Regular Sun Exposure Research Articles

The Environmental and Social Risk Factors for Myopia in Children and Adolescents in Bangladesh

Background: The seriousness of myopia is still underappreciated by the general population. One in five occurrences of blindness may be traced back to uncorrected refractive error (The discrepancy between the patient's vision at presentation and their best-corrected vision). Objective: In this study our main goal is to evaluate the environmental and social risk factors for myopia in children and adolescents in Bangladesh. Method: This prospective cohort research conducted at a major medical center to investigate prenatal through adult risk factors for poor health and noncommunicable illnesses in young people. The study began in July 2020, and 100 people have been asked to participate in yearly follow-ups for two years. The majority of the people living there are from the Dhaka metropolitan area. Schools, daycares, community clinics, general practices, public health agencies, and collaborative research projects are just few of the places where participants are sought for recruitment. Results: During the study, 60% were in 11-18 years age group, 55% were male and 35% were in middle income group. 10% myopia had 3-10 years age group and 21% myopia in 11-18 years age group. 80% patients had everyday outdoor frequency, followed by 50% had 1-2 hours outdoor frequency, 60% had everyday near work frequency. There was a significant associations of myopia with low outdoor activity frequency, high near work duration and low near work frequency. Outdoor activity duration was not significantly associated with myopia. Conclusion: The results of our study indicate that regular sun exposure and limiting the amount of time spent in constant close work may help prevent the development of eye diseases. Furthermore, our cohort found that children of higher socioeconomic status were less likely to be myopic. Strategy development for myopia prevention in children of all ages should be prioritized in light of the massive economic burden imposed by the condition and the apparent ............

Risk perception of sun exposure and knowledge of vitamin D among the healthcare providers in a high-risk country: a cross-sectional study

BackgroundHigh levels of vitamin D deficiency are commonly reported even in regions with abundant sunshine. This necessitates a comprehensive understanding of the determinants that influence sun exposure practices. As the primary source of health-related knowledge for the general public, the attitude of the healthcare professionals towards sunlight and their awareness related to vitamin D deficiency can be critical in this regard.MethodsA cross-sectional survey was conducted among 2,242 physicians, intern doctors, and senior medical students in Bangladesh from October 2019 to February 2020. A pre-tested structured questionnaire (containing twelve close-ended questions) was used. The perceptions of health risks due to sun exposure, and basic knowledge of the physiological and epidemiological aspects of vitamin D deficiency were tested.ResultsAn overall negative attitude towards sunlight in the context of Bangladesh was highlighted – 68% participants thought regular sun exposure would be harmful or very harmful; 26% thought the level of UV radiation was very high; 44% recommended using sunscreen always; skin burns, heat stroke, and cancer were selected as potential consequences of regular sun exposure by 45%, 21%, and 30% respondents respectively. Overall knowledge regarding vitamin D deficiency appeared to be biased towards bone health; other symptoms and associated illnesses not having obvious link to Calcium-metabolism were identified much lesser frequently. Furthermore, ‘sunrise to 10 am’ was identified as the best time to get vitamin D by 69% participants; 60% believed < 30 min of weekly sun exposure would be sufficient for the Bangladeshi population; an only 33% identified that prevalence of vitamin D insufficiency in Bangladesh would be 50% or more. Taking vitamin D-rich food was suggested by more respondents over regular sun exposure (43% vs. 33%) as more effective remedial strategy to curb vitamin D deficiency in Bangladesh.ConclusionIn addition to highlighting some crucial knowledge gaps, results from this study provides a comprehensive baseline dataset for knowledge and attitude regarding the public health aspects of vitamin D deficiency among the healthcare providers in Bangladesh, which would be generalizable to other countries with similar socio-demographic context, and will facilitate taking more effective policies worldwide.

Demographic and clinical features of cutaneous malignant melanoma patients: A single center cohort study.

