The Severe Skin Cancer Consequences of Extended Tanning Bed Use, A Case Report.

INTRODUCTION: Tanning bed use has been directly correlated with increased risk of melanoma and non-melanoma skin cancers with greater duration and frequency of use. Despite this, complete bans for minors accessing indoor tanning devices are active in less than half of the states in the United States. CASE PRESENTATION: A 65-year-old female presented to our Mohs surgery clinic with a history of left temporal T2a melanoma, multiple untreated advanced keratinocyte carcinomas, and innumerable smaller untreated keratinocyte carcinomas on her legs, arms, and back after more than 40 years of weekly tanning bed use. DISCUSSION: Reports from the literature indicate that first exposure under age 35 to tanning devices increases the risk for melanoma and non-melanoma skin cancers. Several programs currently focus on prevention, education, and legislative change surrounding this topic. CONCLUSIONS: Highlighting such severe cases may provide an effective form of education for the public regarding the potential disease burden that results from indoor tanning.

Exploring perceptions of and attitudes towards tanning with school children, parents/carers and educators in Wales: A mixed methods study protocol for the SunChat study.

BACKGROUND: Skin cancer comprises half of all cancers in England and Wales. Most skin cancers can be prevented with safer sun exposure. As over exposure as a child can greatly increase future skin cancer risk, early and accessible sun safety education and promotion of sun safe behaviours is critical. Scientists agree there is no such thing as a 'safe tan', yet the public, including children, often have positive perceptions of tanned skin. To protect against future skin cancer, it is important to understand and address these misconceptions. The Curriculum for Wales with its area for Health and Well-being, and autonomy for schools in designing curriculum content, presents an ideal way to facilitate this exploration. AIMS: Gather data regarding perceptions towards tanning to explore the perceived effects of a tan on health.Inform the development and testing of an educational toolkit for integration within the Curriculum for Wales to encourage positive health behaviours and attitudes of school children towards tanning and sun exposure. METHODS: SunChat is a mixed methods exploratory study comprising three work streams: Workshops with school children to understand their perceptions on tanning.An online multiple-choice survey with parents/carers to understand perceptions, attitudes and behaviours towards tanning both for themselves and their children.An informal focus group with primary school educators to explore challenges in engaging with the school community around the Health and Well-being Area in the Curriculum for Wales. DISCUSSION: To date, there has been no work in Wales exploring children's, parents/carers', and educators' perceptions of tanning and how healthier attitudes can be encouraged. This study will engage with participants to scope current perceptions on tanning and the perceived effects tanning has on health. Findings will feed into future toolkit and curriculum development for health in schools in Wales and beyond.

A prospective cohort study exploring the joint influence of sunlight exposure and tanning bed use on basal cell carcinoma, squamous cell carcinoma, and melanoma risk.

Exposure to solar ultraviolet (UV) radiation and use of UV-emitting tanning devices are known risk factors for skin cancer. Few studies have explored the interaction between these risk factors, namely how the risk of skin cancer increases among those who both have been exposed to high levels of natural sunlight and regularly use tanning beds. Nurses' Health Study II followed 116,430 women, aged 25-42, from 1991 to 2011. Cumulative average UV exposure was based on participants' residences at follow-up periods. History of severe sunburn during ages 15-20 was used as a proxy for early-life sunlight exposure. Tanning bed use in early life data was collected. Participants reported melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) diagnoses. We built multivariable Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for risk of skin cancer associated with joint effects of sunlight exposure and tanning bed use. Participants with high sunlight exposure and tanning bed use during high school/college had an increased risk of BCC (HR = 1.53, 95% CI 1.37-1.71, Pinteraction=0.01; vs. low sun exposure and no tanning bed use). Participants with a history of severe sunburns and tanning bed use during high school/college were at increased risk of BCC (HR = 1.62, 95% CI 1.47-1.79, Pinteraction=0.02; vs. no sunburns and no tanning bed use). No significant interactions were found between sunlight exposure and tanning bed use on SCC and melanoma risk. We found significant interactions between sunlight exposure and tanning bed use on the risk of BCC.

