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Chailurkit LO, Thongmung N, Vathesatogkit P, Sritara P, Ongphiphadhanakul B. Longitudinal study of vitamin D status among Thai individuals in a sun-abundant country. PUBLIC HEALTH IN PRACTICE 2023; 6:100439. [PMID: 38028260 PMCID: PMC10656256 DOI: 10.1016/j.puhip.2023.100439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Vitamin D deficiency is a major public health problem worldwide, even in countries with abundant sunshine. Understanding the risk factors for vitamin D deficiency is important to inform public health recommendations. We conducted a longitudinal analysis of vitamin D status in Thai individuals to assess changes in vitamin D status over time and identify potential determinants. Study design This study is a long term prospective cohort study. Methods Of the 1239 participants who were employees of the Electricity Generating Authority of Thailand, serum 25-hydroxyvitamin D (25(OH)D) levels were measured by liquid chromatography/tandem mass spectrometry from samples collected in 2009 and 2019. Results There was a significant 14.8% increase in serum total 25(OH)D (P < 0.001) from 2009 to 2019, which resulted from significant increases in both 25(OH)D3 and 25(OH)D2. The epimeric form of 25(OH)D2 also increased significantly, while there was no increase in the epimeric form of 25(OH)D3. A univariate analysis showed significant associations between increased total 25(OH)D and increasing age, male sex, and lower body mass index. After controlling for baseline vitamin D status, multivariate regression analyses found that the direction of association and significance from univariate analyses persisted for total 25(OH)D and 25(OH)D3. However, a univariate association found between female sex and an increase in 25(OH)D2 was not significant in multivariate regression analysis. Conclusions A long-term trend of improved vitamin D status was found among Thai adult individuals over a 10-year period; however, improvements were less noticeable in women.
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Affiliation(s)
- La-or Chailurkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nisakron Thongmung
- Research Center, Academic Affairs and Innovations, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Boonsong Ongphiphadhanakul
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Tsai J, Chien AL. Reinforcing Photoprotection for Skin of Color: A Narrative Review. Dermatol Ther (Heidelb) 2023; 13:1935-1958. [PMID: 37495857 PMCID: PMC10442306 DOI: 10.1007/s13555-023-00982-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Skin of color (SOC) is characterized by increased tendency for tanning and decreased likelihood of sunburns due to the attenuation of sunlight by epidermal melanin. Although this contributes to the decreased incidence of skin cancer among SOC populations, individuals with SOC remain susceptible to various health consequences associated with sun exposure, including non-melanoma skin cancer, photoaging, pigmentary disorders, and photodermatoses - many of which not only present differently, but also disproportionately affect SOC. Prior epidemiological studies have found lower prevalence of sun protection behaviors among individuals with SOC, particularly in sunscreen use, signifying an unmet area for improvement in the prevention of sun-induced dermatologic conditions in these populations. The objective of this narrative review was to summarize the biology and health consequences of sun exposure in SOC, as well as cognitive and behavioral factors that affect the practice of photoprotection behaviors in SOC populations. We also review prior interventions that have been used to enhance photoprotection knowledge and behaviors among individuals with SOC, either in racially and ethnically diverse communities or within specific SOC populations.
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Affiliation(s)
- Jerry Tsai
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA.
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Willmott T, Campbell PM, Griffiths CEM, O’Connor C, Bell M, Watson REB, McBain AJ, Langton AK. Behaviour and sun exposure in holidaymakers alters skin microbiota composition and diversity. FRONTIERS IN AGING 2023; 4:1217635. [PMID: 37614517 PMCID: PMC10442491 DOI: 10.3389/fragi.2023.1217635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/03/2023] [Indexed: 08/25/2023]
Abstract
Introduction: The skin microbiota plays a crucial role in maintaining epidermal homeostasis. Ultraviolet radiation (UVR) and other environmental challenges can impact the skin microbiota through direct and indirect mechanisms. This study aimed to investigate the effects of sun exposure on the skin microbiota and its relationship with individual skin phototypes. Methods: Healthy volunteers (n = 21 [4M, 17 F], mean age 33.2 years) holidayed in a sunny destination for a minimum of 7 days with swabs taken pre-holiday and up to 84 days post-holiday. Participant group was categorised by individual typology angle (ITA) classification and the composition of the skin microbiota was examined using 16S rRNA gene sequencing. Results: In the entire cohort and at all time points, the major bacterial phyla were Actinobacteria, Proteobacteria and Firmicutes. There was a significant change in microbial beta diversity at day 28 post-holiday, compared to baseline, for all participants. However, when participants were segregated into three cohorts dependent on the degree of skin tanning response between baseline (pre-holiday) and immediately one-day post-holiday, there was a reduction in Proteobacteria in the sun-seeking participants 1 day after the holiday, which recovered over time. Discussion: These findings suggest that sun exposure can affect the diversity and composition of the skin microbiota, which may have downstream effects on skin health.
