Serial Cross-Sectional Observations of Sun-Protective Behaviors at an Annual Outdoor Motorsport Event in Tropical Queensland, Australia

Skin cancer, the most prevalent cancer in Caucasians resid-ing at low latitudes, can primarily be prevented by avoiding overexposure to sunlight. Serial cross-sectional observations were conducted at an outdoor motorsport event held in Townsville, Queensland each July (Southern winter) to determine whether sun-protection habits changed over time. Most (71.1%) of the 1337 attendees observed (97.6% lightly pigmented skin, 64.0% male) wore a hat (any style shading the face), while few (18.5%) wore three-quarter or full-lengthsleeves. While hat-wearing rates (any style) were similar in 2009 (326, 72.6%) and 2013 (625, 70.4%), the use of sun-protective styles (wide-brimmed/bucket/legionnaires) decreased from 29.2% to 18.6% over the same period, primarily because the use of sun-protective hats halved (from 28.7% to 14.0%) among females, while decreasing from 29.4% to 21.1% in males. Although relatively few individuals wore sun-protective (three-quarter-length or full-length) sleeves regardless of year (OR=0.117, P<0.0001), encouragingly, the use of sun-protective sleeves more than doubled between 2009 (10.5%) and 2013 (22.5%). Interestingly females, albeit the minority, at this sporting event were less likely to wear a hat (OR=0.473, P<0.0001) than males. These findings highlight the need for continued momentum toward skin cancer primary prevention through sun protection with a dedicated focus on outdoor sporting settings

The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 statement

We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.Funding for the SCRIBE project was provided by the Lifetime Care and Support Authority of New South Wales, Australia. The funding body was not involved in the conduct, interpretation or writing of this work. We acknowledge the contribution of the responders to the Delphi surveys, as well as administrative assistance provided by Kali Godbee and Donna Wakim at the SCRIBE consensus meeting. Lyndsey Nickels was funded by an Australian Research Council Future Fellowship (FT120100102) and Australian Research Council Centre of Excellence in Cognition and Its Disorders (CE110001021). For further discussion on this topic, please visit the Archives of Scientific Psychology online public forum at http://arcblog.apa.org. (Lifetime Care and Support Authority of New South Wales, Australia; FT120100102 - Australian Research Council Future Fellowship; CE110001021 - Australian Research Council Centre of Excellence in Cognition and Its Disorders)Published versio

Where Are N-of-1 Trials Headed?

N-of-1 trials and review articles have recently been published in the areas of chronic pain, pediatrics, palliative care, complementary and alternative medicine, rare diseases, patient-centered care, the behavioral sciences and genomics. These are briefly reviewed and the current place of N-of-1 trials discussed. The chapter concludes with a vision for the future of N-of-1 trials

What are N-of-1 Trials?

In this chapter, we define N-of-1 trials and provide a brief historical perspective. We briefly cover the background and rationale for N-of-1 trials, and discuss their benefits

Preliminary observations of hat wearing in Brisbane schools

Background / Aims: \ud Queensland is the Australian state with highest incidence of melanoma, however, only 50% of primary schools in Queensland are SunSmart. Although the SunSmart program has been very successful overall, data on actual implementation of the program are scarce. Though no hat no play is commonly found in SunSmart policies, anecdotal evidence shows that this guideline could be better implemented. This study aims to document the proportions of children and adults at schools observed actually wearing hats.\ud \ud Methods:\ud On 6 separate days from April to June 2012, 2 trained volunteer observers drove to a convenience sample of 71 schools in Western Brisbane and conducted observations from the road for time periods ranging from 1 to 20 minutes during the following: walking into school grounds, before school, late arrivals, morning tea, lunch break, PE lesson, outdoor lesson, in the school yard, excursion, and at the bus stop.\ud \ud Results:\ud Of the 71 schools, 57.7% were public schools. 94.4% were co-educational. 90.1% were primary only and 4.2 % were secondary only. 71.5% of children, 33.5% of adults and 15% of siblings were wearing hats overall and 71.6%, 45.9% and 20% of siblings were wearing a hat of some kind. \ud \ud Conclusion:\ud According to this preliminary data, implementation of hat wearing policies in Brisbane schools could be improved. Adult role modelling of hat wearing and of using hats on students' siblings is an area where more public health education is needed. Further observational studies are needed

Don't burn the baby: advice from Australian nurses recommending therapeutic sun exposure during infancy

Background / Aims: To investigate inappropriate nursing advice advocating therapeutic sun exposure post-partum and during the first year of life. \ud \ud Methods: Questionnaires were completed by 363 nurses (57.2% response) responsible for the care of post-partum women in 11 maternity hospitals in Queensland (QLD) and the Australian Capital Territory ACT).\ud \ud Results: A high proportion of nurses reported holding risky beliefs about the therapeutic benefits of sun exposure, including the treatment of: cracked nipples (QLD 41%, ACT 66%), neonatal jaundice (QLD 50%, ACT 75%), nappy rash (QLD 23%, ACT 17%) and acne (QLD 12%, ACT 30%) and made recommendations consistent with their beliefs. Relatively few nurses stipulated sunning through glass or specified exposure time limits. Approximately 40% of respondents thought people generally looked healthier with a suntan, and 79% [95% CI: 74.4% - 82.8%] of these respondents also had one or more risky beliefs about therapeutic sun exposure. Nursing staff in obstetric and post-natal wards working in public hospitals in Queensland were significantly more likely than nursing staff in private hospitals in Queensland to have one or more risky beliefs about therapeutic sun exposure (p=0.008). However, being born in Queensland was borderline (p=0.08) protective against having one or more risky beliefs about therapeutic sun exposure. \ud \ud Conclusion: As mothers are likely to intentionally expose their babies or themselves to sunlight if advised to do so by nursing staff, professional education is needed to change the beliefs and practices of those who make such recommendations, which could increase children's future risk of skin cancer

N-of-1 Trials in Healthcare

Interest in N-of-1 trials and single-case designs is increasing worldwide, particularly due to the movement towards personalised medicine and patient-centred healthcare [...

An observational study of sub-protective behaviour at an outdoor spectator sporting event in tropical Queensland, Australia

Background/Aims: Queensland has the highest rate of skin cancer in the world. Aims To describe the prevalence of observed sun-protection behaviours of a high-risk population in tropical Queensland engaged in outdoor leisure activity. \ud \ud Methods: Unobtrusive observations of clothing worn by 457 attendees at the Supercar Championship in Townsville, Queensland, Australia were conducted in an unshaded area around solar noon, in July 2009. \ud \ud Results: Caps were the most popular hat choice. More children (45.1%) than adults (27.1%) wore wide-brimmed/legionnaires/ bucket hats (p=0.007). Many women (35.3%), girls (26.3%), men (24.5%) and boys (18.8%) wore no hat. More females than males wore no hat (p=0.016). More women (17.4%) than men (6.6%) wore full-length sleeves (p=0.001). Short-sleeve shirts were worn by 90% of men and 55% of women. A further 28% of women wore sleeveless/cap-sleeved shirts (p<0.0005). More girls (27.7%) than boys (3%) wore sleeveless/cap-sleeved shirts. More boys (87.9%) than girls (61.1%) wore short-sleeves (p=0.037). Full-length sleeves were equally uncommon among boys (9.1%) and girls (11.1%;\ud p=1). \ud \ud Conclusion: Observed sun protection behaviours were inadequate to protect spectators from over-exposure to ultraviolet radiation and risk of skin cancer