Indoor tanning remains a popular activity in Western cultures despite a growing body of literature suggesting its link to skin cancer and melanoma. Advances in indoor tanning research have illuminated problematic patterns of its use. With problems such as difficulty quitting, devoting resources toward its use at the expense of healthy activities, and excessive motivation and urges to tan, symptoms of excessive indoor tanning appear consistent with behavioral addiction. The present study bridges the gap between clinical approaches to understanding indoor tanning problems and behavioral economic considerations of unhealthy habits and addiction. Eighty undergraduate females completed both the Behavioral Addiction Indoor Tanning Screener and the Tanning Purchase Task. Results suggest that behavioral economic demand for tanning significantly differs between risk classification groups, providing divergent validity to the Behavioral Addiction Indoor Tanning Screener and offering additional evidence of the sensitivity of the Tanning Purchase Task to differentiating groups according to tanning profiles.

Given the prevalence and risk associated with indoor tanning among college students, university campuses constitute a prime target for skin cancer prevention. This report identifies the successes and challenges faced in promoting a campus-wide tan-free policy through the National Council on Skin Cancer Prevention (NCSCP) Indoor Tan-Free Skin Smart Campus Initiative. Beginning in February 2016, we communicated with university faculty or staff members who have participated in skin cancer prevention via education, clinical care, or research at 20 universities regarding the steps to adopt the tan-free policy. One campus, East Tennessee State University (ETSU), successfully fulfilled all criteria and implemented the policy change to become the first US Indoor Tan-Free Skin Smart Campus. The greatest challenge faced in recruiting campuses was gaining administrative support. Reported reasons for not adopting the policy change included wanting to wait for other schools to join first and not seeing it as a top priority. Despite the importance of improving skin cancer awareness and decreasing tanning among university students, we faced several challenges in promoting campus-wide policy change. We identify a need for research on effective ways to disseminate university health policies and increased involvement of healthcare providers in policy-related work.

Introduction There is limited research on the relation between weight misperceptions and health-related quality of life (HRQoL) among U.S. adolescents. Methods Baseline data (n = 1509) collected in 2012 from the Team Up for Healthy Living project were used. Measures included BMI percentiles calculated from measured height and weight; self-perception of weight status; and the 23-item PedsQL™ Inventory. Multiple linear regression was performed after adjustment for covariates to examine associations between weight misperception and HRQoL. Results Compared to accurate weight perception, weight underestimation was associated with higher total HRQoL (β = 2.41), physical health (β = 2.77), and emotional (β = 2.83), social (β = 2.47) and psychosocial functioning (β = 2.38) (all p < 0.05). Weight overestimation was associated with lower social functioning (β = −13.13, p < 0.05). Stratified by gender, associations were observed only in males. Discussion Weight underestimation had greater association with HRQoL than weight overestimation; and varied by gender. Better understanding of these associations will assist in improving the health of adolescents in Southern Appalachia.

Millions of Americans engage in tanning each year, defined as intentional ultraviolet radiation (UVR) exposure in the form of sunbathing or the use of indoor tanning beds. An emerging body of research suggests that UVR has addictive properties and some tanners engage in excessive tanning. This article provides an overview of the evidence of tanning addiction and a systematic review of existing tanning interventions with the goal of evaluating their potential to impact addicted tanners. Our search identified 24 intervention studies that were summarized and discussed according to 3 primary themes. First, there is a dearth of tanning interventions that target excessive tanning or are designed as treatments for tanning addiction. Second, tanning interventions are primarily educational interventions designed to increase knowledge of the risks of tanning. Third, there are notable aspects of existing tanning interventions that are relevant to addiction science, including the use of brief motivational and cognitive-behavioral-based interventions. Future directions are considered including recommendations for utilizing the existing evidence base to formulate interventions targeting excessive tanners.

While partnerships for health delivery and improvement are frequently described by their structure, goals, and plans, less attention is paid to the interactive relationships among partners or for larger stakeholder groups’ coalition memberships. The Give-Get Grid group process tool can be used to assess each stakeholders’ expected benefits (“gets”) and contributions (“gives”) needed to establish and maintain long-term, mutually advantageous community–academic partnerships. This article describes three case study experiences using the Give-Get Grid in real-world context to understand and generate ideas to address contemporary health promotion opportunities among a variety of stakeholders. The case studies address three distinct community health promotion opportunities: prevention of school-based adolescent obesity disparities, higher education health professions training programs in rural community-based settings, and methods for engaging community coalitions in state Comprehensive Cancer Control Programs. The case studies demonstrate the Give-Get Grid’s utility in both planning and evaluating partnerships and documenting key elements for progress in health promotion initiatives built on long-term community–academic relationships. Steps are explained with practical lessons learned in using the Grid.

Background: Tobacco use exacerbates diseases, including tuberculosis (TB) and interferes with recovery from such outcomes. However, there is sparse research on the integration of tobacco cessation into TB programs. Moreover, there is limited evidence on how mHealth solutions for tobacco can enhance cessation among TB patients. This study aimed to assess the impact of a training program to integrate tobacco cessation in TB program on the knowledge of health workers. Methods: In June 2017, a 5-day training about tobacco use and control and the use of mHealth solutions to improve tobacco cessation and enhance adherence to TB treatment was conducted in Uganda. A comparison of percent of participants reporting knowledge on selected health outcomes of tobacco use and secondhand tobacco smoke (SHS) exposure was conducted. Knowledge was assessed on a 21-outcome-item before and after training. A non-parametric test, signrank for comparison of paired observations was conducted. The changes were considered statistically significant if the p-value was less than 5%. Results: Twenty three trainees from across the country attended (13 females, 10 males), with median age of the trainees was 39 years. Pre-training knowledge about tobacco use (66.6%) was higher than SHS exposure (45%). Following the training, both sets of knowledge significantly improved (median 100%). Pre-training knowledge about health effects of tobacco use was particularly low for diabetes (27%), meningitis (9.5%), ear infection (43%), impotence (47.6%), and fibrosis (30%). Except heart attack (76%), lung illness among children (91%), lung cancer (81%), and chronic lung disease (81%), pre-training knowledge about SHS was low for all other disease outcomes. Conclusions: Healthcare providers play critical role in preventing and reducing tobacco use. The low pre-training knowledge of the TB health workers suggests the critical need for training health providers in Uganda and elsewhere in Africa in order to curtail the increasing trend in usage.

