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Ricciardo BM, Kessaris HL, Nannup N, Tilbrook D, Farrant B, Michie C, Hansen L, Douglas R, Walton J, Poore A, Whelan A, Barnett TC, Kumarasinghe PS, Carapetis JR, Bowen AC. Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project. Pilot Feasibility Stud 2024; 10:6. [PMID: 38200545 PMCID: PMC10782716 DOI: 10.1186/s40814-023-01428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Indigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association. METHODS This project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0-18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study. RESULTS From 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child's skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review. CONCLUSIONS This co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.
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Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, WA, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia.
- Fiona Stanley Hospital, Murdoch, WA, Australia.
- Perth Children's Hospital, Nedlands, WA, Australia.
| | - Heather-Lynn Kessaris
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Noel Nannup
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Dale Tilbrook
- Telethon Kids Institute, Nedlands, WA, Australia
- Maalingup Aboriginal Gallery, Caversham, WA, Australia
| | - Brad Farrant
- University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Carol Michie
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Lorraine Hansen
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Richelle Douglas
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Jacinta Walton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Ainslie Poore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Alexandra Whelan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Timothy C Barnett
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | | | - Jonathan R Carapetis
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
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Erickson T, Daftary K, Quan VL, Chovatiya R. Capturing the Diversity of Dermatology-What's in a Name? Am J Clin Dermatol 2023; 24:675-680. [PMID: 37328613 DOI: 10.1007/s40257-023-00800-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/18/2023]
Abstract
As research related to skin of color (SOC) in dermatology continues to grow, it is increasingly important to precisely define terminology. The terms 'SOC', 'race', and 'ethnicity' are frequently used to analyze differences in dermatologic disease onset, severity, and outcomes. These terms are used interchangeably, are ill-defined across research studies, and frequently conflate biologic and socially constructed categories. SOC has been thought to represent differing degrees of pigment or melanin in the skin, however skin pigment is quite variable among races and ethnicities. Furthermore, certain individuals with less skin pigment may socially consider themselves to be SOC, while the inverse is also true. Fitzpatrick skin phototype classifications in SOC dermatology, while commonly used as an objective measure of diversity, also present with numerous limitations and inaccuracies. We seek to highlight strengths and weaknesses of the current terminology used in SOC dermatology and recommend a more holistic understanding of reported differences, including a framework reflective of upstream socioeconomic, environmental, and historical factors that may be most relevant to reported associations.
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Affiliation(s)
- Taylor Erickson
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Karishma Daftary
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Victor L Quan
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA
| | - Raj Chovatiya
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, 676 N St Clair St, Suite 1600, Chicago, IL, 60611, USA.
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3
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Fluehr M, Kwok G, Stapleton JL, Masterson M, Devine KA. Factors Associated With Sun Protection Behaviors Among Childhood Cancer Survivors. J Pediatr Hematol Oncol 2023; 45:e323-e327. [PMID: 36706312 PMCID: PMC10038824 DOI: 10.1097/mph.0000000000002618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/08/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Childhood cancer survivors (CCS) are at increased risk of developing skin cancer. Engaging in sun-protective behaviors may ameliorate that risk, but prior work shows that survivors engage in suboptimal levels of sun-protective behaviors. Guided by the Health Belief Model (HBM), this study evaluated factors associated with sun-protective behavior among CCS. METHODS This is a secondary analysis of a survey study of 94 adult survivors of childhood cancer recruited from a long-term follow-up clinic. Participants reported their sun protection habits, skin type/sensitivity, barriers to sun protection, and perceived severity and susceptibility of getting skin cancer. Descriptive statistics were used to describe the prevalence of sun protection behaviors and hierarchical linear regression was used to evaluate predictors of sun protection behavior following the HBM. RESULTS On average, CCS engaged in moderate levels of sun-protective behaviors ( M =2.53; SD=0.59). Hierarchical linear regression indicated that fair skin type ( P =0.02) and higher perceived susceptibility relative to noncancer survivors ( P =0.02) were associated with increased sun protection behaviors. Perceived barriers to sun protection were marginally significant ( P =0.09), whereas other constructs from the HBM did not contribute significantly to the model. CONCLUSIONS Although CCS are at increased risk of developing skin cancer, they engage in suboptimal levels of sun protection behaviors. Findings suggest that interventions to educate survivors about their unique risk of skin cancer and effective prevention behaviors are needed.
