Background Currently, few studies investigated the economic burden of atopic dermatitis (AD) in adult patients and specifically the estimation of out-of-pocket costs. Patients with skin disorders primarily use comfort care to ease dryness, itch or pain, and the costs of comfort care are not subject to any reimbursement from mandatory or complementary insurance.Objective The purpose of this study was to measure the medical and non-medical expenses paid by the patient.Methods Eczema Cohort Longitudinal Adults was a non-interventional study that aimed to assess the burden of AD in terms of quality of life and financial consequences. A self-assessment questionnaire was distributed to adult patients who were cared in four French hospitals. Patients were asked to list the resources consumed for the treatment of AD during the last 12 months and to estimate the corresponding amount of money they had to pay out of their own pockets.The severity of AD was subjected to a stratification based on the PO-SCORAD score.Results A total of 1024 patients answered the questionnaire: 31.9% with severe AD, 40.4% with moderate AD and 27.6% with mild AD. The mean annual out-of-pocket cost was €462.1 for severe AD and €247.4 for moderate AD. Emollients were the most commonly used product: 74.4% for an average out-of-pocket cost of €151.4. The out-of-pocket costs increased significantly with the severity: 27% of patients with severe AD declared having bought specially textured clothes, while 19% of patients with moderate AD reported the same. The corresponding mean out-of-pocket costs were €162 and €91, respectively.Conclusion The amount of out-of-pocket costs for patients with AD for essential medical and non-medical expenses is relatively high, compared to the average out-of-pocket cost for French households. Integration of these essential resources into the list of reimbursed products and services appears necessary for a better coverage of AD.

The results of this study are substantial and clearly demonstrate the deep impact of AD on sexual health, its relationship with disease-related burden and alterations to quality of life. Psychosociological as well as neurosensory phenomena could help to understand these data.

Atopic dermatitis (AD) profoundly alters quality of life in adults. There are few studies concerning patient burden in AD (1), since burden of disease is a recent concept that includes broader aspects of disease-related disability (2), such as psychological, physical, social, and economic factors (2-4). It is possible that the burden of skin diseases may be as great as that of other chronic diseases (5). This study (Eczema Cohorte Longitudinale Adultes; ECLA) assessed the burden of AD using the Atopy Burden Score-Adult (ABS-A), a recently developed specific tool, and compared the results with those obtained with 3 different quality of life scales. PATIENTS AND METHODS Patients with AD were members of the French Association of Eczema (Association Française de l'Eczéma) or outpatients recruited in 4 dermatology centres in France (Brest-Bordeaux-Créteil-Reims). The patients answered questions on their socio-demographic data, disease history and management data; location of lesions; impact on sexuality, partners and family, and professional life; and the financial cost of the disease. Disease severity was evaluated using the Patient-Oriented SCORing Atopic Dermatitis (PO-SCORAD) index. In addition, patients were asked to complete 3 generic quality of life questionnaires (Short Form-12 (SF-12), Dermatology Quality of Life Index (DLQI) and Euro-QoL-5 Dimensions (EQ-5D)) and an AD-specific burden questionnaire, the ABS-A. The PO-SCORAD index has a self-assessment score of AD (6). Although the PO-SCORAD is not recommended to assess clinical signs of AD, it is convenient to define the following large classes of severity: mild (PO-SCORAD score < 25), moderate (between 25 and 50) and severe (> 50). The SF-12 is a short version of the Short Form-36 (SF-36), a generic measure enabling assessment of health status in the general population (7). Two scores, the Physical Component Summary (PCS-12) and the Mental Component Summary (MCS-12), can be calculated from the 12 questions of the SF-12. There is no overall score. A higher score indicates a better quality of life (8). The DLQI is a health quality of life scale specific to dermatological disorders (9). A total score (between 0 and 30) is calculated and can be expressed as a percentage. A higher score indicates a worse quality of life. The EQ-5D has 5 dimensions (Mobility, Self-care, Usual activities, Pain/Discomfort, Anxiety/Depression) (10). At the end of the questionnaire, a visual analogue scale (EuroQoL-visual analogic scale; EQ-VAS) records the respondent's self-rated health on a 20-cm vertical scale (score range 0-100).

The article explores the process of "sportification"--i.e., processing physical activity in a sport regulated by a set of rules and standards, legitimized by supervisory institutions--from two originals practices, parkour and urban golf. To study these practices, we crossed the contributions of urban sociology and of the contemporary sociology of sport while respecting the methodological principles of qualitative sociology. A first point concerns the process of"sport" itself, its definition, its various stages, and the role played by communication of stakeholders on public space. The cultural mediation shows us how to institutionalize the movement that represents the "sports" resulted in the same time reconfiguration of physical practices themselves. Recent events illustrate the ongoing reconfiguration, we will detail them. Finally, we show the effects produced by the process on the definition of urban culture and sports: setting sight of activities, enhanced cooperation with the media-cultural, polarization between different types of practical in the case of parkour, around a confrontation between two of the founders.

Résumé Parler de hooliganisme en France semble être une gageure. Les instances dirigeantes du football, comme les services de police, ou encore les journalistes, oublient, éludent ou dénient la question des phénomènes de violences des foules sportives. Dans l’imaginaire collectif les hooligans sont anglais, jeunes, sportivement incultes, issus des classes défavorisées et délinquants dans la vie quotidienne. Il existe en fait un décalage entre croyances et réalités qui conduit à s’interroger. D’où vient la notion de hooliganisme ? Sur quels types de données reposent les études relatives à ce sujet ? Certains faits ne sont-ils pas dissimulés ? Le manque d’informations sur le sujet ne traduit-il pas tout simplement l’invisibilité ou le déplacement spatial de ces événements ?