A comprehensive approach to evaluating and classifying sun-protective clothing.

BACKGROUND: National standards for clothing designed to protect the wearer from the harmful effects of solar ultraviolet radiation (UVR) have been implemented in Australia/New Zealand, Europe and the U.S.A. Industry standards reflect the need to protect the skin by covering a considerable proportion of the potentially exposed body surface area (BSA) and by reducing UVR-transmission through fabric (the Ultraviolet Protection Factor; UPF). OBJECTIVES: This research aimed to develop a new index for rating sun-protective clothing that incorporates the BSA coverage of the garment in addition to the UPF of the fabric. METHODS: A mannequin model was fixed to an optical bench and marked with horizontal lines at 1-cm intervals. An algorithm (the Garment Protector Factor; GPF) was developed based on the number of lines visible on the clothed vs. unclothed mannequin and the UPF of the garment textile. This data was collected in 2015/16 and analysed in 2016. RESULTS: The GPF weights fabric UPF by BSA coverage above the minimum required by international sun-protective clothing standards for upper-body, lower-body and full-body garments. The GPF increases with BSA coverage of the garment and fabric UPF. Three nominal categories are proposed for the GPF: 0 ≤ GPF < 3 for garments that 'meet' minimum standards; 3 ≤ GPF < 6 for garments providing 'good' sun protection; and GPF ≥ 6 indicating 'excellent' protection. CONCLUSIONS: Adoption of the proposed rating scheme should encourage manufacturers to design sun-protective garments that exceed the minimum standard for BSA coverage, with positive implications for skin cancer prevention, consumer education and sun-protection awareness.

From ultraviolet to Prussian blue: a spectral response for the cyanotype process and a safe educational activity to explain UV exposure for all ages.

Engaging students and the public in understanding UV radiation and its effects is achievable using the real time experiment that incorporates blueprint paper, an "educational toy" that is a safe and easy demonstration of the cyanotype chemical process. The cyanotype process works through the presence of UV radiation. The blueprint paper was investigated to be used as not only engagement in discussion for public outreach about UV radiation, but also as a practical way to introduce the exploration of measurement of UV radiation exposure and as a consequence, digital image analysis. Tests of print methods and experiments, dose response, spectral response and dark response were investigated. Two methods of image analysis for dose response calculation are provided using easy to access software and two methods of pixel count analysis were used to determine spectral response characteristics. Variation in manufacture of the blueprint paper product indicates some variance between measurements. Most importantly, as a result of this investigation, a preliminary spectral response range for the radiation required to produce the cyanotype reaction is presented here, which has until now been unknown.

Keratinocyte skin cancer risks for working school teachers: Scenarios and implications of the timing of scheduled duty periods in Queensland, Australia.

Relative keratinocyte skin cancer risks attributable to lifetime occupational and casual sunlight exposures of working school teachers are assessed across the state of Queensland for 1578 schools. Relative risk modeling utilizing annual ultraviolet exposure assessments of teachers working in different geographic locations and exposed during periods of measured daily playground duty times for each school were made for local administrative education districts by considering traditional school opening and closing hours, and playground lunchtime schedules. State-wide, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) relative risk estimates varied by 24% for BCC and 45% for SCC. The highest relative risk was calculated for the state's north (sunshine) coast education district which showed that risk could increase by as much as 32% for BCC and 64% for SCC due to differences in teacher duty schedules. These results highlight the importance of playground duty scheduling as a significant risk factor contributing to the overall burden of preventable keratinocyte skin cancers in Queensland.

A site-specific standard for comparing dynamic solar ultraviolet protection characteristics of established tree canopies.

A standardised procedure for making fair and comparable assessments of the ultraviolet protection of an established tree canopy that takes into account canopy movement and the changing position of the sun is presented for use by government, planning, and environmental health authorities. The technique utilises video image capture and replaces the need for measurement by ultraviolet radiometers for surveying shade quality characteristics of trees growing in public parks, playgrounds and urban settings. The technique improves upon tree shade assessments that may be based upon single measurements of the ultraviolet irradiance observed from a fixed point of view. The presented technique demonstrates how intelligent shade audits can be conducted without the need for specialist equipment, enabling the calculation of the Shade Protection Index (SPI) and Ultraviolet Protection Factor (UPF) for any discreet time interval and over a full calendar year. •Tree shade UPF measurements are presented using video capture analysis of moving canopies•A standard method for making accurate assessments of tree shade has been developed•Tree shade comparisons are made without the need for specialist equipment.