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Affiliation(s)
- Melissa Fluehr
- Rutgers Cancer Institute of New Jersey; Rutgers, The State University of New Jersey
| | - Gary Kwok
- Rutgers Cancer Institute of New Jersey; Rutgers, The State University of New Jersey
| | | | - Margaret Masterson
- Rutgers Cancer Institute of New Jersey; Rutgers, The State University of New Jersey
| | - Katie A. Devine
- Rutgers Cancer Institute of New Jersey; Rutgers, The State University of New Jersey
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4
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Sheehan DM, Cano MÁ, Trepka MJ. Measuring Race Among Latinos to Address Racism, Discrimination, and HIV Health Inequities: Comparing Self-Reported Race and Fitzpatrick Skin Phototype. J Assoc Nurses AIDS Care 2021; 32:522-525. [PMID: 33859078 PMCID: PMC8422302 DOI: 10.1097/jnc.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Limited research suggests there are significant disparities in HIV outcomes between Black and White Latinos. However, race among Latinos is largely absent from the scientific literature, and relevant measures of race for Latino populations have not been widely incorporated into ongoing research. Using a sample (N = 24) of young (18–34 years old) Latino men who have sex with men living with HIV, we compared self-reported Fitzpatrick skin phototype and self-reported race. Self-identified White Latinos reported skin phototypes 1 “light, pale white” through 4 “olive, moderate brown.” Multiracial Latinos reported skin phototypes 2 “white, fair” through 5 “brown, dark brown.” One-third of participants did not identify with commonly used racial categories, White or Black. Results suggest a widespread of skin phototypes among Latinos self-identifying as White and Multiracial, which may impact the identification of HIV racial disparities, as well as racism, discrimination, and health inequities HIV research among Latino sexual and gender minorities.
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Affiliation(s)
- Diana M. Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA, a Faculty Affiliate, Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA, and a Faculty Affiliate, Research Centers in Minority Institutions (RCMI), Florida International University, Miami, Florida, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA, and a Faculty Affiliate, Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Florida International University, Miami, Florida, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA, and a Faculty Affiliate, Research Centers in Minority Institutions (RCMI), Florida International University, Miami, Florida, USA
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Hahnel E, El Genedy M, Tomova‐Simitchieva T, Hauß A, Stroux A, Lechner A, Richter C, Akdeniz M, Blume‐Peytavi U, Löber N, Kottner J. The effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high‐risk intensive care unit patients: a randomized controlled parallel‐group trial. Br J Dermatol 2019; 183:256-264. [DOI: 10.1111/bjd.18621] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2019] [Indexed: 02/07/2023]
Affiliation(s)
- E. Hahnel
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - M. El Genedy
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - T. Tomova‐Simitchieva
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - A. Hauß
- Department of Clinical Quality and Risk Management Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Stroux
- Department of Biometry and Clinical Epidemiology Charité – Universitätsmedizin Berlin Berlin Germany
| | - A. Lechner
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - C. Richter
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - M. Akdeniz
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - U. Blume‐Peytavi
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
| | - N. Löber
- Department of Clinical Quality and Risk Management Charité – Universitätsmedizin Berlin Berlin Germany
| | - J. Kottner
- Clinical Research Center for Hair and Skin Science Department of Dermatology and AllergyCharité – Universitätsmedizin Berlin Berlin Germany
- Department of Public Health and Primary Care Skin Integrity Research Group (SKINT) University Centre for Nursing and Midwifery Ghent University Ghent Belgium
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6
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Holm-Schou ASS, Philipsen PA, Wulf HC. Skin cancer phototype: A new classification directly related to skin cancer and based on responses from 2869 individuals. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 35:116-123. [DOI: 10.1111/phpp.12432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/29/2018] [Accepted: 10/06/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Ann-Sofie Sonne Holm-Schou
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - Peter Alshede Philipsen
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - Hans Christian Wulf
