Investigating the reciprocal temporal relationships between tobacco consumption and psychological disorders for youth: an international review.

OBJECTIVE: To investigate reciprocal temporal relationships between tobacco consumption and psychological disorders for youth.Design: Review DATA SOURCES: Five databases (PubMed, Embase, Scopus, CINAHL and PsycINFO) on 26 September 2019 and updated on 11 May 2021, indexing tobacco, mental illness and longitudinal.Study selection: Methods used consensus and multiple reviewers. INTERVENTIONS: Cohort studies (n=49) examining tobacco and selected psychological disorders (depression, anxiety, bipolar, psychosis, borderline personality disorder) among youth, and systematic reviews (n=4) of these relationships met inclusion criteria. PRIMARY AND SECONDARY OUTCOME MEASURES: Effect of tobacco on psychological disorders and effect of psychological disorders on tobacco. DATA EXTRACTION AND SYNTHESIS: Independent extraction by the first author and checked by final author. Joanna Briggs Institute Critical Appraisal Tools were used for all studies.Included studies had moderate-to-high appraisal scores. We synthesised findings using vote counting for effect direction and descriptive data. RESULTS: Fifty-three studies were included in the review. Thirteen of 15 studies showed a positive effect direction of tobacco on depression (p<0.001). Six of 12 studies showed a positive effect direction of depression on tobacco (p=0.016). Six of eight studies showed a positive effect direction of tobacco on anxiety (p=0.016). Eleven of 18 studies showed a positive effect direction of anxiety on tobacco (p=0.003). No effect between tobacco and bipolar, or tobacco and psychosis was found. No studies examined tobacco and borderline personality disorder. CONCLUSIONS: Reciprocal relationships existed between tobacco and both depression and anxiety for youth, though causality is unconfirmed. No positive effect direction was found between tobacco and psychosis, perhaps because nicotine has conflicting effects on psychosis. For other relationships examined, evidence was weak because of low number of studies. More research to inform prevention and early intervention is needed. PROSPERO REGISTRATION NUMBER: CRD42020150457.

A population-level analysis of changes in Australian smokers' preferences for smoking cessation support over two decades - from 1998 to 2017.

BACKGROUND: Encouraging and assisting smokers to quit remains a key public health goal. Government and commercial initiatives have nudged smokers towards supported cessation. We tracked long-term trends in Australian smokers' quit attempt methods across 20 years. METHODS: Data from 11,917 smokers were collected from an annual, cross-sectional, face-to-face, random and representative population survey. The survey measured demographic characteristics, tobacco use, recent quit attempts, nicotine dependence, quit intentions, and recent methods used when attempting to quit. Quit attempt preferences were analysed over time and by smoker characteristics. FINDINGS: Each year, more smokers attempted to quit than remained quit, with a stable trend over time. Socioeconomic disadvantage and mental health conditions are more likely among smokers, but there was no difference in quit attempts by these characteristics. Quit attempts have risen among those aged 60 years and over whereas other age groups have remained stable. Although trending downwards, unassisted quitting remained the most common method: 1998: 61% and 2017: 40%. Asking a doctor for help/advice (34%) was the most common assisted method in 2017, increasing from 18% in 1998. Methods of quitting varied by smoker characteristics, with supported methods used more often by older, more dependent, socio-economically disadvantaged smokers and those with a mental health condition. INTERPRETATION: The relative stability of recent quit attempts, persistence in unassisted quitting, and fluctuating preferences for supported cessation methods indicate that it is important for clinicians and policy makers to continue to support quit attempts through a variety of options, tailored to smoker's needs.

Evaluation of an intervention to train health professionals working with Aboriginal and Torres Strait Islander people to provide smoking cessation advice.

OBJECTIVE: To investigate the effectiveness and cultural relevance of Quitskills training tailored for health professionals working with Aboriginal and Torres Strait Islander people who smoke. METHODS: A retrospective analysis was conducted with data collected from 860 participants (54% Aboriginal and Torres Strait Islander participants) in tailored Quitskills training from 2012 to 2016. Course participants took part in a survey at pre-training, post-training and four-six weeks post-training to assess confidence in skills to address tobacco, and perceptions of the strengths, areas for improvement and cultural relevance of the training. RESULTS: Confidence in skills and knowledge to address tobacco increased significantly from pre- to post-training (all indicators of confidence in skills increased p<0.001) and remained high at follow-up. Tailored Quitskills training was perceived as being culturally relevant by Aboriginal and Torres Strait Islander participants, and the training facilitators were the most commonly cited strength of the training. CONCLUSIONS: Quitskills is an appropriate course for increasing skills and confidence among health professionals working with Aboriginal and Torres Strait Islander people who smoke. Implications for public health: Training courses that are tailored for Aboriginal and Torres Strait Islander people can build the capacity of the health workforce in a culturally relevant manner.

