Wide-brimmed Hats Research Articles

Multi-analytical study for the art historical science: The mystery of the “Portrait of a young man in a wide-brimmed hat with a feather”

In this work, we performed a comprehensive spectroscopic analysis of the “Portrait of a Young Man in a Wide-Brimmed Hat with a Feather” authored by an unknown artist and housed in the National Art Museum of the Republic of Belarus. Previously this portrait was a part of the Myatlev collection (St. Petersburg, Russia). Extensive analysis, including microscopic examination, X-ray radiography, luminescent studies, and complex multi-analytical studies of the chemical composition of art materials allowed us to suggest the dating and attribution of the painting. Laser-induced breakdown spectrometry (LIBS), Fourier transform Infrared spectrometry (FTIR) and Surface-enhanced Raman scattering (SERS) were also used. Gold nanoparticles in toluene were used to enhance the signal of Raman scattering, enabling the unambiguous identification of pigments within the painting layers of the historical object.Moreover, we discovered the portrait of another person on the same canvas under the top layer of paint. A comparative analysis of grounds and painting materials did not reveal significant differences in the technological features of both images. Therefore, we can assume that both portraits were created in the same historical period and followed the traditions of the same art school. Lead white, bone black, red, yellow and brown ochres as well as lapis lazuli were identified as the pigments.The results obtained do not contradict to art critics hypothesis that the underlying painting is the portrait of King of Polish-Lithuanian Commonwealth11The Polish–Lithuanian Commonwealth formally known as the Kingdom of Poland and the Grand Duchy of Lithuania was established as a single entity by the Union of Lublin in 1569. It existed until 1795. Wladislaw IV Vasa created in the first half of XVII century. Then, it became the base for a new painting, which might be a self-portrait of the king’s illegitimate son Count Vasenau and was created in the middle of XVII century.

Photoprotection: Current developments and controversies.

This review aimed at summarizing some of the key points that were discussed during the photoprotection session at the International Forum of Dermatology in 2022. This international conference was designed to address prominent topics of clinical dermatology in a holistic way, allowing to articulate multiple viewpoints. Therefore, this review does not claim to be exhaustive, but is instead intended to give an overview of recent developments and ongoing controversies in the field of photoprotection. Cumulative ultraviolet radiation (UVR) exposure is the major aetiological factor in the development of photoageing, photoimunosuppression and photocarcinogenesis. UVA (320-400 nm) penetrates into the dermis and damages DNA and other intracellular and acellular targets primarily by generating reactive oxygen species (ROS). It is the major contributor to photoageing, characterized by fine and coarse wrinkles, dyspigmentation and loss of elasticity. UVB (290-320 nm) is responsible for sunburns through direct damage to DNA by the formation of 6-4 cyclobutane pyrimidine dimers (CPDs) and pyrimidine 6-4 pyrimidone photoproducts. Both UVA and UVB exposure increase the risk of basal cell carcinoma, squamous cell carcinoma and melanoma. In recent years, visible light (VL; 400-700 nm) has also been implicated in the exacerbation of conditions aggravated by sun exposure such as hyperpigmentation and melasma. Photoprotection is a critical health strategy to reduce the deleterious effects of UVR and VL. Comprehensive photoprotection strategies include staying in the shade when outdoors, wearing photoprotective clothing including a wide-brimmed hat, and sunglasses, and the use of sunscreen. Due to the absorption of UV filters, the safety of sunscreens has been questioned. Newer sunscreens are becoming available with filters with absorption even beyond the UV spectrum, offering enhanced protection compared with older products. Prevention of photocarcinogenesis, sun-induced or sunlight-exacerbated hyperpigmentary conditions and drug-induced photosensitivity is an important reason for adopting comprehensive photoprotection strategies.

A Practical Algorithm for Integrating Skincare to Improve Patient Outcomes and Satisfaction With Energy-Based Dermatologic Procedures.

