RIPPLE magazine Summer 2013
STRAIGHT from the
frontline
sunscreen: A shopper’s guide
Plus
Things you
didn’t know about TANNING BEDS
WHAT TO LOOK
STAYING SAFE AT THE BEACH
OUT FOR WHEN BUYING SUNGLASSES
RIPPLE
contents
12 FEATURES
KIDS’ SECTION
07 Straight from the FRONTLINE
18 20
04 BEAT THE BURN for dummies Giulia Magro & Martina Papa Jessica Schembri Higgans
Burning FACTS
Kurt Apap & Michelle-Marie Boffa SUNSCREEN: Shopper’s Guide Matthew Baldacchino
10 Melanoma at a Glance
24 How it Works: SUNGLASSES
Maria Grazia Grech
27
Message from MADV President
Kurt Apap & Michelle-Marie Boffa
12 Lights...Camera.......ACTION!
Kurt Apap & Michelle-Marie Boffa
14 10 Secrets Tanning Salons don’t want you to know
Eve Warrington
28 MOLE PATROL
Naomi Mercieca
30 BUSTED!
15 STAYING SAFE on the beach Sarah Craus
28
Abigail Mula
32 Bukku’s Tips Mark Sammut & Jessica Schembri Higgans
34 RECIPE: Fruity Yoghurt Ice Lollies Janice Azzopardi, Michelle-Marie Boffa & Martina Papa
36 The Golden Rules
Abigail Mula
37 Beach Bag Game
Mark Sammut
39 Crossword Puzzle Mark Sammut 40 Wordsearch Mark Sammut 42 Don’t Make Me Laugh Mark Sammut
EDITORIAL Summer is here! Now that the most awaited season of the year is finally upon us, for most of us time at the beach becomes part of our daily routine. Awareness about sun protection has improved over the years, however, when it comes to implementing what sun protection entails, many fail. People
RIPPLE
magazine Summer 2013
Ripple magazine is a summer publication by the Malta Medical Students’ Association (MMSA) as part of the Beat the Burn campaign and is distributed free of charge.
still worship the sun and so cases of melanoma and other skin cancers are becoming more common.
Editors
Though you may think that this just another summer read, this magazine
Kurt Apap Michelle-Marie Boffa
is intended to serve a far better purpose. Just as a small drop of water has the potential for creating a sequence of small waves on still water, through this initiative, we aim to set the ball rolling for a change in the Maltese mentality. After all, it only takes a single drop of water to start off a ripple. Though like many people around you, you may see sun protection as burden, we hope that through this magazine we manage
Section Editors Maria Grazia Grech Mark Sammut Jessica Schembri Higgans
to convince you otherwise.
Proofreaders
As the interview with a melanoma patient reveals, the battle with
Stephanie Vella Naomi Mercieca
melanoma is full of hardships that burden the sufferer both physically and psychologically. Yet, it is an ordeal you could avoid with little changes in your everyday life such as seeking shade, wearing a hat, and using adequate sunscreen when you are out and about in the sun. With sleek advertisement, and the media bombarding you left, right and centre, you might be confused about which sunscreen you should buy. Through Ripple’s shopper’s guide to buying sunscreen, we aim to clarify some common queries on the issue. Since their conception, tanning beds have always been a hot topic, and so, Ripple delves into the truths
Finance Michelle-Marie Boffa Francesca Chircop Giulia Magro Martina Papa
Design and layout
hidden behind tanning salons’ inviting doors.
Kurt Apap Malcolm Falzon
We would like to take this opportunity to thank our sponsors for make
Cover
this ambitious project possible. Special thanks goes to the Maltese Association of Dermatology and Venereology (MADV) for their generous
Dale Brincat (Photography) Martina Papa (Idea and Concept)
sponsorship as part of the World Skin Health Day Program. Lastly, we would like to thank you, the reader, for taking your time to browse through this magazine. We hope that you enjoy reading it as much as we enjoyed working on it.
Whilst every effort has been made to ensure that the information contained within this magazine is accurate and up to date, MMSA and its members cannot take responsibility for any errors.
Kurt Apap & Michelle-Marie Boffa Beat the Burn Coordinators
CONTACTs beattheburn@mmsa.org.mt info@mmsa.org.mt
www.mmsa.org.mt
Malta Medical Student’s Association MMSA Office University of Malta, Medical School Mater Dei General Hospital Birkirkara Bypass Msida MSD 2090 Malta, Europe
Beat the Burn Coordinator’s - ‘13-’14 Kurt Apap, Matthew Baldacchino, Michelle-Marie Boffa, Dale Brincat, Giulia Magro, Martina Papa
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Beat the Burn for Dummies BY Giulia Magro & Martina pAPA
Hello reader, since you have decided to flip through this magazine, we are sure that your first question is what ‘Beat the Burn’ is. We have therefore tried to compile a short guide, hopefully answering all your queries.
44
RIPPLE Magazine
F
irst and foremost, every-
discussion shifted to summer, we all ex-
tion of this magazine. We have worked
thing stems from our stu-
pressed the concern of the high UV indices
hard, to educate ourselves so that our
dent organisation, formally
experienced in Malta and the detrimental
work may be professional, fact-based and
known as the Malta Medi-
effects of sun exposure. This led to the
correct. Through a wide variety of ac-
cal Students’ Association
birth of the campaign, ‘Beat the Burn’, with
tivities and methods of communication,
(MMSA), which represents all the medi-
the aim of promoting and educating prop-
we have strived to target a wide range
cal students studying at the University of
er sun protection.
of audiences. We believe that the locals need to realise the potential harm that
Malta. MMSA aims to improve the life of the medical students by promoting active
All the coordinators believe that they have
exposure to intense sunlight does to their
participation in their own academic sys-
a commitment towards society. We want
health and that tourists need to be ad-
tem, international exchanges and training
to challenge the belief that the patient is
vised on the high UV indices experienced
in the different fields of public health. It
only a puppet, when it comes to health de-
in the Maltese islands and the need for
also aims to empower society itself, to
cision making. We want to educate soci-
constant hydration and sun protection.
enable individuals to become involved
ety so that they may become more health
in their own health decisions. Basically,
conscious, specifically as regards sun ex-
Our simple idea, has grown and devel-
MMSA helps the medical student survive
posure.
oped, and we have managed to create a campaign, which has the potential to
the five years of laborious study by offering a fun, interactive form of education,
This campaign has now been up and run-
make a difference by educating the peo-
and enabling the student to be of use to
ning for the past year, gaining an increas-
ple. We really hope you enjoy our work, so
society by sharing the knowledge they
ing amount of popularity both amongst
keep reading, and inform yourself so you
gain.
