and make medications soak in more effectively. Brar says it helps restore the skin barrier, reduces water loss, helps heal the abrasions and crusty areas on the skin, and can treat inflammation if the skin is infected. It also serves as a physical barrier, so by covering the area, it can prevent scratching as well, she says.
Wet wrap therapy is often used on children, which parents can administer at home, but it can work for adults, too. Its just a little more cumbersome given the larger bodies and bigger surface area to treat, Brar says.
Essentially, youll apply medication or moisturizer to the affected areas and then wrap the body (or part of the body) with a damp layer followed by a dry layer.
Heres how a full body wet wrap is done, per Seattle Childrens, the National Eczema Association, and Brar:
Wearing the wet clothes can be uncomfortable Mary Elizabeth recalls feeling freezing cold and wet so Brar recommends putting blankets straight out of the dryer on top of the patient for extra warmth.
You can also apply the wet wrap to just the affected areas, say the knees. Brar says in that case, cut the foot off of long socks and use those tubes as the wet layer. Or, if the eczema is on the face, a nurse can help apply a wrap made of gauze and surgical netting, according to National Jewish Health. Brar says to be careful when applying a face wrap to children especially overnight and during naptime because it could shift and end up blocking their nose or mouth.
Mary Elizabeths skin improved dramatically the first night of the therapy. It helped so much within 24 hours, she says. I woke up and it felt tremendously better.
The results will vary from patient to patient, but astudy published in the JulyAugust 2014 issue of The Journal of Allergy and Clinical Immunologyfound the benefits of wet wrap therapy continued one month after treatment ended.
RELATED: Can Essential Oils Help Eczema or Atopic Dermatitis?
The same study noted that in practice, wet wrap therapy is a safe intervention treatment. If youre unsure of how to go about it or want more guidance, speak with a doctor first.
As Mary Elizabeth knows, wearing wet clothes can induce chilling. That was the only side effect noted in aprevious study, though Mary Elizabeth says it was still worth it.
A more serious side effect is the potential increased risk of infection. Areview published in November 2016 in The British Journal of Dermatologyfound a higher incidence of mild skin infections following wet wrap therapy. And astudy published in May 2015 in Acta Dermato-Venereologica found infections were more frequent when corticosteroids were used on the skin rather than moisturizers. Thats a catch, though, because the researchers found using wet wrap therapy with corticosteroids is more effective, so its important to keep a lookout for signs of infection. The researchers found the most common infection was folliculitis, which will look like white-head pimples or red bumps around hair follicles, accordingto the Mayo Clinic.
RELATED: Do You Need a Topical Steroid to Help Control Your Eczema?
Since Mary Elizabeth returned home after that two-week visit to National Jewish Health last November, she hasnt experienced any flare-ups and hasnt needed wet wrap therapy since. Christina now helps administer Dupixent (dupilumab), a biologic medication approved by the U.S. Food and Drug Administration (FDA), twice a month, which has helped keep her daughters symptoms under control.
Mary Elizabeth is no longer scratching her skin continuously throughout the day. I really feel the wet wrap therapy brought her to a level where she could concentrate and she could function like a normal person, Christina says, adding that Mary Elizabeths overall well-being improved and her grades have, too. Teachers noticed, myself and my husband noticed, and she noticed that she was able to concentrate more and the improvement was definitely there in all areas of her life.
Mary Elizabeth has regained self-confidence, too. [My boyfriend] told me when I came back from Denver that he knew I was a changed person because I was just happy in my skin.
Posted: at 10:36 pm
Purple and orange are the colors for Eczema Awareness Month.
The symptoms of eczema, commonly known as atopic dermatitis, can be so visible and intense that people living with this skin condition are constantly aware of them. It isnt just the symptoms the incessant itching, the redness, and the inflammation its the sleepless nights, its the depression and anxiety, explains Julie Block, president and CEO of the National Eczema Association (NEA). Its the truth that for many with moderate to severe disease, every waking moment is a decision based on how their skin is.
