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Limiting ultraviolet radiation exposure during early childhood can significantly reduce the risk of developing skin cancer, making early childhood a critical time for sun protection strategies. This study aimed to measure sun protection practices utilized in Australian early-childhood services over the past decade and evaluate the impact of Cancer Council Australia's SunSmart Early-Childhood Program. Results are presented from cross-sectional and repeated-measures survey data, completed by directors or other staff at randomly sampled early-childhood services in 2008, 2013 and 2018 (N  =   3243). Most sun protection practices were used by a significantly greater proportion of services in 2018 relative to earlier years, such as requiring the use of sunscreen (98.4%), and sun-protective hats (99.7%) and clothing (88.8%). However, only a small and declining proportion of services (16.3%–22.4%) required the use of specific items of sun-protective clothing. SunSmart program members reported enacting significantly more sun protection practices compared to non-members, while new members showed an increase in the use of those practices relative to services whose status did not change (d  =   0.48). The results demonstrate improvements in sun protection in Australian early-childhood settings, and highlight the benefits and limitations of the SunSmart program. [ABSTRACT FROM AUTHOR]

Objective  There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center. Methods  Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form. Statistical Analysis   IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%. Results  A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism. Conclusions  Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to assess the efficacy of a childcare-based intervention in increasing child physical activity by allowing children unrestricted access to outdoor areas for free-play when structured activity is not taking place. A randomized controlled trial was conducted in six childcare services. Intervention services provided children unrestricted access outdoors for active free-play, while control services provided their usual scheduled periods of outdoor play. Consent was obtained from 231 children. Child moderate to vigorous activity (MVPA), the primary trial outcome, was assessed via accelerometer at baseline and 3 months post baseline. Intervention effects were examined using Generalised Linear Mixed Models. Controlling for child age, gender and baseline outcome measure, at follow-up there were no significant differences between groups in minutes of MVPA in-care (mean difference: 4.85; 95% CI: −3.96, 13.66; P = 0.28), proportion of wear time in-care spent in MVPA (mean difference: 1.52%; 95% CI: −0.50, 3.53; P = 0.14) or total physical activity in-care (mean difference in counts per minute: 23.18; 95% CI: −4.26, 50.61; P = 0.10), nor on measures of child cognition (P = 0.45–0.91). It was concluded that interventions addressing multiple aspects of the childcare and home environment might provide the greatest potential to improve child physical activity. [ABSTRACT FROM AUTHOR]