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Solar activity has a cyclic nature with the ≈11-year Schwabe cycle dominating its variability on the interannual timescale. However, solar cycles are significantly modulated in length, shape and magnitude, from near-spotless grand minima to very active grand maxima. The ≈400-year-long direct sunspot-number series is inhomogeneous in quality and too short to study robust parameters of long-term solar variability. The cosmogenic-isotope proxy extends the timescale to twelve millennia and provides crucial observational constraints of the long-term solar dynamo modulation. Here, we present a brief up-to-date overview of the long-term variability of solar activity at centennial – millennial timescales. The occurrence of grand minima and maxima is discussed as well as the existing quasi-periodicities such as centennial Gleissberg, 210-year Suess/de Vries and 2400-year Hallstatt cycles. It is shown that the solar cycles contain an important random component and have no clock-like phase locking implying a lack of long-term memory. A brief yet comprehensive review of the theoretical perspectives to explain the observed features in the framework of the dynamo models is presented, including the nonlinearity and stochastic fluctuations in the dynamo. We keep gaining knowledge of the processes driving solar variability with the new data acquainted and new models developed.

Background: Chronic hand eczema (CHE) is a very common skin disease among the European population. It causes itch and pain and, in more severe cases, seriously impairs hand functioning at work and in private life. Objectives: To explore perspectives of people with lived experience on CHE-related problems, wishes and goals. Methods: Following a qualitative approach, we conducted topic-guided interviews in five European countries and applied template analysis to identify recurrent themes among patients with CHE. Results: We interviewed 60 patients in seven outpatient dermatological and occupational medicine clinics in Croatia, Denmark, Germany, the Netherlands and Spain. Five main themes were identified: (1) knowledge about the disease and its course, (2) preventive behaviour, (3) hand eczema therapy, (4) impact on everyday life and (5) attitudes towards CHE and healthcare. Participants did not feel well informed about CHE, especially about causes, triggers and treatment options. Preventive measures were experienced as more or less effective but also cumbersome. Experiences with therapy were diverse. Treatment satisfaction depended on the results and on the perceived support from the treatment teams. Participants found it important to be taken seriously, to receive practical advice, to try out additional treatments or examinations, find new hope and have occupational perspectives. They wished that others could better understand the physical and emotional burden of CHE. Patient support groups were not mentioned. Participants found it important to learn to take care of themselves and accept life with CHE. Conclusions: Due to its annoying symptoms, high visibility and impaired functioning at work and in private life, CHE has a high emotional and social impact. Some people may require support to learn coping with CHE and its prevention. Patients wish for information about causes and triggers. They value physicians who listen to them and keep looking for solutions.

Background: Hand eczema is a common inflammatory skin disorder. Health care providers need continuously updated information about the management of hand eczema to ensure best treatment for their patients. Objectives: To update the European Society of Contact Dermatitis guideline on the diagnosis, prevention, and treatment on of hand eczema. Method: The Guideline Development Group (GDG) was established on behalf of the ESCD. A call for interest was launched via the ESCD website and via the ESCD members' mailing list. Appraisal of the evidence for therapeutic and preventive interventions was applied and a structured method of developing consensus was used and moderated by an external methodologist. The final guideline was approved by the ESCD executive committee and was in external review on the ESCD webpage for 1 month. Results: Consensus was achieved for several statements and management strategies. Conclusion: The updated guideline should improve management of hand eczema.