October is the month when organizations in the United States such as theNEA and the Asthma and Allergy Foundation of America (AAFA) spread awareness about eczema, its causes, the stigma attached to it, and new developments for relieving symptoms. This is especially important because the disease is prevalent in the United States, affecting 9.6 million individuals younger than 18 as well as 16.5 million adults. (1)
What they are grappling with is a chronic, inflammatory skin condition linked to an overreactive immune system. (2,3) Symptoms include skin that is dry, inflamed, itchy, rashy, scaly, or oozing clear fluid when scratched (a symptom called weepy skin). Triggers for flare-ups can be dry skin, allergens such as pet dander or seasonal pollen,chemical irritants such as laundry detergents or scented soaps,stress,hormonal changes,or infections. (3) Eczema may disappear as a child grows older or continue into adulthood. (4)
Most people with mild symptoms can manage eczema with over-the-counter products, says Block. Yet those who have moderate to severe symptoms can feel worn down by the continual need to avoid triggers or the negative reactions that others may have to visible signs of eczema. Take scaly skin, for example. Some people describe their eczema by saying, Im allergic to life, says Block. The isolation that some people feel is kind of numbing.
In fact, a review published in December 2018 in JAMA Dermatology found that people with eczema are 44 percent more likely to have suicidal thoughts and 36 percent more likely to attempt suicide than those who do not have eczema. The study authors write that contributing factors may be severe symptoms such as pruritus (the urge to scratch), pain, burning, and sleep loss, as well as stigma and feelings of shame. (5)
That is why theNEA has launched the #TheRealEczema campaign for Eczema Awareness Month 2019, whose colors are orange and purple. They are asking people with eczema to share their stories on social media using the hashtag,raise funds for research, and register for theNEA's webinar"The Cure," which took place on October 16.
The best way for people to advocate is to share their truth, says Block.
Also, theNEA is promoting the Understanding AD campaign, which follows the life of a 17-year-old with atopic dermatitis and shows his support network in managing the disease. The biotechnology company Regeneron Pharmaceuticals funds the video series, along withdrugmaker Sanofi. It's the maker of Dupixent (dupilumab), an injectable medication for moderate to severe cases that disrupts the immune systems overreaction to atopic dermatitis triggers.
Meanwhile, the AAFA has launched the #ADinAmerica awareness campaign, encouraging people to share facts about the disease all month through social media.
Use the information below to learn more about Eczema Awareness Month activities, how you can use your voice to fight stigma and advocate for better treatments, where you can find morale-boosting support for managing the disease, and how you can donate toward research or even participate in studies related to eczema.
Fragrances found in baby wipes and ‘slime’ among most common causes of skin allergies – Sydney Morning Herald
Posted: at 10:36 pm
They analysed patch-test data dating from 1993 to 2017 from two tertiary referral patch-testing centres including the results of 511 children who presented with suspected skin allergies.
Of those, more than half had a positive patch-test, and 65.8 per cent of those (38 per cent of the total) had a positive patch-test deemed relevant as an allergic reaction to a substance they had been exposed to.
The five most common relevant patch-test reactions were to fragrance mix (a mixture of eight individual fragrances commonly found in perfumes, cosmetics, laundry products and toothpaste), a group of preservatives (MCI/MI and MI) commonly used in wet wipes, liquid soaps, shampoos, cosmetics and toy 'slime', the plant resin colophonium (which commonly causes reactions to adhesive dressings), another fragrance (myroxylon pereriae) found in cosmetics and food, and nickel sulphate.
The study's lead author Claire Felmingham said MI and MCI/MI are particularly "potent allergens" that have been described as causing an "epidemic" of allergic contact dermatitis in adults and should be generally avoided even without a diagnosed allergy.
Dr Felmingham said the preservatives are being gradually removed from a lot of products, but that given their presence in baby wipes and 'slime', "its not surprising that theyve also affected the paediatric population".
While the study found very few children under five had been patch-tested, among the 6-10 age group, fragrance and colophonium were the most common allergens. Fragrance and nickel sulphate were the most common allergens in the 1117 age group.
Nickel sulphate allergies were more common among girls, which the authors said is consistent with existing literature and likely due to the "increased use of jewellery in females", particularly ear piercings.
Armed with evidence of the most common allergens affecting children, the researchers have proposed the first Australian Paediatric Baseline Series comprising 30 common allergens and potential allergens for patch-testing.
