In Australia, vitamin D supply in food is limited, and sun exposure is the main source of vitamin D. However skin cancer risk is high, and the need to gain some sun exposure for adequate vitamin D is ...challenging public health messages to use protection in the sun. The complex vitamin D public health message may be confusing the public and, in particular, those at highest risk for vitamin D deficiency. This study explored vitamin D and sun exposure attitudes, knowledge and practices of some groups considered at risk of vitamin D deficiency and those delivering healthy sun exposure messages to children.
52 adults participated in six focus groups.
Results corroborated with previous research showing low levels of vitamin D knowledge. Individual and environmental barriers to receiving adequate sun exposure were also identified.
The message advocating balanced sun exposure to produce adequate vitamin D needs to be made clearer and be more effectively communicated. Findings provide insights to aid development of appropriate public health messages for safe sun exposure and vitamin D, especially for vulnerable groups.
This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and ...strategies for increasing the amount of health research conducted with socially disadvantaged groups.
A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition.
In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials.
To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships.
Although many countries still face opposition to the legislation of artificial tanning beds, all Australian states and territories have announced a total ban on commercial tanning beds. A combination ...of epidemiological and policy-centered research, powerful personal stories, and the active advocacy of prominent academics, cancer organizations, and grassroots community campaigners contributed to the decisions to first legislate standards and then ban all commercial tanning beds. We have illustrated that incremental change can be an effective pathway to securing substantial public health reforms.
This study aimed to assess the attitudes, practices and knowledge of general practitioners (GPs) with regards to vitamin D. A cross‐sectional survey of a random sample of GPs stratified by location ...of practice (rural/remote or metropolitan) and employment status (full‐time or part‐time) in New South Wales (NSW), Australia was conducted. Of 500 respondents, 58.1% (95% CI 53.8–62.4) reported that up to 39% of their tested patients showed vitamin D deficiency or insufficiency and a further 37.7% (95% CI 33.5–41.9) of respondents said that over 40% of their patients were vitamin D insufficient. Vitamin D supplementation and advice to receive more natural sunlight were the most common ways vitamin D insufficiency was managed (97.1%; 95% CI 95.6–98.6 and 82%, 95% CI 78.6–85.4, respectively). Some gaps in knowledge were identified. Most respondents (64%; 95% CI 59.8–68.2) believed that a person of average sun sensitivity required 10 min of direct sun exposure during summer in peak UV time and a further 21.6% (95% CI 18.0–25.2) believed that people required 30 min of direct sun. A third of respondents (33.1%; 95% CI 29.0–37.2) advised their patients to use sun protection at all times during winter. In general, the attitude items showed that respondents expressed greater concern about vitamin D deficiency than skin cancer. The results reveal some confusion in general practice regarding vitamin D, sun exposure, sun protection and skin cancer risk. Some of the advice that GPs are offering may needlessly increase their patients' risk for vitamin D insufficiency or skin cancer.
Summary
Skin cancers including melanoma and non‐melanoma skin cancers are a high‐cost and largely preventable form of cancer. While limiting exposure to solar ultraviolet (UV) light via outdoor ...activities is a focus of public health efforts, indoor UV exposure via solaria or ‘tanning booths’ has also become a cause for concern. In recent decades the availability of less harmful non‐UV self‐tanning products such as sprays and lotions has increased. This review explores (i) the available data regarding the prevalence and behavioural factors associated with use of solaria and self‐tanning products and (ii) data that may shed light on the likelihood of solaria users substituting self‐tanning products as a less harmful alternative to solaria exposure. While there are insufficient data on which to draw a firm conclusion about the potential for substitution, it appears unlikely that most solaria users would readily substitute self‐tanning products in place of solaria exposure. Public health advocates may need to consider whether a robust research study of the cost‐effectiveness of encouraging substitutional use of self‐tanners is desirable, or whether efforts to severely restrict access to solaria may be a better approach.