the medical students themselves as well
might be able to be the active protagonist
as amongst the public, both locally and
of health decisions which concern your
Moving to the campaign itself, it all be-
abroad. This has been possible through
own health.
gan, one summer afternoon, when seven
the numerous outreaches, peer education
friends met up for a cold drink. As the
sessions, video uploads and the publica-
RIPPLE Magazine
5
Coordinators ‘13 - ‘14
Outreach Team ‘13 - ‘14
66
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STRAIGHT FROM THE frontline BY Jessica Schembri higgans
This is the story of a woman who battled with melanoma ‌ and survived. Just like every terrifying battle, it left its scars, and not merely cosmetic ones. Such an experience leaves a huge impact on the emotional and psychological aspects of a person; it changes you for life. For those who think that the tan is worth the risk, this might Eaque ipsa quae actually change ab illo ins vens your toremind! veritatis ert quasi. Archirs tecto beatae
RIPPLE Magazine
7
“I
f there ever was an adjective which could describe
Seven. She shudders at the thought that if any one of those
melanoma, it would be the word ‘horrible’.” The
seven moles had remained unnoticed and had had the time to
sincerity in her words was palpable. Having
penetrate deeper into the dermis, the cancer could have spread
suffered from melanoma her words had the ring
like an explosion of seeds in no time at all, invading her whole
of authenticity, and sharing her experience meant that she was
body and ultimately leading to death. The thought that any
sharing the truth about melanoma, disclosing the reality of living
mole, at any time, might become malignant and life-threatening
with the condition. Melanoma is more than just skin cancer
is sobering to say the least. For a person who has already been
and ugly crusted moles, as most pictures on the internet and
diagnosed with melanoma, it becomes a constant anxiety, almost
books show us. Melanoma is a highly underestimated enemy;
an obsession. Checking oneself frequently becomes imperative,
if it is not caught early it is a greater killer than most cancers
and sun protection is raised to a whole new level. Sun safety tips
and treatment is of limited use in improving the prognosis.
are followed religiously and one becomes increasingly aware of
Furthermore, melanoma can also present as moles which appear
other people’s negligence. Although this prevents further damage
quite normal and can easily be misdiagnosed as being benign,
to the skin, the harm that has already been done cannot be erased.
as happened in this particular woman’s case. The sad reality is that this smooth, silent killer is on the increase and we are not doing anything about it. Sun safety is a term that barely exists in our vocabulary and we are still happy to sunbathe in the scorching sun, looking forward to when our lobster-red sunburns turn into a tan. This prompted this woman (who wished to remain anonymous to protect her identity) to speak up, in order to raise awareness in the hope that other persons will never pass through the terrifying experience she had. It all started when the woman noticed one tiny mole on her leg, a mole so small and smooth that it was barely threatening. However its two shades of colour caught her eye and something about it made her feel uneasy. She immediately sought the opinion of a dermatologist, who assured her that it was benign, but she was not convinced. She visited several dermatologists, who were shocked at her insistence on having the mole removed – they were concerned that she would become unnecessary scarred as a result of removing a mole that was most probably harmless. As a result, she was doubtful and worried when she met a doctor who finally gave her the benefit of the doubt, removed the suspicious mole and sent it for biopsy. She describes the doctor as being her angel and life-saver; the doctor’s patience and understanding not only reassured her but also made the diagnosis which ultimately saved her life. The patient’s instinct sometimes is the greatest warning sign, but is unfortunately often ignored by doctors who focus instead on other signs and symptoms.
“When the patient is vigilant, there’s no one who knows the patient better than himself” the woman declared..She was right.The mole was indeed an invasive melanoma; a larger area was excised and she removed fifteen more moles, out of which seven turned out to be melanomas in situ.
8
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Each time that you burn your skin, it will store the damage up for you. It is like a deposit – you will get the interest in the future! Most people think that when sunburned skin loses its red colour and becomes tanned, the sunburn has ‘healed’, but it is definitely not the case. The consequences of sunburn extend into the future; the damage that was done in the past is permanent and irreversible. Thus after being sunburned the increased risk of developing melanoma never decreases or goes away. Melanoma is not a disease but a condition which, once developed, may continue to recur. It changes not only the person’s body but also their mentality and attitude. The woman likened melanoma to an iceberg; you only see the mole which is the tip of the iceberg, but there’s more to it than meets the eye.
Y UGL OF S ED URE ELL PICT EE LAB KS E S S O BOO “TH S YOU N I AS E ARE MOL LANOM ERNET T AS ME THE IN ING” S I OR ON DVERT A BAD
Reflecting on the possible causes for the condition, the woman
T-shirt, working through the midday hours – when in actual
underwent genetic testing to see if she was genetically
fact site safety should also include sun safety. Second-hand sun
predisposed to melanoma, but she did not - thus the cause was
is an important concept, yet it is alien to most of us. Just like
deduced to be purely environmental. She recalls that she often
damage is inflicted on non-smokers through passive smoking,
got sunburnt in summer when she was a child and an adolescent.
second-hand sun, which consists of sunlight reflected off other
“No one ever told me to apply sunscreen”,
objects, is also harmful. Hence sheltering from the sun under
she told us. At that time, there was practically little or no
an umbrella does not protect us efficiently; we still have to apply sunscreen and wear clothing. Melanoma can also affect the eyes and the lips – thus it is important to wear sunglasses and apply lip balm with an SPF (Sun Protection Factor).
awareness at all about sunburn and its dire consequences. Prevention is better than cure – this widespread saying is especially suitable in the case of melanoma, where there are few treatment options available. The next step after prevention is examination; it is indeed the only hope for curing melanoma. If a melanoma is detected early, it can be removed surgically, but if it has already spread, the results are virtually a death sentence. Examination should be a routine like we take care of our nails and hair or go to the dentist … you have to be your own doctor! One should not be hesitant or afraid to take action when one spots a suspicious mole. A scar is a small price to pay compared to your life. In addition, it is dangerous to postpone checking up on a suspicious mole just because it doesn’t look as bad as in pictures you come across. “Those pictures of ugly moles you see labelled as melanomas in books and on the internet are bad advertising”, said the woman, “They are highly misleading.”
“My melanoma was so small and flat and benign looking – nothing like the pictures you see! You really can’t take chances!” This moles
particular in
all. As
woman they
has say,
removed better
safe
over
forty
than
sorry.