Influence of summer daylight saving time on scattered erythemal solar ultraviolet exposures.

The research question of whether there are any influences in the scattered or diffuse erythemal UV exposures to a horizontal plane over a five month period due to the change from standard time to daylight saving time, has been investigated by using physical measurements and applying them to both standard time and daylight saving time. The diffuse erythemal UV was considered for fixed lunch break times and fixed morning and afternoon break times. The cases considered were for groups of the population who are predominantly indoors and who spend their break times outdoors in shade. The biggest influence on the diffuse UV exposures of changing to daylight saving time is the timing of the outdoor meal and break times. The change causes a reduction in diffuse erythemal exposure for early or morning breaks and an increase in the diffuse erythemal exposure for late or afternoon breaks. Similarly, for the lunch break times, the changes in exposure are influenced by the timing of the break with respect to solar noon. Indoor workers who take their breaks outside in a shaded area may have a change in their exposure to diffuse UV due to a shift to daylight saving time, however the magnitude of this change and whether it is a positive or negative change in exposure will depend on the timing of the break. The increase in diffuse UV exposure due to the afternoon break may be negated by the decrease in exposure due to the morning break. In this case, the effect on diffuse UV exposures due to changing to daylight saving time will be minimal.

Concurrent evaluation of personal damaging and beneficial UV exposures over an extended period.

Personal exposure to solar ultraviolet radiation (UVR) is acknowledged as having both positive and negative effects on human health. This study aimed to measure concurrently the personal erythemal UV, UVA and vitamin D effective exposures of participants in each season of a year. Participants were all indoor office workers located at two different sites less than 6.5 km apart at the sub-tropical location of Toowoomba (27°33'S 151°55'E). The subjects wore a combined dosimeter badge horizontally on the shoulder for a minimum of one week in each season; this badge used 8-methoxypsoralen film to record the UVA waveband and polyphenylene oxide film for the erythemal and the vitamin D effective UV wavebands. The results show that median erythemal exposure was highest during the spring and lowest during winter, as was the vitamin D effective exposure. Median UVA exposures were at a similar level in winter and summer, autumn was higher (double) and spring at a lower level. The duration and time of day participants spent outdoors changed in each season; in winter, participants spent an average of 101 minutes outdoors between 10:00-14:00 h over the week, whereas in summer this fell to 79 minutes even though they were outdoors more often. The daily UVA/UVB ratio is lowest between 10:00-14:00 h and also changes with the season resulting in the differences between the distributions of exposure for each of the wavebands. Each category of exposures must be assessed individually as each season and each waveband has different distributions. The results also demonstrate that the dual film dosimeter developed and characterized with a calibration to three different biological responses, is an effective device for the concurrent measurement of erythemal UV, UVA and vitamin D effective UV exposures for periods of up to seven days.

Online educative activities for solar ultraviolet radiation based on measurements of cloud amount and solar exposures.

A set of online activities for children and the community that are based on an integrated real-time solar UV and cloud measurement system are described. These activities use the functionality of the internet to provide an educative tool for school children and the public on the influence of cloud and the angle of the sun above the horizon on the global erythemal UV or sunburning UV, the diffuse erythemal UV, the global UVA (320-400nm) and the vitamin D effective UV. Additionally, the units of UV exposure and UV irradiance are investigated, along with the meaning and calculation of the UV index (UVI). This research will help ensure that children and the general public are better informed about sun safety by improving their personal understanding of the daily and the atmospheric factors that influence solar UV radiation and the solar UV exposures of the various wavebands in the natural environment. The activities may correct common misconceptions of children and the public about UV irradiances and exposure, utilising the widespread reach of the internet to increase the public's awareness of the factors influencing UV irradiances and exposures in order to provide clear information for minimizing UV exposure, while maintaining healthy, outdoor lifestyles.