- Dermatological Research Department D92; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
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Bieliauskiene G, Philipsen PA, Wulf HC. Phototype reproducibility and relation to objectively measured skin sensitivity is best when burn and tan reactivity to sun are answered separately. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2018; 34:366-373. [DOI: 10.1111/phpp.12399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Giedre Bieliauskiene
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
- The Heart Center; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Peter A. Philipsen
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
| | - Hans Christian Wulf
- Department of Dermatology; Bispebjerg Hospital; University of Copenhagen; Copenhagen Denmark
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8
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Tomova-Simitchieva T, Lichterfeld-Kottner A, Blume-Peytavi U, Kottner J. Comparing the effects of 3 different pressure ulcer prevention support surfaces on the structure and function of heel and sacral skin: An exploratory cross-over trial. Int Wound J 2017; 15:429-437. [PMID: 29277963 DOI: 10.1111/iwj.12883] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/21/2017] [Accepted: 11/24/2017] [Indexed: 12/14/2022] Open
Abstract
Special support surfaces are key in pressure ulcer prevention. The aim of this study was to measure the effects of 3 different types of mattresses (reactive gel, active alternating air, basic foam) on skin properties of the sacral and heel skin after 2 hours loading. Fifteen healthy females (median age 66 years) were included. Transepidermal water loss, skin surface temperature, erythema, stratum corneum hydration, epidermal hydration, skin extensibility, elastic function, and recovery as well as skin roughness parameters were measured under controlled room conditions before loading, immediately after loading, and 20 minutes post-loading in the supine position on the different mattresses. The highest increases in transepidermal water loss, skin temperature, and erythema were observed for the foam mattress after loading, indicating higher deformation and occlusion. Cutaneous stiffness decreased in all 3 groups, indicating structural changes during loading. There was a substantial decrease of mean roughness at the heel skin in the foam group, leading to a flattening of the skin surface. Study results indicate that the type of support surface influences skin structure and function during loading. The gel and air mattress appeared to be more protective compared with the foam mattress, but the differences between the gel and air were minor.
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Affiliation(s)
- Tsenka Tomova-Simitchieva
- Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Andrea Lichterfeld-Kottner
- Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany
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9
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Blashill AJ, Rooney BM, Wells KJ. An integrated model of skin cancer risk in sexual minority males. J Behav Med 2017; 41:99-108. [PMID: 28815351 DOI: 10.1007/s10865-017-9879-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 08/04/2017] [Indexed: 11/24/2022]
Abstract
Sexual minority males are an at-risk group for developing skin cancer. Elevated rates of skin cancer among this population are thought to be driven by excess indoor tanning; however, motivations to indoor tan among this population are unknown. Theoretically, appearance-based and affect regulation motives may be proximal predictors of increased indoor tanning in this population. The current study tests an integrated biopsychosocial model of indoor tanning behaviors and future intentions among a sample of sexual minority males. Participants were 231 sexual minority males, between the age of 14 and 35 years, residing in San Diego County, California, who completed a battery of self-report questionnaires online. Constructs assessed included skin tone, perceived susceptibility to skin cancer, sociocultural pressures to tan, appearance-based motives to tan, affect regulation in regard to indoor tanning, indoor tanning behaviors over the previous 3 months, and future intentions to indoor tan. The three proposed proximal predictors of indoor tanning all displayed significant pathways; however, results varied depending upon the specific outcome measure modeled. Affect regulation was significantly associated with increased odds of indoor tanning, and future intentions to indoor tan. Increased appearance reasons to tan were significantly associated with future intentions to indoor tan, while increased appearance reasons not to tan were significantly associated with fewer number of indoor tanning sessions. Results underscore the unique pathways of affect regulation and appearance-based motives in indoor tanning behaviors. Skin cancer prevention programs focusing on sexual minority males may wish to address affect and appearance concerns.