While patch-testing is "the gold standard" for diagnosing allergic contact dermatitis (ACD), it "appears to be performed infrequently in children, and consequently, ACD is likely underdiagnosed," the authors said.
"This is unfortunate because ACD can have a significant impact on a childs quality of life, andearly, correct, identification of allergens and subsequent avoidance can lead to substantial improvement in symptoms, preventing progression to a chronic disease state," the study found.
Dr Felmingham said parents should consider patch-testing their children if they have persistent eczema that isn't responding to treatment, as well as keeping an eye on product labels for ingredients that commonly cause allergies.
Jenny Noyes is a journalist at the Sydney Morning Herald. She was previously a writer and editor at Daily Life.
Posted: at 10:36 pm
When the patient was dressed, Iammatteo returned to the examination room. She didnt think this was an allergy, she told him. But it could be a parasite. She thought it was more likely toxocara, given his recent exposures to dogs and cats. Toxocara is a type of parasite called a nematode or roundworm. It lives in the gastrointestinal tract of dogs and cats. Until the end of the 20th century, visceral toxocariasis could be diagnosed only by the symptoms it caused when it invaded the organs of the body the liver, the lungs, the brain or the eyes. These were serious infections causing everything from wheezing and shortness of breath to blindness or, rarely, death. It wasnt until a diagnostic blood test was developed that other manifestations of the disease were identified. In whats called common toxocariasis, patients have gastrointestinal symptoms as well as an itchy rash. In covert toxocariasis, the only symptom is an itchy rash. These infections often resolve on their own over time, but they can also be treated with a medicine. This patient could have covert toxocariasis.
Iammatteo said she would test for both toxocariasis and strongyloidiasis. She would also refer him to a hematologist to look for a malignancy or other trigger that might have caused his overproliferation of white blood cells. There were other causes of his rash and eosinophilia, but these were the most likely and a good place to start.
A few days later, she got a possible answer and called the patient. You probably have toxocariasis, she told him. The blood test came back positive, but she explained there was a caveat. The test measures whether the immune system has responded to this particular parasite ever. The fact that it was positive meant that the patient had been exposed to the parasite, but it couldnt determine when the exposure occurred. Toxocara infections are most common in children. But the test will still be positive even if the infection is long gone. The only way to know for certain that the toxocara was causing the itch, she told him, was to treat him and see how he responded. She referred him to an infectious-disease doctor who prescribed the recommended five days of Albendazole.
Because he couldnt know for sure if this was the right diagnosis, the patient kept his appointment with the hematologist. That doctor sent off more blood to look for signs that the overabundance of these cells could be caused by an eosinophil gone wild.
But well before those tests results came back negative, the patient felt that he had his answer. Within days of completing his treatment with Albendazole, the itching resolved. And by the time he went back to see Iammatteo two weeks later, even the rash had mostly disappeared.
Why had Iammatteo been able to figure this out when other doctors couldnt? the patient asked when he saw her for a follow-up visit. She explained that shed gone to Albert Einstein College of Medicine in the Bronx, and one professor there was an expert in parasitology. She took her class, and what she learned stuck with her. Different medical schools have different strengths, she told me later. Parasites were one of theirs.
And, she added, doctors are taught that toxocara infection is rare. But now shes not so sure. Since making this patients diagnosis last spring, she told me she has diagnosed nearly a dozen cases of toxocariasis in patients whom she might not have thought to test for the parasite if not for this older man and his rash. I know Ive been successfully diagnosing more of it because its on my mind.
Meet the Northern Ireland people battling eczema who are finally comfortable in their own skin – Belfast Telegraph
Posted: at 10:36 pm
Eczema can be painful and debilitating. Leona ONeill meets three NI families who have learnt how to live with the condition.
Eczema also known as dermatitis is a dry skin condition that can come in many different forms. In mild cases, the skin is dry, scaly, red and itchy while in more severe cases, there may be weeping, crusting and bleeding.
Constant scratching causes the skin to split and bleed and also leaves it open to infection. At its worst, the condition can be very painful.
Dermatitis affects people of all ages but is primarily seen in children one in five children and one in 12 adults live with eczema.
Three Northern Ireland women tell us about their familys experiences and how theyve learned to cope with the condition
Myrtle Johnston, from Belfast, represents the NI Support Network for the National Eczema Society. She joined the society after her son and daughter were both diagnosed with the condition. She says:
I got involved in the National Eczema Society 40 years ago when both my son and daughter had the condition.