There is a worldwide increase in the incidence of malignant melanoma (MM). Although it is a highly aggressive tumor and associated with high mortality and morbidity rates, it is highly curable if diagnosed early. Both genetic and environmental risk factors are associated with MM, which may show geographic variations. In this study we aimed to investigate the demographic and clinical features of cutaneous melanoma patients who are under follow-up in our department and whether there is an association between patients' characteristics and disease features. Thirty-four patients with cutaneous MM who were under follow-up in the dermatology outpatient clinic, and dermoscopy unit at our hospital were retrospectively analyzed. The patients' demographic data and features related to MM were evaluated. Nineteen (55.9%) women and 15 (44.1%) men were enrolled in the study. When the patients were evaluated according to their Fitzpatrick skin types, type 2 was the most common in 21 (61.8%) of the patients, followed by type 3 in 9 (26.5%), and 1 in 4 (11.8%) patients. Twenty-two (64.7%) of the patients had a history of regular sun exposure. Twelve (35.3%) patients had a history of working outdoors. Sixteen of the patients (47.1%) had at least one sunburn history during childhood. The mean age at which patients were diagnosed with MM was 50.12±12.67 years. Age at diagnosis was found to be higher in those with actinic keratosis and those with solar lentigo (p=0.030, p=0.030; respectively). It was determined that there was a statistically significant difference in terms of localization according to the place of birth of the patients (p=0.007). We believe that defining the patients' characteristics and developing follow-up strategies accordingly, will improve the treatment rates in melanoma. Dermatologists should schedule personalized follow-up programs for patients who have priorly defined and regional risk factors.

Factors associated with vitamin D deficiency among patients with musculoskeletal disorders seeking physiotherapy intervention: a hospital-based observational study

BackgroundA considerable number of studies have suggested that there is a strong correlation between 25-hydroxyvitamin D or vitamin D levels and overall health, with reported impacts ranging from mental health and vital organ health to musculoskeletal health. This study aimed to determine the prevalence of 25-hydroxyvitamin D deficiency and identify its associated factors among patients with musculoskeletal disorders (MSDs) currently seeking medical attention.MethodsA total of 143 patients with MSDs were randomly selected for blood sample collection to measure serum 25-hydroxyvitamin D levels. Descriptive statistics were used to describe the demographic and clinical characteristics of the study participants. Multiple logistic regression analyses were performed to compute the adjusted odds ratio.ResultsOverall, 53.1% of patients had vitamin D deficiency. Vitamin D deficiency was more prevalent among patients with higher body mass index, a bachelor’s degree, lower sun exposure time, and lower serum calcium levels and those living in an urban setting. The multiple logistic regression model suggested that the duration of weekly sun exposure and living location were the independent predictors of vitamin D deficiency.ConclusionIt is recommended for patients with MSDs to participate in routine physical exercise, consume calcium- and vitamin D-enriched foods, and have regular sun exposure for minimizing the risk of vitamin D deficiency.

Diet, Sun, Physical Activity and Vitamin D Status in Children with Inflammatory Bowel Disease.