The next logical question is: if the skin is our largest organ, how are we protecting it? This woman is not only aware of sun protection, but also passionate about it. She went beyond sunscreen and even mentioned sun protective clothing: clothes containing UV filters. She also raised several interesting points. Since we should avoid the sun between 11 and 4 o’clock, our mentality must change from spending a day at the beach to that of spending an afternoon at the beach. Why shouldn’t pools stay open till late instead of closing at 5 o’clock in the evening, seeing that in Malta during summer the sun sets late and we still have natural light at 9 o’clock in the evening? We are accustomed to seeing construction workers, most of them with their skin burnt to a dark brown and not even wearing a
BE NOT TO LD AID SHOU AFR ONE R O “ONE NT HEN LE.” W A IT MO ION HES ACT PICIOUS E K TA SUS TS A PO S As the interview drew to a close, I realised that I had been greatly impressed by the woman; not only by her courage to speak up but also by the passion she put into it, by her concern not only for her family but also for others. She is a person to admire as well as someone to learn from. Most people learn at their own cost, which may be too late! She shared her experience in order to raise awareness on this highly important subject which unfortunately is only given a short while in the limelight before the summer starts. Just as the sun is with us all year round, we should do our best to raise awareness all year round. At the end of the interview she left us with this simple yet very useful piece of advice:
“Practice sun safety every day, it is not like over-eating; eating an extra piece of cake today and dieting tomorrow. The skin will store the damage up for you, and it might pop up suddenly tomorrow!” RIPPLE Magazine
9
MELANOMA AT A gLANCE
BY Kurt apap & Michelle- mARIE boffa What is Melanoma ? Most dangerous and deadly type of skin cancer Arises due to a problem in the DNA of certain skin cells called melanocytes, that leads to uncontrolled growth and production of these cells The number of damaged cells increases as time goes by, and there is an increased risk of the tumour spreading How many people get Melanoma ? According to WHO statistics there are:
132,000 cases of melanoma each year around the world
In Malta, statistics provided by Health Information Department show that between 2004 - 2008 there were:
217 cases Estimated mortality rate of
15 percent
Common Sites
x2
Legs
Back
Is it treatable ? One blistering sunburn in childhood or adolescence doubles one’s risk of developing melanoma. Melanoma could still occur in non-sun exposed parts. 10 10
RIPPLE Magazine
The outcome depends on the thickness of the lesion, so if it is detected early it could be cured by simple surgical removal. In more advanced cases other modes of treatment may be used, but are less effective.
LIGHTS CAMER
ACTI
BY Kurt apap & Michel
‘You will regret not protecting your
Emma, the 23-year-old protagonis which is similar to that of many fictitious but realistic video, we, a out to the public by indirectly expl protection through another mediu wakeup call to those neglecting su everyone else.
This video was produced in the s YouTube.
Short, fun and catchy – this video is conveys a very important message.
• • • • • •
Over 40 13 medic 30 days 4 filming 2 directo 1 video
This
CHECK IT OUT! 12
RIPPLE Magazine
www.youtube.com/
S... RA.....
ION!
lle MARIE boffa
rself. Emma did.’
st of ‘Emma’s Story’, leads a lifestyle young adults nowadays. Through a as medical students, sought to reach laining the importance of proper sun um. This captivating video serves as a un protection, whilst further educating
summer of 2012 and is available on
s bound to be enjoyable to watch and .
000 views cal students s of hard work g locations ors
s is Emma’s Story!
/watch?v=0xWVJaPEmj4
RIPPLE Magazine
13
10
Secrets tanning salons Don’t want you to know
BY EVE WARRINGTON
With the growing awareness about the harmful rays of the sun, many people have turned towards what they believe is a safer, healthier alternative – tanning salons. Tanning salons market themselves as a fast risk-free way of getting tanned, but what exactly is it that they are not telling us?
1
Indoor tanning is no safer than tanning outside in the sun – it simply offers faster
results by exposing the body to greater concentrations of UVA and UVB rays, which are responsible for skin damage and cancer.
2
The amount of UVA and UVB rays emitted by a tanning bed is roughly equal to sun exposure in the tropics – therefore
risks are even higher than when tanning outside in a normal climate.
3 14
Indoor tanning before the age of 35 increases the risks
RIPPLE Magazine
of melanoma by 75 percent and can also
through tanning beds – will not protect
cause other types of skin cancer.
your skin from future sunburns – contrary
4 5
to what tanning salons like to advertise. Frequent and regular indoor tanning increases the risks of melanoma by 300 percent!
8
Tanning beds can cause se-
skin warts.
vere damage to the eyes
9
– besides melanoma which can, believe it or not, devel-
op in the eyes, the UV rays used in tanning beds can also cause both short and
If the tanning bed is not cleaned properly, one can get serious skin infections like genital warts, skin rashes, and
Tanning is not required for Vitamin D – in reality, most people get enough Vitamin D through their daily activities.
long-term damage to the eyes, including
Tanning salons often falsely state that
cataracts, blurred vision, and blindness. In
tanning is a necessary activity for us to ac-
spite of this alarming fact, more than half
quire our daily required dose of Vitamin D.
of the tanning salons allow customers to tan without wearing eye protection.
6 7
Indoor tanning increases the risk of wrinkles, premature aging, pigmentation, and sagging skin.
10
In most countries there are no age restrictions for tanning salons, which target youngsters who are more susceptible
to
damage
by tanning beds. As a result, the number of young women getting skin cancer is
Having a good “base tan” – which can be achieved
steadily increasing.
staying Safe on the Beach
BY Sarah Craus Lifeguards are very important when it comes to safety at sea because they not only can help prevent an accident whilst at the beach, but can also help the person who is in difficulty in case of an accident. As part of this article, we interviewed Mark Portelli, a 4th year medical student who is also a lifeguard.
A
lthough the sea around the Maltese Islands is normally warm, during the winter months protective clothing should be worn when in the water, since this will delay the onset of hypothermia. If one
finds oneself in some difficulty while at sea, keeping calm is very important in order to be able to think clearly. One should always wear a life jacket before setting sail. This will help to keep a person afloat without effort or swimming, independent of how much clothing one is wearing. Additionally, if a person is unconscious, a life jacket will help to keep that person’s mouth clear of water. It is also important to check the weather forecast regularly before setting sail. In a move to improve safety standards for sea craft and swimmers alike, the Malta Maritime Authority has designated exclusively as ‘Swimmers’ Zones’ a number of beaches/zones around the Maltese Islands which are very popular with swimmers. This applies during the period between 15 June and 30 September. These particular “no navigation” zones are cordoned off to all types of mechanically propelled sea craft or sailing boats including wind surfers, surf boards, jet skis and other sea craft. These areas are indicated at a distance of about 100 metres from the shore and are delineated by a line of single yellow buoys spaced at 50 metre intervals. It is forbidden for any sea craft, whether mechanically driven or by sail, including windsurfers or aqua-scooters, to navigate or circulate within these areas reserved as swimming RIPPLE Magazine
15
zones. This ensures maximal protection to swimmers whilst at sea. Some beaches are equipped with different coloured flags. Green flags signify good conditions and yellow flags suggest
Interview with
lifeguard
one should swim with caution, but one should absolutely avoid swimming if red flags are put up. Children should not be left unattended at any time. They should be wearing arm bands to help them float if they are not fully able to do so without aid. As a swimmer, one should restrict oneself to swimmers’ zones. It is advisable to swim with a companion, so there is always someone close by to give assistance if necessary. Alcohol should not be consumed before swimming as this impairs one’s abilities and judgement. One should avoid staying in the sun between 11 o’clock in the morning and 4 o’clock in the afternoon.