My son had it when he was a baby and throughout his school years. My daughter developed it a bit later.
There are people who have experiences that are a lot worse than ours, and I just hope they know they can talk to people about it.
What people dont realise is how eczema can affect a whole family. Children do suffer badly, meaning their parents do, too.
Some children have it really quite bad on their face and I know another mother who was taking off her sons socks and the skin just came off with it.
There are some really heart-breaking stories where people have had to think about giving up their career and lots of other things.
Eczema wont kill you, but it is very disabling.
East Belfast mum Michelle Laverty (48) says her son Henrys eczema left him feeling itchy and uncomfortable and was starting to impact on his confidence, before she found something that worked for him. She says:
My son Henry has eczema on his upper arms. He has had it from he was a little baby and it really came out as he started getting older.
It seems that it had something to do with him getting ready in the morning. The stuff I was using on his hair was coming down over his upper arms and that was causing his eczema.
It had never even occurred to me that could happen. He had raised red spots and it was so itchy and uncomfortable for him.
He would have scratched himself and it looked so red and awful.
Eczema does not have a nice appearance and it really affected his confidence. He was lucky in a way because it was on his upper arms, so it was quite covered most of the time.
I mentioned it to one of the girls in my office and she suggested Elave cream, which she said worked for her child.
Obviously eczema is a huge thing for children and it affects so many.
So, I got the shampoo and the shower gel and within about 10 days it was significantly better. It worked really well.
I nipped it in the bud before it got any worse, because I know how bad some children can suffer with eczema.
Mum-of-three Angela Morgan (42), from Belfast says her daughter Evies (5) eczema was so bad there would be blood on her bed clothes. The Four Winds beauty salon owner says she felt helpless about the condition until she found something that worked for her little girl. She says:
My youngest daughter Evie has eczema, asthma and allergies.
She has had all of those from birth. Since she was very small her skin would be itchy and red, particularly in between the creases of her arms and legs. Then it spread. Her face would be totally broken out. Around her cheeks, the skin was raw and would get quite infected, particularly when she was teething.
It was really hard to manage. She was on all types of creams and antibiotics and steroids. We tried everything but nothing worked.
They thought initially that it was baby eczema, but as she started getting older, nearing a year old, we realised that the likes of strawberries, bananas and tomatoes would have set her skin off.
So by the time she got that little bit older, it was very much tied to food as well.
At its worst, during a really bad flare-up, it would appear all over her.
I remember one day when she was very young, taking her into a cafe before a doctors appointment and people were staring at her because her face was so raw.
She would have just scratched herself until she bled.
Angela says that she tried every cream on the market as well as everything the doctor prescribed, to no avail.
Any time her skin looked in any way dry at all, we plastered her in cream, she says.
She would have scratched herself in the middle of the night, so there would be blood on the bed clothes in the morning. And I felt terrible because there was nothing I could do about it.
The doctors were giving me cream after cream, hoping that something was going to work. And with Evie being so young, I didnt want to resort to antibiotics all the time.
It was a constant battle trying to get to it before it got to the stage where she needed antibiotics.
Evie also lives with asthma and severe allergies, associated with her eczema.
Evie would take an anaphylactic reaction to nuts, pulses, legumes, kiwi and eggs, says Angela.
We knew that she was sensitive to certain things. But at that stage, she hadnt been tested for anything. I just didnt give her any nuts, because I assumed that it probably wouldnt be a good idea.
But I came home one day, and Evie was coughing while sitting on the sofa. I asked my husband how long she had been doing that and he said around half an hour.
I could see her skin also starting to break out, so I picked her up and took her around to the chemist.
They gave her some Periton and told me to take her to the hospital.
She had eaten a peanut M&M and that was the start of it. She had an overnight stay there.
Then, a few weeks later, she had a mouthful of vegetable soup which had lentils in it. And it was the same again her face and lips swelled, and we had to go straight to the hospital where she got adrenaline and all sorts of things.
We have had a few dramas.
We had an issue where someone gave her peanut butter recently and I had to give her the EpiPen and take her to the hospital.