In the course of inflammatory bowel disease (IBD) malabsorption may lead to a vitamin D deficiency and calcium–phosphate misbalance. However, the reports on the vitamin D status in children with IBD are few and ambiguous. Here, we are presenting complex analyses of multiple factors influencing 25OHD levels in IBD children (N = 62; Crohn’s disease n = 34, ulcerative colitis n = 28, mean age 14.4 ± 3.01 years, F/M 23/39) and controls (n = 47, mean age 13.97 ± 2.57, F/M 23/24). Additionally, calcium–phosphate balance parameters and inflammatory markers were obtained. In children with IBD disease, activity and location were defined. Information about therapy, presence of fractures and abdominal surgery were obtained from medical records. All subjects were surveyed on the frequency and extent of exposure to sunlight (forearms, partially legs for at least 30 min a day), physical activity (at least 30 min a day) and diet (3 days diary was analyzed with the program DIETA 5). The mean 25OHD level was higher in IBD patients compared to controls (18.1 ng/mL vs. 15.5 ng/mL; p = 0.03). Only 9.7% of IBD patients and 4.25% of controls had the optimal vitamin D level (30–50 ng/mL). Despite the higher level of 25OHD, young IBD patients showed lower calcium levels in comparison to healthy controls. There was no correlation between the vitamin D level and disease activity or location of gastrointestinal tract lesions. Steroid therapy didn’t have much influence on the vitamin D level while vitamin D was supplemented. Regular sun exposure was significantly more common in the control group compared to the IBD group. We found the highest concentration of vitamin D (24.55 ng/mL) with daily sun exposure. There was no significant correlation between the vitamin D level and frequency of physical activity. The analysis of dietary diaries showed low daily intake of vitamin D in both the IBD and the control group (79.63 vs. 85.14 IU/day). Pediatric patients, both IBD and healthy individuals, require regular monitoring of serum vitamin D level and its adequate supplementation.

Influence of the appendicular skeletal muscle mass index on the bone mineral density of postmenopausal women

BackgroundThe appendicular skeletal muscle mass index (ASMI) is an important risk indicator for osteoporosis because of the anatomical proximity and metabolic connection between muscle and bone mass. The present study investigated the relationship between ASMI and the bone mineral density (BMD) categories of postmenopausal women.MethodsIn this cross-sectional study with a probabilistic sample, sociodemographic, lifestyle, menopause time, anthropometric, and physical activity variables were collected. ASMI and BMD were assessed by dual-energy X-ray absorptiometry (DXA). Participants were grouped according to BMD values into normal density, osteopenia, and osteoporosis. Multivariate logistic regression models were applied to verify the influence of ASMI on BMD. Data were analyzed using the SPSS statistical software, version 22. The significance level for all tests was set at 5%.ResultsOf the 114 women analyzed, most were between 60 and 69.9 years of age (62.3%), on menopause for ≤19.0 (51.8%), self-declared brown race/color (49.1%), had < 4 years of education (41.2%), never smoked (69.0%) or drank alcohol (62.8%). Of these, 52.6% were classified as sufficiently active and 52.2% had regular sun exposure. Women with osteoporosis were older (p = 0.035), on menopause for a longer time (p = 0.011), underweight (p = 0.004), had adequate waist circumference (p = 0.017), and low ASMI values (p = 0.002). There was an association between the 1st tertile of ASMI and osteoporosis. However, after adjustments for age, race/color, and body mass index, the strength of association between BMD and ASMI was not maintained.ConclusionsASMI was not associated with the BMD of the postmenopausal women evaluated. Total body and muscle mass, in addition to bone mass, should be monitored during menopause treatment. Longitudinal studies must be conducted to elucidate the mechanisms and gaps in this relationship.

Vitamin D Postpartum Concentrations: Relationship with Nutritional Condition and Morbidities during Pregnancy.

Objective To evaluate postpartum vitamin D deficiency/insufficiency and to relate it to pregestational BMI, gestational weight gain, and sociodemographic variables. Methods This is a cross-sectional study with 225 full-term pregnant women. Data collected are as follows: maternal health, socioeconomic status, pregestational body mass index (BMI), and gestational weight gain. Laboratory evaluation included vitamin D [25(OH)D], calcium, phosphorus, magnesium, and alkaline phosphatase. Results The mean age of women was 25.6±6.6 years. Dark skin color, low education, and work in the urban region were predominant. Regular sun exposure, photoprotection, and vitamin D supplementation were reported by 144 (64.0%), 44 (19.6%), and 5 (2.2%) women, respectively. The mean plasma concentrations of 25(OH)D were 26.0±6.8 ng/mL. Levels compatible with deficiency (<20 ng/mL) and insufficiency (20-30 ng/mL) were observed in 43 (19.1%) and 124 (55.1%) women, respectively. The increase of 1 ng/mL in 25(OH)D concentrations was associated with an increase of 0.16 mg/dL (95%CI 0.19 to 2.02; p=0.018) for calcium. There were no associations with 25(OH)D concentrations with pregestational BMI and with gestational weight gain. Conclusions The high frequency of postpartum vitamin D deficiency/insufficiency in women with a full-term pregnancy in a region with a large and permanent sun exposure reminds us of the need for intervention policies aimed at preventing vitamin D deficiency during pregnancy.