Medical aesthetic procedures for facial antiaging with laser and energy-based devices (EBDs) are rapidly increasing, but standards integrating skincare before, during, and after these treatments are lacking. The algorithm for integrated skin care for facial antiaging treatment with EBDs aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes. A panel of 8 global physicians employed a modified Delphi method and reached a consensus on the algorithm integrating skincare based on the best available evidence, the panel's clinical experience, and opinions. The algorithm has a pretreatment (starts 2 - 4 weeks before the procedure) and treatment (day of treatment) section, followed by care after the procedure (0 - 7 days) and follow-up care (1 - 4 weeks after the procedure or ongoing). Applying a broad-spectrum sunscreen with an SPF 50 or higher, combined with protective measures such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with skin of color (SOC). Clinicians may recommend skincare using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Medical aesthetic procedures for facial antiaging with EBDs integrating skincare or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.  J Drugs Dermatol. 2024;23(5):353-359.     doi:10.36849/JDD.8092.

A Practical Algorithm Integrating Skin Care With Nonenergy and Injectable Dermatologic Procedures to Improve Patient Outcomes and Satisfaction.

The most rapidly increasing medical aesthetic procedures for facial antiaging comprise nonenergy and injectable treatments. Currently, standards for skin care before, during, and after nonenergy and injectable treatments are lacking. The algorithm on supportive skin care for facial antiaging nonenergy and injectable treatments aims to stimulate healing, reduce downtime, and improve comfort and treatment outcomes.  Methods: A panel of 7 global physicians employed a modified Delphi method and reached a consensus on an algorithm for supportive skin care for nonenergy and injectable antiaging treatments based on the best available evidence and the panel members’ clinical experiences and opinions. The algorithm has a pretreatment (starts 2 – 4 weeks before the procedure) and treatment or ongoing (day of treatment) section, followed by care after the procedure (0 – 7 days) and follow-up care (1 – 4 weeks after the procedure). Applying a broad-spectrum sunscreen with an SPF 30 or higher, combined with protective measures, such as wearing a wide-brimmed hat and sunglasses, is recommended to protect the face from sun exposure. Dyschromia is a significant concern for those with richly pigmented skin. Clinicians may recommend skin care using a gentle cleanser and moisturizer containing vitamins C and E, retinoid, or other ingredients, such as niacinamide, kojic acid, licorice root extract, azelaic acid, and tranexamic acid, depending on the patient's facial skin condition. Nonenergy and injectable procedures combined with skin care or topical treatments may improve outcomes and patient satisfaction. Topical antioxidants and free radical quenchers can combat photodamage and may offer a safe alternative to topical hydroquinone.    J Drugs Dermatol. 2024;23(4):     doi:10.36849/JDD.7918.

Knowledge, attitudes and practices of people with albinism about photoprotection and skin cancers prevention in Togo

Objective: The aim of this study was to evaluate the knowledge, attitudes, and practices of people with albinism (PWAs) related to photoprotection and prevention of skin cancers in Togo. Materials and Method: A qualitative, cross-sectional study was conducted over a period of three months in the year 2020 among PWAs over eighteen years of age residing in Lomé, Togo. Results: A total of 78 PWAs were interviewed. Their mean age was 23.38 ± 15.11 years (extremes: 18 and 63 years), and their sex ratio (M/F) was 0.81. In terms of knowledge, all PWAs declared that photoprotection was essential to prevent skin cancers. Interview data revealed the following strengths: wearing a wide-brimmed hat (n = 77; 98.7%) and using sunscreen cream (n = 75; 96.2%) were the main means/measures of prevention. In terms of attitudes, only 27 PWAs (34.6%) said that a dermatology consultation would be their first reaction to an unusual skin lesion. The main prevention means/measures in their possession were wide-brimmed hats (91.3%), sunscreen creams (85.9%), dark clothes (76.9%), and tinted glasses (70.5%). Regarding the practices, sunscreen creams were used by 88.5% of PWAs (n = 69). About two-thirds (64.1%) of respondents used tinted glasses to protect themselves from the sun. Finally, less than a quarter of the respondents (17.9%) consulted a dermatologist for a skin lesion in the last twelve months. Conclusion: The results of this study indicated that PWAs in Togo have fairly good knowledge about photoprotection and prevention of skin cancers. Attitudes and practices were generally positive but some behaviors such as dermatological follow-up still require improvement. Key words: Albinism, Sun protection, Skin cancers, Togo

