Introduction Skin cancer is the most common cancer, and its incidence is increasing. Young adults expose themselves to large amounts of ultraviolet radiation (UV) and engage in minimal skin ...protection, which increases their risk. Internet interventions are effective in modifying health behaviors and are highly disseminable. The current study’s purpose was to test an Internet intervention to decrease UV exposure and increase skin protection behavior among young adults. Study design RCT conducted in 2014, with data analyzed in 2015. Setting/participants A national sample of adults aged 18–25 years at moderate to high risk of developing skin cancer by a self-report measure was recruited online. Intervention Participants were randomized to one of three intervention conditions: assessment only, the website of a skin cancer organization, or a tailored interactive multimedia Internet intervention program (UV4.me) based on the Integrative Model of Behavioral Prediction. Main outcome measures Self-reported overall UV exposure and skin protection assessed at 3 and 12 weeks after baseline. Secondary outcomes were self-reported intentional and incidental UV exposure, sunburns, sunscreen use, and skin cancer screening. Results For the intervention arm, there were significant decreases in UV exposure and increases in skin protection at both follow-up time points compared with the assessment-only condition ( p <0.001). The effect sizes (Cohen’s d ) comparing the experimental and assessment-only arm for exposure behaviors were 0.41 at 3-week follow-up and 0.43 at 12-week follow-up. The effect sizes for protection behaviors were 0.41 at 3-week follow-up and 0.53 at 12-week follow-up. The control condition was not significantly different from the assessment only condition. All three conditions exhibited decreased exposure and increased protection at both follow-ups ( p <0.01), but the effect was much stronger in the intervention group. Secondary outcomes were generally also significantly improved in the intervention condition compared with the other conditions. Conclusions This is the first published report describing the results of an RCT of an Internet intervention to modify skin cancer risk behaviors among young adults. The UV4.me intervention significantly improved self-reported skin cancer prevention behaviors. Future research will investigate mechanisms of change and approaches for dissemination. Trial registration This study is registered at www.clinicaltrials.gov NCT02147080.
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Head and Neck Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and ...maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the head and neck (H&N), and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding the increase in human papillomavirus-associated oropharyngeal cancer and the availability of immunotherapy agents for treatment of patients with recurrent or metastatic H&N cancer.
Exercise rates are low, but perceived support from close others can influence exercise habits. The purpose of the study was to examine the influence of perceived support for exercise as well as close ...others’ exercise habits on own exercise, and to examine the differential effects of friend’s exercise and romantic partner’s exercise.
Undergraduates (
N
=
220) at a northeastern university completed questionnaires on their own exercise habits, their romantic partner’s and best friend’s exercise habits, and perceived support for exercise.
Friend’s exercise was associated with own exercise, but only when perceived support was high. Being male, partner’s exercise, and friend’s exercise all independently predicted own exercise.
Exercise habits of close others are associated with one’s own exercise habits, though this relationship may vary depending on perceived support. Attention should be paid to women’s exercise habits, since they are less likely to exercise than men.
► We examined social support, close others’ exercise, and own exercise. ► We also examined the effects of friend’s versus romantic partner’s exercise. ► Friend’s exercise was associated with own exercise when perceived support was high. ► Exercise of close others and social support are associated with own exercise.
Online surveys are a valuable tool for social science research, but the perceived anonymity provided by online administration may lead to problematic behaviors from study participants. Particularly, ...if a study offers incentives, some participants may attempt to enroll multiple times. We propose a method to identify clusters of non-independent enrollments in a web-based study, motivated by an analysis of survey data which tests the effectiveness of an online skin-cancer risk reduction program.
To identify groups of enrollments, we used a hierarchical clustering algorithm based on the Euclidean distance matrix formed by participant responses to a series of Likert-type eligibility questions. We then systematically identified clusters that are unusual in terms of both size and similarity, by repeatedly simulating datasets from the empirical distribution of responses under the assumption of independent enrollments. By performing the clustering algorithm on the simulated datasets, we determined the distribution of cluster size and similarity under independence, which is then used to identify groups of outliers in the observed data. Next, we assessed 12 other quality indicators, including previously proposed and study-specific measures. We summarized the quality measures by cluster membership, and compared the cluster groupings to those found when using the quality indicators with latent class modeling.