Circannual rhythm of plasmatic vitamin D levels and the association with markers of psychophysical stress in a cohort of Italian professional soccer players

ABSTRACTAdequate plasmatic Vitamin D levels are crucial to maintain calcium homeostasis and bone metabolism both in the general population and in athletes. Correct dietary supply and a regular sun exposure are fundamental for allowing the desired and effective fitness level. Past studies highlighted a scenario of Vitamin D insufficiency among professional soccer players in several countries, especially in North Europe, whilst a real deficiency in athletes is rare. The typical seasonal fluctuations of Vitamin D are wrongly described transversally in athletes belonging to teams that play at different latitudes and a chronobiologic approach studying the Vitamin D circannual rhythm in soccer players has not been described yet. Therefore, we studied plasma vitamin D, cortisol, testosterone, and creatin kinase (CK) concentrations in three different Italian professional teams training at the same latitude during a period of two consecutive competitive seasons (2013 and 2014). In this retrospective observational study, 167 professional soccer players were recruited (mean age at sampling 25.1 ± 4.7 years) and a total of 667 blood drawings were carried out to determine plasma 25(OH)D, serum cortisol, serum testosterone and CK levels. Testosterone to cortisol ratio (TC) was calculated based as a surrogate marker of overtraining and psychophysical stress and each athlete was drawn until a maximum of 5 times per season. Data extracted by a subgroup of players that underwent at least 4 sample drawings along a year (N = 45) were processed with the single and population mean cosinor tests to evaluate the presence of circannual rhythms: the amplitude (A), acrophase (Φ) and the MESOR (M) are described. In total, 55 players (32.9%) had an insufficient level of 25(OH)D during the seasons and other 15 athletes (9.0%) showed, at least once, a deficiency status of Vitamin D. The rhythmometric analyses applied to the data of Vitamin D revealed the presence of a significant circannual rhythm (p < 0.001) with the acrophase that occurred in August; the rhythms of Vitamin D levels were not different neither among the three soccer teams nor between competitive seasons. Cortisol, testosterone and TC showed significant circannual rhythms (p < 0.001): cortisol registered an acrophase during winter (February) while testosterone and TC registered their peaks in the summer months (July). On the contrary, CK did not display any seasonal fluctuations. In addition, we observed weak but significant correlations between 25(OH)D versus testosterone (r = 0.29 and p < 0.001), cortisol (r = −0.27 and p < 0.001) and TC (r = 0.37 and p < 0.001). No correlation was detected between Vitamin D and CK. In conclusion, the correct chronobiologic approach in the study of annual variations of Vitamin D, cortisol and testosterone could be decisive in the development of more specific supplementation and injury prevention strategies by athletic trainers and physicians.

Regular sun exposure benefits health

Since it was discovered that UV radiation was the main environmental cause of skin cancer, primary prevention programs have been started. These programs advise to avoid exposure to sunlight. However, the question arises whether sun-shunning behaviour might have an effect on general health. During the last decades new favourable associations between sunlight and disease have been discovered. There is growing observational and experimental evidence that regular exposure to sunlight contributes to the prevention of colon-, breast-, prostate cancer, non-Hodgkin lymphoma, multiple sclerosis, hypertension and diabetes. Initially, these beneficial effects were ascribed to vitamin D. Recently it became evident that immunomodulation, the formation of nitric oxide, melatonin, serotonin, and the effect of (sun)light on circadian clocks, are involved as well. In Europe (above 50 degrees north latitude), the risk of skin cancer (particularly melanoma) is mainly caused by an intermittent pattern of exposure, while regular exposure confers a relatively low risk. The available data on the negative and positive effects of sun exposure are discussed. Considering these data we hypothesize that regular sun exposure benefits health.