Dual calibrated dosimeter for simultaneous measurements of erythemal and vitamin D effective solar ultraviolet radiation.

A miniaturized ultraviolet radiation (UV) dosimeter based on polyphenylene oxide (PPO) has been dual calibrated for both erythemal and vitamin D effective exposures (UVB 280 - 320 nm) over extended periods up to five days. Optimal human health requires a balanced amount of UVB exposure as both too much and too little have different but serious potential health consequences. Dosimetry is an established method of measuring specific UV exposures to an object or subject. PPO dosimeters have previously been used to measure the erythemally effective UV exposure. An extension of this use is to dual calibrate the miniaturized dosimeter which will also enable measurement of vitamin D effective exposures. By calibration to the erythemal and vitamin D effective action spectra, PPO dosimeters were able to record both types of biologically effective exposure as both are active within the UVB waveband. Dose response tests were conducted in each season by exposure to solar UV with the corresponding dual calibrations made for each season. The calibration provided an R(2) of 0.95-0.99 for erythemal UV and an R(2) of 0.99 for vitamin D effective UV. The successful outcome of this testing has established that PPO is suitable for use as a long term, dual calibrated dosimeter provided the film is seasonally calibrated. This enables one dosimeter to provide two sets of exposure results. The combination of dual calibration and the long term exposure potential of PPO makes the PPO dosimeter more versatile and increases the scope of UV field research on erythemal UV and vitamin D effective UV in the future.

Intra-articular amphotericin B treatment of Sporothrix schenckii arthritis.

Arthritis caused by Sporothrix schenckii may not respond satisfactorily to a full course of intravenous amphotericin B therapy. Left untreated, the fungus continues to be recovered from cultures of joint fluid, and the patient typically has serious joint disability. We have shown in one patient with sporotrichosis of the knee that direct low-dose injections of amphotericin B can be performed safely, resulting in eradication of the fungus. The patient has had continued useful range of motion and weight bearing on the involved knee.

Mild nephrotoxicity associated with vancomycin use.

Nephrotoxicity related to vancomycin hydrochloride therapy has been reported at overall rates of 7% to 16% and as high as 35% when combined with an aminoglycoside antibiotic. We conducted a prospective study in older men. A group that received vancomycin was compared with a control group to determine the incidence of nephrotoxicity secondary to vancomycin therapy alone and in combination with aminoglycosides, to identify possible risk factors associated with nephrotoxicity, and to determine the incidence of other adverse effects associated with vancomycin use. Nephrotoxicity occurred in 11 (17%) of 66 patients receiving vancomycin and in 3 (5%) of 57 controls overall. Stepwise logistic-regression analysis failed to identify underlying illnesses or concurrent risks that may have contributed to the development of nephrotoxicity associated with vancomycin. Adverse effects, including phlebitis (14%), neutropenia (1%), rash (0%), and red neck syndrome (0%), occurred at rates similar to previous reports.

Dosimeter based on 8-methoxypsoralen for UVA exposures over extended periods.

A miniaturized UVA dosimeter based on 8-methoxypsoralen (8-MOP) has been developed and characterized for the evaluation of UVA (320-400 nm) exposures over extended periods longer than one day. Current research indicates that UVA is a contributing factor in non-melanoma skin cancers and the associated financial cost of damage caused by UVA is significant. Dosimetry is a technique that is commonly employed to measure UV exposures to an object or subject. Miniaturized dosimeters using polyphenylene oxide (PPO) have previously been used to measure received erythemal UV (UVery) exposures. A new miniaturized dosimeter using 8-MOP as the photoactive material has been characterized and a technique developed for the calibration of UVA exposures. Using Mylar as a UVB filter the spectral response showed 8-MOP to react only to wavelengths between 320 and 400 nm. The measured cosine response has an error of less than 13.8% for angles between 0° and 60°. Seasonal dose response tests conducted, indicate that these UVA dosimeters are able to measure exposures <4.6 kJ/m(2). These results have shown that a dosimeter constructed from 8-MOP in conjunction with a Mylar filter can measure UVA exposures over extended periods longer than one day.