1. What is your role as a lifeguard? Can you tell us something about your training and certifications? Beaches are very attractive but are never without their own particular dangers. As a lifeguard I help reduce these dangers, protect the swimmers and help them when in need. In the organisation I work with, our motto is “Striving for the safety of others” and that’s what we aim to do through lifeguarding. Our training is quite rigorous and also continues during the winter months. Being a lifeguard requires continuous training both in stamina and physical fitness as well as increasing my wealth of knowledge in the field. My current certifications include open
Dealing with Jellyfish Stings - Soak or rinse the area in sea water. Fresh water should not be used as this results in more toxins being released.
water and pool lifeguarding as well as that of team leader and instructor in lifeguarding. 2. Can anyone become a lifeguard? What should one do if he or she is interested in becoming a lifeguard? Essentially yes. However it requires a degree of dedication and
- Remove tentacles with a stick, card or a pair of tweezers, being careful not to touch them with other areas of the skin.
interest in order to complete the training process. To become a lifeguard one requires certification and membership with a an organisation which provides such a service – in my case it is the Emergency Response and Rescue Corps.
- Apply alcohol to the area. 3. What are the most important characteristics of a lifeguard?
- Do not rub the area, or apply very cold or very hot water.
I’d sum them up in three words: dedicated, observant and teamworker. It requires dedication to reach the level required to be
- One should seek medical advice if the pain persists or is very severe; the rash worsens by time; the affected area becomes red, warm and tender; and if the person affected has difficulty breathing.
able to protect people from harm; being observant and being continuously attentive to what is happening around you. 4. What encouraged you to become a lifeguard? Lifeguarding provided me with the pleasure of helping others in need while providing me with a taste of what a healthcare approach to others would be like. 5. What equipment do you use to help you save people at sea?
Jellyfish Stings
There is a whole range of equipment we use in our rescues and new equipment is always being developed based on international standards. However, we mostly use, first of all, a basic life support kit together with an AED and oxygen tank and a full advanced first aid kit. We also use spine boards and cervical spine collars and the characteristic lifeguard rescue can.
16
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6. Do you recall any particular experience where you felt your role as a lifeguard was very useful? Yes. Every experience I have shows that, but if I had to choose one, I would say my first rescue on the island of Comino. It was a foreign student who suffered a suspected spinal injury after falling in shallow waters. The team instantly reached the casualty, rescued and immobilised her and called for a helicopter. As any first aid course mentions it is important to keep monitoring until further help arrives. 7. In which beaches in Malta are lifeguards usually present? There are lifeguard teams in many beaches around the islands. In the case of the lifeguard teams of the Emergency Response and Rescue Corps, we are located in Ramla Bay in Gozo and the Blue Lagoon in Comino. 8. What suggestions would you give someone who encounters a problem whilst swimming? First of all to calm down; panicking always makes everything worse. Call for the help of a lifeguard if on site. If it is a beach without lifeguard supervision, swim to the nearest shore with caution. If you happen to be the rescuer of a family member, a friend or even a stranger, make sure the area is safe and be very careful. A panicked swimmer can be very dangerous and can drown you easily. They tend to hold on to the nearest thing that floats i.e. you. In such cases take a floating object with you and hand it to the swimmer to hold on to. In dangerous waters it is always advisable not to enter the water. Throw a rope with a floating object at the end and haul the patient in. Your safety remains the most important factor. 9. What type of dangerous situations do you come across? Dangerous situations would definitely include dangerous waters such as strong waves and rip currents – something which we learn to recognise and deal with. Other dangerous situations include the panicked patient who would grab on to the lifeguard without thinking twice. Dangerous situations with regards to casualties would include a wide range of scenarios including heat strokes, spinal injuries and head injuries, CPR to multiple casualty incidents.
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17
The Shadow Rule The Shadow Rule When a person’s shadow is shorter than his length the intensity of the UV radiation is more likely to cause sunburn. When a person’s shadow is shorter than his length the intensity of the UV radiation is more likely to cause sunburn.
Sunstroke Sunstroke Sunstroke refers to a condition in which the normal cooling processes of the body stop functioning properly, such that the body Sunstrokefollowing is the term for a condition in which the normal cooling processes of the body stop functioning properly followoverheats, sunused exposure. ing sun exposure, so that the body overheats. Signs: Signs: - Throbbing headache - Red, hot, dry skin - Throbbing headache - Muscle weakness or cramps
- Red, hot, skin - Nausea anddry vomiting - Muscle weakness or cramps - Rapid breathing
- Nausea and vomiting - Dizziness, confusion and possibly loss of consciousness or fits Rapid breathing - May stop sweating
- Dizziness, confusion and possibly loss of consciousness or fits
- May What tostop do ifsweating someone gets a heatstroke: What to do ifcall someone gets a heatstroke: - Immediately the ambulance (112) or take the person to hospital - Cool the person by placing him in an air-conditioned room or a shady place, removing unnecessary clothing, then: - Immediately call the ambulance (112) or take the person to hospital Cool person by placingwhilst him inwetting an air-conditioned roomfacecloth; or a shady place, removing unnecessary clothing, then: o -Fan airthe over the individual him with a damp Fan air in over individual whilst wetting with a damp facecloth; o Or apply o icepacks thethe person’s armpits, groin, neck him and back; o Orthe apply icepacks the person’s armpits, groin, neck and back; o Or immerse individual in in a body of cool water o Or immerse the individual in a body of cool water 18 18
RIPPLE Magazine
Burning
FActs BY Kurt apap & Michelle-mARIE boffa
Children get 80% of their lifetime sun exposure before the age of 18. Therefore it is particularly important to protect children from the harmful effects of prolonged sun exposure.
