Summary Background The International Agency for Research on Cancer has identified artificial ultraviolet (UV) radiation as a class 1 carcinogen. The contribution of sunbeds to malignant melanoma has been estimated at 100 deaths per year in the U.K. The sunbed industry is growing and claims self‐regulation. Objectives To explore the standards of operation and client protection for sunbed users. Methods An observational study of tanning parlour practices was conducted by Environmental Health Practitioners who made unannounced visits to the majority of known commercial tanning parlours in Northern Ireland (population 1·77 million) during July/August 2007. Descriptive statistics were produced and comparisons between groups were made using χ2 analysis. Results All 332 premises visited cooperated with the survey. The UV type in machines was unknown in 71·2% of premises while 15·6% reported using type 4, high‐dose UV devices; 36·2% of premises did not regularly service sunbeds or were unsure. Unsupervised use of sunbeds was reported in 8·6% of parlours and 3·4% provided a home sunbed service. Eye protection was available in 97·6% of premises but 34·6% charged for the service and only 79·6% sanitized these between use. Of the responders 15·9% were members of the Sunbed Association. These were more likely to have maintenance records and operating manuals but were also more likely to provide a home sunbed service. Conclusions This study highlights the need for improved standards of regulation of the sunbed industry to protect clients from excessive and dangerous levels of UV radiation in a population where the numbers of melanomas continue to rise.
Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age (p = 0.02) and Non-Hispanic Black race (p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) (p = 0.003), perception of low healthcare quality (p = 0.006), no routine checkup within two years (p = 0.002), perceived discrimination (p = 0.02), and nSES deprivation (p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.
Objectives: Despite efforts to increase minority enrollment in research, racial disparities still exist and a belief persists that minorities are inherently less likely to enroll in medical research. This lingering view may impact the manner in which studies are presented to minority patients. This study aimed to assess racial differences in reported discrimination while seeking medical care and likelihood to participate in a medical research study.Methods: 844 residents were enrolled via convenience sampling, and asked to complete a survey designed to examine perceived discrimination while seeking healthcare and likelihood to participate (LoP) in a medical research study.Results: Participants who reported worse treatment than other races had lower mean LoP scores (53.7 ± 17.6) than participants who reported being treated the same as (61.1 ± 16.1) or better than (64.0 ± 15.0) other races (p < .001). There were no significant differences in mean LoP score by race/ethnicity. The interaction of race with discrimination had no significant effect on mean LoP (p = 0.8). There was a statistically significant association between race and discrimination (X 2 = 11.32, p = 0.023), although the majority of participants reported no discrimination. Conclusion:Patient experiences in the medical arena may have an impact on their willingness to join a medical study. An effective strategy to increase minority participation in research may be to work with investigators and staff on implicit bias with regards to minority patients. Further research should focus on the impact of research staff interactions on an individual's decisionmaking process.
BackgroundFinancial compensation of research participants has been standard practice for centuries, however, there is an ongoing debate among researchers and ethicists regarding the ethical nature of this practice. While these debates develop ethical arguments and theories, they fail to incorporate input from those most affected by financial compensation: potential research participants.MethodsTo identify attitudes surrounding clinical research, participants of a long-standing cohort completed a one-time interview. Open-ended questions stimulated a participant-driven discussion surrounding medical research. Following a grounded theory methodology, 58 semistructured interview transcripts were coded, focusing on attitudes surrounding financial compensation of research participants.ResultsOf the interviews coded, the majority of participants identified as Black/African American (n=44) and were women (n=40). Five major themes emerged. In support of financial compensation, participants felt that study participants should be compensated for time, effort and risk. However, participants were concerned that compensation may differentially impact low-income populations and entice them to hide potentially harmful side effects. Participants also mentioned that financial compensation may invalidate study results if participants knowingly provide false information to subvert inclusion/exclusion criteria.ConclusionThe emergence of both positive and negative themes reiterates the complicated issue of providing financial compensation for study participation. While compensation as a motivator for research participation raises ethical concerns, participants discussed weighing the benefits with the risks in order to make an informed decision. To avoid paternalistic behaviours, research staff must allow potential research participants to review the available information and make the decision that best reflects their wishes.
Objectives Many academic medical centers are positioned amidst disadvantaged urban neighborhoods in which healthcare services are underutilized, participation in research studies is low, and need for health improvement is vast. The goal of Temple Health: Block-by-Block (THB 3 ) is to establish a sustainable cohort of Philadelphia residents engaged in individual and community health improvement through health research. Methods Recruitment of a population-based sample from 11 Philadelphia zip codes began in August 2015. The cornerstone of the project is the in-home, biannual assessment of each subject. ResultsThe first-year goal of 1000 enrolled subjects was met. Greater than 90% of subjects represent minority racial or ethnic groups; average age is 46 years; 65% of subjects have a high school education or less. A high burden of health conditions exists including obesity (54%), smoking (41%), hypertension (44%), and diabetes (17.8%).Conclusions THB 3 provides a research infrastructure to promote community participation in a health improvement initiative from which future translational research, health education and preventive services will emanate. The launch of this cohort study has provided extensive lessons regarding urban community-based research and health promotion initiatives.
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