PD08 Sun protection practices of men in the west of Ireland

Abstract Irish men get more skin cancer than women, especially of the head and neck area. They typically get more sun exposure and are less likely to wear sun protection factor (SPF). Little is known about the types of hats men wear, or photoprotective practices regarding the lips. We carried out an observational study, using a questionnaire, on men aged > 18 years attending dermatology for any reason. Fitzpatrick skin type and Norwood classification for male pattern baldness was documented. Sixty-one men [mean (SD) age 56 (16.9) years] were involved. Forty-nine per cent were attending for the assessment of skin lesions. Thirty-eight per cent were on immunosuppression. Sixty-four per cent worked outdoors currently or in the past, 79% have or had spent > 3 h outdoors daily. Twenty-six per cent had a Norwood classification of ≥ 3v (vertex of scalp showing). The majority (71%) was of Fitzpatrick skin types I and II. Seventy-nine per cent wore SPF, 19% daily and 17% during the summer. Only 15% of men reported wearing lip SPF. Sixty-eight per cent reported wearing a hat on a ‘sunny day’. Of these, 54% wear baseball (BB) caps, 20% wear a wide-brimmed hat (WBH), 20% a narrow-brimmed hat, 4% a wool or traditional cap and 2% a total face covering. Age did not influence whether a hat was worn, but it did influence the type, with younger men more likely to wear BB caps and older men more likely to wear WBH. Those with hair thinning were more likely to wear a hat (87% vs. 67%). Non-hat-wearers were also less likely to wear SPF. Despite the incidence of skin cancer in sun-exposed sites in men, few studies have focused on photoprotective practices of the head and neck. Our study demonstrates that while Irish men wear SPF, few wear SPF on their lips. Additionally, Irish men often wear a hat type that would not be considered to provide adequate photoprotection to the head and neck. Hat type varied with age, with younger patients wearing less photoprotective hats. When considering photoprotection campaigns, factors such as age, fashion trends and education regarding lip SPF should be considered.

The anatomical distribution of lentiginous melanoma (lentigo maligna and lentigo maligna melanoma): Differences according to sex.

The anatomical distribution of lentiginous melanoma (lentigo maligna and lentigo maligna melanoma): Differences according to sex.

Sun-protective behaviors and sunburn among US adults.

Individuals can reduce the risk of developing skin cancer by minimizing ultraviolet sunlight exposure, though recent trends in sun-protective behaviors remain to be investigated. To evaluatesun-protective behaviorsand sunburn among US adults. We analyzed data from the 2010, 2015, and 2020 National Health Interview Survey (NHIS), an annual, cross-sectional survey conducted by the US Census Bureau. Multivariable regression models were stratified by demographic variables and constructed to evaluate sun-protective behaviors and sunburn avoidance across time. From 2010 through 2020, US adults had significantly increased prevalence of seeking shade (pvalue, 0.003), wearing wide-brimmed hats (< 0.001), wearing long-sleeved shirts (< 0.001), using sunscreen (< 0.001), and avoiding sunburns (< 0.001) and significantly decreased prevalence of sun avoidance (< 0.001). Disparities in sun-protective behaviors also exist among different sexes, ages, education levels, and those reporting higher sun sensitivity. This cross-sectional study found that by 2020, US adults had an increased prevalence of wearing sun-protective clothing and sunscreen use, though decreased prevalence of sun avoidance. Although certain sun-protective behaviors have become more prevalent, the incidence of skin cancer continues to rise. Efforts to understand drivers of sun-protective behaviors and targeted intervention efforts are needed.