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Affiliation(s)
- Aaron J Blashill
- Department of Psychology, San Diego State University, 6363 Alvarado Ct. Suite 103, San Diego, CA, 92120, USA. .,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Benjamin M Rooney
- Department of Psychology, San Diego State University, 6363 Alvarado Ct. Suite 103, San Diego, CA, 92120, USA
| | - Kristen J Wells
- Department of Psychology, San Diego State University, 6363 Alvarado Ct. Suite 103, San Diego, CA, 92120, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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10
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Sex Differences in the Relationship Between Socio-Cultural Norms and Sunbathing. Int J Behav Med 2016; 24:428-437. [DOI: 10.1007/s12529-016-9606-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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11
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Talib HJ, Ponnapakkam T, Gensure R, Cohen HW, Coupey SM. Treatment of Vitamin D Deficiency in Predominantly Hispanic and Black Adolescents: A Randomized Clinical Trial. J Pediatr 2016; 170:266-72.e1. [PMID: 26707619 PMCID: PMC4769970 DOI: 10.1016/j.jpeds.2015.11.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/01/2015] [Accepted: 11/09/2015] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To compare 3 different treatment regimens for vitamin D deficiency in minority adolescents and to explore factors that impact treatment efficacy. STUDY DESIGN We conducted an 8-week, prospective, open-label, randomized clinical trial in an urban, academic, children's hospital. A total of 183 vitamin D-deficient adolescents, mean 25-hydroxyvitamin D or 25(OH)D 13.7 ± 3.9 ng/mL; mean age 16.6 ± 2.2 years, were randomized into 3 vitamin D3 (cholecalciferol) treatment arms: 50,000 IU/wk; 5000 IU/d; and 1000 IU/d. Serum 25(OH)D and vitamin D binding protein (VDBP) levels were measured pre-and posttreatment; 122 (67%) participants completed posttreatment measures. Complete-case and multiple-imputation, intention-to-treat analyses were performed. RESULTS Mean change in 25(OH)D level posttreatment was significantly different among the 3 arms, 24.9 ± 15.1 vs 21.0 ± 15.2 vs 6.2 ± 6.5 ng/mL, for 50,000 IU, 5000 IU, and 1000 IU doses, respectively, P < .001. Both high-dose treatments were effective in increasing the 25(OH)D level out of deficiency range (≥ 20 ng/mL) in more than 80% of participants, and 60% remained deficient after low-dose treatment. Only 72%, 56%, and 2% achieved vitamin D sufficiency (>30 ng/mL) with 50,000 IU, 5000 IU, and 1000 IU doses, respectively, P < .001. Obese participants had substantially less mean change in 25(OH)D level after treatment than normal-weight participants, 13.7 ± 10.7 vs 21.9 ± 16.9 ng/mL, P < .001. Mean baseline VDBP level was almost twice as high in Hispanic compared with black participants (P < .001) and did not alter treatment response or change with treatment. CONCLUSIONS Adult-sized adolescents require 8 weeks of high-dose cholecalciferol, at least 5000 IU/d, to correct deficiency. Obese adolescents have poorer response to treatment and may need higher doses than nonobese youth. Hispanic and black adolescents have different VDBP levels but similar treatment responses. TRIAL REGISTRATION ClinicalTrials.gov: NCT01784029.