Supersensitive endocrine response to physostigmine in dopamine-depleted rats: a model of depression?

Depressed patients exhibit an abnormal "supersensitive" increase in the plasma concentration of several pituitary hormones following intravenous injection of the acetyl cholinesterase inhibitor physostigmine (PHY). In the present study, we examined the effects of PHY treatments on the plasma concentrations of prolactin (PRL) and adrenocorticotrophic hormone (ACTH) in the rat. Physostigmine (0-0.6 mg/kg, s.c.) produced a dose-dependent increase in PRL and ACTH immunoreactivity in unoperated animals. Neurotoxin-induced depletion of brain dopamine (DA) or norepinephrine (NE) did not significantly alter baseline plasma PRL or ACTH values. Following depletion of brain DA, but not NE, animals exhibited a "supersensitive" increase in plasma ACTH values, which was evidenced by a sixfold left shift in the dose-response properties of PHY. These results suggest that there are intriguing parallels between the abnormal endocrine response to PHY demonstrated by depressed patients and that demonstrated by rats following depletion of central nervous system (CNS) DA levels.

Fluconazole therapy for chronic disseminated candidiasis in patients with leukemia and prior amphotericin B therapy.

OBJECTIVE: To study the efficacy of fluconazole against chronic disseminated candidiasis (hepatosplenic candidiasis) in patients with leukemia in whom amphotericin B treatment had failed. DESIGN: Retrospective analysis of patients with chronic disseminated candidiasis treated with fluconazole on a compassionate investigational new drug protocol. SETTING: Multi-institutional. PATIENTS AND METHODS: Twenty consecutive patients received 100 to 400 mg of fluconazole per day for a median of 30 weeks. All had either failed to respond to treatment with more than 2 g of amphotericin B or had serious amphotericin B-related toxicities. RESULTS: Fourteen of 16 evaluable patients (88%) responded. Responses were observed in seven of nine patients in whom adequate doses of amphotericin B had failed and in all seven patients who had amphotericin B-related toxicities. In 12 patients, cytotoxic chemotherapy was continued without flare of the infection. Fluconazole was well tolerated with rare side effects. Aspergillus superinfection developed in three patients and contributed to the death of two of them. CONCLUSION: Fluconazole is a safe and effective agent with significant activity against chronic disseminated candidiasis.

Diagnosis and treatment of depression in late life.

Major depression and dysthymia are common and often disabling disorders in late life. Several features of late-life depression, such as its frequent association with general medical conditions, polypharmacy, cognitive disturbances, and adverse life events, make accurate diagnosis a substantial clinical challenge. Yet, prompt diagnosis is an important component of implementing appropriate treatment strategies. An ideal treatment program integrates patient and family education, focused psychotherapy, and pharmacotherapy. Because of pharmacokinetic and pharmacodynamic changes associated with aging, lower doses of medication and more gradual dose increases than are required in younger adults are needed in the treatment of elderly depressed patients. In addition, medications should be selected that have minimal antihistaminic, anticholinergic, and antiadrenergic effects, minimal cardiovascular risk, and minimal drug-drug interactions. Since depression in late life tends to be at least as chronic and/or recurrent as depression earlier in life, treatment for acute depressive episodes should last at least 6-8 months, and long-term maintenance treatment should be considered in selected individuals.

Measurements of occupational ultraviolet exposure and the implications of timetabled yard duty for school teachers in Queensland, Australia: preliminary results.