Photoprotection in skin of color.

As populations in many parts of the world are projected to become more racially diverse over the coming decades, we must better understand the unique characteristics of the skin of populations with skin of color (SOC). This review aims to highlight important physiologic and clinical considerations of photoprotection in SOC. Ultraviolet radiation and visible light affect dark and light skin differently. SOC populations have historically not been informed on photoprotection to the same degree as their light skinned counterparts. This has exacerbated dermatologic conditions in which SOC populations are disproportionately affected, such as hyperpigmentary disorders. Patients should be encouraged to utilize multiple methods of photoprotection, ranging from avoidance of sunlight during peak intensity hours, seeking shade, wearing sun-protective clothing and wide-brimmed hat, and applying sunscreen. Ideal sunscreens for SOC populations include those with UVA-PF/SPF ratios ≥ 2/3 and tinted sunscreens to protect against VL. Although there have been increased efforts recently, more research into photoprotection for SOC and targeted public education are required to disseminate photoprotection resources that are patient-centered and evidence-based.

Sunburns and Sun Protection Behaviors among Male Hispanic Outdoor Day Laborers.

Individuals who work outside are at increased risk for skin cancer due to excessive exposure to ultraviolet (UV) radiation. Little is known about UV exposures and sun safety practices of outdoor day laborers, who are disproportionately Hispanic. This study identified the correlates of sunburn and sun protection behaviors in a sample of male, Hispanic day laborers (n = 175). More than half of the participants (54.9%) experienced one or more sunburns when working during the past summer, and 62.9% reported having one or more symptoms of heat illness. The frequency of engaging in sun protection behaviors was suboptimal, including sunglasses use (M = 2.68, SD = 1.71), staying in the shade (M = 2.30, SD = 0.94), wearing sunscreen (M = 2.10, SD = 1.39), and wearing a wide-brimmed hat (M = 1.75, SD = 1.32), based on a 5-point scale (1 = never; 5 = always). Lower education level, higher levels of skin sensitivity to the sun, any symptom of heat illness, fewer barriers to wearing a wide-brimmed hat, and not wearing a wide-brimmed hat were associated with a greater number of sunburns. Factors associated with each sun protection behavior varied. Implications and directions for future research are discussed.

Philippa

Philippa Allen Bratton (bio) Philippa, on the chaise longue, draws her knees up toward her shoulders. The clouds have come in, and her stomach hurts. The Mediterranean is dark, the coastal forests are dark. She is glad to put on a robe; she’s bloated, her nipples show through her swimsuit, her inner thighs are red with razor burn. The robe doesn’t hide her bruised knees or the scrapes on her toe knuckles from the bottom of the swimming pool, whose surface fuzzes with the light beginning of rain. Her sister Blanche says, “Oh no, it’s actually raining.” Their stepmother Jeanne is putting on her wide-brimmed hat, stepping back into her sandals. She says, “We’ll stay in for dinner, then.” On the safer side of the glass doors, Jeanne runs her fingers through her long dark hair, combing out the superficial damp. She watches the sea like the wife of a sailor. But she is the wife of the Duke of Lancaster, and the housekeeper is running out onto the terrace, rescuing the cloth cushions and umbrellas. [End Page 106] _______ When Philippa wipes after peeing, the tissue comes away with a slick dark stripe down its center. She looks between her legs just in time to see a heavy teardrop of—what is it, placenta? no, uterine lining? was that the same thing?—splash into the water. This is such a fucking joke, she thinks. As of three hours ago she was five ten and eight-and-a-half stone, 16.5 BMI, data she tracks even though she knows it means nothing. She gets dizzy when she stands, her stomach aches, she’s perpetually constipated. Still her body punishes her for having failed to let a man come inside her. Philippa is eighteen. Her mother had been twenty-one when she had her first child. Then she had five others, of which Philippa was the last. She had died aged twenty-nine; if she had started at eighteen, she might not have even lived to twenty-six. What right did Jeanne have, marrying Philippa’s father at the age of forty-five and never giving birth to a single one of his children? The villa is nice, though. The shower in her suite is so big Philippa feels wrong being naked in it, kicking blobs of uterus down the drain. _______ Philippa’s brother Tom is an associate at a boutique investment firm. Her brother John is an associate at a private equity firm. Her brother Humphrey teaches tennis to the children of oligarchs. Her brother Hal is their father’s heir, and that is what he is. But even the son and heir has got to “do” things. At school he did tennis, at uni it was drugs; then an internship at a Tory think tank, then something unimpressive at their uncle’s energy company. Now he manages the estate: he meets the needs of the tenant farmers out of spite for his boyfriend, who thinks the thousand acres should be rewilded. Tonight Tom and John are at work, and Humphrey is on a [End Page 107] superyacht near Corfu, flirting with the hot governess. God knows where Hal is; Philippa says a prayer for him. She stands on the balcony of the bedroom Jeanne has assigned her and smokes her French Marlboros with the label that says fumer tue. The rain is clearing, but the sun has just set. The sea breaks on the rocks. Philippa scrolls through her Instagram, comparing her thighs to those of the girls she’d gone to school with and not really liked. She is still on the balcony when the darkness is full and the air is dry and a person appears on the terrace below. The pool is lit, glowing turquoise, throbbing with subaqueous shadow. The person walks down the steps into the water. It’s Jeanne, of course, or else a trespasser: the hair is black, Philippa and Blanche are blonds. She walks till the water is too deep to stand in, then pulls her legs up and floats. _______ Cramps wake Philippa at four in the morning. The painkillers she’d taken...