UV Radiation - Most of the sun’s radiation, including UVA and UVB rays, reaches the earth’s surface. Exposure to both types of UV rays increases the risk of developing melanoma and other skin cancers. - Light clouds, haze and temperature do not affect the intensity of UV radiation. Exposure during the winter months can be as damaging to your skin as exposure during summer. - Surfaces such as sand, water and concrete, which are light in colour, reflect UVA and UVB rays hence increasing your exposure to sunrays. A beach umbrella provides only as little as 50 percent protection from UV radiation due to reflection from sand. - Being in water (or covered in water) does not protect your skin from the danger caused by the UV rays, on the other hand it may actually magnify the damage.
Minimal sun protection required Wear sunglasses on clear days and use sunscreen when close to reflective surfaces.
UV 1-2
Sun protection required A hat, sunglasses and sunsreen are recommended.
UV 3-7
Maximal sun protection Required Seek shade particularly around midday. Wear sunglasses and apply sunscreen generously. Wear a broad-brimmed hat and adequate clothing to minimise the area of exposed skin.
UV 8-11+ RIPPLE Magazine
19
Sunscreen A Shopper’s Guide
BY mATTHEW bALDACCHINO
Why do we need SUNSCREEN? Choosing THE BEST SUNSCREEN
Summer is finally upon us and the onslaught of crowds heading to our nation’s beaches is now a common sight. However, another unfortunately common practice is that of poor education about sunscreen and its application. Many of us are tempted by cheap deals and flashy products, but sunscreen plays an especially important part in keeping ourselves safe and healthy throughout the summer months. 20
RIPPLE Magazine
Why do we need sunscreen? Despite the age-old proverbs about getting a good dose of sunlight to ensure we maintain good levels of Vitamin D (even though we can get most of our Vitamin D through our diets) we have very poor knowledge of what the excessive amounts of sunlight can do to us. The sun emits a wide spectrum of wavelengths of energy which include visible light and ultraviolet (UV) radiation. UV radiation has been shown to be the cause of 90% of non-melanoma skin cancers and 65% of melanoma skin cancers, underlining the essentiality of using sunscreen. UV can be split into three components: 1. UVA: these are not absorbed by the ozone layer. They penetrate deeply into the skin and are related to ageing and wrinkling. Circa 90% of visible skin changes associated with ageing are attributed to sun exposure. 2. UVB: these rays are partially absorbed by the ozone layer. Mostly affect the surface of the skin and are the primary source of sunburn. The thinning ozone layer means effects of UVB are now more extreme. 3. UVC: this spectrum of light is not particularly clinically relevant as most of this UV radiation is blocked out by the ozone layer. Both UVA and UVB have been shown to be linked to cancer formation.
The first thing to look out for is the Sun Protection Factor (SPF). This is an indicator of how well the sunscreen can deflect UVB rays. Essentially, the higher the SPF displayed on the sunscreen, the greater the protection against UVB. This can also be roughly explained in terms of how much longer a person would theoretically be able to stay in the sun compared to if they had no sunscreen (for example a person wearing SPF 15 sunscreen would technically be able to stay 15 times longer in the sun before getting a sunburn). This is not easily transcribed into real-life scenarios mainly due to limitations in the way sunscreen is applied and the varying amounts of UV radiation throughout the day. Thus caution should still be exercised in the sun even when wearing sunscreen. Ideal sunscreen use should include using a product with an SPF of at least 30, although SPF 15 sunscreen is generally considered to be fine for the majority of people. However, people with fairer skin, a family history of skin cancer or conditions that increase sensitivity to light (such as lupus) should use sunscreens with an SPF of at least 30 or higher. The highest recognised SPF in the EU is denoted as 50+ and a general rule of thumb would be to remember that a higher SPF is by and large preferable, even if the amount of protection from UVB is not increased as much. One must keep in mind that SPF is dependent on a number of factors that can limit its effectiveness between different people including: 1. Skin type. 2. Amount of sunscreen applied. 3. Reapplication of sunscreen throughout the day, after swimming, etc. 4. Activities a person engages in (swimming, etc.). 5. Amount of sunscreen absorbed by the skin.
Choosing the best sunscreen Different kinds of sunscreen work in different ways. Some work by scattering and reflecting light, whereas others absorb the UV light before it can reach the skin. When choosing a sunscreen, you
Spf
have to keep several things in mind, mainly SPF, UV protection and the specific use for your sunscreen. One should note that tanning oils are NOT sunscreens and do not protect against sunburn and other harmful effects of the sun. RIPPLE Magazine
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Specific use for your sunscreen
UVA & uvb
When choosing a sunscreen, make sure to choose one that is suited to your needs. There are different formulations for sunscreens, including sprays, lotions, gels and creams, that may be used for different areas of the body such as balding areas (the scalp is extremely susceptible to skin cancer if left exposed) or exposed hairy skin (for which, for example, a spray would be ideal).
Another factor to look out for is that the sunscreen you are using provides protection from both UVA and UVB radiation. In the past, UVB radiation was thought to be the sole cause of melanoma – however recent research has shown that even UVA plays a part in skin cancer in that it affects the DNA of cells deep within the skin increasing the likelihood of malignant melanoma. Apart from checking labelling for UVA/UVB protection, keep an eye out for particular active ingredients which are shown to have an increased effect on UVA protection such as zinc oxide, avobenzone and ecamsule. Other products such as titanium dioxide may also provide some UVA protection but not as profoundly as zinc oxide.
If you plan to engage in activities that may cause you to break a sweat, a water resistant sunscreen would be indicated. Note that NO sunscreen is waterproof and that it should be reapplied frequently.
Sunscreen and Children Children should be educated from an early age on sunscreen use. However their skin, like the skin of babies, is more sensitive than adult skin and could be easily irritated by the chemicals in adult sunscreens. Avoid sunscreens containing PABA (para-aminobenzoic acid) and benzephones (dioxybenzone, oxybenzone, sulisobenzone). Chemicals that are less likely to irritate the skin are titanium dioxide and zinc oxide since they reflect the UV rather
It is interesting to note that titanium dioxide and zinc oxide also have the added benefit of reflecting UV rather than absorbing it so this prevents excess contact of UV with the skin.
than absorb it. Sunscreen for children over 6 months should have an SPF of at least 15 whereas babies under 6 months should be kept out of direct sunlight. Particularly in babies remember that areas that are not sufficiently protected by clothing (mostly the face and back of the hands) should be covered with sunscreen. If someone has sensitive skin or conditions like rosacea, one may use sunscreen for children. Look out for products containing PABA and benzephones and instead opt for products containing zinc oxide or titanium dioxide. In people with acne, opt for products that are oil-free or non-comedogenic (i.e. products that do not block pores). If you suffer from skin irritation or allergies, avoid sunscreen with alcohol, fragrances or preservatives and if you have oily or dry skin, you may look for sunscreens containing moisturisers. As always, remember that the best plan of action when shopping around would be to consult your doctor or pharmacist on the sunscreen tailored for your needs. You should also note that you should use a sunscreen that is easy to use and one that you feel comfortable using.
