Racial disparities in fifth-grade sun protection: Evidence from the Healthy Passages study.

BACKGROUND/OBJECTIVES: Despite rising skin cancer rates in children, multiple studies reveal inadequate youth sun-protective behavior (eg, sunscreen use). Using Healthy Passages data for fifth-graders, we set out to determine sunscreen adherence in these children and investigated factors related to sunscreen performance. METHODS: Survey data were collected from 5119 fifth-graders and their primary caregivers. Logistic regression was used to assess associations between sunscreen adherence and performance of other preventive health behaviors (eg, flossing, helmet use) and examine predictors of sunscreen adherence. Analyses were repeated in non-Hispanic black, Hispanic, and non-Hispanic white subgroups. RESULTS: Five thousand one hundred nineteen (23.4%) children almost always used sunscreen, 5.9% of non-Hispanic blacks (n = 1748), 23.7% of Hispanics (n = 1802), and 44.8% of non-Hispanic whites (n = 1249). Performing other preventive health behaviors was associated with higher odds of sunscreen adherence (all P < .001), with the greatest association with flossing teeth (odds ratio = 2.41, 95% confidence interval = 1.86-3.13, P < .001). Factors for lower odds of sunscreen adherence included being male and non-Hispanic black or Hispanic and having lower socioeconomic status. School-based sun-safety education and involvement in team sports were not significant factors. CONCLUSION: Our data confirm low use of sun protection among fifth-graders. Future research should explore how public health success in increasing prevalence of other preventive health behaviors may be applied to enhance sun protection messages. Identifying risk factors for poor adherence enables providers to target patients who need more education. Improving educational policies and content in schools may be an effective way to address sun safety.

Video-based education about systemic corticosteroids enhances patient knowledge more than verbal education: A randomized controlled trial.

BACKGROUND: Video-based patient education about long-term systemic corticosteroid treatment has not been assessed. OBJECTIVE: To compare video-based versus verbal education in patient knowledge gained and satisfaction. METHODS: English-speaking adults (≥18 years) were recruited from March-August 2013 from medical dermatology clinics. Study provider clinics were the unit of randomization. Verbal subjects heard a script based on the standard discussions of two top systemic corticosteroid prescribers at Emory. Video subjects viewed a video developed by the investigators. A 12-item survey created by the the investigators assessed baseline and post-education knowledge (immediate, one-, three-, and six-month). RESULTS: Baseline knowledge scores averaged 7.2±2.2 correct answers with no between-group differences. Post-education, the video group's (N=39) mean paired score difference was 0.9±2.0 higher than the verbal group's (p<0.04). After 1 month, most scores maintained gains with no between-group differences. 97% of patients in each group were satisfied (none were unsatisfied) with their education. LIMITATIONS: Our cohort was more literate than the general public, and a minority of subjects completed long-term follow up assessments. CONCLUSION: Video education enhanced near-term patient knowledge more than verbal education and maintained patient satisfaction.

Dermatology on Tumblr.

Tumblr broke into the social media scene in 2007 as a micro-blogging platform that hosts 169 million blogs, 75 billion total posts, and 111 million posts daily to date. This study aimed to determine the presence of dermatology-focused journals, organizations, and groups on Tumblr. These were entered into the Tumblr search query to identify affiliated Tumblr blogs and 'dermatology Tumblr' was searched on Google to determine the first four distinct results that were active within the last six months. None of the dermatology-focused journals, organizations, or groups maintained a Tumblr blog and three of the first four blogs on Google were maintained by private practices. In conclusion, Tumblr remains a social media domain that lacks a strong presence from dermatology journals and organizations, remaining an untapped resource for information dissemination and interaction with the public.

Effectiveness of a strategy to reduce major vascular complications from catheter ablation of atrial fibrillation.

INTRODUCTION: Vascular access site complications are among the most frequently observed complications after catheter ablation of atrial fibrillation (AF). We sought to determine whether implementation of a three-point strategy would reduce major vascular complications resulting from catheter ablation of atrial fibrillation. METHODS: Three hundred twenty-four consecutive patients undergoing catheter ablation of AF were studied: 162 in each group (with and without the test strategy). The three-point test strategy included the following: (1) performing the procedure on Warfarin with an INR from 2.0 to 3.5 (mean INR of 2.44), rather than stopping Warfarin prior to the procedure and bridging the patient back to Warfarin with low molecular heparin, (2) using a small 21 G needle to obtain femoral vein access rather than a larger 18 G needle, and (3) eliminating the use of femoral arterial access. Major vascular complications were defined as complications requiring either blood transfusion or surgical/percutaneous repair. RESULTS: Major vascular complications were identified in 6/162 (3.7%) of the control patients without the strategy listed above compared to 0/162 (0%) in the test patients with implementations of this strategy (p = 0.03). The frequency of other complications was comparable between the two groups (tamponade requiring drainage: 1/162 control, 1/162 test; pericardial effusion not requiring drainage: 0/162 control, 1/162 test; transient ischemic attack: 1/162 control and 1/162 test; stroke: 1/162 control, 0/162 test): (p = NS for each). CONCLUSIONS: A three-point strategy including performing procedures with therapeutic Warfarin, using a small gauge needle to obtain vascular access and eliminating femoral arterial access significantly reduced major vascular access complications and did not affect other major complications, during catheter ablation of AF. Implementation of this strategy may be useful to reduce groin complications resulting from AF ablation.

Temporary inactivation of ventral tegmental area neurons with either muscimol or baclofen reversibly disrupts maternal behavior in rats through different underlying mechanisms.

The purpose of this study was to examine the effects of inactivation of ventral tegmental area (VTA) projection neurons, while sparing fibers of passage, on maternal behavior in rats. Because VTA neurons contain GABA-A and GABA-B receptors, the effects of muscimol or baclofen were studied. Although bilateral injections of either drug into the VTA disrupted maternal behavior, it is likely that they did so through different underlying mechanisms. Muscimol disrupted both retrieval of pups and nursing behavior, while causing stereotyped motor activity. Baclofen disrupted retrieval behavior without affecting nursing behavior, and control injections of baclofen into the region dorsal to VTA were ineffective. The effects of VTA baclofen on maternal behavior are similar to the effects of interference with mesolimbic dopamine (DA) function. The case is made that muscimol probably caused a hyperexcitation of VTA DA neurons through a process of disinhibition. In contrast, baclofen may have depressed the activity of all VTA projection neurons, including VTA DA neurons. Baclofen is a promising tool to explore whether medial preoptic area neurons interact with VTA neurons to control active maternal responses.