The Effect of a School-Based Intervention on Sunbed Use in Danish Pupils at Continuation Schools: A Cluster-Randomized Controlled Trial

PurposeTo examine the effect of an educational intervention on sunbed use and intentions and attitudes toward sunbed use in 14- to 18-year-olds at continuation schools.MethodsWe randomized 33 continuation schools either to receive the educational intervention (n = 16) or to be controls (n = 17). Intervention schools received an e-magazine addressing the health risks of sunbed use. Information on behavior and intentions and attitudes toward sunbed use was gathered through self-administrated questionnaires before the intervention and at 6 months as a follow-up. The effect of the intervention was examined by multilevel linear regression and logistic regression.ResultsSunbed use was significantly lower at follow-up among pupils at intervention schools versus pupils at control schools (girls: odds ratio .60, 95% confidence interval .42–.86; Boys: odds ratio .58, 95% confidence interval .35–.96). The intervention had no effect on intention to use sunbeds or attitudes toward sunbed use. The analyses revealed a significant impact of school on attitudes toward sunbed; the intraclass correlation coefficient was estimated to be 6.0% and 7.8% for girls and boys, respectively.ConclusionsThe findings from the present study provide new evidence of a positive effect of an educational intervention on sunbed use among pupils aged 14–18 years at continuation schools.     

High-risk sun-tanning behaviour: a quantitative study in Denmark, 2008–2011

Objectives

The incidences of melanoma and non-melanoma skin cancer have increased markedly over the past 30 years. The main risk factor is ultraviolet radiation from the sun and from sunbeds. The Danish Sun Safety campaign was launched in 2007 to curb this development by reducing the exposure of adolescents and young children. In this study, the characteristics of high-risk sun-tanning behaviour were assessed and the effect of the campaign was determined.

Study design

Cross-sectional study.

Methods

Data from annual Internet surveys were compiled in 2008–2011 of 18, 685 15–64-year-old Danes. A tanning index based on sunbed use and intentional tanning in and outside Denmark was the outcome measure in a linear regression model, which included age, gender, skin type, education, income and survey year as exposure variables.

Results

High-risk tanning behaviour was associated with female gender, younger age, shorter education, skin type 3 or 4, higher income, smaller household and living in larger cities. The tanning index, where 100 represent high-risk behaviour, increased by 13.45 points for women as compared with men, dropped by 1.35 points for each 5-year increase in age, rose by 20.72 points for skin type 4 as compared with type 1 and increased by 10.33 points with an income >€105, 409 as compared with <€26, 352. High-risk behaviour decreased during the study period, especially among women and younger people.

Conclusions

High-risk sun-tanning behaviour is linked to certain personal and social characteristics. After initiation of the Danish Sun Safety Campaign in 2007, this high-risk behaviour decreased, especially in the groups initially targeted by the campaign. The campaign may thus reduce the future incidence of melanoma and non-melanoma skin cancer.     

Use of sunbeds by minors despite a legal regulation: extent, characteristics, and reasons

Aim

Sunbed use can have severe health consequences, e.g. skin cancer, especially for children and adolescents. Therefore, our aim was to quantify how many adolescents use tanning beds despite a legal ban in Germany. In addition, we aimed at identifying characteristics of users and at analyzing reasons for use and user behavior.

Subjects and methods

The nationwide representative SUN-Study 2012 included a subgroup of 518 minors (14–17 years). Besides calculating the prevalence, we used bivariate statistics to identify user groups and to compare minors with adults in terms of reasons for use, place of last use, and obtained advisory service.

Results

Overall, 8.7 % of minors had ever used a sunbed; 5.2 % used it during the last 12 months. Out of these, nearly a half was not aware of the legal ban for minors. Users were mainly smokers, had darker skin, and a migration background. Compared to adults, minors were more likely to use unsupervised sunbeds and were less frequently advised by service personnel.

Conclusion

The data showed that minors use tanning beds, although there is a legal ban in Germany. The circumvention of the ban and the widespread use of unsupervised sunbeds underline the importance of education and further legal requirements.     

Time to delivery: Transfers for threatened preterm labour and prelabour rupture of membranes in Western Australia

Objective

To describe the outcomes of patients transferred to King Edward Memorial Hospital (KEMH) with signs of labour at preterm gestations.

Design

A retrospective observational study of the 69 cases transferred to KEMH during 2015.

Setting

Patient transfers from all locations across Western Australia (WA) to the sole tertiary perinatal centre in Perth.

Participants

Pregnant women within WA with threatened or actual preterm labour (PTL) or preterm prelabour rupture of membranes (PPROM) between 23 and 32 weeks gestation.

Main outcome measures

The occurrence of delivery during the admission and time‐to‐delivery as well as length of admission and association between clinical factors and time‐to‐delivery.

