Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke

Background Children's exposure to other people's cigarette smoke (environmental tobacco smoke, or ETS) is associated with a range of adverse health outcomes for children. Parental smoking is a common source of children's exposure to ETS. Older children are also at risk of exposure to ETS in child care or educational settings. Preventing exposure to cigarette smoke in infancy and childhood has significant potential to improve children's health worldwide. Objectives To determine the effectiveness of interventions aiming to reduce exposure of children to ETS. Search methods We searched the Cochrane Tobacco Addiction Group Specialized Register and conducted additional searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsycINFO, EMBASE, CINAHL, ERIC, and The Social Science Citation Index & Science Citation Index (Web of Knowledge). Date of the most recent search: September 2013. Selection criteria Controlled trials with or without random allocation. Interventions must have addressed participants (parents and other family members, child care workers and teachers) involved with the care and education of infants and young children (aged 0 to 12 years). All mechanisms for reduction of children's ETS exposure, and smoking prevention, cessation, and control programmes were included. These include health promotion, social-behavioural therapies, technology, education, and clinical interventions. Data collection and analysis Two authors independently assessed studies and extracted data. Due to heterogeneity of methodologies and outcome measures, no summary measures were possible and results were synthesised narratively. Main results Fifty-seven studies met the inclusion criteria. Seven studies were judged to be at low risk of bias, 27 studies were judged to have unclear overall risk of bias and 23 studies were judged to have high risk of bias. Seven interventions were targeted at populations or community settings, 23 studies were conducted in the 'well child' healthcare setting and 24 in the 'ill child' healthcare setting. Two further studies conducted in paediatric clinics did not make clear whether the visits were to well or ill children, and another included both well and ill child visits. Thirty-six studies were from North America, 14 were in other high income countries and seven studies were from low- or middle-income countries. In only 14 of the 57 studies was there a statistically significant intervention effect for child ETS exposure reduction. Of these 14 studies, six used objective measures of children's ETS exposure. Eight of the studies had a high risk of bias, four had unclear risk of bias and two had a low risk of bias. The studies showing a significant effect used a range of interventions: seven used intensive counselling or motivational interviewing; a further study used telephone counselling; one used a school-based strategy; one used picture books; two used educational home visits; one used brief intervention and one study did not describe the intervention. Of the 42 studies that did not show a significant reduction in child ETS exposure, 14 used more intensive counselling or motivational interviewing, nine used brief advice or counselling, six used feedback of a biological measure of children's ETS exposure, one used feedback of maternal cotinine, two used telephone smoking cessation advice or support, eight used educational home visits, one used group sessions, one used an information kit and letter, one used a booklet and no smoking sign, and one used a school-based policy and health promotion. In 32 of the 57 studies, there was reduction of ETS exposure for children in the study irrespective of assignment to intervention and comparison groups. One study did not aim to reduce children's tobacco smoke exposure, but rather aimed to reduce symptoms of asthma, and found a significant reduction in symptoms in the group exposed to motivational interviewing. We found little evidence of difference in effectiveness of interventions between the well infant, child respiratory illness, and other child illness settings as contexts for parental smoking cessation interventions. Authors' conclusions While brief counselling interventions have been identified as successful for adults when delivered by physicians, this cannot be extrapolated to adults as parents in child health settings. Although several interventions, including parental education and counselling programmes, have been used to try to reduce children's tobacco smoke exposure, their effectiveness has not been clearly demonstrated. The review was unable to determine if any one intervention reduced parental smoking and child exposure more effectively than others, although seven studies were identified that reported motivational interviewing or intensive counselling provided in clinical settings was effective

Impact of energy limitations on function and resilience in long-wavelength Photosystem II

Photosystem II (PSII) uses the energy from red light to split water and reduce quinone, an energy-demanding process based on chlorophyll a (Chl-a) photochemistry. Two types of cyanobacterial PSII can use chlorophyll d (Chl-d) and chlorophyll f (Chl-f) to perform the same reactions using lower energy, far-red light. PSII from Acaryochloris marina has Chl-d replacing all but one of its 35 Chl-a, while PSII from Chroococcidiopsis thermalis, a facultative far-red species, has just 4 Chl-f and 1 Chl-d and 30 Chl-a. From bioenergetic considerations, the far-red PSII were predicted to lose photochemical efficiency and/or resilience to photodamage. Here, we compare enzyme turnover efficiency, forward electron transfer, back-reactions and photodamage in Chl-f-PSII, Chl-d-PSII, and Chl-a-PSII. We show that: (i) all types of PSII have a comparable efficiency in enzyme turnover; (ii) the modified energy gaps on the acceptor side of Chl-d-PSII favour recombination via PD1+Phe- repopulation, leading to increased singlet oxygen production and greater sensitivity to high-light damage compared to Chl-a-PSII and Chl-f-PSII; (iii) the acceptor-side energy gaps in Chl-f-PSII are tuned to avoid harmful back reactions, favouring resilience to photodamage over efficiency of light usage. The results are explained by the differences in the redox tuning of the electron transfer cofactors Phe and QA and in the number and layout of the chlorophylls that share the excitation energy with the primary electron donor. PSII has adapted to lower energy in two distinct ways, each appropriate for its specific environment but with different functional penalties