Attitudes and behaviors regarding sun exposure in Japan compared to Europe and North America.

The objective of our study was to assess the attitudes and behaviors in Japan regarding sun exposure and compare them to those in Europe and North America. The study population was a representative sample of individuals aged >18 years from Ipsos panels in Japan (N = 1000), North America (N = 1000), and Europe (N = 6000) using the quota method. Questionnaires covered habits, practices, and perceptions regarding sun exposure. Results revealed that the majority of people (80.1%) believed that the sun gives them energy, and 61.1% considered that being tanned made them look healthier. However, there was a significant difference between men and women regarding the appeal of tanned skin, with 54.95% of men versus 34.67% (p < 0.001) of women seeing a tan as an aesthetic asset. People aged <40 years were less likely to find a tan attractive (30.3%) compared to those aged ≥40 years (48.9%) (p < 0.001). Of those questioned, 45.70% of used sunscreen with a much higher use among women (70.10%) than men (18.74%) (p < 0.001). Almost 54% of people said they stayed in the shade to protect themselves from the sun with this behavior being more prevalent among women (67.05%) and fair-skinned individuals (56.13%). Fear of the risks of sun exposure was more common among women, with 84.8% fearing premature skin aging, compared to 71.8% of men (p < 0.001). In Japan, 44.30% of those questioned said tanned skin was attractive (p < 0.001); for Europeans and North Americans the proportions were 81.1% and 77.6%, respectively. Only a quarter (25.80%) thought it essential to return from vacation with a tan. On the other hand, Europeans showed a strong recognition of the energy the sun brings (83.18%), and widely believed that tanned skin is attractive (82.32%) and healthy (73.15%). In North America, attitudes were similar to those in Europe regarding the attractiveness of tanned skin (77.65%) and the importance of returning tanned from vacation (48.15%). Compared to Europeans and North Americans, the Japanese seemed to be more cautious about sun-induced hazards and considered lighter skin to be more attractive.

A photoaging smartphone application to promote sun safety behaviors among youth in late childhood and adolescence.

BACKGROUND: Ultraviolet (UV)-exposure behaviors can directly impact an individual's skin cancer risk, with many habits formed during childhood and adolescence. We explored the utility of a photoaging smartphone application to motivate youth to improve sun safety practices. METHODS: Participants completed a preintervention survey to gather baseline sun safety perceptions and behaviors. Participants then used a photoaging mobile application to view the projected effects of chronic UV exposure on participants' self-face image over time, followed by a postintervention survey to assess motivation to engage in future sun safety practices. RESULTS: The study sample included 87 participants (median [interquartile (IQR)] age, 14 [11-16] years). Most participants were White (50.6%) and reported skin type that burns a little and tans easily (42.5%). Preintervention sun exposure behaviors among participants revealed that 33 (37.9%) mostly or always used sunscreen on a sunny day, 48 (55.2%) experienced at least one sunburn over the past year, 26 (30.6%) engaged in outdoor sunbathing at least once during the past year, and zero (0%) used indoor tanning beds. Non-skin of color (18 [41.9%], p = .02) and older (24 [41.4%], p = .007) participants more often agreed they felt better with a tan. Most participants agreed the intervention increased their motivation to practice sun-protective behaviors (wear sunscreen, 74 [85.1%]; wear hats, 64 [74.4%]; avoid indoor tanning, 73 [83.9%]; avoid outdoor tanning, 68 [79%]). CONCLUSION: The findings of this cross-sectional study suggest that a photoaging smartphone application may serve as a useful tool to promote sun safety behaviors from a young age.

Skin cancer risk behaviors in sexual minority men: A mixed methods approach.