Because Evie is that little bit older, she is more aware of it and has become more vigilant about what she eats now. We dont have anything that could harm her at home and her school were very good they are nut-free. But we have to be very careful and carry an EpiPen and Periton around with us everywhere, just in case.
When she was three years old, we discovered that she was asthmatic as well. She takes inhalers now also.
Angela says that she finally found her miracle cream in the form of Elave skincare.
All the stuff that we got from the doctor just didnt work, she says.
And then I heard about the Elave products and started using them on Evies skin. Her skin has been amazing since.
For the majority of the year as the change in the weather can flare her up she has been really good.
We just keep the cream on the spots that are more likely to flare up.
I use the whole range; the bath wash, the shampoo and the cream with Evie. Using all three works a treat.
I love it because it is a totally natural product, there is nothing harsh in it that can harm her skin. The condition is so easily triggered.
For something as simple as this product is, to be so effective, has been amazing and is working really well for her.
The National Eczema Society confidential telephone and email Helpline provides information, support and reassurance to people struggling to cope with eczema. You can contact the helpline on 0800 089 1122. Myrtle Johnston is also available through the helpline if you want to make contact with support from Northern Ireland
The Gardiner family history of creating skin care products goes back to 1934 when Joseph Gardiner created the first Family Apothecary in Ireland.
Their expertise in making traditional Ovelle apothecary products like Silcocks Base, Aqueous Cream and Emulsifying Ointment allowed them to draw on dermatological advances in skincare to create the now multi-award winning Elave skincare headed up by Josephs granddaughter Joanna which helps prevent flare up of sensitive including eczema, dermatitis and rosacea prone skin.
Their promise of absolute purity means no sulfates SLES/SLS, no parabens, no perfume, no formaldehyde, no methylisothiazolinone (MI), no alcohol, no soap, no colours and more. Elave sensitive skincare has been awarded cruelty-free status by PETA and is also vegan friendly.
Their products are available in most pharmacies and online at http://www.elave.myshopify.com/
ANN & ROBERT H. LURIE CHILDREN’S HOSPITAL OF CHICAGO: Painless Tape Strips Used to Detect Molecular Changes in Skin of Children with Eczema -…
Posted: at 10:36 pm
Ann & Robert H. Lurie Children's Hospital of Chicago issued the following announcement on Oct. 16.
In a study using non-invasive tape strips in young children with eczema (or atopic dermatitis), researchers found many molecular signs of immune dysfunction and skin changes that relate to disease activity. These signs (or biomarkers) were present even before eczema was visible and can be used to track disease activity over time. With more research, these biomarkers also may help predict response to medicine and development of conditions associated with eczema, such as asthma, other allergies, infections and even attention deficit hyperactivity disorder (ADHD). Findings were published in JAMA Dermatology
Our study was the most comprehensive to date to demonstrate that tape strips can be used in infants and young children instead of painful biopsies to assess early-onset atopic dermatitis on the molecular level, says senior author Amy Paller, MD, from Ann & Robert H. Lurie Childrens Hospital of Chicago, who also is Chair of Dermatology and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. We found the highest number of atopic dermatitis biomarkers, including new ones, that might be predictors of treatment response, disease progression, and development of comorbid conditions.
Atopic dermatitis is a long-lasting, inflammatory, extremely itchy skin disorder that affects 10-20 percent of children in the United States. Currently, molecular profiling of skin biopsies is the gold standard for evaluating atopic dermatitis.
In young children, skin biopsies are virtually impossible to perform, even in research, since they are painful and leave scars, says Dr. Paller. This reinforced our desire to find a way to evaluate these kids that did not hurt at all.
The study included 51 children younger than 5 years, with 21 children who had moderate to severe atopic dermatitis that had its onset less than six months previously. Tape strips were collected from the skin with and without lesions in the children who had atopic dermatitis, as well as from the normal skin of children who did not have the condition. Researchers evaluated gene expression of 77 biomarkers of immune dysfunction and skin barrier changes (97 percent of biomarkers assessed) in children with atopic dermatitis.
Our findings pave the way for more routine use of tape strips in pediatric longitudinal research and clinical trials for atopic dermatitis, says Dr. Paller. Eventually, we hope this technology will become commercially available for use in the clinic.
Original source can be found here.