Factors affecting consistency and accuracy in identifying modern macroperforate planktonic foraminifera

Planktonic foraminifera are widely used in biostratigraphic, palaeoceanographic and evolutionary studies, but the strength of many study conclusions could be weakened if taxonomic identifications are not reproducible by different workers. In this study, to assess the relative importance of a range of possible reasons for among-worker disagreement in identification, 100 specimens of 26 species of macroperforate planktonic foraminifera were selected from a core-top site in the subtropical Pacific Ocean. Twenty-three scientists at different career stages – including some with only a few days experience of planktonic foraminifera – were asked to identify each specimen to species level, and to indicate their confidence in each identification. The participants were provided with a species list and had access to additional reference materials. We use generalised linear mixed-effects models to test the relevance of three sets of factors in identification accuracy: participant-level characteristics (including experience), species-level characteristics (including a participant’s knowledge of the species) and specimen-level characteristics (size, confidence in identification). The 19 less experienced scientists achieve a median accuracy of 57 %, which rises to 75 % for specimens they are confident in. For the 4 most experienced participants, overall accuracy is 79 %, rising to 93 % when they are confident. To obtain maximum comparability and ease of analysis, everyone used a standard microscope with only 35× magnification, and each specimen was studied in isolation. Consequently, these data provide a lower limit for an estimate of consistency. Importantly, participants could largely predict whether their identifications were correct or incorrect: their own assessments of specimen-level confidence and of their previous knowledge of species concepts were the strongest predictors of accuracy

Social and Behavioural Correlates of High Physical Activity Levels among Aboriginal Adolescent Participants of the Next Generation: Youth Wellbeing Study

Physical activity typically decreases during teenage years and has been identified as a health priority by Aboriginal adolescents. We examined associations between physical activity levels and sociodemographic, movement and health variables in the Aboriginal led ‘Next Generation: Youth Well-being (NextGen) Study’ of Aboriginal people aged 10–24 years from Central Australia, Western Australia and New South Wales. Baseline survey data collected by Aboriginal researchers and Aboriginal youth peer recruiters from 2018 to 2020 examined demographics and health-related behaviours. Logistic regression was used to estimate odds ratios (OR) for engaging in high levels of physical activity in the past week (3–7 days; 0–2 days (ref), or ‘don’t remember’) associated with demographic and behavioural factors. Of 1170 adolescents, 524 (41.9%) had high levels of physical activity; 455 (36.4%) had low levels; 191 (15.3%) did not remember. Factors independently associated with higher odds of physical activity 3–7 days/week were low weekday recreational screen time [55.3% vs. 44.0%, OR 1.79 (1.16–2.76)], having non-smoking friends [50.4% vs. 25.0%, OR 2.27 (1.03–5.00)] and having fewer friends that drink alcohol [48.1% vs. 35.2%, OR 2.08 (1.05–4.14)]. Lower odds of high physical activity were independently associated with being female [40.2% vs. 50.9%, OR 0.57 (0.40–0.80)] and some findings differed by sex. The NextGen study provides evidence to inform the co-design and implementation of strategies to increase Aboriginal adolescent physical activity such as focusing on peer influences and co-occurring behaviours such as screen time

Two Centuries of Relative Sea-Level Rise in Dublin, Ireland, Reconstructed by Geological Tide Gauge