OBJECTIVE: Sexual minority men experience disproportionately elevated rates of skin cancers, likely driven by excess ultraviolet radiation exposure-namely through tanning behaviors. However, limited integrated theoretical models exist to explain sexual minority men's elevated skin cancer risk. The aim of the current study is to further test and refine an integrated theory of skin cancer risk behaviors among sexual minority men by incorporating minority stress into the integrated health behavior model of tanning. METHOD: The study employed a parallel mixed methods design, with a Phase 1 qualitative stage (N = 30) and a Phase 2 quantitative stage (Model 1: N = 320; Model 2: N = 319). In both phases, participants were sexual minority men, equally stratified as those with versus without recent tanning exposure and were recruited from across the United States. RESULTS: Qualitative and quantitative data supported the overall integrated model, with some quantitative paths varying depending on the tanning behavior outcome. Overall, appearance-related motives to tan and beliefs that tanning regulates affect emerged as the most consistent proximal predictors. Minority stress significantly predicted holding more positive attitudes toward tanning as an effective affect regulation strategy. CONCLUSIONS: The results from this mixed methods study support the inclusion of minority stressors into the adapted integrative health behavior model of tanning. Replication within prospective designs would strengthen the evidence for this model, which may be helpful in guiding future skin cancer prevention programs tailored to sexual minority men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Which factors influence the participation in statutory skin cancer screenings in Germany?

BACKGROUND AND OBJECTIVES: Due to increasing skin cancer incidence, Germany implemented a statutory nationwide routine skin cancer screening (rSCS) in 2008. The present study aims (1) to analyze which patient factors are associated with the participation in rSCS in Germany and (2) to investigate reasons for nonparticipation. PATIENTS AND METHODS: Participants and nonparticipants of rSCS (≥ 35 years) were recruited in routine care in nine dermatological outpatient clinics. Reasons for (non-)participation, knowledge about skin cancer as well as clinical and socioeconomic data were obtained. Stratified by groups, descriptive analyses and binary logistic regression analyses for associations with participation were performed. RESULTS: Of the 294 rSCS participants and 162 non-participants, 46.5% were male with a mean age of 54.5 ± 12.7 years. In total, 87.1% had sunburns in childhood and 47.1% used sunbeds before. Higher age, female gender, previous sunbed use, and concern for and knowledge of skin cancer were significantly associated with previous rSCS participation. Of the non-participants, 46% were unaware of the option for free rSCS and 40% justified their nonparticipation on the basis of feeling healthy. CONCLUSIONS: The reasons for nonparticipation in rSCS, such as sociodemographic characteristics and risk behavior, should be known in order to optimize rSCS programs.

Protocol for a cluster-randomized trial of a school-based skin cancer preventive intervention for adolescents.

BACKGROUND: Adolescents infrequently use sun protection and engage in intentional tanning more frequently compared to other age groups, leading to increased ultraviolet radiation (UVR) exposure that heightens skin cancer risk across the lifespan. High schools are therefore an ideal setting for offering skin cancer preventive interventions. Yet, there are limited UVR protection interventions for high school students, especially those that are personalized, tested using randomized designs, and include long-term outcome assessment to determine the durability of intervention effects. METHOD: The Sun-safe Habits Intervention and Education (SHINE) cluster-randomized trial will test a novel, personalized intervention that targets high school adolescents' sun protection and tanning behaviors, and tracks their outcomes for up to one year following intervention. Enrolled high schools will be randomized to receive either the personalized SHINE intervention, which includes facial UVR photographs and sun protection action planning, or standard education using publicly available materials. Students in both conditions will receive information about skin cancer, sun protection, and skin self-examination. Outcome variables will include students' sun protection and tanning behaviors and sunburn occurrence. Potential moderators (e.g., race/ethnicity) and mediators (e.g., self-efficacy) will also be assessed and tested. CONCLUSIONS: This trial examines the efficacy of a personalized intervention targeting sun protection and tanning of high school students. The project will lead to new scientific understanding of the theoretical mechanisms underlying outcomes and moderators of the intervention effects, which will inform future intervention tailoring to meet the needs of vulnerable subgroups.

2-Mercaptonicotinoyl glycine prevents UV-induced skin darkening and delayed tanning in healthy subjects: A randomized controlled clinical study.