Simultaneous personal measurements of the occupational ultraviolet exposure weighted to the International Commission on Non-Ionising Radiation Protection hazard sensitivity spectrum (UVICNIRP) were made over a five week period (44 person-days) in the second half of the summer school term of 2012 in Queensland, Australia for individual high school teachers located at latitudes of 27.5°S and 23.5°S. These teachers were employed for the duration of the study in a predominately indoor classroom teaching role, excluding mandatory periods of lunch time yard duty and school sport supervisions. Data is presented from personal measurements made to the shirt collar using polyphenylene oxide (PPO) film UV dosimeters. UVICNIRP exposure data is presented for each week of the study period for the shirt collar measurement site and are further expressed relative to the measured ambient horizontal plane exposure. Personal exposures were correlated with time outdoors, showing a higher exposure trend on days when teachers were required to supervise outdoor areas for more than 2h per week (mean daily exposure: 168Jm(-2)UVICNIRP±5Jm(-2) (1σ)) compared to the study average (mean daily exposure: 115Jm(-2)UVICNIRP±91Jm(-2) (1σ)). Time spent in an open playground environment was found to be the most critical factor influencing the occupational UVICNIRP exposure. A linear model was developed showing a correlation (R(2)=0.77) between the time teachers spent on yard duty and UVICNIRP exposure, expressed relative to ambient. The research findings indicate a greater reduction in personal exposure can be achieved by timetabling for yard duty periods in playground areas which offer more shade from trees and surrounding buildings. All mean daily personal exposures measured at the shirt collar site were higher than the ICNIRP occupational daily exposure limit of 30Jm(-2) for outdoor workers.

Evaluation of the cloudy sky solar UVA radiation exposures.

The influence of cloud on the solar UVA (320-400 nm) exposures over five minute periods on a horizontal plane has been investigated. The first approach used cloud modification factors that were evaluated using the influence of clouds on the global solar exposures (310-2800 nm) and a model developed to apply these to the clear sky UVA exposures to allow calculation of the five minute UVA exposures for any cloud conditions. The second approach established a relationship between the UVA and the global solar exposures. The models were developed using the first six months of data in 2012 for SZA less than or equal to 70° and were applied and evaluated for the exposures in the second half of 2012. This comparison of the modelled exposures for all cloud conditions to the measured data provided an R(2) of 0.8 for the cloud modification model, compared to an R(2) of 0.7 for the UVA/global model. The cloud modification model provided 73% of the five minute exposures within 20% of the measured UVA exposures. This was improved to 89% of the exposures within 20% of the measured UVA exposures for the cases of cloud with the sun not obscured.

Dosimetric investigation of the solar erythemal UV radiation protection provided by beards and moustaches.

A dosimetric technique has been employed to establish the amount of erythemal ultraviolet radiation (UVR) protection provided by facial hair considering the influence of solar zenith angle (SZA) and beard-moustache length. The facial hair reduced the exposure ratios (ERs) to approximately one-third of those to the sites with no hair. The variation in the ERs over the different sites was reduced compared with the cases with no beard. The ultraviolet protection factor (UPF) provided by the facial hair ranged from 2 to 21. The UPF decreases with increasing SZA. The minimum UPF was in the 53-62° range. The longer hair provides a higher UPF at the smaller SZA, but the difference between the protection provided by the longer hair compared with the shorter hair reduces with increasing SZA. Protection from UVR is provided by the facial hair; however, it is not very high, particularly at the higher SZA.

Cloud cover and horizontal plane eye damaging solar UV exposures.

The spectral UV and the cloud cover were measured at intervals of 5 min with an integrated cloud and spectral UV measurement system at a sub-tropical Southern Hemisphere site for a 6-month period and solar zenith angle (SZA) range of 4.7 degrees to approximately 80 degrees . The solar UV spectra were recorded between 280 nm and 400 nm in 0.5 nm increments and weighted with the action spectra for photokeratitis and cataracts in order to investigate the effect of cloud cover on the horizontal plane biologically damaging UV irradiances for cataracts (UVBE(cat)) and photokeratitis (UVBE(pker)). Eighty five percent of the recorded spectra produced a measured irradiance to a cloud free irradiance ratio of 0.6 and higher while 76% produced a ratio of 0.8 and higher. Empirical non-linear expressions as a function of SZA have been developed for all sky conditions to allow the evaluation of the biologically damaging UV irradiances for photokeratitis and cataracts from a knowledge of the unweighted UV irradiances.