Review: Fruteros: Street Vending, Illegality, and Ethnic Community in Los Angeles, by Rocío Rosales

Review: Fruteros: Street Vending, Illegality, and Ethnic Community in Los Angeles, by Rocío Rosales

Defensive behavior of the invasive alien hornet Vespa velutina nigrithorax against potential human aggressors

AbstractIn areas where wasps are common, many wasp sting incidents occur. However, guidance on the correct response to wasp attacks remains lacking. In this study, behavioral response experiments were conducted with the aim of minimizing damage from group wasp attacks. The study species was Vespa velutina, which frequently causes wasp sting injuries in the southern regions of South Korea. Results demonstrated that worker wasps showed defensive behavior when a person approached within 3 m of the nest, and the attack rate was higher when the person conducted a large arm swing. When a person walked away after touching a nest, the number of workers attacking did not significantly decrease until they reached 5 m, this reduced to less than half when the person reached 10 m. Approximately 1.3 workers attacked even up to 300 m. However, when the person ran, the number of workers attacking was almost one or less after 10 m. Therefore, it is best to escape quickly to at least 10 m to reduce injury from group attacks. When wasps attacked, even if the person crouched, the attack did not decrease. Our recommended defensive behavior when wasps attack unexpectedly is that victims should turn their face in the opposite direction to the nest or the wasps, protect their face with their hands and arms, lean forward and run away rapidly to minimize injury. Wearing a wide brim hat was very effective, preventing about 75% of stings to the head, so this is also recommended.

Knowledge, attitude and practices of traffic enforcers on sun exposure and sun protection: A cross-sectional study

