June 21, 2016 Edition

Welcome to Summer!
A Note from Dr. Gail Feinberg

Since today is the first day of Summer, it is important to understand the relevance of sunscreen, its ingredients, and what the SPF numbers mean.

Simply put, SPF is Sun Protection Factor – the measure of the sunscreen’s ability to protect skin from damaging effects of UVB rays (which are the ones that cause the burn).  If it takes 20 minutes for your skin to start turning red, an SPF of 15, in theory, prevents reddening 15 times longer – so about 5 hours.  SPF 30, 40, 50, likewise would protect even longer.  

For most of us, SPF 15 is fine, but those of us who have very fair skin, a family history of skin cancer or medical conditions that increase sensitivity to sunlight should be using an SPF 30 or higher.  And don’t be fooled by the number.  SPF 30 does not protect twice as much as 15.  While SPF 15 filters out 93% of UVB, SPF 30 filters out 97%, which, although better, is only a slight improvement.  However no sunscreen, regardless of SPF factor, really remains effective longer than 2 hours without reapplication. 

 What type of Sunscreen to use:  This will depend on how much sun exposure you anticipate.  It should protect you from both the UVA and UVB. 

  1. If you work outside and spend a lot of time outdoors, you need a water resistant sunscreen that holds together on the skin.  These are also the types that you want to use on hot days or if you are playing sports, as they are less likely to drip if you sweat, and may not be as good for everyday wear as they are stickier, don’t go as well with makeup, and still need to be applied every 2 hours as they are not water-proof.
  2. Some cosmetics, moisturizers and after-shave lotions now have sunscreen already in them, and this would be sufficient for everyday activities with a few minutes here and there in the sun.
  3. Look for those that combine several active chemical and physical ingredients in order to provide the largest protection.  PABA, salicylates and/or cinnamates (octylmethoxycinnamate and cinoxate) protect from UVB; benzophenones (oxybenzone and sulisobenzone) protect from some UVA; avobenzone, ecamsule, titanium dioxide or zinc oxide protect from the remaining UVA.

Who should use sunscreen:  Anyone over the age of 6 months, actually.  Even those of us who work inside near windows as we continue to be exposed to those UVA rays!  Children under 6 months should not be exposed to direct sunlight, since their skin is highly sensitive to the chemical ingredients in sunscreens as well as the sun itself.  The best ways to protect them is with shade and protective clothing.  When you do select a sunscreen for your infant/child, avoid the ones with PABA.  Children’s sunscreens are the best to select as they are less likely to irritate the skin, and protect without being absorbed.  

How much to use and how often to apply: About 1 oz (a shot glass full) at a time.  Sunscreen should be applied 30 min prior to exposure to allow the ingredients to fully bind to the skin, and should be reapplied every 2 hours, immediately after swimming/toweling off, or sweating a great deal.

However…No matter how high the SPF, or how often or thickly you put it on, sunscreen will never fully protect you.  In addition to wearing good sunscreen, to protect your skin from damage and decrease your cancer risk, you still need to take other precautions:

  1. Stay in the shade when possible
  2. Wear sunglasses
  3. Stay inside when UV radiation levels are highest (10a-4p)
  4. Wear a broad brimmed hat
  5. Wear sun-protective clothing, preferably with Ultraviolet protection rating (UVP) on the label, or at least clothing that is dark and tightly woven which offers a bit more protection.

Enjoy the sun, but protect yourself!

Gail Feinberg, DO, FACOFP, M.Ed
Professor, Chair Department of Primary Care
College of Osteopathic Medicine

School of Nursing Visits Kenya

Over 7 million children under the age of 5 die each year from preventable causes in Kenya.  While this rate is startling, it is even higher in remote areas of the country.  This reality motivated the School of Nursing (SON) to action and resulted in a trip to Sega, Kenya for Dr. Ann Stoltz and Jacqueline Clavo-Hall.  Sega is a small, remote village that is located northwest of Nairobi near the Ugandan border.

The mission of the trip was for the faculty of the SON to gain an understanding of the health care system in the area and identify ways to partner with existing health care stakeholders. Jacqueline and I accompanied the Executive Director of Goal4, Piper Gianola, to Africa in May 2016. Goal4 is a U.S. non–profit organization that has operations in Kenya with a mission to reduce infant and child mortality. The first visits included trips to the Mary Ann Van Dam School of Nursing and the Matibabu Foundation, with a hospital and clinic in the neighboring village of Ukwala.  The TUC SON donated blood pressure cuffs and textbooks to the nursing school, spoke to the nursing students, and are establishing a mentoring program between our students and the nursing students in Ukwala. Next visits were to the county clinic and hospital, the private mission clinic and hospital, and the Sega Dispensary. We also participated in the Goal4 Executive Committee meeting and meetings with leaders of the community and travelled the footpaths with home health nurses.    

The two main causes of neonatal death are asphyxiation and infection.  To address this issue, Jacqueline conducted two workshops on neonatal resuscitation, one for non-medical community health workers and one for nurses.  The workshops included instruction and hands-on practice with manikins, which were well received.  Since the workshops, we have received requests for additional training sessions.

While in Sega, we lived in a local home with no running water, frequent electrical interruptions, mosquito nets, no internet connection, and frequent torrential rains.  We learned first-hand that nurses are the backbone of the health care system in Sega, resources are minimal, and there is much work to be done! The SON is in the process of setting priorities for projects and research opportunities.  The first project is helping a 5 year old child obtain surgery for spina bifida to improve her quality of life.  All of our goals were accomplished, and we came home with an ardent appreciation for life as we know it in the US, information to educate the SON students on global health, and most important, memories of the beautiful people of Sega emblazoned on our hearts and a fervent desire to make a difference, even a small one.

Ann D. Stoltz, PhD, RN, CNL
Director, School of Nursing
College of Education and Health Science

Congratulations Imran Masood, Distinguished Pediatric Student

Please join us in congratulating Student Doctor Imran Masood (Class of 2017) as our Distinguished Pediatric Student!  He demonstrated outstanding performance during his pediatric rotation, as well as supreme commitment to his specialty field of Pediatrics. 

Per the Pediatric Core Rotation Syllabus:  “The Division of Pediatrics offers the Pediatric Distinguished Student Award.  This award is designed to honor a senior medical student who intends to enter a pediatric residency and has demonstrated superior performance in his or her activities as a medical student. Pediatrics evolved as a specialty because children have unique physiologic, biochemical, and psychosocial needs which reflect dynamics of change during growth and development. The recipient of the Pediatric Distinguished Student Award should demonstrate a sound grasp of these concepts as well as skill in applying them to the care of children. Awardees should have completed their pediatric core clerkship and demonstrated exceptional ability and potential for future contributions to the specialty of pediatrics.”

Congratulations, Student Doctor Masood!  We’re proud of you!