When we excluded the clustered enrollments and/or lower-quality latent classes from the analysis of study outcomes, the estimates of the intervention effect were larger. This demonstrates how including repeat or low quality participants can introduce bias into a web-based study. As much as is possible, web-based surveys should be designed to verify participant quality. Our method can be used to verify survey quality and identify problematic groups of enrollments when necessary.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective: The study's purpose was to investigate moderator, implementation, and mediator variables related to the efficacy of UV4.me, an Internet intervention that decreased ultraviolet radiation ...(UV) exposure and increased skin protection behaviors among young adults. Method: A total of 965 18-25 year olds at risk for skin cancer were recruited nationally online. Participants were randomized to an experimental website (UV4.me), a control website, or assessment only. Participant characteristics (moderators), engagement with and perceptions of interventions (implementation measures), and exposure and protection attitudinal variables (mediators) were assessed. Linear regression and mediation analyses were conducted. Results: Intervention effects on skin protection were greater for participants with a family history of skin cancer (p = .01). Intervention effects on UV exposure were greater among recent indoor tanners (p = .04). Improvements in skin protection (but not UV exposure) were associated with perceiving the interventions as satisfying or helpful (ps < .01). The experimental group had better outcomes if they completed more modules (ps < .01) or set more behavioral goals (ps < .01). Knowledge and exposure decisional balance mediated intervention effects for UV exposure (ps < .05), and protection decisional balance, self-efficacy, and intentions mediated intervention effects for protection (ps < .05). Conclusions: The experimental intervention was more efficacious for certain high risk groups. The more individuals liked and engaged with the interventions (e.g., by setting goals), the better their outcomes. Mediation results inform theory about change mechanisms and differed by behavioral outcome.
Tanning during adolescence increases skin cancer risk. Relatively few studies have examined the association between thinness attitudes and tanning attitudes and behaviors. The purpose of the current ...study was to examine psychosocial predictors of sunbathing and tanning bed use, specifically thin ideal internalization (TII) and motives for tanning among high school girls. Adolescent girls (N = 229) completed a 10-minute questionnaire designed to assess sunbathing and indoor tanning, TII and motives to tan (appearance, social and well-being). Hierarchical regression analyses showed that TII, β = .05, p < .05, appearance motives, β = .11, p < .01 and well-being motives, β = .11, p < .01 were all independently positively associated with sunbathing. Social motives were negatively associated with sunbathing, β = −.07, p < .05. A three-way interaction was found between the three types of motives on indoor tanning, in that appearance and well-being motives interacted to increase indoor tanning levels, especially among those who strongly endorsed social motives for tanning, β = .22, p < .05. Motives for tanning, specifically those associated with appearance and well-being, can interact to increase tanning bed use. When designing tailored interventions for skin cancer prevention in young people, researchers should consider tailoring based on motivation. Researchers and healthcare professionals who work with adolescents should attend to tanners who are motivated for both appearance and mood-related reasons, as they may be most at risk for tanning dependence and skin cancer.
Ampullary cancers refer to tumors originating from the ampulla of Vater (the ampulla, the intraduodenal portion of the bile duct, and the intraduodenal portion of the pancreatic duct), while ...periampullary cancers may arise from locations encompassing the head of the pancreas, distal bile duct, duodenum, or ampulla of Vater. Ampullary cancers are rare gastrointestinal malignancies, and prognosis varies greatly based on factors such as patient age, TNM classification, differentiation grade, and treatment modality received. Systemic therapy is used in all stages of ampullary cancer, including neoadjuvant therapy, adjuvant therapy, and first-line or subsequent-line therapy for locally advanced, metastatic, and recurrent disease. Radiation therapy may be used in localized ampullary cancer, sometimes in combination with chemotherapy, but there is no high-level evidence to support its utility. Select tumors may be treated surgically. This article describes NCCN recommendations regarding management of ampullary adenocarcinoma.
Ultraviolet radiation (UV) therapy is sometimes used as a treatment for various common skin conditions, including psoriasis, acne, and eczema. The dosage of UV light is prescribed according to an ...individual's skin sensitivity. Thus, to establish the proper dosage of UV light to administer to a patient, the patient is sometimes screened to determine a minimal erythema dose (MED), which is the amount of UV radiation that will produce minimal erythema (sunburn or redness caused by engorgement of capillaries) of an individual's skin within a few hours following exposure. This article describes how to conduct minimal erythema dose (MED) testing. There is currently no easy way to determine an appropriate UV dose for clinical or research purposes without conducting formal MED testing, requiring observation hours after testing, or informal trial and error testing with the risks of under- or over-dosing. However, some alternative methods are discussed.
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