Not only age but also tactile perception influences the preference for cosmetic creams applied to the forearm.

OBJECTIVE: We aimed to examine whether and how age as well as tactile sensitivity and perception had an impact on how women liked richer and lighter creams. Furthermore, the question arose if age and tactile perception had an influence on the ability to distinguish between the creams and how the ability to distinguish between creams influenced the liking of these creams. METHODS: A total of 299 female participants were invited to rate how much they liked four different cosmetic creams applied to their forearms. The creams were based on the same base formula but differed with respect to the texture. In order to arouse the impression of more lightness (quasi-light) or more richness (quasi-rich), polyethylene particles of different sizes were added to the base formula. First of all, the participants were tested for their tactile sensitivity and perception. Tactile sensitivity was tested by Von Frey filaments, tactile spatial perception by the tactile Landolt ring test and the ability to discriminate surface structures by a sandpaper test. Furthermore, the participants rated the creams with respect to the acceptance, the subjective skin feeling after application and performed paired-comparison tests. Analyses of variance and regression analyses were applied to the data. RESULTS: In general, participants liked quasi-rich creams less than quasi-light creams. However, older women compared to younger women and women with lower tactile performance in comparison with women with higher tactile performance revealed a weaker influence of cream type-specific acceptance ratings. Further results revealed that young participants perceived the quasi-light creams (with particles of ~50 µm diameter) as soft and quasi-rich creams (with particles of ~100 µm and ~165 µm diameter), as coarse. In contrast, this subjective skin feeling after application in participants at age 50 and older did not differ much. CONCLUSION: Age and tactile perceptual abilities have additive effects on the acceptance of creams with different textures when applied to the forearm.

Implementing staff nurse geriatric education in the acute hospital setting.

The implementation and evaluation of staff nurse geriatric educational interventions on medical units in an urban teaching hospital are described.

The geriatric floating interdisciplinary transition team.

Older adults often receive suboptimal care during hospitalizations and transitions to postacute settings. Inpatient geriatric services have been shown to increase care quality but have not improved patient outcomes consistently. Acute Care for the Elderly units improve patient outcomes but are resource intensive. Transitional care has been shown to reduce hospital readmissions and healthcare costs. This article describes the Geriatric Floating Interdisciplinary Transition Team (Geri-FITT), a model that combines the strengths of inpatient geriatric evaluation and comanagement and transitional care models by creating an inpatient comanagement service that also delivers transitional care. The Geri-FITT model is designed to improve the hospital care of older adults and their transitions to postacute settings. In Geri-FITT, a geriatrician-geriatric nurse practitioner team assesses patients, comanages geriatric syndromes, provides staff education, encourages patient self-management, communicates with primary care providers, and follows up with patients soon after discharge. This pilot cohort study of Geri-FITT included hospitalized patients aged 70 and older on four general medicine services (two Geri-FITT, two usual care) at an academic medical center (N=717). The study assessed the effect of Geri-FITT on patients' care transition quality (Care Transitions Measure) and their satisfaction with hospital care (four questions). The results indicate that Geri-FITT is associated with slightly higher, though not statistically significantly so, quality care transitions and greater patient satisfaction with inpatient care. Geri-FITT may be a feasible approach to enhancing inpatient management and transitional care for older adults. Further study of its effect on these and other outcomes in other healthcare settings seems warranted.

The influence of pre-irradiation on the predictability of in vivo UVA protection with a new in vitro method.

BACKGROUND/PURPOSE: UVA protection of sunscreen formulations is becoming increasingly important especially because of recent investigations on the long-term skin damage associated with UVA light. The development of a new in vitro method to measure UVA protection performance made it possible to predict reliably the in vivo UVA protection performance of representative sunscreen formulations found presently in the European and US market (1). This study was performed in order to determine the applicability of the method developed by Wendel et al. (1) to photostable and photolabile filter combinations and in order to measure the influence of sample pre-irradiation on predicting the in vivo performance. This was done by subjecting six photostable and six photolabile filter combinations to a standard irradiation. Then the in vitro UVA protection afforded by each combination was measured and compared with the persistent pigment darkening (PPD) values determined in vivo. RESULTS: The results clearly showed that pre-irradiation does not affect the in vitro PPD factor of the photostable and photolabile samples in the same way. Almost identical values were determined for the stable filter combinations with and without pre-irradiation, whereas distinct reductions in the in vitro factors by as much as 93% were observed after irradiation in the group of less stable filter combinations. Comparison of the in vivo and in vitro PPD factors showed that all 12 samples comprise a homogeneous distribution with identical factors before irradiation. After pre-irradiation only the factors for the six less stable products were selectively reduced. The correlation with the data determined on the skin was clearly poorer for these products after irradiation. CONCLUSION: Overall, the results showed that pre-irradiation should not to be used for the assessment of UVA protection using this method. Furthermore, it can be assumed that normalizing the in vitro absorbance curves to the labelled SPF of the sunscreen will adequately take into account the photochemical behaviour of UV filters on the skin during sun exposure.

Distribution of sunscreens on skin.