We demonstrate the utility and reproducibility of the saltmarsh foraminifera-based ‘geological tide gauge’ (GTG) approach by developing two independent records of relative sea-level (RSL) change for Dublin, Ireland. Our records, recovered from two different saltmarshes, indicate that RSL rose at a century-scale rate of 1.5 ± 0.9 mm yr–1 over the last 200 years. This compares favourably with the shorter, but more precise, mean sea level (MSL) record from the Dublin Port tide gauge, which indicates long-term (1953–2016 CE) rise at a rate of 1.1 ± 0.5 mm yr–1. When corrected for the influence of glacio-isostatic adjustment our saltmarsh-based reconstruction suggests sea levels in Dublin rose at a rate of 1.6 ± 0.9 mm yr–1 since the start of the 19th century, which is in excellent agreement with the regional value of MSL rise over the same period (1.5 ± 0.2 mm yr–1) calculated from a compilation of tide gauge records around Britain. Whilst our record has decadal-scale temporal resolution (1 sample every 8 years), we are currently unable to resolve multidecadal-scale variations in the rate of sea-level rise which are masked by the size of the vertical uncertainties (± 20 cm) associated with our reconstruction of palaeomarsh-surface elevation. We discuss the challenges of applying the GTG approach in the typically minerogenic saltmarshes of the NE Atlantic margin and outline potential solutions that would facilitate the production of Common Era RSL reconstructions in the region

Electronic cigarettes: A position statement from the Thoracic Society of Australia and New Zealand*

The TSANZ develops position statements where insufficient data exist to write formal clinical guidelines. In 2018, the TSANZ addressed the question of potential benefits and health impacts of electronic cigarettes (EC). The working party included groups focused on health impacts, smoking cessation, youth issues and priority populations. The 2018 report on the Public Health Consequences of E-Cigarettes from the United States NASEM was accepted as reflective of evidence to mid-2017. A search for papers subsequently published in peer-reviewed journals was conducted in August 2018. A small number of robust and important papers published until March 2019 were also identified and included. Groups identified studies that extended, modified or contradicted the NASEM report. A total of 3793 papers were identified and reviewed, with summaries and draft position statements developed and presented to TSANZ membership in April 2019. After feedback from members and external reviewers, a collection of position statements was finalized in December 2019. EC have adverse lung effects and harmful effects of long-term use are unknown. EC are unsuitable consumer products for recreational use, part-substitution for smoking or long-term exclusive use by former smokers. Smokers who require support to quit smoking should be directed towards approved medication in conjunction with behavioural support as having the strongest evidence for efficacy and safety. No specific EC product can be recommended as effective and safe for smoking cessation. Smoking cessation claims in relation to EC should be assessed by established regulators

Controls on variations in sedimentary deposits produced by a retreating ice stream grounding line