Results

The percentage of the study population delivered during the admission following transfer was 72.5%. Eighty‐six per cent of those who delivered did so within 72 hours of transfer. The median time from transfer to delivery was 1 day. Sixty‐three per cent of those who did not deliver during the admission progressed to 36 weeks gestation. Patients transferred with PPROM were less likely to deliver during the admission compared to those with uterine activity (50% versus 19.6%, P = 0.007) and nulliparas were more likely to deliver (93.5% versus 55.3%, P < 0.001).

Conclusion

The majority of women transferred with signs of PTL progress to delivery during the same admission with the highest risk of delivery being the first 72 hours following transfer. If the pregnancy is ongoing at 72 hours, there is a reasonable chance of progression to late preterm gestation supporting the return of woman to their place of origin for antenatal care following discharge.     

The use of haematopoietic stem cell transplantation in Fanconi anaemia patients: a survey of decision making among families in the US and Canada

Background

Fanconi anaemia (FA) is a rare genetic disorder associated with bone marrow failure (BMF), congenital anomalies and cancer susceptibility. Stem cell transplantation (SCT) offers a potential cure for BMF or leukaemia, but incurs substantial risks. Little is known about factors influencing SCT decision making.

Objective

The study objective was to explore factors influencing patients' with FA and family members' decision making about SCT.

Design

Using a mixed‐methods exploratory design, we surveyed US and Canadian patients with FA and family members who were offered SCT.

Main variables studied

Closed‐ended survey items measured respondents' beliefs about the necessity, risks and concerns regarding SCT; multivariable logistic regression was used to examine the association between these factors and the decision to undergo SCT. Open‐ended survey items measured respondents' perceptions of factors important to the SCT decision; qualitative analysis was used to identify emergent themes.

Results

The decision to undergo SCT was significantly associated with greater perceived necessity (OR = 2.81, P = 0.004) and lower concern about harms of SCT (OR = 0.31, P = 0.03). Qualitative analysis revealed a perceived lack of choice among respondents regarding the use of SCT, which was related to physician influence and respondent concerns about patients' quality of life.

Conclusions

Overall, study results emphasize the importance of the delicate interplay between provider recommendation of a medical procedure and patient/parental perceptions and decision making. Findings can help providers understand the need to acknowledge family members' perceptions of SCT decision making and offer a comprehensive discussion of the necessity, risks, benefits and potential outcomes.     

Isolated specialist or system integrated physician – different views on sickness certification among orthopaedic surgeons: an interview study

Background  

Sickness certification is a frequent and sometimes problematic task for orthopaedic surgeons.     

The association of remotely-sensed outdoor temperature with blood pressure levels in REGARDS: a cross-sectional study of a large,national cohort of African-American and white participants

Background  

Evidence is mounting regarding the clinically significant effect of temperature on blood pressure.     

Improved diabetes control in the elderly delays global cognitive decline

Objectives  

To examine whether improved diabetes control is related to better cognitive outcomes.     

Indium lung—case reports and epidemiology

Purpose  

The present review is aimed to introduce an new occupational lung disease, Indium Lung.     

Dose and time-dependent hypercholesterolemic effects of iodine excess via TRβ1-mediated down regulation of hepatic LDLr gene expression

Background  

With the global improvement of iodine nutrition, iodine excess is emerging as a new concern.     

Testing for cattle allergy: modified diagnostic cutoff levels improve sensitivity in symptomatic claw trimmers

Background  

The diagnosis of cattle-related sensitization is complicated by the variability and complexity of cattle allergen extracts.     

Validation of a short form Wisconsin Upper Respiratory Symptom Survey (WURSS-21)

Background  

The Wisconsin Upper Respiratory Symptom Survey (WURSS) is an illness-specific health-related quality-of-life questionnaire outcomes instrument.     

HIV Prevalence among Aboriginal British Columbians

Context  

There is considerable concern about the spread of HIV disease among Aboriginal peoples in British Columbia.     

Validation of the AQLQ12+ among adolescents and adults with persistent asthma

Background  

To date, there is limited psychometric evidence on the Asthma Quality of Life Questionnaire (AQLQ12 +) among populations that include adolescents and adults.     

Depressive symptoms are associated with food insufficiency and nutritional deficiencies in poor community-dwelling elderly people

Abstract  

Depression is associated with nutritional deterioration in older persons and is highly prevalent among people of low socioeconomic status (LSES).     

<Emphasis Type="Italic">Gastrodia elata</Emphasis> Blume water extracts improve insulin resistance by decreasing body fat in diet-induced obese rats: vanillin and 4-hydroxybenzaldehyde are the bioactive candidates

Background  

Insulin resistance is a common symptom of metabolic diseases such as obesity, type 2 diabetes and hyperlipidemia.     

Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review

Background

The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited.

Objective

To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services.

Search strategy

Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings.

Inclusion criteria

UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016.

Data extraction and synthesis

Data were extracted into a grid and subjected to narrative synthesis following thematic analysis.

Main results

From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi‐structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes “public cognizance” and “attitudes towards services” each with 4 subthemes.

Discussion and conclusions

Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists’ clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness.     

Thyroid function in Danish greenhouse workers

Background  

From animal studies it is known that currently used pesticides can disturb thyroid function.