Sunburn and sun-protective behaviors among adults with and without previous nonmelanoma skin cancer (NMSC): A population-based study

Individuals with previous nonmelanoma skin cancer (NMSC) are at increased risk for subsequent skin cancer, and should therefore limit ultraviolet exposure. We sought to determine whether individuals with previous NMSC engage in better sun protection than those with no skin cancer history. We pooled self-reported data (2005 and 2010 National Health Interview Surveys) from US non-Hispanic white adults (758 with and 34,161 without previous NMSC). We calculated adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (CI), taking into account the complex survey design. Individuals with previous NMSC versus no history of NMSC had higher rates of frequentuse ofshade (44.3% vs 27.0%; aPOR 1.41; 95% CI 1.16-1.71), long sleeves (20.5% vs 7.7%; aPOR 1.55; 95% CI 1.21-1.98), a wide-brimmed hat (26.1% vs 10.5%; aPOR 1.52; 95% CI 1.24-1.87), and sunscreen (53.7% vs 33.1%; aPOR 2.11; 95% CI 1.73-2.59), but did not have significantly lower odds of recent sunburn (29.7% vs 40.7%; aPOR 0.95; 95% CI 0.77-1.17). Among those with previous NMSC, recent sunburn was inversely associated with age, sun avoidance, and shade but not sunscreen. Self-reported cross-sectional data and unavailable information quantifying regular sun exposure are limitations. Physicians should emphasize sunburn prevention when counseling patients with previous NMSC, especially younger adults, focusing on shade and sun avoidance over sunscreen.

Rickets, BeriBeri, and Iron Deficiency: micronutrient deficiencies in children

Some “forgotten” micronutrient deficiencies continue to be common in children. Deficiencies of vitamin D and/or calcium can cause rickets, a crippling condition related to poor mineralization of growing bones. Rickets is diagnosed by identifying skeletal deformities, elevation of alkaline phosphatase levels, and abnormal epiphyses on x-ray. Treatment is with vitamin D and calcium. Prevention hinges on improving the daily intake of calcium, regular sun exposure, or dietary supplementation. Beriberi is due to thiamine deficiency. Infants with beriberi present in heart failure while older children present with neurological abnormalities. Treatment is with thiamine, and prevention requires alterations to improve dietary thiamine intake – by supplementing mothers of breastfed babies, increasing legume and unpolished rice intake, and diversifying diets. Iron deficiency continues to be a problem for nearly half of the world’s children. Bhutan has made strides to eliminate this problem through active de-worming programs and iron supplementation programs.

Skin Protection Behaviors among Young Male Latino Day Laborers: An Exploratory Study Using a Social Cognitive Approach

Latino Day Laborers (LDLs) are employed in occupations where multiple work hazards exist. One such hazard is the overexposure to solar ultraviolet radiation for continuous periods of time. Regular sun exposure can put individuals at increased risk of developing skin cancers, especially without adequate protection. The purpose of this cross-sectional exploratory study was to use a social cognitive framework to assess skin protective behaviors among LDLs. A community-based nonrandom and purposive sample of LDLs was recruited in two states: Mississippi and Illinois. The study sample consisted of 137 male participants, of which the majority were of Mexican ancestry (72%). The average age was 35.40 (SD = 9.89) years. Results demonstrated that a substantial number of LDLs do not adequately practice sun protection behaviors on a regular basis. The skin cancer knowledge scores were very modest. The most frequently indicated barriers towards sun protection were “inconvenient,” “forget to use,” and “not being able to reapply sunscreen.” Overall, LDLs had moderate confidence in their abilities to adopt successful sun protection strategies. This study underscores the need for intervention programs aimed at LDLs to reduce extended time in the sun and increase use of sun protective measures when working outdoors.