The majority of glaciers draining the Antarctic Peninsula Ice Sheet are thinning and retreating rapidly1. It is widely understood that these changes are driven by both a warming ocean and atmosphere. However, there are other mechanisms, including pinning points created by bathymetric highs and a reverse bed gradient, that are thought to have an important control on ice stream behaviour (Weertman, 1974; Jamieson et al., 2012). Our understanding of the interplay between these mechanisms and time-scales over which they are important is currently limited in time to the advent of satellite monitoring. By reconstructing the cause and style of ice stream retreat following the Last Glacial Maximum (LGM; 25-19 ka BP), it is possible to gain a greater insight into the mechanisms which drive glacier retreat (Ó Cofaigh et al., 2014). Sedimentary sequences deposited during the LGM and the subsequent deglaciation on polar continental shelves, provide an important archive of past changes (Ó Cofaigh et al., 2014). Previous studies have typically identified three sediment facies assemblages; sub-glacial, transitional and open marine (Ó Cofaigh et al., 2014; Domack et al., 1988; Smith et al., 2011). Transitional sediment facies are deposited at the grounding line and are often targeted for radiocarbon dating, as they represent the onset of glaciomarine sedimentation following the retreat of grounded ice (Domack et al., 1988; Smith et al., 2014; Heroy et al., 1996). Despite the development of depositional models to help explain the processes occurring at grounding lines (Powell et al., 1995 and 1996), there is still significant uncertainty about the temporal and spatial variations in grounding line sedimentation along and across a palaeo-ice stream trough. Here we use a multi-proxy approach (water content, shear strength, magnetic susceptibility, density, contents of biogenic opal, Total Organic Carbon and CaCO3, grain size distribution and X-radiographs) on marine sediment cores recovered from the Anvers-Hugo Palaeo-Ice Stream Trough (AHT), western Antarctic Peninsula shelf, to identify variability in transitional sediment facies deposited along and across the trough. We discuss possible controls on the variability in transitional sediment facies and how this is related to the rate and style of ice stream retreat. Our data reveal systematic variability in the types and volume of transitional sediments deposited during the last deglaciation of AHT. A detailed analysis of the transitional sediment facies shows that this variability reflects different phases of ice stream behaviour. Large volumes of ice proximal sediment facies recovered seawards of grounding zone wedges are indicative of episodes of grounding line still-stands. Re-advances of the grounding line, concurrent with a shallowing of the reverse bed gradient and a narrowing of the trough, appear to have occurred during the final stages of deglaciation. This is indicated by interlaminated ice-proximal and ice-distal sediment facies within inner shelf cores. Transitional sediment variability additionally captures the evolution of the ice stream during deglaciation, including the formation of a small ice shelf on the inner shelf. Keywords: Antarctic Peninsula, Last Glacial Maximum, ice stream, sediment cores References Cook, A. J., Holland, P. R., Meredith, M. P., Murray, T., Luckman, A. & Vaughan, D. G, 2016. Ocean forcing of glacier retreat in the western Antarctic Peninsula. Science, 353, 283-286. Weertman, J, 1974. Stability of the Junction of an Ice Sheet and an Ice Shelf. Journal of Glaciology, 13, 3-11. Jamieson, S. S. R., Vieli, A., Livingstone, S. J., Cofaigh, C. O., Stokes, C., Hillenbrand, C.-D. & Dowdeswell, J. A, 2012. Ice-stream stability on a reverse bed slope. Nature Geoscience, 5, 799-802. Ó Cofaigh, C., Davies, B. J., Livingstone, S. J., Smith, J. A., Johnson, J. S., Hocking, E. P., Hodgson, D. A., Anderson, J. B., Bentley, M. J., Canals, M., Domack, E., Dowdeswell, J. A., Evans, J., Glasser, N. F., Hillenbrand, C.-D., Larter, R. D., Roberts, S. J. & Simms, A. R, 2014. Reconstruction of ice-sheet changes in the Antarctic Peninsula since the Last Glacial Maximum. Quaternary Science Reviews, 100, 87-110. Domack, E. W. & Harris, P. T, 1998. A new depositional model for ice shelves, based upon sediment cores from the Ross Sea and the Mac. Robertson shelf, Antarctica. Annals of Glaciology, 27, 281-284. Smith, J. A., Hillenbrand, C.-D., Kuhn, G., Larter, R. D., Graham, A. G. C., Ehrmann, W., Moreton, S. G. & Forwick, M, 2011. Deglacial history of the West Antarctic Ice Sheet in the western Amundsen Sea Embayment. Quaternary Science Reviews, 30, 488-505. Smith, J. A., Hillenbrand, C.-D., Kuhn, G., Klages, J. P., Graham, A. G. C., Larter, R. D., Ehrmann, W., Moreton, S. G., Wiers, S. & Frederichs, T, 2014. New constraints on the timing of West Antarctic Ice Sheet retreat in the eastern Amundsen Sea since the Last Glacial Maximum. Global and Planetary Change, 122, 224-237. Heroy, D. C. & Anderson, J. B, 1996. Radiocarbon constraints on Antarctic Peninsula Ice Sheet retreat following the Last Glacial Maximum (LGM). Quaternary Science Reviews, 26, 3286-3297. Powell, R. D., Dawber, M., McInnes, J. N. & Pyne, A. R, 1996. Observations of the Grounding-line Area at a Floating Glacier Terminus. Annals of Glaciology, 22, 217-223. 1Powell, R. D. & Domack, E, 1995. Modern Glacimarine Environments. In: Glacial Environments, Volume 1 (ed. J Menzies). Butterworth-Heinemann, 445-486

'Next Generation Youth Well-being Study:' understanding the health and social well-being trajectories of Australian Aboriginal adolescents aged 10-24 years: study protocol

INTRODUCTION:Australian Aboriginal and/or Torres Strait Islander (hereafter referred to as 'Aboriginal') adolescents (10-24 years) experience multiple challenges to their health and well-being. However, limited evidence is available on factors influencing their health trajectories. Given the needs of this group, the young age profile of the Aboriginal population and the long-term implications of issues during adolescence, reliable longitudinal data are needed. METHODS AND ANALYSIS:The 'Next Generation: Youth Well-being Study' is a mixed-methods cohort study aiming to recruit 2250 Aboriginal adolescents aged 10-24 years from rural, remote and urban communities in Central Australia, Western Australia and New South Wales. The study assesses overall health and well-being and consists of two phases. During phase 1, we qualitatively explored the meaning of health and well-being for adolescents and accessibility of health services. During phase 2, participants are being recruited into a longitudinal cohort. Recruitment is occurring mainly through community networks and connections. At baseline, participants complete a comprehensive survey and undertake an extensive age relevant clinical assessment. Survey and clinical data will be linked to various databases including those relating to health services; medication; immunisation; hospitalisations and emergency department presentations; death registrations; education; child protection and corrective services. Participants will receive follow-up surveys approximately 2 years after their baseline visit. The 'Next Generation' study will fill important evidence gaps by providing longitudinal data on the health and social well-being of Aboriginal adolescents supplemented with narratives from participants to provide context. ETHICS AND DISSEMINATION:Ethics approvals have been sought and granted. Along with peer-reviewed publications and policy briefs, research findings will be disseminated via reports, booklets and other formats that will be most useful and informative to the participants and community organisations.Lina Gubhaju, Emily Banks, James Ward, Catherine D, Este, Rebecca Ivers ... Peter Azzopardi ... et al. (on behalf of the, Next Generation, investigator team

