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Matthews KRW, Lowe SJ, Master Z. US state laws on medical freedom and investigational stem cell procedures: a call to focus on state-based legislation. Cytotherapy 2024; 26:404-409. [PMID: 38310500 PMCID: PMC11010147 DOI: 10.1016/j.jcyt.2024.01.002] [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] [Received: 06/22/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
The premature marketing of investigational stem cell interventions (SCIs) is a growing market in the US. Several US states have passed legislation to permit and promote unproven and experimental SCIs for individuals with terminal or chronic diseases. These SCI medical freedom laws, which are largely based on right-to-try legislation, increase access to experimental SCIs with little to no oversight. They undermine federal regulatory authority and can compromise patient safety and informed decision-making. SCI medical freedom laws have gone largely unnoticed by scientific societies interested in the responsible translation of stem cell medicine. In this article, we analyze state SCI medical freedom laws and describe their detrimental impact on patients and society. We contend that scientific and medical societies are uniquely poised to advocate against state-based policy promoting unproven SCIs but recognize resource and other constraints to advocate for or against legislation in 50 states. We recommend societies establish coalitions and share resources to address state-based SCI medical freedom laws and other legislation surrounding unproven SCIs.
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Affiliation(s)
- Kirstin R W Matthews
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA.
| | - Samantha J Lowe
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA
| | - Zubin Master
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA; Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
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Woźna J, Stępka J, Bałoniak A, Adamski Z. Evaluation of social knowledge on photoprotection and its relationship with education and age in a Polish seaside town during summer holidays. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12920. [PMID: 37927110 DOI: 10.1111/phpp.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE This survey aimed to evaluate knowledge of photoprotection among individuals from a random group in a resort town in Poland, Kołobrzeg, and explore the correlation between their knowledge and demographics like age, gender, education, and residence. METHODS An anonymous survey was conducted among a diverse group. This population comprised individuals from various backgrounds: health spa patients undergoing treatments, therapies and medical appointments, guests visiting the resort for leisure, passersby, and staff working at the spa and recreational facilities. The survey was designed by authors, encompassed 16 questions about knowledge on photoprotection, sunscreen use and related topics, and gathered demographic data. Responses from 142 individuals were statistically analyzed using PQStat Software. RESULTS Only 7.7% use sunscreen all year-round. The majority apply sun protection factor (SPF) creams on sunny days or with prolonged sun exposure. Over half of the respondents (53.5%) are aware when to apply sunscreen but 43% reapply it less than every 4 h. 25.4% do not reapply at all. 38.7% think protection provided by higher SPF means longer sun exposure time. Over 50% believe SPF 30 offers double the protection of SPF 15. Almost half (46.8%) use extra sun protection, like sunglasses or hats. Significant correlations exist between education/age and certain survey responses. CONCLUSIONS The findings emphasize the urgency to improve photoprotection knowledge in the Polish population, particularly regarding the year-round harmful solar effects and the correct use of sun protection products.
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Affiliation(s)
- Julia Woźna
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jan Stępka
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Andrzej Bałoniak
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Zygmunt Adamski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
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Diehl K, Battenberg MC, Jansen C, Görig T. Sun Protection Counseling at the Pharmacy: A German Qualitative Study on Status Quo, Potential Deficits, and Sources of Information. Healthcare (Basel) 2023; 11:1907. [PMID: 37444741 PMCID: PMC10341076 DOI: 10.3390/healthcare11131907] [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: 12/22/2022] [Revised: 06/02/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
The sale of sunscreen products is lucrative for pharmacies, and many people buy sunscreen in pharmacies because they expect to receive good advice on sunscreen use and sun protection. However, little is known about the knowledge level of pharmacists and pharmacy technicians in the field of skin cancer prevention. By conducting a qualitative study in Germany, we aimed to explore what pharmacy personnel know about sun protection and the proper use of sunscreens, where they get their information from, and where they see deficits concerning these topics. We found that there is a need for education regarding the terms skin type and sun protection factor, both of which can be helpful tools when advising customers on sun protection. In addition, participants wished for more independent information from health authorities because sunscreen manufacturing companies, which offer product-specific information, are often the only source of information. Overall, it seems reasonable that pharmacy staff should be educated more about sun protection behavior and the proper use of sunscreen to be able to advise their customers correctly. Our findings offer a starting point for strengthening the role of pharmacies in skin cancer prevention. It seems to make sense to develop and offer tailored handouts for customer counseling. Since sunscreen products are perceived as seasonal products, an educational leaflet can help refresh knowledge about the use of sunscreen and the concepts of skin type and sun protection factor in early summer.