Estimating the risk of squamous cell cancer induction in skin following nonlinear optical imaging

High power femto-second (fs) laser pulses used for in-vivo nonlinear optical (NLO) imaging can form cyclobutane pyrimidine dimers (CPD) in DNA, which may lead to carcinogenesis via subsequent mutations. Since UV radiation from routine sun exposure is the primary source of CPD lesions, we evaluated the risk of CPD-related squamous cell carcinoma (SCC) in human skin due to NLO imaging relative to that from sun exposure. We developed a unique cancer risk model expanding previously published estimation of risk from exposure to continuous wave (CW) laser. This new model showed that the increase in CPD-related SCC in skin from NLO imaging is negligible above that due to regular sun exposure.

Sun exposure and risk of lymphoid neoplasms in Singapore

Epidemiologic studies have reported an inverse association between sun exposure and non-Hodgkin lymphoma (NHL), but these have been almost exclusively conducted in Western populations residing in temperate locations. We evaluated the association between personal outdoor sun exposure and risk of malignant lymphomas in Singapore. A hospital-based case-control study of 541 incident cases of lymphoid neoplasms and 830 controls were recruited during 2004-2008. Participants were interviewed regarding recreational or occupational outdoor activities during childhood and in adulthood. Basic demographics and potential confounders were also collected. Odds ratios (OR) and 95 % confidence intervals (CI) were calculated using unconditional logistic regression analysis. Compared with individuals who did not have regular sun exposure, a lower risk of NHL was observed for those who reported regular exposure on non-school days during childhood [OR, 0.62; 95 % CI, 0.46-0.83] and non-working days in adulthood [OR, 0.70; 95 % CI, 0.51-0.97]. The protective effect was more evident among women. Our findings support an inverse relationship between intermittent sun exposure and the risk of NHL. These findings are consistent with the growing evidence from various countries, but further studies, especially prospective studies, are needed in Asian populations.

Vitamin D: emerging roles in infection and immunity

In the preantibiotic era, TB of the skin was treated successfully with UV light. By the 1920s, pulmonary TB was being treated with regular sun exposure. During the last decade, basic laboratory research into the antimicrobial actions of vitamin D has provided new insights into these historical observations. Vitamin D has a critical role in the innate immune system through the production of antimicrobial peptides – particularly cathelicidin. Vitamin D would appear to have an important role in respiratory tract, skin and potentially gut health. A number of autoimmune diseases, including multiple sclerosis, Type I diabetes, systemic lupus erythematosus and rheumatoid arthritis, are associated with vitamin D deficiency. Vitamin D could have an important role in the prevention and possible treatment of these conditions; however, much of the current evidence relates to basic science and epidemiological research. In many situations, appropriate double-blind, randomized controlled trial data to guide clinicians treating infectious and autoimmune disease is still lacking.

The Vitamin D Deficiency Pandemic: a Forgotten Hormone Important for Health

Early in the twentieth century more than 80 percent of children in industrialized Europe and North America were ravaged by the devastating skeletal consequences of rickets. Finding that exposure to ultraviolet radiation or sunlight treated and prevented rickets led to the ultraviolet irradiation of foods including milk. These practices along with the fortification of a variety of foods including dairy products with vitamin D and widespread use of cod liver oil eradicated rickets as a significant health problem by the late 1930s. Many countries mandated the fortification of milk with vitamin D to prevent rickets during wartime shortages. In the 1950s, in Europe, many countries forbid fortification of dairy and food products except breakfast cereals and margarine because of an outbreak of vitamin D intoxication in neonates. Vitamin D deficiency has again become a major public health interest with its association with osteoporosis, osteomalacia, fractures, and more recently with prevention of cancer, diabetes, heart disease and other chronic illnesses. Regular sun exposure has decreased due to changing lifestyles. Vitamin D deficiency is especially prevalent in dark skinned children and adults living in Northern latitudes, and obese children and adults. Improving the vitamin D status worldwide would have dramatic effects on public health, and reduce healthcare costs for many chronic diseases. The most cost-effective way to remedy this deficiency is to increase food fortification with higher levels of vitamin D along with sensible sun exposure, and adequate vitamin D supplementation. I review the pathophysiology of vitamin D deficiency and its health consequences and provide recommendations for a new policy approach to this vital public health issue.