Objectives: This study aimed to examine the association of Per and Polyfluoroalkyl substances (PFAS) and markers of chronic inflammation and oxidative stress. Methods: Using data (n = 6652) from the National Health and Nutrition Examination Survey (NHANES) 2005–2012, generalized linear models were used to examine the association between PFAS and inflammatory (ferritin, alkaline phosphatase, C-reactive protein, absolute neutrophil count and lymphocyte count) and oxidative stress (serum bilirubin, albumin and iron) per unit exposure to PFAS while adjusting for covariates. Study participants were those ≥20 years of age. Outcome variables were markers of chronic inflammation and oxidative stress and exposure variables were PFAS. Resullts: Percentage change in Perfluorohexane sulfonic acid (PFHxS), Perfluorononanoic acid (PFNA), Perfluorooctanoic acid (PFOA), Perfluorooctane sulfonic acid (PFOS), and Perfluorodecanoic acid (PFDA) were all significantly associated with percentage increases in lymphocyte counts, beta (95% confidence interval); 0.04(0.02,0.05), 0.04(0.02,0.05), 0.05(0.03, 0.07), 0.04(0.03,0.05), 0.03(0.13,1.23) and with percentage increases in serum iron 0.07(0.05,0.09), 0.04(0.02,0.07), 0.10(0.07,0.12), 0.05(0.03,0.07), 0.04(0.02,0.06) and increased serum albumin 0.02(0.02,0.02), 0.02(0.02,0.03), 0.03(0.03,0.04), 0.02(0.017, 0.025), 0.01 (0.01, 0.05). Only PFHxS, PFNA, PFOA and PFOS were associated with percentage increases in serum total bilirubin 0.04(0.03,0.05), 0.02(0.00,0.03), 0.06(0.04,0.08), 0.03(0.02,0.05). Similar results were obtained for categorical quintile analysis with PFOA showing a significant trend (P < 0.001) with lymphocyte count, serum iron, serum total bilirubin and serum albumin. Trend for neutrophil count was not significant (p = 0.183). Conclusion: Per and Polyfluoroalkyl substances are associated with markers of chronic inflammation and oxidative stress. Increased exposure leads to increase in serum concentration of these markers meaning these chemicals are associated with both chronic inflammation and oxidative stress.

This study describes the changes in prevalence odds ratios (PORs) for Alzheimer disease (AD) in the northeast Tennessee region (NTR) during a 3-year period, describes the statistical assessment process, and critically assesses the database from which the statistical association was derived. The article also examines several beliefs pertinent to the clinical management of AD in the NTR from the perspective of professionals delivering services. Methods We extracted prevalence data for NTR counties for 2013, 2014, and 2015 from the Centers for Medicare and Medicaid Services Geographic Variation Public Use File. We used the crude prevalence and the 2010 US Census Data fixed population for each county to compute the POR. The 2013 Economic Research Service Rural-Urban Continuum Codes were used to identify rural and urban counties in the NTR. We collected primary data on the perceived observation of the increasing prevalence in the NTR during the last 3 years and barriers to early diagnosis through an online survey from 44 experts and professionals working in AD-related fields within the NTR. Results The PORs of AD in rural counties in NTR increased by 18.3%, 4.7%, and 19% compared with urban counties for 2013, 2014, and 2015, respectively. The POR of AD for the entire NTR region increased by 22.7%, 22.5%, and 21.2% compared with other regions in Tennessee for 2013, 2014, and 2015, respectively. Compared with 2012, 68.4% of respondents currently work with more individuals with AD; 71.8% reported that the NTR has a higher number of late-stage diagnoses of AD. A total of 92.3% strongly agreed that early detection of AD is important, and 95% agreed that early diagnosis could prolong the lives of patients with AD; 51.2% were unaware of existing AD screening services. Reported barriers were denial, lack of patient awareness, inefficient screening methods, communication, and lack of community resources. Conclusions Increased prevalence of AD among inhabitants in the NTR and identified barriers to early screening or diagnosis in the management of AD were identified. Access to early screening techniques must be prioritized in deprived areas within the NTR. Healthcare providers and medical professionals in the NTR must be well equipped with the required training and resources to respond adequately to the increasing prevalence of AD.

No description available.

Diarrhoeal diseases are a global public health burden, killing 1.8 million people annually. Diarrhoea disproportionately affects children and those in poverty. Most diarrhoeal cases can be prevented through safe drinking water and basic hygiene and sanitation measures, with drinking water interventions having the most impact on reducing diarrhoeal disease. A metaevaluation of studies assessing a specific household water treatment method, the biosand water filter, was completed. Results from the meta-evaluation illustrated that biosand water filters improve drinking water quality and reduce diarrhoeal disease. However, short follow-up times and inconsistent measures are a concern. Furthermore, there is no generally accepted field method for determining biosand water filter effectiveness that is useable in low-resource communities. This study adds to understanding of biosand water filters.