Health behaviours associated with healthy body composition among Aboriginal adolescents in Australia in the ‘Next Generation: Youth Well-being study’

OnlinePublThis study described the distribution of healthy body composition among Aboriginal adolescents in Australia aged 10–24 years and examined associations with health behaviours and self-rated health. Data were crosssectional from the ‘Next Generation: Youth Well-being study’ baseline (N = 1294). We used robust Poisson regression to quantify associations of self-reported health behaviours (physical activity, screen time, sleep, consumption of vegetables, fruit, soft drinks and fast food, and tobacco smoking and alcohol) and self-rated health to healthy body mass index (BMI) and waist/height ratio (WHtR). Overall, 48% of participants had healthy BMI and 64% healthy WHtR, with healthy body composition more common among younger adolescents. Higher physical activity was associated with healthy body composition (5–7 days last week vs none; adjusted prevalence ratio (aPR) healthy BMI 1.31 [95% CI 1.05–1.64], and healthy WHtR 1.30 [1.10–1.54]), as was recommended sleep duration (vs not; aPR healthy BMI 1.56 [1.19–2.05], and healthy WHtR 1.37 [1.13–1.67]). There was a trend for higher proportion of healthy body composition with more frequent fast food consumption. Healthy body composition was also associated with higher self-rated health (‘very good/excellent’ vs ‘poor/fair’; aPR healthy BMI 1.87 [1.45–2.42], and healthy WHtR 1.71 [1.40–2.10]). Culturally appropriate community health interventions with a focus on physical activity and sleep may hold promise for improving body composition among Aboriginal adolescents.Christopher D. McKay, Lina Gubhaju, Alison J. Gibberd, Bridgette J. McNamara, Rona Macniven, Grace Joshy, Robert Roseby, Robyn Williams, Aryati Yashadhana, Ted Fields, Bobby Porykali, Peter Azzopardi, Emily Banks, Sandra J. Eade

History of Anvers-Hugo Trough, western Antarctic Peninsula shelf, since the Last Glacial Maximum. Part I: Deglacial history based on new sedimentological and chronological data

Reconstructing the advance and retreat of past ice sheets provides important long-term context for recent change(s) and enables us to better understand ice sheet responses to forcing mechanisms and external boundary conditions that regulate grounding line retreat. This study applies various radiocarbon dating techniques, guided by a detailed sedimentological analyses, to reconstruct the glacial history of Anvers-Hugo Trough (AHT), one of the largest bathymetric troughs on the western Antarctic Peninsula (WAP) shelf. Existing records from AHT indicate that the expanded Antarctic Peninsula Ice Sheet (APIS) advanced to, or close to, the continental shelf edge during the Last Glacial Maximum (LGM; 23-19 cal kyr BP [ = calibrated kiloyears before present]), with deglaciation of the outer shelf after ∼16.3 cal kyr BP. Our new chronological data show that the APIS had retreated to the middle shelf by ∼15.7 cal kyr BP. Over this 600-year interval, two large grounding-zone wedges (GZW) were deposited across the middle (GZW2) and inner shelf (GZW3), suggesting that their formation occurred on centennial rather than millennial timescales. Expanded sequences of sub-ice shelf sediments occur seaward of the inner GZW3, which suggests that the grounding line remained stationary for a prolonged period over the middle shelf. Grounding-line retreat rates indicate faster retreat across the outer to middle shelf compared to retreat across the middle to inner shelf. We suggest that variable retreat rates relate to the broad-scale morphology of the trough, which is characterised by a relatively smooth, retrograde seabed on the outer to middle shelf and rugged morphology with a locally landward shallowing bed and deep basin on the inner shelf. A slowdown in retreat rate could also have been promoted by convergent ice flow over the inner shelf and the availability of pinning points associated with bathymetric highs around Anvers Island and Hugo Island