Introduction to the Symposium: Cultural Considerations in Alternative-Energy Transfer

Introduction to the Symposium:Cultural Considerations in Alternative-Energy Transfer John C. Pierce (bio) and Brent S. Steel (bio) The growing world population, coupled with a rapidly increasing demand for energy, exerts great pressure on nature's limited resources (EIA, 2008). To satisfy this growing worldwide demand, governments have been relying heavily on fossil fuels—coal, oil, and gas—for electricity production (IEA, 2008, p. 24). At the same time, carbon-dioxide emissions from the combustion of fossil fuels and industrial processes, which account for 98% of total carbondioxide emissions, have been accelerating rapidly (Raupach et al., 2007). Other environmental problems that can be linked directly to fossil-fuel consumption include ash waste disposal and mining runoff and oil spills, as well as the perhaps bigger challenges of air pollution, ocean pollution, and global climate change. As these problems have become increasingly severe, many national and international policies and regimes have been developed to address them (Chasek, Downie, & Brown, 2006; Moan & Smith, 2007, p. 78). Moreover, to address the problems of environmental degradation and depletion of fossil fuels, and at the same time to be able to provide the expected quality of life for their citizens, countries around the world are intensifying the search for alternative fuels and renewable energies that are expected to be less damaging to the environment and human health. Renewable energies also have the advantage that they very often can be tailored to the geographic characteristics of the area where they are produced. Thus regions with regular sun exposure could invest in solar energy, windy areas could harvest the power of the wind, coastal areas could get their electricity supplied directly from the ocean, and biofuels could be developed in renewable crops. To be sure, the renewable-energy sources themselves face significant obstacles, including, among others, cost, technological capacity, and political interests. The articles in this symposium address the cultural considerations in alternative-energy development—an influence not addressed as often as one might expect. [End Page 247] Cultural Considerations In this issue, we take a fairly broad view of "culture," following Daniel Elazar's description of culture as "the explicit and implicit or overt and covert patterns of shared beliefs, values, and traditions about life held by a particular people" (1994, p. 3). Our question here is whether there are certain shared patterns of beliefs and values held by individuals who either support or oppose the development of alternative-energy technologies. This question is stimulated by several considerations. First, in many ways, alternative-energy technologies can be seen as part of the "green revolution," wherein the goal is to reduce the carbon footprint of humans. Moreover, the frequently articulated goal of sustainability implies a capacity to substitute renewable-energy sources for those currently dependent on nonrenewable ones, such as coal. So we would expect there to be substantial support for alternative-energy technologies among individuals with environmental values, and with the more general political ideologies and values associated with them, and opposition to the technologies among those who do not. Such bundles of shared values and ideologies thus comprise a cultural consideration at play in the transfer of alternative-energy technologies. At the same time, the movement to develop many alternative-energy technologies faces significant opposition from both those committed to development and hence seeing no need to employ renewable resources, as well as from many of those with strong environmentalist values. The development of green, renewable-energy sources is viewed by many as unnecessary, either in consideration of criticisms of the data about such phenomena as global warming, or about the implications of a rapidly diminishing carbon-based fuel supply. Perhaps more interesting and less expected is the occasional opposition from environmentalists, especially those with bio-centric (as opposed to anthropo-centric) orientations to the environment. These environmentalists may identify harmful side effects of some alternative renewable technologies, such as wind power, hydropower, and wave energy. Wind farms are viewed as a danger to birds, for example, hydropower as a cause of decline in anadromous fisheries, and wave-energy farms as potential impediments to migrating fish or whales or to bottom-dwelling species displaced through the installation of turbines on the ocean floor. The...