BACKGROUND: Chronic nonextreme sun exposure induces two mechanisms of skin pigmentation, causing immediate darkening and delayed tanning. A new molecule, 2-mercaptonicotinoyl glycine (2-MNG), has been shown in vitro to inhibit both immediate darkening and new melanin synthesis via covalent conjugation of the thiol group of 2-MNG to melanin precursors. OBJECTIVE: To evaluate 2-MNG in preventing both mechanisms in vivo. METHODS: In a randomized, intra-individual and controlled study, 33 subjects with melanin-rich skin were exposed to UV daylight on designated areas on the back and treated with a cosmetic formula containing 0.5% or 1% 2-MNG alone or 0.5% 2-MNG in association with lipohydroxy acid (LHA, 0.3%) plus Mexoryl-SX (MSX, 1.5%). The respective vehicles were used as controls and 4-n-butyl-resorcinol (4-n-BR, 2.5%) as a positive reference. RESULTS: 2-MNG alone significantly reduced immediate darkening and inhibited new melanin production when compared with vehicle, with higher performance at 1% than at 0.5%. 2-MNG at 0.5% in association with LHA and MSX showed significantly higher performance than 2-MNG 0.5% alone. 2-MNG at 0.5% and 1% showed significantly better performance than 4-n-BR. CONCLUSIONS: 2-MNG inhibited both UV-induced skin pigmentation mechanisms in vivo. The association of 2-MNG with LHA plus MSX showed the highest efficacy on melanin-rich skin with pigmentation induced by UV exposure.

Association of sun-seeking behaviors with indoor tanning behavior in US white females during high school/college in Nurses' Health Study II.

BACKGROUND: Frequent exposure to ultraviolet light has more detrimental and longer-term effects on the skin in early life than in adulthood. Teenagers with strong sun-seeking behaviors may be more likely to use an indoor tanning bed than those who seek less sun. We aimed to examine associations between sun-seeking behaviors and indoor tanning behavior during high school/college in US females. METHODS: In this cross-sectional study, we used data from The Nurses' Health Study II, a large prospective cohort of US female nurses. We included a total of 81,746 white females who provided responses on the average annual frequency of indoor tanning during high school/college. Our study exposures were number of times/week spent outdoors in a swimsuit and percentage of time wearing sunscreen at the pool/beach as a teenager, weekly hours spent outdoors in direct sunlight during the daytime during high school/college, and number of severe sunburns that blistered between ages 15-20 years. The main outcome was annual frequency of indoor tanning bed usage during high school/college. RESULTS: In multivariable-adjusted logistic regression, we demonstrated positive associations between sun-seeking behaviors and indoor tanning use. Specifically, teenagers who spent 7 times/week outdoors in a swimsuit (adjusted odds ratio [aOR], 95% confidence interval [CI] for daily vs. <1/week: 2.68, 1.76-4.09) were more likely to use indoor tanning beds ≥ 12 times/year. Teenagers with ≥ 10 sunburns (aOR, 95% CI for ≥ 10 vs. never: 2.18, 1.53-3.10) were more likely to use indoor tanning beds ≥ 12 times/year. Also, teenagers/undergraduates who spent ≥ 5 h/week outdoors in direct sunlight (aOR, 95% CI for ≥ 5 h/week vs. <1 h/week: 2.18, 1.39-3.44) were more likely to use indoor tanning ≥ 12 times/year. However, there was not a significant association between average usage of sunscreen at the pool/beach and average usage of indoor tanning beds. Multivariable-adjusted linear regression models also showed similar results. CONCLUSIONS: Teenagers who spent more time outdoors in a swimsuit/direct sunlight or got more sunburns tended to use indoor tanning more frequently. These findings provide evidence that teenagers with stronger sun-seeking behaviors may have more exposure to artificial ultraviolet radiation as well.

Tanning bed use in Germany between 2015 and 2022: Representative data of 28,000 individuals on indoor tanning, risk awareness and reasons for use.

