Sunbed use legislation in Europe: assessment of current status.

BACKGROUND: The use of UV-emitting tanning devices for cosmetic purposes is associated with an increased risk of melanoma and non-melanoma skin cancer. Young women are the most frequent users, therefore, there is an increasing concern about the regulation of sunbed use. OBJECTIVE: The primary objective is to assess the current legislation on sunbed use among European countries. METHODS: We developed a 30-item questionnaire to gather the most relevant information about sunbed use legislation. The questionnaire was sent to Euromelanoma coordinators and to designated coordinators out of the Euromelanoma network. RESULTS: We obtained a response rate of 64%. More than 25% of the countries did not report any specific legislation. Roughly one-third of the countries does not have a restriction for minors. Even in countries with a specific legislation, a lack or insufficient enforcement of age limit was observed in up to 100% of the inspections based on the PROSAFE report from 2012. Self-tanning devices were reported in 50%, and almost 40% of countries do not require supervision of use. Although a warning display is required in 77% of cases, a signed informed consent is not required in 80%. In the vast majority of cases, the number of licensed or closed tanning centres is unknown. CONCLUSIONS: Despite the evidence of its harmful effects, and its frequent use by young people, many of whom are at high risk of skin cancer because of fair skin, a significant number of European countries lack a specific legislation on tanning devices. In order to limit the access of young people to sunbeds, a more strictly enforced regulation is needed, as well as regulation regarding advertisement, and location of tanning centres, in addition to health promotion campaigns that target the vulnerable population of young women seeking its use for improved cosmesis.

Ambient humidity and the skin: the impact of air humidity in healthy and diseased states.

Humidity, along with other climatic factors such as temperature and ultraviolet radiation, can have an important impact on the skin. Limited data suggest that external humidity influences the water content of the stratum corneum. An online literature search was conducted through Pub-Med using combinations of the following keywords: skin, skin disease, humidity, dermatoses, dermatitis, eczema, and mist. Publications included in this review were limited to (i) studies in humans or animals, (ii) publications showing relevance to the field of dermatology, (iii) studies published in English and (iv) publications discussing humidity as an independent influence on skin function. Studies examining environmental factors as composite influences on skin health are only included where the impact of humidity on the skin is also explored in isolation of other environmental factors. A formal systematic review was not feasible for this topic due to the heterogeneity of the available research. Epidemiological studies indicated an increase in eczema with low internal (indoors) humidity and an increase in eczema with external high humidity. Other studies suggest that symptoms of dry skin appear with low humidity internal air-conditioned environments. Murine studies determined that low humidity caused a number of changes in the skin, including the impairment of the desquamation process. Studies in humans demonstrated a reduction in transepidermal water loss (TEWL) (a measure of the integrity of the skin's barrier function) with low humidity, alterations in the water content in the stratum corneum, decreased skin elasticity and increased roughness. Intervention with a humidifying mist increased the water content of the stratum corneum. Conversely, there is some evidence that low humidity conditions can actually improve the barrier function of the skin. Ambient relative humidity has an impact on a range of parameters involved in skin health but the literature is inconclusive. Further studies are needed to better delineate the interactions that can occur in normal and diseased states. Therapeutic measures might be forthcoming especially for skin diseases such as eczema, which are regarded as being characterized by 'skin dryness'. Further research examining the interaction between different environmental exposures thought to impact the skin, and indeed the interplay between genetic, environmental and immunological influences, are required.

Is an online skin cancer toolkit an effective way to educate primary care physicians about skin cancer diagnosis and referral?

BACKGROUND: Skin disorders account for over 20% of GP consultations. Half of dermatology referrals to secondary care are for skin lesions, but only 12% of urgent skin cancer referrals are deemed appropriate. Suitably designed online learning resources may positively impact GP confidence in the recognition of skin cancer and improve patient outcomes. OBJECTIVE: This study evaluated the impact of a national, online, skin cancer recognition toolkit on GP confidence and knowledge in diagnosing skin cancers and referral behaviour to secondary care. METHODS: The toolkit, consisting of a referral decision aid, lesion recognition resource, clinical cases and a quiz, was launched in March 2012. Website usage statistics and online focus groups were used to assess the usability of the website and perceived changes in behaviour. The impact of the toolkit was assessed using national skin cancer referral data, cross-sectional questionnaires and urgent skin cancer referral data to two NHS trusts. RESULTS: The toolkit was accessed by 20% of GPs in England from 20th March to 31st October 2012; spending a mean of over 5 minutes each, with over 33% return users. A survey revealed that the toolkit improved perceptions of skin cancer training and self-reported knowledge about skin cancer referral pathways. Analysis of referral patterns did not identify an impact of the toolkit on number or appropriateness of urgent skin cancer referrals in the eight months following the launch of the website. Online focus groups confirmed the usefulness of the resource and suggested a positive influence on knowledge and referral behaviour. CONCLUSION: The skin cancer toolkit is an accessible online learning resource for improving confidence with skin cancer referral amongst GPs. Although we were unable to identify any immediate changes in skin cancer diagnoses or appropriate referral behaviours, research is required to evaluate its longer term effects on outcomes.

Sex-roles of ideal opposite sexed persons for college males and females.

Relationships between sex-roles as measured by the Bem Sex-Role Inventory (BSRI) and the ideal sex-role of persons of the opposite sex as measured by a modified BSRI were investigated for 169 college males and 204 college females. The distributions of sex-roles were different for men and women, as were the distributions of ideal sex-roles of opposite sexed persons. Androgynous (A), feminine (F) and masculine (M) men identified F women as ideal, while undifferentiated (U) men identified U women as ideal. M women preferred M men, and U women preferred U men. Effects of ideal sex-role of the two sexes on sexual attraction were discussed.