Background. Prolonged sun exposure without adequate sun protection places outdoor workers such as traffic enforcers at risk for skin cancer. Data on knowledge, attitude, and practices amongst traffic enforcers are currently unavailable, hence the need for research on this matter. Objectives. 1) To evaluate the knowledge, attitude, and practices of traffic enforcers on sun exposure and sun protection, 2) To identify any association with sociodemographic characteristics, and 3) To determine whether knowledge and attitude are correlated with sun-protective practices. Method. An analytical cross-sectional study was conducted from January to February 2019 among traffic enforcers in Pasig City, Philippines thru a self-administered questionnaire. Descriptive statistics were used to summarize the sociodemographic profile of the respondents while the Fisher’s exact/Chi-square test was used to determine the association between sociodemographic variables and adequacy of knowledge, attitude, and practices. Pearson’s rho was used to determine the degree of association between knowledge, attitude, and practices. Results. A total of 178 traffic enforcers with a 100% response rate participated in the study. 94.4% had adequate knowledge and 93.8% had a desirable attitude as opposed to 46.1% who had adequate sun-protective practices. Adequate knowledge was found to be significant when obtained from television (51.19% at p=0.018), with the respondents being least knowledgeable about proper sunscreen use. Only a few had the desired positive attitude that sunscreen is not an added expense at 39.89%. The most common methods of sun protection were the wearing of sunglasses (82.02%), long-sleeved clothing (68.54%), and the wearing of a wide-brimmed hat (65.17%). Reapplication of sunscreen was the least common at 32.02%. Those with an adequate sun-protective practice obtained their knowledge from social media (48.78% at p=0.003). Adequacy of knowledge when compared to actual practice noted that there were more respondents with poor knowledge translating to poor practice (9.38% at p=0.019). There was insufficient evidence to state associations between the sociodemographic profile and knowledge, attitude, or practice. Correlations between knowledge, attitude, and practices on sun exposure and sun-protective practices were found to be weak. Conclusion. Most of the traffic enforcers who partici pated in this study had adequate knowledge and a desirable attitude on sun exposure and sun protection but had inadequate sun-protective practices, emphasizing the need to investigate other factors that hinder translation of adequate knowledge and attitude to adequate practice. Occupational health policies need to be implemented to reduce the harmful effects of UV radiation in high-risk populations such as traffic enforcers.

Sun protection knowledge and habits among street vendors of the Moshoqueque market, Chiclayo

espanolObjetivo: Determinar los conocimientos y habitos de proteccion solar en comerciantes ambulantes del mercadoMoshoqueque (Chiclayo, Lambayeque), en los meses de enero y febrero del 2020. Materiales y metodos: Estudio descriptivo y transversal. Se elaboro una ficha de recoleccion de datos. El tamano muestral fue de 362 comerciantes ambulantes. Se aplico el 95 % de confianza, el 5 % de precision y 50 % de la frecuencia esperada.Resultados: La edad promedio fue de 48,54 (DE = 11,6 anos) y la mayoria de los participantes fueron mujeres (61 %). La mediana del tiempo como comerciantes ambulantes fue 15 anos. El 92,50 % de los participantes se expone al sol por 7,6 horas al dia. En cuanto a los conocimientos, mas del 90 % reconoce que el enrojecimiento y el envejecimiento de la piel son efectos de la radiacion ultravioleta (RUV). Respecto a los habitos de proteccion solar, el 34 % nunca usa bloqueador y el 90 % no usa sombrero de ala ancha, pero si visera y sombrilla.Conclusiones: Los comerciantes conocen que el enrojecimiento y el envejecimiento son productos de la radiacion ultravioleta. Sin embargo, desconocen que el dolor de cabeza no es causado por RUV y que despues de tener una quemadura solar es necesario utilizar fotoproteccion. En cuanto a habitos de proteccion, nunca usan bloqueador, pero si visera o gorro (pero no sombreros de ala ancha). Trabajan alrededor de 7,6 h diarias, por mas de una decada. EnglishObjective: To determine the sun protection knowledge and habits among street vendors of the Moshoqueque market (Chiclayo, Lambayeque) in January and February 2020. Materials and methods: A descriptive and cross-sectional study. A data collection sheet was prepared. The sample consisted of 362 street vendors. A 95 % confidence interval, 5 % accuracy and 50 % of the expected frequency were applied. Results: The average age of the study subjects was 48.54 (SD = 11.6 years) and most of them were women (61 %). The median time as street vendors was 15 years. Ninety-two point five percent (92.5 %) were exposed to the sun 7.6 hours perday. Regarding sun protection knowledge, more than 90 % were aware that skin redness and aging are effects of ultraviolet radiation (UVR). As for their sun protection habits, 34 % never used sunscreen, 90 % did not wear wide-brimmed hats, butthey used visors and umbrellas.Conclusions: Vendors know that redness and aging are the result of UVR. However, they do not know that headache is not caused by UVR and that after sun burning it is still necessary to use sunscreen. As for their sun protection habits, theynever use sunscreen; they wear a visor or a hat (but not wide-brimmed hats). They have worked around 7.6 hours a day for more than a decade.