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Affiliation(s)
- Thomas Willmott
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Paul M. Campbell
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Christopher E. M. Griffiths
- Centre for Dermatology Research, Manchester Academic Health Science Centre, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, United Kingdom
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Clare O’Connor
- No7 Beauty Company, Walgreens Boots Alliance, Nottingham, United Kingdom
| | - Michael Bell
- No7 Beauty Company, Walgreens Boots Alliance, Nottingham, United Kingdom
| | - Rachel E. B. Watson
- Centre for Dermatology Research, Manchester Academic Health Science Centre, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, United Kingdom
- A*STAR Skin Research Laboratory (A*SRL), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Andrew J. McBain
- School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Abigail K. Langton
- Centre for Dermatology Research, Manchester Academic Health Science Centre, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, United Kingdom
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Abstract
Photoprotection behaviors can mitigate skin damage caused by ultraviolet radiation, and common methods include seeking shade, avoiding sun exposure during peak daylight hours, wearing sun-protective clothing, applying sunscreen, and using sunglasses. While the role of sun protection in preventing sunburns, photoaging, and skin cancer is well established in fair-skinned populations, individuals with skin of color (SOC) are presumed to suffer fewer negative effects from solar radiation. Thus, the importance of photoprotection in this population is understudied and may be underestimated. In SOC populations, sun exposure is known to cause pigmentary disorders, photoaging, and basal cell carcinoma (BCC), highlighting the potential benefits of photoprotection. Although SOC populations tend to practice photoprotection by seeking shade and wearing sun-protective clothing, survey and interview-based studies have consistently found relatively low use of sunscreen among these populations. Common motivators for photoprotection in individuals with SOC include preventing sunburn and pigmentation, with the prevention of skin cancer being a less important reason. As a skin cancer risk behavior, indoor tanning is relatively rare in SOC populations, but its use may increase with acculturation to US norms. While more studies are necessary to clarify whether photoprotection behaviors may decrease skin cancer-related mortality in SOC populations, regular dermatologic care and counseling on photoprotection remain essential in patients with SOC for overall skin health.
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Affiliation(s)
- Jerry Tsai
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N Caroline Street, Suite 8060C, Baltimore, MD, 21287, USA.
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Tay GWN, Chan MJ, Kembhavi G, Lim J, Rebello SA, Ng H, Lin C, Shek LP, Lança C, Müller-Riemenschneider F, Chong MFF. Children's perceptions of factors influencing their physical activity: a focus group study on primary school children. Int J Qual Stud Health Well-being 2021; 16:1980279. [PMID: 34661503 PMCID: PMC8525992 DOI: 10.1080/17482631.2021.1980279] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose Establishing healthy lifestyle behaviours in primary school children is important, as these behaviours are likely to track into adulthood. This study aimed to explore the factors influencing physical activity (PA) in primary school children through their perspectives. Approach Eleven focus group discussions and one interview were conducted with 52 children (n = 29 girls) aged 9–12 years from two primary schools in Singapore. Data analyses were conducted using thematic analysis, deductively following the socio-ecological model (SEM) and inductively for themes at each SEM level. Results At individual level, children’s perceived enjoyment, health benefits and expectation of rewards motivated them to engage in PA, while time constraints and their apathy towards PA hindered PA engagement. Children’s PA occasions at home were reported to be influenced by parental permission, priorities and availability, and the availability of preferred peers. Physical environmental factors such as opportunities for PA in school, access to facilities for PA and weather influenced children’s time spent on PA and the types of activities they engaged in. Conclusion This study summarized some factors that children have reported to influence their PA behaviour. These findings could help inform future interventions aimed at promoting PA among primary school children in Singapore.
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Affiliation(s)
| | - Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | | | - Jubilee Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Hazyl Ng
- Health Promotion Board, Singapore
| | | | - Lynette P Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | | | | | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
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Maymone MBC, Wirya SA, Secemsky EA, Vashi NA. Primary Language in Relation to Knowledge of Diagnosis and Sun-Related Behaviors in Adults with Sun-Exacerbated Dermatoses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193710. [PMID: 31581616 PMCID: PMC6801846 DOI: 10.3390/ijerph16193710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/30/2022]
Abstract
Objective: To evaluate how patients’ primary spoken language influences the understanding of their disorder and their subsequent sun-related behaviors. Methods: This was a cross-sectional study conducted between February 2015 and July 2016 in two outpatient dermatology clinics among 419 adults with a sun-exacerbated dermatosis. The primary outcome was a successful match between the patient-reported diagnosis on a survey and the dermatologist-determined diagnosis. Results: Of participants, 42% were native English speakers, and 68% did not know their diagnosis. Fewer non-native English speakers identified one risk factor for their condition (46% versus 54%, p < 0.01). A greater number of non-native English speakers were less familiar with medical terminology. Native English speakers were 2.5 times more likely to know their diagnosis compared to non-native speakers (adjusted odds (aOR) 2.5, 95% confidence interval, 1.32 to 4.5; p = 0.005). Additional factors associated with higher odds of knowing the diagnosis included: Higher education, sunscreen use, female gender, symptoms for 1–5 years, and diagnosis of melasma and postinflammatory hyperpigmentation (PIH). Conclusions: Knowledge of the diagnosis and understanding of factors that may influence skin disease may promote conscious sun behavior. Patients who knew that their diagnosis was sun-exacerbated had higher odds of wearing sunscreen.
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Affiliation(s)
- Mayra B C Maymone
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Stephen A Wirya
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA.
| | - Eric A Secemsky
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, Boston, MA 02118, USA.
- Boston Health Care System, Department of Veteran Affairs, School of Medicine Boston Medical Center, Boston, MA 02118, USA.
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