BACKGROUND: Tanning beds were classified as first-group carcinogens in 2009. Nonetheless, research shows that people in industrialized Western countries use tanning beds. Based on the National Cancer Aid Monitoring (NCAM) including representative data on 28,000 individuals from Germany, we quantified the prevalence as a trend from 2015 to 2022, identified determinants of tanning bed use and analysed risk awareness and reasons for use. METHODS: We used NCAM data from 2015 to 2022 to analyse the trends in the prevalence of tanning bed use (n = 28,000). To determine the characteristics of tanning bed users, risk awareness and reasons, we combined data from the waves 2019 to 2022 (n = 16,000, 49.2% female, 16-65 years) in a pooled dataset to have sufficient power to detect even smaller associations. RESULTS: Tanning bed use decreased to 5.1% in 2022. The use of tanning beds in spas, fitness and beauty facilities increased, except during the COVID-19 pandemic, while the use in tanning salons decreased. Typical tanning bed users were female, middle-aged, occupied, higher educated, had an immigrant background and were former or current smokers. Risk awareness was the lowest among the current users. The most frequently mentioned reasons were relaxation, enhancement of attractiveness and pre-tanning. DISCUSSION: Our nationwide representative data showed that the prevalence of indoor tanning has decreased. Of concern are the lower risk awareness among current users and the shift in place of use towards facilities associated with health and wellness. To further reduce the use of tanning beds, targeted information, educational campaigns and extended legislation are considered helpful.

Alternative therapy improves hematological profiles of captive snakes from northeastern Brazil / Efeitos positivos de uma terapia alternativa nos perfis hematológicos de serpentes cativas no nordeste brasileiro

Objective: Evaluate the effects of alternative therapy on the hematological profiles of different families of captive snakes. Methodology: Captive snakes at NUROF-UFC were submitted to a clinical and hematological evaluation before and after applying an alternative treatment, including systematic sunbathing and hydration by soaking bathes twice a week for five weeks. The biometric, clinical, and hematological data were compared by multivariate analysis of variance and investigated for possible causal relationships by general linear models. Results: A significant difference was observed between erythrograms and global leukograms in the three families of snakes evaluated before and after treatment. The significant reduction in the heterophil: lymphocyte ratio in the Family Colubridae after treatment was noteworthy. Discussion: The results were most likely due to stress level reduction by improving thermoregulation and conversion of vitamin D during sunbathing, oral rehydration and refreshing in soaking baths, and general metabolic rates due to physical exercise. Conclusion: The results confirm the initial hypothesis, assuming that a simple but systematic treatment that included sunlight exposure and immersion hydration was efficient in reducing stress rates.

Objetivo: Avaliar a influência de banhos de sol e de imersão em água nos perfis hematológicos de serpentes cativas, antes e após a aplicação deste tratamento alternativo. Metodologia: Serpentes cativas no NUROF-UFC foram submetidas à avaliação clínica e hematológica, depois submetidas ao tratamento alternativo por cinco semanas, sendo novamente avaliadas após. Os dados obtidos foram submetidos à análise estatística multivariada (NPMANOVA e GLM) para investigação de possíveis relações causais entre o tratamento e os perfis hematológicos. Resultados: Foi observada diferença significativa entre os eritrogramas e leucogramas nas três famílias de serpentes avaliadas antes e após o tratamento. Ressalta-se a redução significativa na razão heterófilos:linfócitos na Família Colubridae após o tratamento. Discussão: A diferença estatística deveu-se provavelmente à redução nos níveis de estresse, possibilitada por aquecimento e aumento de conversão da vitamina D durante a exposição solar; reidratação oral e refrescância nos banhos de imersão, e ao recondicionamento pelo exercício físico. Conclusão: Os resultados confirmaram a hipótese inicial, admitindo que um tratamento alternativo, simples mas aplicado sistematicamente, que incluiu exposição à luz solar e hidratação por imersão em água foi eficiente em reduzir as taxas de estresse em serpentes cativas.

