High School Students' Knowledge and Attitudes on Tanning and Sun Exposure Before and After Educational Presentations.

BACKGROUND: Rising rates of skin cancer are a significant medical concern with a nearly 300 percent increase in new melanoma cases since the 1970s. There is a prominent lag time between UV radiation carcinogen exposure primarily in adolescence and pathology presentation primarily in the elderly. Teenagers spend the most time in the sun while paying the least attention to sun protective measures. A potential intervention method is primary prevention in the high school population. METHODS: A local high school was visited by medical student facilitators. Eligible participants of the IRB approved study were students in freshman physical education classes attending class in-person. Participants were given a prepresentation survey to assess behaviors, knowledge, and attitudes surrounding sun exposure and tanning. A 15-minute educational PowerPoint presentation was given. A post-presentation survey, identical to the pre-presentation survey, was given immediately after. RESULTS: Overall, 181 freshmen (75.4 percent) participated. Knowledge about sun exposure, UV radiation, and skin cancer was higher post-presentation. Additionally, students reported positive attitude changes regarding protecting oneself from UV radiation, perceived risks/benefits of tanning/sun exposure, and perceptions of their future likelihood/concern of developing skin cancer. CONCLUSIONS: Our study revealed brief educational presentations can increase knowledge and change attitudes in freshman high school students regarding UV radiation associated with tanning and sun exposure. Given the current rising rates of skin cancer, easy interventions such as the one demonstrated in this study should be part of a likely multi-factorial public health response. Future steps include additional analysis of changes to participants' behavior.

The Effects of Regular Light Strength Training and Flexibility Training on Physical and Mental Health in Senior Citizens.

INTRODUCTION: Frequent exercise is known to be associated with better physical and mental health outcomes in all age groups. Vermillion, South Dakota, has no easily accessible way for senior citizens to exercise in groups safely. Clinical observations suggested the hypothesis that senior citizens living independently would benefit both physically and mentally from a tri-weekly chair-based exercise program. METHODS: Twenty-three individuals between the ages of 58-88 from Vermillion were enlisted in this study. Each participant was part of a chair-based exercise class for senior citizens that focused on strengthening the legs, back, and core. Various measurements were taken upon entry into the class and every three months following entry, with the final measurement being six months from the first. Measurements included blood pressure, heart rate, weight, handgrip strength, Tinetti Balance and gait scores, and geriatric depression scale. Data were divided into three groups: Period 1 (measurements on initial entry into the class), Period 2 (measurements three months after an individual has entered the class), and Period 3 (measurements six months after an individual has entered the class). Tukey's multiple comparison test and single factor ANOVA were used for analysis. RESULTS: There were no statistically significant differences in any measurements over time. This is true both when comparing all values for each period to one another and when comparing values only of participants who completed all three measurement periods. For participants that attended the class long enough to have all three measurements, there was an average weight loss of 8.56 lbs. Geriatric depression scale scores were also trending toward improvement, with the initial mean score being 1.2 and the final score being 0.8. Any score above 4 is concerning for depression so the closer to zero the better. CONCLUSIONS: The data failed to support the hypothesis. The study shows no statistically significant change in measurements taken at initial visit, three months, or six months into the exercise course. Out of 23 participants, only 16 joined early enough to take the three-month measurements, and only five joined early to take the six-month measurements. The trend of participant weight loss and improved Geriatric depression scale scores suggests that if a larger sample size were to participate in the course and stay for all measurements, there might be statistically significant results. Future studies looking to replicate should incentivize increased duration of participation, and they should also track each individual participant's number of sessions attended to use as another variable.

Travel Distance for Rural South Dakota Dermatology Care.

BACKGROUND: Nearly 40 percent of dermatologists in the U.S. practice in the 100 most population dense areas, with less than 10 percent practicing in rural areas. Rurality, delayed detection time, and increased travel distance have been associated with worse malignancy outcomes. Without their local rural dermatologist, we hypothesized patients would face significantly increased travel distance and be less likely to receive dermatological care. METHODS: A survey was created to assess travel distance, likelihood to travel further for care, and use of primary care providers for dermatologic care. Eligible participants of the IRB approved study were patients of the only dermatology clinic in Yankton, South Dakota. Yankton is a town in southeastern South Dakota with a population of 14,687. RESULTS: Overall, 100 surveys were completed. Most patients (53.5 percent) did not know where they would receive dermatologic care if the dermatology clinic was not available. The average patient would travel 42.6 miles further to the closest non-outreach dermatology clinics. Over 25 percent of patients were unlikely or not willing to travel further for care. As patient's age increased, so did their likelihood to travel further. CONCLUSIONS: The data supports the hypothesis that without their local rural dermatologist, patients would face significantly increased travel distance and be less likely to receive dermatological care. Given the barriers to care in rural areas, it is imperative to proactively confront these challenges. Further studies are needed to assess for confounding factors in this dynamic and develop innovative solutions.

Netherton Syndrome in a Mother and Her Two Children.

Netherton syndrome (NS) is a rare autosomal recessive condition caused by mutations in the serine peptidase inhibitor, Kazal type 5 (SPINK5) gene which encodes for a serine protease inhibitor, lymphoepithelial Kazal-typerelated inhibitor (LEKT1). NS is characterized by a triad of ichthyosiform erythroderma, trichorrhexis invaginata, and atopic diathesis with elevated IgE levels. The syndrome typically presents in infancy, where life-threatening complications are frequent, and evolves into a less severe condition with milder clinical symptoms in adulthood. This case report details the clinical history and genetic testing of a mother and two children with clinically symptomatic and genetically proven NS.