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Affiliation(s)
- Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Professorship of Epidemiology and Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | | | - Charlotte Jansen
- Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Tatiana Görig
- Department of Medical Informatics, Biometry and Epidemiology, Professorship of Epidemiology and Public Health, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
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Julian AK, Tribby CP, Perna FM. Visual Aids for Sunscreen Application: A mixed methods study. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2023; 39:21-26. [PMID: 35462431 DOI: 10.1111/phpp.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/04/2022] [Accepted: 04/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Consumers routinely underapply sunscreen, and this may be because they misinterpret application quantity directions on sunscreen labels. U.S. labels use ambiguous terms such as "apply generously" to communicate application quantity. Visual aids may be helpful to consumers to determine proper application quantity. PURPOSE To examine sunscreen application practices and sunscreen quantity visual aid preferences. METHODS Sets of five GIFs and five static images were created corresponding to five quantities of sunscreen. Participants extracted their typical-use sunscreen quantity from a pre-measured tube and answered questions about their estimation process and use of labeled instructions. Participants then identified their typical-use sunscreen quantity in response to three stimuli: teaspoons, images, and GIFs and reported their preferred format. RESULTS No participants reported using the label directions for application quantity to inform their sunscreen use. The GIF-based visual aid for sunscreen application quantity (44%) was preferred over image-based (40%) or teaspoon-based (16%) versions (p = .0249). Addition of a GIF demonstration to clarify application quantity was reported as highly helpful. CONCLUSION Consumers have difficulty determining the appropriate quantity of sunscreen to use and labeling does not influence their application quantity. A QR code incorporating an image or GIF demonstration of proper sunscreen quantity could be useful to sunscreen consumers.
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Affiliation(s)
- Anne K Julian
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
| | - Calvin P Tribby
- Health Data at Scale Collaboratory, Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Frank M Perna
- Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
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Rigel D, Lim HW, Draelos Z, Weber TM, Taylor S. PHOTOPROTECTION FOR ALL: CURRENT GAPS AND OPPORTUNITIES. J Am Acad Dermatol 2021; 86:S18-S26. [PMID: 34942298 DOI: 10.1016/j.jaad.2021.12.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 12/31/2022]
Abstract
The effects of solar radiation on human skin differ based on skin phototype, the presence or absence of photodermatoses, biological capacity to repair DNA damage, wavelength, intensity of sun exposure, geographic latitude, and other factors, underscoring the need for a more tailored approach to photoprotection. To date, the focus of photoprotection guidelines has been to prevent sunburn and DNA damage induced by ultraviolet (UV) radiation, both UVB and UVA; however, several recent studies have shown that visible light (VL) also generates reactive oxygen and nitrogen species that can contribute to skin damage and pigmentation on the skin, particularly in people of color. Therefore, dark-skinned individuals, while naturally better protected against UVB radiation by virtue of high eumelanin content in melanocytes, may need additional protection from VL-induced skin damage. The current options for photoprotection products need to expand, and potential strategies against VL include the addition of iron oxide, titanium dioxide, and biologically relevant antioxidants to sunscreen formulations, as well as supplementation with orally active antioxidants.