A relação com o saber nas atividades lúdicas escolares / The relationship with knowledge in school recreational activities / La relación con el saber en las actividades lúdicas escolares

O brincar é uma atividade importante para o desenvolvimento infantil, porque melhora aspectos cognitivos, emocionais e físicos. Além disso, jogos e brincadeiras podem ser explorados como recurso educacional. Partindo do entendimento da ludicidade enquanto um processo subjetivo, este trabalho investigou a relação com o saber estabelecida durante as brincadeiras, buscando compreendê-las em suas dimensões epistêmica, social e identitária. Dezesseis estudantes do 5º ano do ensino fundamental foram entrevistados a partir de um roteiro baseado no instrumento "balanço do saber", proposto por Bernard Charlot. As questões foram adaptadas para possibilitar apreender o que as crianças dizem aprender durante as brincadeiras em que participam, com ênfase naquelas realizadas em sala de aula. Os resultados da análise de conteúdo realizada mostraram que, apesar de existirem conflitos sobre como se estabelecem as funções lúdica e educativa, quando a brincadeira infantil é utilizada como recurso pedagógico, os sujeitos podem identificar benefícios no processo de aprendizagem por meio dela. Aponta-se, também, a necessidade de considerar a condição social da criança no ambiente escolar para o sucesso ao utilizar essas atividades como práticas pedagógicas.(AU)

Child's play is an important activity for child development since it improves cognition, emotional, and physical aspects. Games can also be explored as an educational resource. Starting from the understanding that playfulness is a subjective process, this work has investigated the relationship to the knowledge stablished during games, aiming to understand it in its epistemic, social, and identitary dimensions. A group of 16 5th grade students were interviewed from a script based on the instrument "balance of knowledge," as proposed by Bernard Charlot. The questions were adapted to enable the apprehension of what children say they learn on the games they play, emphasizing those which are played in classrooms. The results of the content analysis performed have showed that, despite the conflicts on how both playful and educative functions are stablished when child's play is used as a pedagogic resource, the subjects can identify benefits on the process of learning with it. The need to consider the child's social condition in the school environment to reach success when using these activities as pedagogical practices is also pointed out.(AU)

Jugar es una actividad importante para el desarrollo de los niños, porque mejora aspectos cognitivos, emocionales y físicos. Por tanto, los juegos son explorados como recurso educativo. Partiendo de la comprensión de que lo lúdico es un proceso subjetivo, este trabajo analizó la relación con el saber que se establece durante el juego, con el objetivo de comprenderlo en sus dimensiones epistémica, social e identitaria. Se entrevistó a dieciséis estudiantes de quinto grado a partir de un guion basado en el instrumento "balance del saber" propuesto por Bernard Charlot. Las preguntas fueron adaptadas para permitir la aprehensión de lo que los niños dicen que aprenden en sus juegos, enfatizando los que se juegan en las aulas. Los resultados del análisis de contenido realizado mostraron que, a pesar de que existen conflictos sobre cómo se establecen ambas funciones lúdica y educativa cuando se utiliza el juego infantil como recurso pedagógico, los niños pueden identificar beneficios en el proceso de aprendizaje a través del juego. Se señala la necesidad de considerar la condición social del niño en el entorno escolar para alcanzar el éxito al utilizar estas actividades como prácticas pedagógicas.(AU)

Telas na infância: postagens de especialistas em grupos de cuidadores no facebook / Screens in childhood: posts of specialists in caretakers' groups in the facebook / Pantallas en la infancia: las publicaciones de expertos en grupos de cuidadores en facebook

Apesar das crescentes investigações sobre uso de telas na infância, essa é uma temática complexa e ainda recente, que traz diversos desafios para pesquisadores e cuidadores. Comunidades virtuais em redes sociais são utilizadas por mães e pais para esclarecer dúvidas e receber conselhos acerca da parentalidade e saúde infantil, podendo, simultaneamente, assumir uma função prescritiva e normativa quanto ao seu modo de agir. Sendo assim, este artigo pretende compreender como o uso de telas na infância vem sendo abordado por especialistas em grupos de mães e pais no Facebook. Foi realizado um estudo qualitativo envolvendo 49 postagens de especialistas, sobretudo psicólogos e educadores, extraídas de cinco grupos públicos de mães e pais nessa rede social. Os textos das publicações foram verificados por meio de análise temática e discutidos com base no referencial teórico psicanalítico. Os resultados mostraram que os especialistas destacam os possíveis prejuízos do uso de telas na infância, além de fornecer orientações aos pais sobre como lidar com sua presença no cotidiano das crianças e de suas famílias. Concluiu-se que apesar dos grupos de cuidadores no Facebook serem uma ferramenta de divulgação de informações acerca do uso de telas na infância, cabe não naturalizar a presença de especialistas nesses espaços virtuais criados por pais e mães, interpondo-se nos saberes e nas trocas horizontalizadas entre os cuidadores.(AU)