18621 Temporal increase in the number of annual days with a very high UV index across the US

The ultraviolet (UV) index is an international standard indicating the intensity of solar radiation at a given place and time with respect to the risk of sunburn. The World Health Organization recommends utilizing sun protection including wide brim hats, sunglasses and sunscreens with SPF of at least 30 when UV index values are moderate (UV index levels of 3-5). Extra protection and greater awareness of high sunburn risk are urged for very high and extreme levels of UV exposure, when the UV index is 8 or above. At this UV index level, a typical individual may sunburn in less than 20 minutes. Using archived data from the NOAA Center for Weather and Climate Prediction, we investigated the number of very high UV index days for numerous metropolitan areas across the US to determine how the intensity of solar exposure has changed over a 20-year period (1997-2017). Overall, the number of very high UV index days was observed to increase across all evaluated cities. Most striking were the significant increases in areas with moderate annual UV levels such as Boston in and Seattle. However, the number of high UV index days increased even in areas with average UV exposure such as the desert southwest. While there are numerous factors that contribute to the intensity of solar radiation at a specific location, this data indicates that Americans currently face a greater annual risk of solar overexposure and the resulting short and long-term negative skin health outcomes.

Effects of health beliefs, social support, and self-efficacy on sun protection behaviors among medical students: testing of an extended health belief model.

Sun protection behaviors (SPB) are important modifiable risk factors for skin cancer. As the most common malignancies in the world, skin cancers account for significant morbidity, mortality, and economic burden. Physicians play a key role in educating patients about proper SPB. Medical education provides the foundation for physician understanding of SPB and future patient education. The Health Belief Model (HBM) is a theoretical model that offers constructs to help explain health behaviors. This cross-sectional study examined a convenience sample of 186 medical student to assess their engagement in SPB through the lens of the 6 HBM constructs and social support. Overall, we found engagement in SPB among our cohort to be low. About 70.4% report never using wide-brimmed hats and only 44.6% often or always use sunscreen. Hierarchical multiple regressions were performed in three blocks to analyze the relationship between the independent variables (HBM constructs and social support) and dependent variable (SPB) after controlling for the influence of demographic covariates. In our health constructs model, beliefs about susceptibility, benefits minus barriers, and self-efficacy were found to be significant predictors of engaging in SPB. Addition of social support in the final model did not significantly improve prediction of SPB engagement. These findings support use of educational programs based on HBM for the improvement of SPB among medical students.

Examination of use and barriers for five sun protection strategies in parents and their children.

Sun protection starting in childhood is an important means of skin cancer prevention. Factors associated with sunscreen use have been previously described. However, less is known about factors associated with children's utilization of non-sunscreen sun protection strategies. We sought to examine parent and child characteristics, parental use of sun protection, and barriers associated with children's use of five sun protection strategies: sunscreen, shirts with sleeves, wide-brimmed hats, sunglasses, and shade. A cross-sectional survey of parents of children entering kindergarten through grade 8. Survey participants were recruited at the 2016 Minnesota State Fair. A total of 409 parents were surveyed. The most common sun protection strategies parents reported for their child were wearing a shirt with sleeves (69.9%) and using sunscreen (61.9%), while protection via shade, wide-brimmed hats, and sunglasses were reported by less than one-quarter of parents. For each individual strategy, parents' own use of that strategy was strongly associated with that strategy in their children. Lack of child cooperation was associated with decreased use of sunscreen, shirts with sleeves, and wide-brimmed hats. Significant room for improvement exists in childhood sun protection. Parents should especially be encouraged to use shade, wide-brimmed hats, and sunglasses as methods of protection for their children. Advising parents to model seeking shade, applying sunscreen, and choosing appropriate clothing and hats may improve sun safety practices.