The effectiveness of sunscreens was originally achieved by incorporation of soluble organic UV absorbers such as cinnamates and others into cosmetic formulations. Determinations of the sun protection factor (SPF) of emulsions containing different organic UV absorbers clearly indicate that the efficacy depends on the absorption characteristics of each single UV filter substance. Nowadays, micronised pigments such as titanium dioxide or zinc oxide have also been found to be protective against harmful UV rays. Our investigations using optical and electron microscopy proved that neither surface characteristics, particle size nor shape of the micronised pigments result in any dermal absorption of this substance. Micronised titanium dioxide is solely deposited on the outermost surface of the stratum corneum and cannot be detected in deeper stratum corneum layers, the human epidermis and dermis.

A quick, practical test procedure to evaluate the performance of instruments used for in vitro UV protection measurements.

The in vitro determination of the UV protection of sunscreens is usually performed by means of transmission measurements with special photometers. Many different instruments are used. Besides numerous commercially available instruments, which are equipped by the manufacturer for the specific measurement, other modular instruments are used. We present here a quick and practical method to evaluate the performance of these instruments with respect to their measuring ranges and to compare the uniformity and reliability of the results obtained with these instruments.

Demographic and health characteristics of residents choosing to use on-site medical care in a newly opened continuing care retirement community (CCRC).

OBJECTIVE: To determine demographic and health characteristics of older adults choosing to use on-site medical care in a continuing care retirement community (CCRC). DESIGN: A descriptive study of residents moving into a newly opened CCRC. Residents responded to a self-report mail survey composed of questions related to reasons for moving to a CCRC, health and functional status,health care use during the previous 5 years. RESULTS: Of 942 residents, 642 (68%) completed the survey. Medical center users and nonusers were similar demographically and reported similar reasons for moving to the CCRC including desire for a low maintenance apartment (49% vs. 48%; P = 0.806), concern about health or spouse's health (67% vs. 63%; P = 0.345), and desire for social activities (63% vs. 58%; P = 0.151). However, on-site medical center users versus nonusers reported increased rates of fair/poor health (31% vs. 18%; P = 0.0001), fair/poor vision (27% vs. 15%; P = 0.0003),difficulty walking in the home (13% vs. 8%; P = 0.53), using the toilet (6% vs. 2%; P = 0.044), shopping (29% vs. 20%; P = 0.007), using transportation (19% vs. 10%; P = 0.005), doing laundry (13% vs. 7%; P = 0.016), using the telephone (8% vs. 3%; P = 0.002), and taking medication (5% vs. 1%; P = 0.022). CONCLUSION: For both users and nonusers of the medical center, the most frequently cited reason for moving to the CCRC was concern about health. On-site medical center users had lower perceived health, were functionally more disabled, and had health characteristics that made them at higher risk for high health care utilization. The challenges to provide high quality medical care and enhance quality of life for CCRC residents will continue to increase. Physicians should play an active role not only in providing medical care to CCRC residents, but also in providing medical leadership for these institutions.

Studying coronary artery disease in the retirement community.

A study was conducted to identify the prevalence of heart disease and associated health-related behaviors among continuing care retirement community (CCRC) residents; researchers also sought to identify management strategies for heart disease. Study results indicated that self-reported heart disease is prevalent among CCRC residents: 60% reported three or more health risk behaviors. The CCRC environment lends itself to providing various management advantages, including access to on-site clinicians, group education, and exercise and dining facilities to promote adherence to exercise, nutrition, and medical management plans.

The human stratum corneum layer: an effective barrier against dermal uptake of different forms of topically applied micronised titanium dioxide.

Electron microscopy visualisation and light microscopic investigations of three different application forms of titanium dioxide proved that neither surface characteristics, particle size nor shape of the micronised titanium dioxide result in any dermal absorption of this substance: Micronised titanium dioxide is solely deposited on the outermost surface of the stratum corneum and cannot be detected in deeper stratum corneum layers, the human epidermis and dermis.

Prazosin and stress effect on tumoral growth of 7,12-dimethylbenz[A]anthracene-induced rat mammary tumors.

Repeated isolation stress and prazosin effect were evaluated in 7,12-dimetylbenz[A]anthracene (DMBA) mammary tumors. Tumor volume was significantly lower in stressed than in control animals from 10 to 52 days considering day 1 the moment when tumors became palpable and treatment began. Control Prazosin (0.5 mg/kg) rats showed diminished tumor volume after 40 days. Stress Prazosin curve was similar to stress alone. The proportion of progressing tumors in control was significantly higher than in stressed groups, regardless of Prazosin administration. Body weight gain was similar in every group throughout the experiment. Behavioral studies were performed when stress effect was no longer evident. Grooming and the number of fecal boli were similar in all groups, as well as prolactin serum levels, suggesting that habituation took place. No significant differences were observed between groups for estrogen receptors. However, a greater concentration of progesterone receptors was found in Stressed rats, compared to all other groups. We conclude that the decrease of tumor volume provoked by stress could not be reversed by the alpha 1-adrenergic antagonist prazosin. Then, it appears that the main effect of stress is not mediated by the alpha 1-adrenergic receptors. Higher progesterone receptors in stressed rats could explain the differences observed.