Barriers and facilitators for health professionals referring Aboriginal and Torres Strait Islander tobacco smokers to the Quitline.

OBJECTIVE: To examine the barriers and facilitators among health professionals to providing referrals to Quitline for Aboriginal and Torres Strait Islander clients who smoke. METHODS: A brief online survey, based on the Theoretical Domains Framework, was completed by 34 health professionals who work with Aboriginal and Torres Strait Islander people in South Australia and the Northern Territory. RESULTS: Respondents who frequently made referrals had higher domain scores than less frequent referrers for 'Skills and knowledge' (M=4.44 SD=0.39 vs. M=4.09 SD=0.47, p<0.05) and 'beliefs about capabilities' (M=4.33 SD=0.44 vs. M=3.88 SD=0.42, p<0.01). Barriers to providing referrals to Quitline were lack of client access to a phone, cost of a phone call, preference for face-to-face interventions, and low client motivation to quit. CONCLUSIONS: Health professionals working with Aboriginal and Torres Strait Islander clients should be supported to build their skills and confidence to provide referrals to Quitline and other brief cessation interventions. Building capacity for face-to-face support locally would be beneficial where phone support is not preferable. Implications for public health: Engaging with health professionals who work with Aboriginal and Torres Strait Islander people to increase referrals to Quitline is strategic as it builds on their existing capacity to provide cessation support.

Staff and patient perspectives of a smoke-free health services policy in South Australia: A state-wide implementation.

Few jurisdictions have implemented and evaluated a complete smoking ban across all health sites in their jurisdiction, with no designated smoking areas. This article examines staff and patient perceptions and experiences of a mandated smoke-free policy implemented across all government health facilities in South Australia, including mental health sites. An online survey of health staff was conducted prior to policy implementation (n=3098), 3 months post-implementation (n=2673) and 15 months post-implementation (n=2890). Consumer experiences of the policy were assessed via a telephone survey (n=1722; smokers n=254). Staff support for the policy was high across all time points. Two thirds of staff reported having witnessed some policy non-compliance, and self-reported exposure to second-hand smoke was comparable pre-implementation to 15 months post-implementation. Under the policy, 56.3% of smoking patients abstained completely whilst hospitalised and 37.6% cut down the amount that they smoked. Furthermore, 34.7% reported having been offered cessation support during hospitalisation. Whilst the smoke-free policy was viewed positively and had benefits for staff and patients, reports of witnessing some non-compliance were prevalent. While the extent of non-compliance is not known, and the measure used was sensitive, complementary strategies may be needed to reduce exposure to second-hand smoke, particularly at entrances. Health-care staff should be further encouraged to offer support to nicotine-dependent patients to foster compliance and promote abstinence during hospitalisation.

Barriers to Seeking Help for Skin Cancer Detection in Rural Australia.

This study explores rural South Australians' barriers to help-seeking for skin cancer detection. A total of 201 randomly selected rural adults (18-94 years, 66% female) were presented with a skin-cancer-related scenario via telephone and were asked the extent to which various barriers would impede their help-seeking, based on an amended version of the Barriers to Help-Seeking Scale. Older (≥63 years) and less educated participants endorsed barriers more strongly than their younger, more educated counterparts in the following domains; "Concrete barriers and distrust of caregivers", "Emotional control", "Minimising problem and Normalisation", "Need for control and self-reliance" (every domain other than "Privacy"). Socioeconomic disadvantage, gender, and farmer status did not predict stronger overall barriers, but some gender and occupation-related differences were detected at the item level. Farmers were also more likely to endorse the "Minimising problem and normalization" domain than their non-farmer working rural counterparts. Widely endorsed barriers included the tendency to minimise the problem, a desire to remain in control/not be influenced by others, reluctance to show emotion or complain, and having concerns about privacy or waiting times.

Are tool properties always processed automatically? The role of tool use context and task complexity.

Previous work with healthy adults supports the idea that perception of the orientation of a tool's handle may automatically activate cognitive components for grasping and use. An important source of evidence for this automatic activation view comes from studies showing interference when automatically activated action representations are inconsistent with the behaviors demanded by a task (e.g., Tucker and Ellis, 1998). Here, we evaluated whether such effects occur in a grip selection task in which responses were chosen based on a learned rule (Rule task) versus anticipatory planning (Plan task). Participants were asked to pantomime grasping horizontally presented objects with handles. In the Rule task, a color cue indicated on which side of the tool's handle the thumb had to be placed. In the Plan task, participants had to choose the most comfortable way to grasp and rotate the object into a specific end-position. Across three experiments we found evidence of interference on grip selection exclusively during the Rule task, and only when it was preceded by a prime task that involved tool use. These findings suggest that prior activation of cognitive components through use of tools can be effective over time and interferes with grip selection based on use of a pre-learned rule. Absence of interference effects during the plan task, even when preceded by the Use task, suggest that engagement of similar mechanisms during active planning overwrites this automatic activation of previously effective components. Possible cognitive and neural mechanisms are discussed.