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RIPPLE Magazine
Things to Remember Remember to check the expiration date on your sunscreen. Sunscreen will not remain stable after the expiration date and will break down, failing to offer protection. Furthermore, extremely hot temperatures will inactivate and degrade your sunscreen so store it in a cool place when not in use. Always apply sunscreen 20 minutes before going outdoors in order to give it time to be absorbed properly by the skin. Reapply your sunscreen every two hours especially after swimming, sweating and towelling but do not apply sunscreen on sweaty or wet skin (always dry the skin beforehand). When applying your sunscreen, an ounce (circa one shot glass) of sunscreen per adult should be sufficient – remember to cover all exposed skin including the face, ears, neck and any balding scalp. If you are applying a thin layer of sunscreen only, this is not enough. Your sunscreen should not last you the whole season and you should go through several bottles each summer. Finally remember that sunscreen is not failsafe and one must always exercise caution and protect the rest of the body too. Wear a hat that covers the ears, UV-protection sunglasses, use a lip balm with a minimum SPF 15, wear sun-protective clothing (look out for UVP ultraviolet protection rating labels on clothing) and avoid the sun during peakhours (mainly 10.00hrs till 16.00hrs). Note that no tan is medically considered as healthy so remember to stay safe in the sun.
tips
RIPPLE Magazine
23
HOW IT WORKS:
SUNGLASSES
BY maria grazia grech
They’re cool, stylish, enduring fashion items but more importantly they play a vital role in protecting your eyes. Here’s a brief history of one of our most favourite summer accessories:
high standard pair of sunglasses. In fact the lenses undergo several processes and they have a number of different layers, each having a specific function, namely:
James Ayscough experiments with differe tinted glasses, coming to the conclusion t blue/green tinted glasses are the best alleviating visual impairments. These howe have little protection against sun damage
RIPPLE Magazine
1430
18001900
1750
1352 1300
Chinese judges use crystal sunglasses in courts so that their facial expressions would be inscrutable. 24 24
There are a lot of technologies in use in order to produce a
First time sunglasses are included in a painting, by Tommaso de Modena, thus making this the first official record of the use of sunglasses.
1200
Inuits use snow-goggles to protect their eyes from snow-blindness.
HOW DO SUNGLASSES WORK?
Tinted glasses used as vision correcting glasses in Italy.
Tinted glasses are highl prescribed for syphilis patient to protect against light sensitivity one of the symptoms of th disease.
ly ts, y, he
rays and thus allow you to see better with more contrast.
The tint is the colour of the lenses. Most of the time it
AA good test to check whether your sunglasses are truly
is added while the lens is being formed but sometimes it
polaroid or not is to hold them in front of an LCD screen
is layered on after the lens is built. Different tints have
(e.g. your computer) and rotating them through 90-180°. The
different functions i.e. they absorb different colours from the
screen should turn dark and then light again as you rotate.
light spectrum. For example, grey tints decrease brightness and therefore are all-purpose. Apart from that they are very good at reducing glare (excess brightness). On the other hand yellow tinted glasses filter blue light and rose tinted glasses are perfect for use against a green or blue background.
B POLARISATION
Light rays emitted from the sun are scattered in all directions. When they meet a suface at a horizontal orientation they are reflected at a horizontal angle and create what is known as glare. An example of this is when you look at the sea and there is sunlight directly above it. You won’t be able to make out what there is under the surface of the water because of the reflection of the sunlight. This may hide useful light rays
C ULTRA-VIOLET COATING Apart from light rays, the sun emits UVA (Ultra -Violet A) and UVB (Ultra-Violet B) rays, the latter two being harmful to the eyes. UVB is completely absorbed by the cornea (the hard outer covering of your eye) but some UVA is not absorbed and may affect the retina (the layer on the inside of your eye where light rays hit the eye). A good pair of sunglasses should be able to filter 99 to 100% of these rays and not allow them to reach your eyes. Otherwise, prolonged exposure can lead to cancer and cataracts, which may lead to serious eye damage including blindness. These rays are not visible to the human eye.
for the human eye. Polaroid sunglasses filter these horizontal
Sam Foster sells the first pair of sunglasses. They quickly become popular on the Atlantic City Boardwalk in New Jersey. Later on this becomes the Foster Grant Company.
The ‘Wayfarer’ sunglasses are released by Ray Ban. These are the top best-selling type of sunglasses and are still popular to this day.
TODAY
Polarised lens sunglasses become available after experiment conducted by Edwin Land. The ‘Aviator’ sunglasses are released by Ray Ban, a style which is still considered very fashionable.
2004
1936
1953
1929
ently that for ever e.
A TINTS
Sunglasses have become a fashion staple and they are here to stay. Owing to significant advances in technology, lots and lots of different styles, colours, shapes and sizes are available, so there is a pair of sunglasses to satisfy everyone’s taste.
The first pair of sunglasses with a built-in audio playing device are released by Oakley. RIPPLE Magazine
25
TIPS SUNFOR BUY GLA SSE ING S
D ANTI-REFLECTIVE COATING This prevents light rays from hitting the back of the lens (i.e.the part of the lens that’s facing your eye) and being reflected back to your eye. Sunglasses
also
have
a
reflective
coating
on
Make sure that you choose the right colour of lens depending on the reason why you are buying sunglasses.
the
front of the lens so that people are not able to see your eyes, together with a scratch resistant coating.
There should be a sticker or label stating that that particular pair of sunglasses filter 99 or 100% of the light. Don’t fall for brand names. Expensive and high quality aren’t the same thing. Several studies have shown that generic sunglasses are in some cases better than well-known brand names. That said, be careful not to sacrifice your eyesight to what looks like a potential bargain. In the long run it won’t be worth it. Several fake sunglasses are in fact just lenses which have been dyed and thus don’t have the normal layering. This means that you are not protecting your eyes. In fact you may be exposing them to more danger. This is because since the lens would be allowing less light to enter, the pupil would widen, thus exposing the retina to more damage than usual as UV rays wouldn’t be appropriately filtered. A darker tint more protection
doesn’t mean from the sun.
Sunglasses must be able to filter more than 60% of sunlight otherwise they are not of much use. Choose sunglasses with wide arms. These help reflect away rays which may still be hitting your eyes from the sides. Some companies actually offer wrap-around sunglasses.
