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Background:
Pruritus often accompanies chronic skin diseases, exerting considerable burden on many areas of patient functioning; this burden and the features of pruritus remain insufficiently characterized.
Objective:
To investigate characteristics, including localization patterns, and burden of pruritus in patients with chronic dermatoses.
Methods:
We recruited 800 patients with active chronic skin diseases. We assessed pruritus intensity, localization, and further characteristics. We used validated questionnaires to assess quality of life, work productivity and activity impairment, anxiety, depression, and sleep quality.
Results:
Nine out of every 10 patients had experienced pruritus throughout their disease and 73% in the last 7 days. Pruritus often affected the entire body and was not restricted to skin lesions. Patients with moderate to severe pruritus reported significantly more impairment to their sleep quality and work productivity, and they were more depressed and anxious than control individuals and patients with mild or no pruritus. Suicidal ideations were highly prevalent in patients with chronic pruritus (18.5%) and atopic dermatitis (11.8%).
Conclusions:
Pruritus prevalence and intensity are very high across all dermatoses studied; intensity is linked to impairment in many areas of daily functioning. Effective treatment strategies are urgently required to treat pruritus and the underlying skin disease. ( J Am Acad Dermatol 2021;84:691-700.)
Artificial light at night (ALAN), one form of human-induced rapid environmental change, is continuously spreading in space and time and increasing in intensity as part of the ongoing urbanization. A vast range of animals is known to be affected by ALAN as, among other things, it can mask natural light cues and change both the perceived as well as the actual predation risk. Since ALAN per se is restricted to the night, the majority of studies so far have focused on nocturnal species or behavioral changes during the night. How polyphasic species respond to ALAN has been largely overlooked, although they can possibly carry over effects of nighttime illumination into the day. Additionally, individuals within a species are known to consistently differ in their personality which includes risk-taking behavior. While this implies that ALAN can lead to varying anti-predatory responses in animals within a population, knowledge on this topic is still very limited. This thesis aims at investigating what initial behavioral reaction is caused by ALAN in polyphasic small mammals while also incorporating an animal’s personality. Nighttime and daytime activity, movement and foraging behavior of the bank vole (Myodes glareolus) were investigated in regards to effects of different light intensities and partial illumination in the laboratory. Additionally, changes in intra- and interspecific interactions of bank voles and striped field mice (Apodemus agrarius) subjected to ALAN were studied in experimental populations in semi-natural outdoor enclosures. Chapter I explores whether behavioral responses to ALAN of varying intensity are related to animal personality. Results showed that bank voles reduced movement and foraging already under dim light and that bold animals generally moved and foraged more than shy animals. Exclusively under bright illumination did bold animals exploit the food patches more than shy animals. The results demonstrate that bank voles are affected by light intensities prevalent in urban habitats. Additionally, certain light scenarios might lead to an advantage of and a shift towards certain personality types. Chapter II focusses on the effects of partial ALAN on foraging behavior of animals with varying animal personalities while extending the view towards possible carry-over effects of ALAN into the daytime. While bank voles reduced foraging behavior in illuminated areas at night, they increased foraging behavior in those areas at the subsequent day. Bold individuals generally had lower giving-up densities than shy individuals but this difference was especially pronounced during daytime at formerly illuminated food patches. Thus, ALAN can have carry-over effects into the daytime in polyphasic animals and thus has the potential to affect daytime intra- and interspecific interactions. Chapter III broadens the view from the individual to the population level. Experimental populations consisting of bank voles and striped field mice were established in large outdoor enclosures successively experienced natural and artificial light conditions at night. VHF telemetry data revealed that animals were predominantly active during the day under natural conditions. This difference between day and night vanished under ALAN. Additionally, conspecifics reduced home range overlap, proximity and activity synchrony while boldness was not associated with behavioral changed due to ALAN. The results suggest that ALAN has the potential to alter intraspecific interactions and thus can have fitness consequences on the population level. Overall, the present thesis shows that ALAN can affect nighttime and daytime behavior as well as intraspecific interactions of polyphasic small mammals. Differences in risk- taking behavior of individuals may vary in importance depending on other environmental variables. Thus, this thesis hopefully triggers broadening the view regarding the role of an animal’s personality in coping with ALAN and the effects on daytime behavior and diurnal species.