Expectations can modulate the frequency and timing of multiple saccades: a TMS study.

This study was undertaken to determine if target predictability could modulate saccadic planning and timing at the level of the frontal eye fields (FEF). To this end, healthy participants performed two gap saccade tasks in which the targets were displaced left or right of the midline in either a predictable or a random fashion. Additionally, half of the participants were informed about this manipulation. Single pulse transcranial magnetic stimulation (TMS) was applied to the left FEF before, during, or after the target onset. We examined both the saccade latency and the frequency of multiple saccades (MS) (i.e., saccades that covered <90 % of the distance to the target and were subsequently followed by a corrective saccade). Findings revealed that saccadic reaction times were quickest to the more predictable target side and also confirmed that MS were released more quickly than single saccades. Further, the frequency of MS differed between target locations; higher frequencies of MS were found on the unpredictable side, showing more vulnerability to TMS disruption. In conclusion, we have demonstrated that target predictability modulates saccade planning and that this modulation takes place at least in part in the FEF. The influence of FEF in these processes is observed both in the latencies with which saccades are executed and in the timing and characteristics of the multiple saccades that are observed under different task constraints. Finally, the timing of the FEF contribution also appears to be influenced by the manipulation of target predictability. Each of these observations serves to further clarify the role of the human FEF in saccade planning.

Handedness-dependent and -independent cerebral asymmetries in the anterior intraparietal sulcus and ventral premotor cortex during grasp planning.

When planning grasping actions, right-handers show left-lateralized responses in the anterior intraparietal sulcus (aIPS) and ventral premotor cortex (vPMC), two areas that are also implicated in sensorimotor control of grasp. We investigated whether a similar cerebral asymmetry is evident in strongly left-handed individuals. Fourteen participants were trained to grasp an object appearing in a variety of orientations with their left and right hands and with a novel mechanical tool (operated with either hand). BOLD fMRI data were then acquired while they decided prospectively whether an over- or under-hand grip would be most comfortable for grasping the same stimulus set while remaining still. Behavioral performances were equivalent to those recorded previously in right-handers and indicated reliance on effector-specific internal representations. In left-handers, however, grip selection decisions for both sides (left, right) and effectors (hand, tool) were associated with bilateral increases in activity within aIPS and vPMC. A direct comparison between left- and right-handers did reveal equivalent increases in left vPMC regardless of hand dominance. By contrast, aIPS and right vPMC activity were dependent on handedness, showing greater activity in the motor-dominant hemisphere. Though showing bilateral increases in both left- and right-handers, greater increases in the motor dominant hemisphere were also detected in the caudal IPS (cIPS), superior parietal lobule (SPL) and dorsal premotor cortex (dPMC). These findings provide further evidence that regions involved in the sensorimotor control of grasp also participate in grasp planning, and that for certain areas hand dominance is a predictor of the cerebral organization of motor cognitive functions.

Multiple cytokines regulate the NK gene complex-encoded receptor repertoire of mature NK cells and T cells.

Mature NK cells comprise a highly diverse population of lymphocytes that express different permutations of receptors to facilitate recognition of diseased cells and perhaps pathogens themselves. Many of these receptors, such as those belonging to the NKRP1, NKG2, and Ly49 families are encoded in the NK gene complex (NKC). It is generally thought that these NKC-encoded receptors are acquired by a poorly understood stochastic mechanism, which operates exclusively during NK cell development, and that following maturation the repertoire is fixed. However, we report a series of observations that demonstrates that the mature NK cell repertoire in mice can in fact be radically remodeled by multiple cytokines. Thus, both IL-2 and IL-15 selectively induce the de novo expression of Ly49E on the majority of mature NK cells. By contrast, IL-4 not only blocks this IL-2-induced acquisition of Ly49E, but reduces the proportion of mature NK cells that expresses pre-existing Ly49 receptors and abrogates the expression of NKG2 receptors while leaving the expression of several NKRP1 receptors unaltered. IL-21 also abrogates NKG2 expression on mature NK cells and selectively down-regulates Ly49F. IL-4 and IL-21 additionally cause dramatic and selective alterations in the NKC-encoded receptor repertoire of IL-2-activated T cells but these are quite different to the changes induced on NK cells. Collectively these findings reveal an unexpected aspect of NKC receptor expression that has important implications for our understanding of the function of these receptors and of the genetic mechanisms that control their expression.