26
RIPPLE Magazine
Message from the maltese association of dermatology and venereology (madv) President 29 July 2013 It is with the utmost pleasure that MADV is offering its support to the MMSA Beat the Burn Campaign for 2013. In the first instance it is gratifying to see today’s’ medical students involving themselves directly in health issues in spite of the ever increasing amount of scientific information they somehow have to digest. Furthermore, our future doctors are taking it upon themselves to originate various projects rather than merely act as collectors of sample and/or statistics for one or other senior doctor’s research project although this too has merits. In so doing, they are donating their little free time to society addressing issues that they feel are within their remit and for this we must be indeed grateful. This “public conscience” is an integral part of a doctor’s duty “simply to do good” and bodes well for the future of medicine in our islands. Turning to the Beat the Burn campaign, like so many other medical and social problems, education is the anchor of success, and it is only fair to say that there can never be enough because human attitudes do not change overnight. MADV itself has conducted sun awareness campaigns annually for many years in conjunction with EU wide Melanoma Days campaigns. Some success has been achieved but it is not enough! With skin cancer rates still at significant levels it is crucial to press on with ongoing education campaigns and who best to influence the attitudes of young people than other young people? It is far from easy with crowds still enjoying 11am-4pm sun exposure not only here but also in the country of the most sophisticated “sun campaigns” practically starting in infancy-Australia. It’s tough but together we can............ Good Luck in your endeavours
Prof Joseph Pace MD FRCPEdin FRCPLond FCPP President For the Board of MADV Email: josephlpace@onvol.neg Fax +356 25401123 RIPPLE Magazine
27
Mole
Patrol BY nAOMI MERCIECA
According to the World Health Organisation, one in every three cancers diagnosed is a skin cancer. Skin cancers mainly affect Caucasians with fair skin and are chiefly caused by exposure to the harmful ultraviolet (UV) rays that reach the Earth together with sunlight. One’s risk of getting skin cancer may be reduced and this is why the disease is currently being targeted by several preventive programs.
apart from giving the skin its colour, is
skin type I will have ivory white skin and
responsible for reducing any damage
green or pale blue eyes, and burns but
done to the skin by sunlight. If the damage
does not tan in the sun.
is too great for the defences of the skin to cope with, the cells will begin to grow
On the other hand, a person with type VI
abnormally, causing a cancer. There are
skin has dark brown or black skin and eyes
several types of skin cancer, including
and tans but does not burn.
melanoma, which causes nearly 80% of deaths due to skin cancer although it
Risk factors for melanoma may be innate
makes up only 4% of all diagnosed cases
(cannot be changed) or environmental
of skin cancer .
(may be controlled). Innate risk factors include fair skin, moles, freckles and a
Skin types are classified on the Fitzpatrick
family history of melanoma. Environmental
Scale which ranges from I to VI. The scale
risk factors mainly involve exposure to
takes into consideration one’s tendency
UV rays: if one is exposed intermittently
Each person’s skin is made up of tiny
to burn instead of tan when exposed to
to sunlight, or makes use of artificial
subunits called ‘cells’, some of which
sunlight, as well as the colour of one’s
tanning devices including sun-beds and
contain a pigment called ‘melanin’ which,
skin, hair and eyes. A person classified as
tanning lamps, one increases the risk of
Skin Cancer and Skin Types
28
RIPPLE Magazine
Skin Examination Common moles, also called nevi, are pink or brown, often round, patches of skin which are not larger than 5mm across.They are usually dome-shaped with a smooth surface and have clear edges. One may also have dysplastic nevi, which are unusual, large flat moles with indistinct edges and may have mixed shades of pink and brown. People with more than 50 common moles or with many dysplastic nevi have a greater chance of developing melanoma. Thus one should check one’s skin regularly for changes in moles using the ABCDE rule.
Asymmetry One half of the mole does not match the other half
Border Ragged or blurred edges
Colour Mixed shades including brown and pink as well as red, grey or blue
Diameter
developing melanoma. A number of recommendations have been issued to reduce one’s chances of
Increase in size to more than 6mm across
developing skin cancer. These include avoiding the sun between the hours of 11.00hrs and 16.00hrs, wearing protective clothing (preferably with long sleeves) and using sunscreen with a sun protection factor (SPF) of 15 or higher.
Evolving The mole has changed in texture (mole becomes hard or lumpy) and height
ABCDE rULE
One is advised to inform their doctor about any such changes in moles and if the mole begins to itch or bleed.
RIPPLE Magazine
29
BUSTED! ering
answ
BY ABIGAIL MULA on
omm ost c
the m
ure xpos
myths
There are a lot of common misconceptions among the general public, with respect to sun exposure. RIPPLE gives you the truth about some of these myths.
sun e
A suntan, as opposed to sunburn, myth does not cause UV-induced damage.
TRUTH
myth
TRUTH
30
A suntan, often advertised as a “healthy” glow, is actually a symptom of UV-induced skin damage. The skin’s natural response to sun exposure is to increase melanin (i.e. the pigment which creates the tan) production within melanocytes (i.e. a type of cell found within the skin epidermis). In spite of the fact that this natural response will help protect against further injury to the skin, there is a limit up to which this is effective. Moreover, it is not possible to reverse all of the damage which would have already been caused by previous overexposure to the sun. What one must keep in mind is that, cumulatively, suntans will produce the same deleterious effects as sunburn. Such effects include problems associated with premature skin ageing and skin cancer. Still sunless tanning, through tanning lotions for instance, provides a healthy alternative to those who are still keen on regaining that darker skin tone lost during the colder, winter season.
myth
TRUTH
Sunscreen is the sole and best means of sun protection there is. Despite the fact that sunscreen is effective in limiting UV penetration (most of which is UVB), other effective methods of sun protection do exist. Sun protective clothing manages to filter both UVA and UVB. Although this type of clothing covers most of the skin, it is typically cool and comfortable to wear. What one should look for when buying such clothing is the UPF (UV Protection Factor) which, according to numerous dermatologists, should be at least 30. Similar to SPF (Sun Protection Factor), its maximum value is 50+. However UPF should not be confused with SPF, the latter of which is found on sunscreen bottle labels, since this only indicates the ability of the sunscreen to provide protection against UVB. An indication of protection against UVA is the PPD (Persistent Pigment Darkening). One should not forget that other outerwear for the summer months includes sunglasses and hats. Although all aforementioned methods are effective in providing sun protection, the best outcome will be obtained by combining them. Moreover, skincare should not be limited to the period of sun exposure but also later on during the day through the application of an after-sun cream which will help repair the stressed-out skin.
Well over 50% of lifetime UV-induced damage occurs in adolescence, therefore people belonging to older age groups should not worry about sun exposure. In actual fact, according to the Skin Cancer Foundation, only 23% of lifetime sun damage occurs by age 18. This means that persons belonging to older age groups should not be allured by the sun and make sure they protect themselves from its damaging rays.
