A re-evaluation of teenage sunbed use following the introduction of banning legislation for under 18-year-olds

Background

There is little information on the effectiveness of introducing age restriction legislation alone to reduce the rate of sunbed usage by teenagers. Prior to the Public Health (Sunbed) Act of 2014 prohibiting the use of sunbeds in under 18-year-olds in Ireland we reported the rate of sunbed use at 7.5%.

Objectives

The aim of the study was to compare the rate of sunbed usage among Irish teenagers before and after the introduction of banning legislation to determine if it had the desired effect of reducing its rate of use.

Methods

In a cross-sectional survey, students from the same schools as in our previous study completed an anonymous, written questionnaire pertaining to sunbed usage.

Results

In total, 783 questionnaires, from 13 schools across Ireland, were completed. The rate of sunbed use in the current study was 7.2%, compared to 7.5% in the pre-ban study, (P = 0.76). A higher rate of sunbed use was observed in Dublin schools and female public students.

Conclusion

Our study suggests that legislation alone is ineffective at reducing sunbed usage in a teenage population. A multifaceted approach is required that includes enforcement of the legislation together with targeted public education and awareness campaigns using all aspects of the media.

Seeking help in times of economic hardship: access, experiences of services and unmet need

BACKGROUND

Economic recessions are often accompanied by increased levels of psychological distress and suicidal behaviour in affected populations. Little is known about the experiences of people seeking help for employment, financial and benefit-related difficulties during recessions. We investigated the experiences of people struggling financially in the aftermath of the Great Recession (2008-9) - including some who had self-harmed - and of the frontline support staff providing assistance.

METHODS

Interviews were conducted with three groups of people in two cities: i) people who had self-harmed due to employment, financial or benefit concerns (n = 19) ('self-harm'); ii) people who were struggling financially drawn from the community (n = 22), including one focus group) ('community'); iii) and frontline staff from voluntary and statutory sector organisations (e.g., Job Centres, Debt Advice and counselling agencies) providing support services to the groups (n = 25, including 2 focus groups) ('service providers'). Data were analysed using the constant comparison method.

RESULTS

Service provision was described by people as confusing and difficult to access. The community sample reported considerably more knowledge and access to debt advice than the participants who had self-harmed - although both groups sought similar types of help. The self-harm group exhibited greater expectation that they should be self-reliant and also reported lower levels of informal networks and support from friends and relatives. They had also experienced more difficult circumstances such as benefit sanctions, and most had pre-existing mental health problems. Both self-harm and community groups indicated that practical help for debt and benefit issues would be the most useful - a view supported by service providers - and would have particularly helped those who self-harmed.

CONCLUSION

Interventions to identify those in need and aid them to access practical, reliable and free advice from support agencies could help mitigate the impact on mental health of benefit, debt and employment difficulties for vulnerable sections of society.

Zachsia zenkewitschi (Teredinidae), a Rare and Unusual Seagrass Boring Bivalve Revisited and Redescribed

The sea-grass borer Zachsia zenkewitschi belongs to a group of economically and ecologically important bivalves, commonly referred to as shipworms. The sole recognized representative of the genus Zachsia, this species displays an unusual life history and reproductive strategy that is now understood to include: environmental sex determination of free swimming larvae, extreme sexual and size dimorphism between males and females, internal fertilization, maintenance of often large harems of male dwarfs within a specialized cavity of the female mantle, and complex maternal care of larvae in specialized brood pouches within the gill. It is also the only shipworm species known to burrow in sea grass rhizomes rather than terrestrial wood. Although Z. zenkewitschi is rare and little studied, understanding of its biology and anatomy has evolved substantially, rendering some aspects of its original description inaccurate. Moreover, no existing type specimens are known for this species. In light of these facts, we designate a neotype from among specimens recently collected at the type location, and undertake a re-description of this species, accounting for recent reinterpretation of its life history and functional anatomy.

The preparticipation evaluation for athletes with disability

BACKGROUND

Athletes are routinely assessed medically prior to competition. Although standardized preparticipation examinations (PPEs) are available for able-bodied athletes, the literature lacks any validated equivalent for the athlete with disability (AWD). Since participation and level of competition is increasing in this population, evidence-based tools such as a standardized PPE form should be available for health professionals to assess AWD health and safety.

AIM OF THE STUDY

To develop an AWD-targeted standardized preparticipation history evaluation (PPE history) using consensus-based expert recommendations.

METHODS

Researchers developed a PPE history for critical evaluation of its content validity. Structured Delphi method for collecting and interpreting contributions from an expert panel using a series of questionnaires with controlled feedback was performed. Opinions based on the experience of related experts - physiotherapists, sports medicine physicians and physiatrists - were studied during each of the three survey rounds. The process was terminated once adequate consensus relating to the proposed PPE history document was reached.

RESULTS

Majority consensus was reached for forty-nine of fifty-four items to create a refined ten section AWD-specific document to supplement the current standardized PPE. Modifications were made by researchers to accommodate the five items that did not reach statistical consensus.

CONCLUSION

Consensus was reached on a variety of AWD-specific PPE items, including the disability-related history and functional review. Equipment issues represent a complex area of evaluation, worthy of future research and discussion. The current proposed PPE history tool is considered comprehensive and ready for application in a clinical setting as an adjunct to existing PPE tools. Injury research in the AWD population will provide guidance for refinement and further validation of this PPE history document.

LEVEL OF EVIDENCE

5.

Previously documented mutations in the epidermal growth factor receptor (EGFR) gene in a non-small cell lung cancer (NSCLC) population treated with gefitinib are not associated with response

7163

Background: Mutations in the tyrosine kinase domain of EGFR that may correlate with clinical features and response of NSCLC to EGFR tyrosine kinase inhibitors have been described. But, varying methodologies have contributed to an uncertain relationship between EGFR mutational status and response. This study sought to characterize EGFR mutations in microdissected tumour tissue from pts with advanced NSCLC treated with gefitinib and correlate their clinical data. Methods: Biopsy material from pts treated with gefitinib for advanced NSCLC at the British Columbia Cancer Agency was analyzed. Malignant cells (cytology specimens) or tissue (paraffin embedded biopsies) was reviewed and tumour cells isolated by laser- capture microdissection or manual scrape. Genomic DNA was extracted and exons coding for the EGFR tyrosine kinase domain (18 - 24) were amplified by PCR and sequenced. When insufficient, the priority was 18, 19, 21, followed by 20, 23, 22, and 24. EGFR mutational analyses were correlated with response to gefitinib and clinical features. Results: 61 pts were identified, 14 (23%) radiological responders (CR, PR): 10 Asian, 10 female, 8 non-smokers, 8 adenocarcinoma, 2 BAC. Of 51 tumour samples available, 39 had adequate tissue for sequencing analysis. EGFR copy number by FISH is pending. Laser-capture microdissection allowed for high quality DNA to be extracted almost exclusively from tumour. Exons 18, 19, 20, 21, 22, 23 and 24 have been sequenced in 37, 34, 30, 33, 12, 10, and 13 patients, respectively. 4 mutations were identified: 2 in 2 non-smoking Asian pts (exon 19; deletion or substitution of L747-T751) and 2 in Caucasians (exon 20 point mutation resulting in a L798F substitution). None of these pts had a response to gefitinib. Conclusions: As with other series, most responders were female, non-smokers of Asian origin. Our results support the relationship between Asian ethnicity and EGFR mutations but question the role of EGFR mutational status in predicting response. Prospective studies will need to focus the detection of additional genetic features using accurate and reproducible techniques before recommendations for selecting populations to be treated can be made.

No significant financial relationships to disclose.