Although investigations on the use of screens in childhood are increasing, this is a complex and recent topic, which poses several challenges for researchers and caregivers. Virtual communities in social networks are used by mothers and fathers to clarify doubts and receive advice regarding parenting and child health, at times, simultaneously, assuming a prescriptive and normative role on their way of acting. Therefore, this study aimed to understand how the use of screens in childhood has been approached by experts in groups of mothers and fathers on Facebook. A qualitative study was carried out involving 49 posts from specialists, mainly psychologists and educators, extracted from five public groups of mothers and fathers in this social network. The publications' texts were verified via thematic analysis and discussed based on the psychoanalytical theoretical framework. The results showed that experts highlight the possible damage of the use of screens in childhood, in addition to providing guidance to parents on how to deal with the presence of digital technology in the daily lives of children and families. It was concluded that, although caregivers' groups on Facebook are a tool for disseminating information about the use of screens in childhood, it is important not to naturalize the presence of specialists in these virtual spaces created by fathers and mothers, interposing in the horizontally interchanges that occur between the caregivers.(AU)

A pesar de las crecientes investigaciones sobre el uso de pantallas en la infancia, este es un tema complejo y aún reciente, que plantea varios desafíos para investigadores y cuidadores. Las comunidades virtuales en las redes sociales son utilizadas por madres y padres para aclarar dudas y recibir consejos sobre educación y salud infantil, pudiendo, al mismo tiempo, asumir un rol prescriptivo y normativo sobre su forma de actuar. Por lo tanto, este estudio tuvo como objetivo comprender cómo el uso de las pantallas en la infancia ha sido abordado por especialistas en grupos de madres y padres en Facebook. Se realizó un estudio cualitativo a partir de 49 publicaciones de especialistas, principalmente de psicólogos y educadores, extraídas de cinco grupos públicos de madres y padres en esta red social. Se realizó en los textos de las publicaciones un análisis temático y se utilizó el marco teórico psicoanalítico. Los resultados mostraron que los expertos destacan posibles daños que provoca el uso de pantallas en la infancia, además de orientar a los padres sobre cómo afrontar esta presencia de la tecnología digital en el día a día de los niños y sus familias. Se concluyó que, a pesar de que los grupos de cuidadores en Facebook son una herramienta de difusión de información sobre el uso de pantallas en la infancia, es importante no naturalizar la presencia de especialistas en estos espacios virtuales creados por padres y madres que se interpone entre los saberes e intercambios horizontales de los cuidadores.(AU)

Osteomalacia. Diagnóstico y tratamiento / Osteomalacia. Diagnosis and treatment

Introducción: la osteomalacia se caracteriza por la falta de mineralización de la sustancia osteoide, que afecta al hueso cortical y al hueso esponjoso maduro. Es una enfermedad que se presenta en adultos y niños, aunque la causa es diferente en cada uno. Objetivo: exponer la generalidad de la osteomalacia por ser una enfermedad que produce serias afectaciones a la población que la padece, especialmente a los niños. Se enfatiza en el diagnóstico y su tratamiento. Desarrollo: a fin de resumir los elementos esenciales para establecer el diagnóstico de osteomalacia hay que plantear en primer lugar, la presencia de un trastorno de la mineralización ósea, de ahí que además de tener en cuenta las causas de la enfermedad, su curso clínico y la sintomatología. Conclusiones: una recomendación importante es no tener en cuenta la posibilidad de complicaciones en el curso de la enfermedad, como las fracturas, que, aunque sean parte del cuadro clínico, al producirse pueden ocasionar graves problemas, como el caso de las que aparecen en las costillas, que si se desplazan pueden interesar órganos vitales, de modo que en este tipo de pacientes no debe excluirse la posibilidad de emergencias o de urgencias reumatológicas tanto en los adultos como en los niños(AU)