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Affiliation(s)
- Hina J. Talib
- Pediatrics, Division of Adolescent Medicine, Children’s Hospital at Montefiore/Albert Einstein College of Medicine
| | - Tulasi Ponnapakkam
- Pediatrics, Division of Pediatric Endocrinology, Children’s Hospital at Montefiore/Albert Einstein College of Medicine
| | - Robert Gensure
- Pediatrics, Division of Pediatric Endocrinology, Children’s Hospital at Montefiore/Albert Einstein College of Medicine
| | - Hillel W. Cohen
- Epidemiology and Population Health, Albert Einstein College of Medicine
| | - Susan M. Coupey
- Pediatrics, Chief, Division of Adolescent Medicine, Children’s Hospital at Montefiore/Albert Einstein College of Medicine
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Kucukunal A, Altunay I, Arici JE, Cerman AA. Is the effect of smoking on rosacea still somewhat of a mystery? Cutan Ocul Toxicol 2015; 35:110-4. [DOI: 10.3109/15569527.2015.1046184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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13
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Gerber AL, Münst A, Schlapbach C, Shafighi M, Kiermeir D, Hüsler R, Hunger RE. High expression of FOXP3 in primary melanoma is associated with tumour progression. Br J Dermatol 2015; 170:103-9. [PMID: 24116716 DOI: 10.1111/bjd.12641] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND The antitumour immune response plays an important role in the prognosis of melanoma. High numbers of circulating regulatory T cells have been associated with rapid disease progression. OBJECTIVES To assess the influence of forkhead box protein (FOXP)3, CD1a and langerin expression on the prognosis of primary melanoma. METHODS We analysed 185 primary melanomas by immunohistochemical staining for expression of the regulatory T-cell marker FOXP3 and the dendritic cell markers langerin and CD1a, and correlated marker expression with clinical outcome. RESULTS Disease-free survival and overall survival were significantly longer in patients expressing low levels of FOXP3 in the primary melanoma, whereas they were associated with high expression of CD1a. The negative prognostic value of FOXP3 expression was independent of the Breslow tumour thickness. Langerin expression did not correlate with the clinical outcome. CONCLUSIONS High expression of FOXP3 in the primary melanoma may be used as an additional independent prognostic marker for early tumour progression in patients with melanoma.
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Affiliation(s)
- A L Gerber
- Department of Dermatology, Inselspital, University Hospital Bern, Bern, Switzerland
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Prior SM, Fenwick KD, Peterson JC. Adolescents' reasons for tanning and appearance motives: a preliminary study. Body Image 2014; 11:93-6. [PMID: 24129215 DOI: 10.1016/j.bodyim.2013.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 09/03/2013] [Accepted: 09/03/2013] [Indexed: 11/16/2022]
Abstract
We examined adolescents' reasons for tanning and how these relate to appearance evaluation and orientation. Two hundred and sixty-four Canadian adolescents (age range 15-19 years) in grades 10, 11, and 12 completed a survey that included scales measuring their reasons for tanning, appearance evaluation, and appearance orientation. It was found that girls and boys differed on four of nine subscales measuring reasons for tanning. Girls believed more strongly than boys that tanning improved their general appearance and that friends influenced their decision to tan. Girls also expressed less concern than boys that tanning caused immediate skin damage or premature aging. The pattern of correlations between the reasons for tanning and appearance orientation was similar for girls and boys. For both, appearance reasons for tanning and sociocultural influences on tanning were positively associated with appearance orientation. Suggestions for future research with adolescents and a proposal for a guiding model are provided.
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Affiliation(s)
- Suzanne M Prior
- Department of Psychology, St. Thomas University, Fredericton, NB, Canada.
| | | | - Jasmine C Peterson
- Department of Psychology, St. Thomas University, Fredericton, NB, Canada
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15
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Uter W, Benz M, Mayr A, Gefeller O, Pfahlberg A. Assessing skin pigmentation in epidemiological studies: The reliability of measurements under different conditions. Skin Res Technol 2012; 19:100-6. [DOI: 10.1111/srt.12013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2012] [Indexed: 02/07/2023]
Affiliation(s)
- W. Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen; Erlangen Germany
| | - M. Benz
- Fraunhofer Institute for Integrated Circuits; Erlangen Germany
| | - A. Mayr
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen; Erlangen Germany
| | - O. Gefeller
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen; Erlangen Germany
| | - A. Pfahlberg
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen; Erlangen Germany
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