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Affiliation(s)
- Darrell Rigel
- Department of Dermatology, Icahn School of Medicine at Mt. Sinai, New York, NY USA
| | - Henry W Lim
- Department of Dermatology, Henry Ford Hospital, Detroit, MI USA
| | - Zoe Draelos
- Dermatology Consulting Services, PLLC, High Point, NC USA
| | | | - Susan Taylor
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
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Levine A. Reducing the prevalence of chemical UV filters from sunscreen in aquatic environments: Regulatory, public awareness, and other considerations. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2021; 17:982-988. [PMID: 33913613 DOI: 10.1002/ieam.4432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/25/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
Given increasing concerns about the persistence and toxic effects of some sunscreen ingredients in aquatic ecosystems, several states, territories, and nations have banned the sale and/or possession of sunscreens containing chemicals of concern. Little is known, however, about the outcomes or effectiveness of these efforts to reduce the prevalence of toxic chemicals in coastal waters. This article reviews the state of knowledge relating to regulatory and other efforts to reduce the impact of chemical ingredients in sunscreens on aquatic ecosystems, focusing on the following questions: To what extent will local legislative restrictions on ingredients actually reduce the concentrations of chemicals in coastal waters and protect aquatic health? Do these legislative measures effectively decrease overall public use of sunscreens containing potentially harmful ingredients, or would other measures, such as local outreach programs, consumer education, or broad-scale ingredient regulation, be more effective? How might restrictions on chemical UV filters impact human health? Although it is still early to assess the outcomes of recent ingredient bans, their effectiveness is limited by the fact that legislation generally applies only to sunscreens sold within the legislating jurisdiction. Public awareness campaigns can be locally effective, but they are hindered by the absence of clear environmental labeling standards for sunscreen. Although retail and industry groups, and many dermatologists, cite concerns that sunscreen ingredient bans might lead to increased incidences of skin cancer, consumer preferences are influenced by a wide range of factors and no studies clearly document whether restrictions on chemical ingredients will cause people to use sun protection less frequently or less effectively. Until more information is available, many consider it prudent to take a precautionary approach to sunscreen regulation supported by broad-scale, consistent regulatory policies and labeling standards that limit chemical ingredients to those considered safe for human use and ecosystem health. Integr Environ Assess Manag 2021;17:982-988. © 2021 SETAC.
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Affiliation(s)
- Arielle Levine
- Department of Geography, San Diego State University, San Diego, California, USA
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Al-Qarqaz F, Marji M, Bodoor K, Al ALshiyab D, Muhaidat J, Al Ghamdi S. Awareness about proper use of sunscreen in people of color: A Jordanian-based survey. J Cosmet Dermatol 2020; 19:1131-1136. [PMID: 31468687 DOI: 10.1111/jocd.13120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/24/2019] [Accepted: 08/01/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The use of sunscreen is an important preventive measure against skin cancer and treatment for other skin conditions. There is evidence pointing to lack awareness and misconceptions regarding use of Sunscreen. This is especially evident in populations with skin of color (POC). METHODS This is a cross-sectional study of 2000 individuals. A structured questionnaire was designed to collect data on general knowledge and use of sunscreen as well as reasons for stopping use of sunscreen. RESULTS The results of this study indicate a clear deficiency in the use and knowledge about sunscreen among Jordanians. Females are using sunscreen more than males. However, the use of sunscreen is inadequate in many aspects including timing of application, frequency of use, and amount used among other things. There is an obvious lack of knowledge about sunscreen as shown by lack of awareness about benefits of use in various times of the year, use in children, use for all skin types, and several misconceptions among other knowledge gaps. Main reasons for stopping sunscreen include side effects, cost, and being not suitable for skin. Awareness about sunscreen can be improved by proper counseling by healthcare professionals and utilization of various media platforms. CONCLUSIONS The use of sunscreen is inadequate in this population of color (POC). Lack of proper counseling, failure to read use instructions can contibute to inadequate use of sunscreen. Risks and benefits of sunscreen should be explained by medical professionals. The media should be more utilized to disseminate such knowledge.
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Affiliation(s)
- Firas Al-Qarqaz
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Maha Marji
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khaldon Bodoor
- Department of Biotechnology and Genetic Engineering, Faculty of Science, Jordan University of Science and Technology, Irbid, Jordan
| | - Diala Al ALshiyab
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Jihan Muhaidat
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Saleh Al Ghamdi
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Prado G, Ederle AE, Shahriari SR, Svoboda RM, Farberg AS, Rigel DS. Online sunscreen purchases: Impact of product characteristics and marketing claims. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:339-343. [DOI: 10.1111/phpp.12480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/16/2019] [Accepted: 05/11/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Giselle Prado
- National Society for Cutaneous Medicine New York New York
| | - Ashley E. Ederle
- University of Arkansas for Medical Sciences Little Rock Arkansas
| | | | - Ryan M. Svoboda
- Department of Dermatology Duke University School of Medicine Durham North Carolina
| | - Aaron S. Farberg
- Department of Dermatology Icahn School of Medicine at Mount Sinai New York New York
| | - Darrell S. Rigel
- Ronald O. Perelman Department of Dermatology NYU School of Medicine New York New York
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