Introduction: osteomalacia is characterized by the lack of mineralization of the osteoid substance, which affects cortical bone and mature cancellous bone. It is a disease that occurs in adults and children, although the cause is different in each. Objective: to expose the generality of osteomalacia for being a disease that causes serious affectations to the population that suffers it, especially to children. Emphasis is placed on the diagnosis and its treatment. Development: in order to summarize the essential elements to establish the diagnosis of osteomalacia, we must first consider the presence of a bone mineralization disorder, hence, in addition to taking into account the causes of the disease, its clinical course and the symptomatology. Conclusions: an important recommendation is not to take into account the possibility of complications in the course of the disease, such as fractures, which, although they are part of the clinical picture, can cause serious problems when they occur, as in the case of those that appear in the ribs, which if they move may involve vital organs, so that in this type of patients should not exclude the possibility of emergencies or rheumatological emergencies in both adults and children(AU)

Producción científica sobre fotoprotección en menores de 14 años de países latinoamericanos: Un estudio bibliométrico / Scientific production on photoprotection in children under 14 from Latin American countries: A bibliometric study

Objetivo: Identificar la producción científica sobre nivel de conocimientos, actitudes y prácticas sobre fotoprotección en padres de menores de 14 años latinoamericanos. Materiales y métodos:Estudio bibliométrico descriptivo y transversal. Se realizó una búsqueda bibliográfica en las bases de datos: PubMed, Scopus y la Biblioteca Virtual de Salud, utilizando las palabras claves: "fotoprotección" "niños", "escolares", entre el primero de enero del 2013 al 31 de junio del 2018. Se excluyeron artículos no originales o que no midieran conocimiento sobre fotoprotección. Resultado: Se encontró un total de seis artículos el 28.3% de los padres reportaron que sus hijos se exponen más de 60 minutos al sol entre semana; en el fin de semana se incrementa a un 42.8%. En Chile, el 14.2% de los niños han presentado alguna vez quemadura solar, con 2/3 de la población de estudio pasan más de 2 horas diarias al exterior. En Uruguay, El 55% de los padres afirmó que se protegen del sol, el 30% solo a veces y el 15% no se protege. En Cuba el 72.5% han presentado al menos una quemadura solar. En Perú, El estudio peruano demostró que el 48% utiliza protector solar en crema, el 46% ropa de protección y el 51% gorro o sombrero. Conclusiones: Se requieren intervenciones sanitarias para incrementar el conocimiento de los padres sobre fotoprotección, en México demuestra que una intervención educativa puede incrementar en un futuro el conocimiento de los jóvenes en el cuidado de la piel. (AU)

Objective: To identify scientific production on the level of knowledge, attitudes, and practices on photoprotection in parents of children under 14 years of age in Latin America. Materials and methods: Descriptive and transversal bibliometric study. A bibliographic search was carried out in the databases: PubMed, Scopus and the Virtual Health Library, using the keywords: "photoprotection" "children", "school children", between January 1, 2013, and June 31, 2018, We excluded articles that were not original or that did not measure knowledge about photoprotection. Result: A total of six articles were found, 28.3% of parents reported that their children are exposed to more than 60 minutes in the sun during the week; in the weekend it increases to 42.8%. In Chile, 14.2% of children have ever presented sunburn, with 2/3 of the study population spending more than 2 hours a day abroad. In Uruguay, 55% of parents said they protect themselves from the sun, 30% only sometimes and 15% do not protect themselves. In Cuba, 72.5% have presented at least one sunburn. In Peru, the Peruvian study showed that 48% use sunscreen cream, 46% protective clothing and 51% hat or hat. Conclusions: Health interventions are required to increase parents' knowledge about photoprotection, in Mexico it shows that an educational intervention can increase the knowledge of young people in skin care in the future. (AU)