Red Joan

Red Joan John Ordway Red Joan 2018 Directed by Trevor Nunn Distributed by Embankment Films https://www.embankmentfilms.com/portfolio_page/red-joan/ 100 minutes A grandmotherly British woman prunes the plants in her garden and then steps back into her tidy semi-detached home—thinking, perhaps, of a cup of tea. She glances at a newspaper on the table, a headline of which announces the death of Sir William Mitchell, a man her age and the former head of the Foreign Office. There is a knock on the door, and a look of anxiety flits across her face. She composes herself, answers the door, and the reason for her fleeting look of terror becomes clear: The doorstep is lined with police officers, who place her under arrest for espionage and lead her to an unmarked car waiting at the curb. These opening scenes set the tone for Red Joan, a film based on Jennie Rooney's 2013 novel that was, in turn, based on the true story of Melita Norwood. It is a film about spies and spying, secrets and betrayals, but not, in any sense of the word, a "spy movie." It is a character study of Joan Stanley—a subtle, nuanced portrait slowly built up from multiple layers of carefully observed detail—and the scenes of 1940s era espionage "tradecraft," though surprisingly numerous and frequently suspenseful, are there to reveal her character, rather than to advance the plot. The "atomic secrets" that Joan, a minor player in Britain's wartime nuclear-bomb research program, funnels to the Soviet Union during and just after World War II are a McGuffin in the classic Hitchcockian sense. It doesn't matter what they are, only that everyone wants them. Red Joan exists in two eras simultaneously: the present, where Joan (played by Judi Dench) is interviewed by a pair of coolly-professional police detectives and interacts with her adult son, a respected barrister; and the past, where Joan (played by Sophie Cookson) goes from a naïve first-year natural-sciences student at Cambridge to a terrified-but-effective Soviet asset. As in Christopher Nolan's Dunkirk (2018), the two stories unfold at different speeds. The "present" events unfold in less than a week of what appears to be 1999 or 2000, the "past" events in slightly more than a decade: from 1938 to 1949. Judi Dench's screen time is nowhere near as great as the advertising for Red Joan implies—the ratio of "past" to "present" scenes is on the order of 70-30—but it is, nonetheless, Dench's film. In her time on screen she plays out a complete character arc, relying (because her lines are, by design, bland and muted) almost entirely on posture, facial expression, and tone of voice. Sophie Cookson, in the flashback scenes, seems at first to be simply be the "naïve young woman who learns painful lessons," but it gradually becomes clear that she is up to something more complex. She shows us Joan—an awkward, naïve, provincial teenager in her first scenes—evolving not just into a strong, confident woman, but into the specific strong, confident woman that Judi Dench is playing. Like Dench, Cookson relies on subtle acting rather than the deliberately low-key dialogue to establish her character, but—unlike Dench—she receives bravura assistance from the film's hairstylists and costume designers, who change her look to subtly underscore her changing personality. Young Joan is neatly but blandly dressed in her prewar scenes at Cambridge, where she stands out because many of her friends are sleekly, flamboyantly stylish. She begins to develop a sense of style during the war years (trading her shapeless knit cap for wide-brimmed hats, for example), and the effect is accentuated because—thanks to rationing and the fact that she works among scientists—everyone around her is a bit dowdy. In her final scenes, revealing new levels of resolve (and ruthlessness) as she blackmails an old Cambridge friend into helping her and her lover flee England, she looks the second coming of Barbara Stanwyck—a perfect reflection of who her character is becoming. [End Page 40] It is central to the...

High Mas: Carnival and the Poetics of Caribbean Culture

High Mas: Carnival and the Poetics of Caribbean Culture