RIPPLE Magazine
Kids’ Section
Flip the page over for:
Bukku’s Tips by Mark Sammut & Jessica Schembri Higgans
RIPPLE Magazine
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RIPPLE Magazine
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reci
pe
FRUITY YOGHURT ICE-LOLLIES BY Janice Azzopardi, michelle-marie boffa & martina papa Water makes up 3/4 of your body weight and so it is important to replace any water lost during the day, particularly in summer when the heat could make you lose much more water than usual. To do this you should drink up and drink often! It’s also a great idea to eat loads of fruit and vegetables in summer as these also contain a lot of water that could help you stay hydrated. Not only are these fun lollies bursting with flavour, but they are also a great treat to help you stay hydrated this summer! So grab your aprons and let’s get cooking!
s4 e rv
Se
WHAT YOU NEED: • • • •
300g thick strawberry yoghurt 1 banana A few drops of red food colouring (optional) 4 ice-lolly moulds
A METHOD:
C
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RIPPLE Magazine
1. Add the few drops of red food colouring to the thick yoghurt and mix well to obtain brightly coloured ice-lollies. 2. Wash and finely chop the banana into small cubes. Attention! Use a knife with a rounded point and ask the help of an adult in this step to avoid getting hurt. 3. Add the banana pieces to the yoghurt and mix well. 4. Pour the mixture into the ice-lolly moulds. 5. Put the lid on the moulds. Place in the freezer. 6. To serve: Run some warm water over the moulds for a few seconds and the lollies will loosen.
“mm
mh
!”
B CHEF’S TIPS: •
You could mash the bananas instead, for a smoother texture.
•
You could also experiment with different types of fruit and yoghurt to come up with your own healthy treat.
RIPPLE Magazine
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The Golden Rules BY ABIGAIL MULA The Sun is beautiful, the sun is bright, However careful we must be due to its might. Although it will melt our delicious ice cream cones, Through Vitamin D it also makes stronger bones. In summer it also gives us a golden glow, Thus “The Golden Rules” we must follow. Between 10 and 4 out of the Sun we must stay, Thus keeping its damaging effects at bay. Without a clock when it is safe how will we know? Easy, by making sure we’re shorter than our shadow. During Summer the UV index is often higher than three, Thus throughout the day out of the Sun we should be. Protect our skin from the powerful UV rays we must, Before the sun’s rays are cast. Sunscreen we must therefore apply, As often as possible we must try. Take care of our eyes we shall, By wearing sun glasses, very well. Before to the beach we are set, Our hat we must not forget. A white shirt we should also wear, If the sun’s rays we want to scare In summer water we must drink, Nearly as often as we blink. The Sun is beautiful, the sun is bright Still we will protect ourselves from the sunlight. “The Golden Rules” we must follow, If outside we want to go.
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RIPPLE Magazine
By Mark Sammut It’s such a lovely day outside and Bukku has decided to meet up with his friends at the beach. However, he is confused about which things to take with him and needs your help! What are the 6 most important things that he must take? Swimming Trunks Sunglasses Flip Flops Sunscreen Umbrella Bucket and Spade Beach Ball Cap
Towel Water Bottle Video Game T-shirt Magazine Camera Goggles Check out how well you fared on the next page
RIPPLE Magazine
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Points Swimming Trunks Sunglasses Flip Flops Sunscreen Umbrella Bucket and Spade Beach Ball Cap Towel Water Bottle Video Game T-shirt Magazine Camera Goggles
7 8 5 10 9 3 3 8 8 6 2 8 5 5 3
20-25 points - Watch out! You need to be more careful when going to the beach! You are not taking all the necessary precautions. Read ‘Ripple’ carefully so that you’ll enjoy your summer! 26-35 points - Not bad but you can still do better! Try to be more careful. 36-50 points - Well done! You know how to protect yourself properly from the sun. Keep it up and encourage others to do the same!
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RIPPLE Magazine
CROSSWORD PUZZLE BY mArk sammut
BY MARK SAMMUT
1 2
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DOWN
ACROSS 2
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Stay here if you want to avoid the Sun! Open it in Winter and Summer Eye protection Last Month of Summer Protect your skin with _________ The Sun emits these harmful rays Don’t forget your bucket and spade when you go to the _____ Summer footwear
*Answers on the last page
1 You can build a castle with this 2 She sells _________ by the seashore 3 Refreshing summer fruit 4 Stay _______ between noon and 4pm 5 Essential skin vitamin 6 A good read! 7 Vacation 8 Redness of the skin caused by excessive sun exposure 9 The Earth travels round this 10 Prevent this by drinking plenty of water 13 Watch out! They sting! 14 A type of skin cancer caused by excessive sun damage 16 A season that starts on the 21st June 19 A sea creature that hides in the rocks 20 “The Cat in the ___” RIPPLE Magazine
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Wordsearch BY mArk sammut
*Answers on the last page 40
RIPPLE Magazine
L R O C C C Y E I B A S D E T S U M R L N R R G I B U C K T T Y K A N R A U N K O Q L H M A R A U E I F L I F E G U A D O N S D O R N B P S R B S D O B T R K I N C O M I E O W M L R O G S R L M E A A C L I T C A W B H L O O H C S R E M M S O E G B A M W H R I B A M R T E L N H E S B E A C H L I D R G N I N N A T H R E A P N S O R L H F L A C F M I P R G L H Q I S L O K E H F L F T P B S S E I L C A N O E I N G O H E A E F E S K N I R D D L O C I W S D T R S N W P E B B L E L
t
u Look o For
BBQ
Beach
Bucket
Beach Lido
Boats
Cold Drinks
Camping
Canoeing
Feast
Cruise
Deckchair
Floaters
Fireworks
Fishing
Ice Cream
Frisbee
Holidays
Ripple
Life Guard
Pebbles
Sunny
Shorts
Summer School
Tanning
Sunscreen
Swimming Pool
Towel
Beach Ball RIPPLE Magazine
41
Don’t make me laugh Why do fish swim in salt water? Because pepper makes them sneeze!
What's the best day to go to the beach? SUNDAY!
Which fish is the most famous? The star fish!
Where do fish sleep? On a seabed 42
RIPPLE Magazine
by Mark Sammut What do you call a witch who lives on the beach? A sandwitch!!
What is the strongest creature in the sea? A mussel !
What do you call a fish without an eye? Fsh! ish? f a e s u confu shbowl o y o d How ound fi r a n i orner! c e h t Put it o go to t t i l l e and t
Y urn A D eb O T e atth
g a kP
E K I L w
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Kids’ Section Answers
Stay tuned for regular updates from BTB Team and follow our campaign throughout the year
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