Therapeutic management of bone demineralization in the HIV-infected population

Therapeutic management of bone demineralization in the HIV-infected population

Skin cancer and solar UV radiation

Ultraviolet (UV) radiation in sunlight is the most prominent and ubiquitous physical carcinogen in our natural environment. It is highly genotoxic but does not penetrate the body any deeper than the skin. Like all organisms regularly exposed to sunlight, the human skin is extremely well adapted to continuous UV stress. Well-pigmented skin is clearly better protected than white Caucasian skin. The sun-seeking habits of white Caucasians in developed countries are likely to have contributed strongly to the increase in skin cancer observed over the last century. Skin cancer is by far the most common type of cancer in the U.S.A. and Australia, which appears to be the result of an ‘unnatural displacement’ of people with sun-sensitive skin to sub-tropical regions. Although campaigns have been successful in informing people about the risks of sun exposure, general attitudes and behaviour do not yet appear to have changed to the extent that trends in skin cancer morbidity and the corresponding burden on public healthcare will be reversed. The relationship between skin cancer and regular sun exposure was suspected by physicians in the late 19th century, and subsequently substantiated in animal experiments in the early part of the 20th century. UV radiation was found to be highly genotoxic, and DNA repair proved to be crucial in fending off detrimental effects such as mutagenesis and cell death. In fact, around 1940 it was shown that the wavelength dependence of mutagenicity paralleled the UV absorption by DNA. In the 1970s research on UV carcinogenesis received a new impetus from the arising concern about a possible future depletion of the stratospheric ozone layer: the resulting increases in ambient UV loads were expected to raise skin cancer incidences. Epidemiological studies in the last decades of the 20th century have greatly refined our knowledge on the aetiology of skin cancers. Analyses of gene mutations in skin carcinomas have identified UV radiation as the cause. The relationship between the most fatal skin cancer, i.e. malignant melanoma and solar UV exposure is, however, still unclear and needs to be clarified to optimise preventive measures and minimise mortality from skin cancers.

Beneficial Effects of Sun Exposure on Cancer Mortality

For more than 50 years, there has been documentation in the medical literature suggesting that regular sun exposure is associated with substantial decreases in death rates from certain cancers and a decrease in overall cancer death rates. Recent research suggests that this is a causal relationship that acts through the body"s vitamin D metabolic pathways. The studies reviewed here show that (a) sunlight activation is our most effective source of vitamin D; (b) regular sunlight/vitamin D "intake" inhibits growth of breast and colon cancer cells and is associated with substantial decreases in death rates from these cancers; (c) metabolites of vitamin D have induced leukemia and lymphoma cells to differentiate, prolonged survival of leukemic mice, and produced complete and partial clinical responses in lymphoma patients having high vitamin D metabolite receptor levels in tumor tissue; (d) sunlight has a paradoxical relationship with melanoma, in that severe sunburning initiates melanoma whereas long/term regular sun exposure inhibits melanoma; (e) frequent regular sun exposure acts to cause cancers that have a 0.3% death rate with 2,000 U.S. fatalities per year and acts to prevent cancers that have death rates from 20–65% with 138,000 U.S. fatalities per year; (f) there is support in the medical literature to suggest that the 17% increase in breast cancer incidence during the 1991–1992 year may be the result of the past decade of pervasive anti-sun advisories from respected authorities, coinciding with effective sunscreen availability; and (g) trends in the epidemiological literature suggest that approximately 30,000 U.S. cancer deaths yearly would be averted by the widespread public adoption of regular, moderate sunning. Advising the public to seek regular moderate sun exposure finds good support in the scientific literature as a means of lowering cancer mortality.