A content analysis of the tweets of e-cigarette proponents in Australia.

ISSUE ADDRESSED: Social media sites have become platforms for public discourse on e-cigarettes, providing proponents with an opportunity to disseminate favourable information about the devices. Research examining the information being presented by Australian proponents of e-cigarettes is limited. Accordingly, this study explored the Twitter feeds of Australian proponents of e-cigarettes to determine the nature of the e-cigarette-related content being disseminated. METHODS: All publicly available e-cigarette-related tweets and retweets (n = 1397) disseminated over a 15-week period by five Australian e-cigarette proponents were captured and analysed. RESULTS: The main topics covered in the 1397 tweets analysed related to (a) criticism of the arguments made by public health agencies/advocates who oppose e-cigarettes (29%), (b) Australian e-cigarette policy (19%), (c) the health risks of e-cigarettes (16%) and (d) the efficacy of e-cigarettes as smoking cessation aids (13%). Proponents argued that the precautionary principle adopted by public health agencies/advocates lacks an appropriate evidence base and that legalising e-cigarettes would reduce smoking rates and smoking-related harm. Proponents minimised the risks associated with e-cigarette use and only presented evidence indicating that use facilitates smoking cessation. CONCLUSIONS: The assessed tweets have the potential to reduce the public's trust in the information being presented by authoritative public health agencies/advocates. The dissemination of information downplaying the health risks associated with e-cigarettes may distort perceptions of the devices. SO WHAT?: To assist tobacco control efforts, results highlight the need for (a) ongoing surveillance of the tweets of e-cigarette proponents and (b) provision of evidence-based counterarguments on social media.

The association between childhood trauma and overweight and obesity in young adults: the mediating role of food addiction.

PURPOSE: Childhood trauma is associated with increased risk of obesity during adulthood, which may be associated with the development of food addiction. This study examined whether food addiction mediated the relationship between childhood trauma and obesity in young adults. METHODS: A sample of 512 young adults, aged 18 to 30 years, living with overweight and obesity (Body Mass Index ≥ 25 kg/m2), from the United Kingdom participated in the study. Participants completed the Childhood Trauma Questionnaire (CTQ), the Yale Food Addiction Scale, and provided their current height and weight to compute their Body Mass Index (BMI). RESULTS: Using the PROCESS macro, a mediation analysis found that food addiction accounted for 45% of variance in the relationship between childhood trauma and BMI. Post hoc analyses were conducted to examine the mediating effect of food addiction across each of the five subscales of the CTQ (emotional/physical/sexual abuse and emotional/physical neglect). Food addiction accounted for 32% to 51% of the variance in the relationship between each CTQ subscale and BMI. CONCLUSIONS: These findings suggest that experiences of childhood trauma are associated with the development of overweight and obesity during early adulthood and up to half of this relationship can be attributed to food addiction, which is likely used as a maladaptive coping mechanism in response to trauma. Young adults living with overweight and obesity who report experiences of childhood trauma may benefit from the support of clinical and counselling psychologists to improve their understanding of the underlying psychosocial factors that influence their eating behaviours. LEVEL OF EVIDENCE: Level V, cross-sectional analytic study.

The perceived effect of parental cancer on children still living at home: According to oncology health professionals.

OBJECTIVE: How children are affected by their parent's diagnosis is limited in the literature, and children are typically not considered in current clinical practice. Despite suggestion that the patient's oncology team are well placed to support their children, this is yet to be sufficiently explored. This study aimed to explore how oncology healthcare professionals (HPs) perceive children are affected by a parent's diagnosis of cancer. METHODS: This qualitative study was informed by principles of grounded theory and embedded within a social constructivist framework. 15 health professionals working in oncology were interviewed using a semi-structured format. Data were analysed using methods of constant comparison. RESULTS: From the perspective of HPs, when a parent is diagnosed with cancer, their dependent children are rendered invisible. Factors within the (a) clinical healthcare system and (b) the families' psychosocial context were identified, which contribute to the invisibility of children. CONCLUSION: HPs are well-placed to facilitate an entry point into the healthcare system for patients' children; however, this is not occurring due to children's lack of visibility. Clinical and psychosocial barriers need to be addressed to ensure HPs are visibly aware of all children and thus able to appropriately support, intervene or refer on.

Learning words without trying: Daily second language podcasts support word-form learning in adults.

Spoken language contains overlapping patterns across different levels, from syllables to words to phrases. The discovery of these structures may be partially supported by statistical learning (SL), the unguided, automatic extraction of regularities from the environment through passive exposure. SL supports word learning in artificial language experiments, but few studies have examined whether it scales up to support natural language learning in adult second language learners. Here, adult English speakers (n = 70) listened to daily podcasts in either Italian or English for 2 weeks while going about their normal routines. To measure word knowledge, participants provided familiarity ratings of Italian words and nonwords both before and after the listening period. Critically, compared with English controls, Italian listeners significantly improved in their ability to discriminate Italian words and nonwords. These results suggest that unguided exposure to natural, foreign language speech supports the extraction of relevant word features and the development of nascent word forms. At a theoretical level, these findings indicate that SL may effectively scale up to support real-world language acquisition. These results also have important practical implications, suggesting that adult learners may be able to acquire relevant speech patterns and initial word forms simply by listening to the language. This form of learning can occur without explicit effort, formal instruction or focused study.