Objective: In Australia, vitamin D supply in food is limited, and sun exposure is the main source of vitamin D. However skin cancer risk is high, and the need to gain some sun exposure for adequate ...vitamin D is challenging public health messages to use protection in the sun. The complex vitamin D public health message may be confusing the public and, in particular, those at highest risk for vitamin D deficiency. This study explored vitamin D and sun exposure attitudes, knowledge and practices of some groups considered at risk of vitamin D deficiency and those delivering healthy sun exposure messages to children. Method: 52 adults participated in six focus groups. Results: Results corroborated with previous research showing low levels of vitamin D knowledge. Individual and environmental barriers to receiving adequate sun exposure were also identified. Conclusions and Implications: The message advocating balanced sun exposure to produce adequate vitamin D needs to be made clearer and be more effectively communicated. Findings provide insights to aid development of appropriate public health messages for safe sun exposure and vitamin D, especially for vulnerable groups.
The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the ...presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past.
The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI).
Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child - OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years - logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km - logOR = 3.45 (95%CI: 1.05-11.36), time spent with child < 1 hour/day - logOR = 6.28 (95%CI: 1.98-19.91).
Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.
Biodegradability of polyesteramides prepared by anionic ring-opening copolymerization of ε-caprolactone and ε-caprolactam and of aromatic-aliphatic co-polyesters (PETP/LA) synthesized by solvolysis ...of poly(ethyleneterephthalate) with water solutions of lactic acid by microorganisms producing extracellular esterase and lipase was investigated. The bacterium Pseudomonas aeruginosa, yeast Candida guilliermondii and micromycete Aspergillus fumigatus exhibiting strong esterase and lipase activities on agar plates with artificial nitrophenyl substrates were selected to be used in six-week degradation experiments at 28°C. PETP/LA samples exhibited mass reductions of up to 5-10% in both the presence of the three microorganisms and in abiotic controls where the polymers were exposed only to Nutrient Broth or malt extract-glucose medium. Scanning electron microscopy revealed breaks in PETP/LA fibres when polymers were exposed to A. fumigatus and C. guilliermondii, attributable to microbial action. Polyesteramides were resistant to biodegradation. Degradation of both polymer types resulted in a 5-10-fold increase of toxicity of culture supernatans measured with Vibrio fischeri bioluminescence test and Sinapis alba germination plant test, as compared to the biotic and abiotic controls. No genetic toxicity was detected with Salmonella typhimurium His- test. The study suggests that ecotoxicity of compounds produced by biodegradation of polymers should be monitored.
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•Polyesteramide- and aromatic-aliphatic copolyester polymers were synthesized.•Their biodegradability by esterase/lipase- producing microorganisms was investigated.•Weak polymer mass reductions were detected, paralleled by an increase of toxicity.•Electron microscopy showed breaks in aromatic-aliphatic copolyester caused by fungi.•No breaks resulting from biodegradation were observed in polyesteramide polymers.
Studies on childhood asthma demonstrate socioeconomic disparities in medical care utilization. A lack of information for Poland prompted our investigation into this question. Its goal was to discover ...if the utilization of medical services by asthmatic children depends on social and family factors.
Subjects were 186 children with physician-diagnosed asthma, identified through a questionnaire survey of 4,535 school children in Katowice District, Poland. Utilization of medical care was assessed by such past year events as medical visits (44.0%), any diagnostic test (35.4%) and spirometry (30.6%). Association of those events with socioeconomic variables was explored by means of logistic regression, according to the criterion p< 0.1.
After adjustment for disease severity and gender medical visits were related to younger age (p=0.009), family history of respiratory diseases (p=0.08) and rural residence (p=0.09), any diagnostic tests to younger age (p=0.08), smaller number of siblings (p=0.01) and rural residence (p=0.004); spirometry to smaller number of siblings (p=0.09) and rural residence (p=0.006).
Clinical status and age are important determinants of utilization of medical services by asthmatic children. The effects of rural residence and family size may reflect a more attentive response to the needs of a sick child.
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