The Psychosocial Effect of Parental Cancer: Qualitative Interviews with Patients' Dependent Children.

BACKGROUND: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent's diagnosis is still developing and patients' children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent's cancer diagnosis, from children's perspectives. METHODS: Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. RESULTS: Findings indicate that patients' children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent's cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. CONCLUSIONS: Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children's ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice.

A Conceptual Model Depicting How Children Are Affected by Parental Cancer: A Constructivist Grounded Theory Approach.

Cancer patients' children are vulnerable to psychosocial and behavioural issues. The mechanisms underlying how children are affected by their parent's diagnosis are unknown, warranting further research. This study investigated how children are affected by their parent's cancer diagnosis and provides a theoretical model conceptualising this experience. Informed by methods of grounded theory, embedded within a social constructivist framework, 38 informants (15 health professionals (HPs); 11 parents; 12 children (5 to 17 years)) were interviewed using a semi-structured format. Three themes were identified: (i) children were worried and distressed because they felt alone, (ii) parents were unable to tend to children's needs because they were overwhelmed by practical factors, and (iii) HPs were not detecting children due to barriers that affected their visibility in clinical settings. The proposed Alexander's Children's Cancer Communication (ACCC) Model and clinical recommendations made can be used to guide the clinical practice and development of future intervention research.

Dorsal penile nerve block for male pediatric circumcision--randomized comparison of ultrasound-guided vs anatomical landmark technique.

BACKGROUND: Dorsal penile nerve block (DPNB) is a commonly performed regional anesthetic technique for male circumcision. Traditionally, DPNB is based on an anatomical landmark technique. Recently, an ultrasound-guided technique for DPNB has been described. OBJECTIVES: The aim of our study was to compare the anatomical landmark technique with this ultrasound-guided technique. The hypothesis to be tested was that ultrasound guidance of DPNB would lead to less administration of opioid when compared to the anatomical landmark technique. METHODS: Boys of ASA status I/II scheduled for day case circumcision were prospectively recruited and randomized. DPNB was performed under general anesthesia using the anatomical landmark technique or ultrasound guidance. Fentanyl was administered intraoperatively and immediately postoperatively if patients demonstrated signs of pain. Similarly, oral codeine was given prior to discharge if required. The primary outcome measure was the number of patients requiring fentanyl. Secondary outcome measures included initial pain score on emergence from general anesthesia, requirement for codeine predischarge, and time to perform block. RESULTS: A total of 32 patients were recruited to the landmark group and 34 to the ultrasound group. There was no significant difference between the two groups in terms of fentanyl administration. The ultrasound technique took longer to perform but was associated with a reduction in codeine requirement prior to discharge. CONCLUSIONS: This study does not support the routine use of ultrasound for the performance of DPNB in male pediatric circumcision. Nonetheless, an associated reduction in codeine administration postoperatively suggests some benefit in terms of postoperative pain.

Weight bias among health care professionals: A systematic review and meta-analysis.

OBJECTIVE: Weight-biased attitudes and views held by health care professionals can have a negative impact on the patient-provider relationship and the provision of care, but studies have found mixed results about the extent and nature of bias, which warrants a review of the evidence. METHODS: A systematic review and random-effects meta-analysis were conducted by including studies up to January 12, 2021. RESULTS: A total of 41 studies met inclusion criteria, with 17 studies providing sufficient data to be meta-analyzed. A moderate pooled effect (standardized mean difference = 0.66; 95% CI: 0.37-0.96) showed that health care professionals demonstrate implicit weight bias. Health care professionals also report explicit weight bias on the Fat Phobia Scale, Antifat Attitudes Scale, and Attitudes Towards Obese Persons Scale. Findings show that medical doctors, nurses, dietitians, psychologists, physiotherapists, occupational therapists, speech pathologists, podiatrists, and exercise physiologists hold implicit and/or explicit weight-biased attitudes toward people with obesity. A total of 27 different outcomes were used to measure weight bias, and the overall quality of evidence was rated as very low. CONCLUSIONS: Future research needs to adopt more robust research methods to improve the assessment of weight bias and to inform future interventions to address weight bias among health care professionals.

A systematic review of the current interventions available to support children living with parental cancer.

OBJECTIVE: Children living with parental cancer are vulnerable to distress and developmental disruption. This review aims to identify current interventions to support cancer patients' children and summarise how effective these are based on children's reports. METHODS: Between 25 May 2015 and 6 August 2018, a broad search strategy was used to identify relevant references. Seven databases were searched, and grey literature was also vetted. This review was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane guidelines. RESULTS: Eight studies evaluating six interventions were retained. Research designs and interventions were heterogenous, and study quality was low. A limited number of significant results were reported by studies. These evidenced improvement for PTSD symptoms, emotional regulation, and depression. However, overall current interventions do not appear effective among patients' children. CONCLUSION: Despite encouraging preliminary findings, interventions do not yet adequately support cancer patients' children. There is a need for more tailored and targeted interventions. A theoretical model conceptualising the impact of parental cancer may assist this. PRACTICE IMPLICATIONS: Findings will assist future intervention research by promoting standardised levels of care among cancer patients' children, that is empirically supported, effective, and meets principles of non-maleficence.