Smoking cessation and tobacco prevention in Indigenous populations

This article systematically reviews 91 smoking cessation and tobacco prevention studies tailored for Indigenous populations around the world, with a particular focus on Aboriginal and Torres Strait Islander populations in Australia. We identified several components of effective interventions, including the use of multifaceted programs that simultaneously address the behavioural, psychological and biochemical aspects of addiction, using resources culturally tailored for the needs of individual Indigenous populations. Pharmacotherapy for smoking cessation was effective when combined with culturally tailored behavioural interventions and health professional support, though it is generally underused in clinical practice. From a policy perspective, interventions of greater intensity, with more components, were more likely to be effective than those of lower intensity and shorter duration. For any new policy it is important to consider community capacity building, development of knowledge, and sustainability of the policy beyond guided implementation. Future research should address how the intervention can be supported into standard practice, policy, or translation into the front-line of clinical care. Investigations are also required to determine the efficacy of emerging therapies (such as e-cigarettes and the use of social media to tackle youth smoking), and under-researched interventions that hold promise based on non-Indigenous studies, such as the use of Champix. We conclude that more methodologically rigorous investigations are required to determine components of the less-successful interventions to aid future policy, practice and research initiatives. Evidence Base, issue 3, 201

Exploration of computerised automatic processing tasks and their use in digital psychological health interventions in real-world settings amongst adults

Introduction: Digital psychological health interventions, targeting both behaviour change and mental health disorders, have shown promising results at creating positive change in a variety of health areas. These interventions are based on dual-process theories, which propose that the brain uses two types of thinking to influence behaviour: automatic processing and reflective processing. Automatic processing is fast, immediate, non-conscious, and unintentional. Reflective processing centres around logical reasoning; it is slow, step-by-step, voluntary and intentional. Most health interventions tend to solely target the reflective system; even though repeated laboratory testing has found behaviour can be influenced via targeting automatic processing pathway. This happens through conditioning; which involves pairing a stimulus that naturally elicits a response with one that does not until the second stimulus elicits a response like the first (39). However, there is a lack of translation of automatic processing tasks into real-world settings and a lack of consolidated evidence on how effective these tasks are in a real-world setting. Further, automatic processing tasks are often described as ‘boring’ by participants. Having an enjoyable experience could play a significant role in amplifying the conditioning effects of automatic processing tasks. Enjoyment can be increased via gamification, which uses gaming style elements (rewards, points and leader boards) to increase engagement. This thesis aims to further investigate the use of automatic processing tasks in digital health interventions in real-world settings and address the gaps identified by the completion of two studies. Study 1 will address the lack of consolidated evidence of automatic processing tasks in real-world settings by way of a scoping review, and study 2 will explore the role of enjoyment in contributing to the effectiveness of automatic processing tasks by evaluating the role of enjoyment as a moderator in an effective gamified automatic processing app called ‘Flex.’ Methodology: Study 1 followed the methodologies proposed by Arskey and O’Malley (2005), and Colquhoun (2016) for scoping reviews. A study protocol highlighting search strategy and inclusion and exclusion criteria was developed before conducting the review. Study 2 was nested within a pilot randomised control trial (RCT) of a gamified automatic processing smartphone app called ‘Flex’. The RCT found, that at 24-hour follow-up, there was a significant between-group effect such that people in the Flex experimental group had more favourable automatic associations of physical activity than those in the Flex control group. Our nested study was interested in further exploring this association, by examining if the moderator ‘enjoyment’ was responsible for the increase in effectiveness of automatic processing of physical activity stimuli. This was done by evaluating enjoyment through a validated survey. Results: Study 1: 4,038 studies were found for possible inclusion into study 1; however, only 14 studies met inclusion/exclusion criteria. Attentional bias modification tasks were the most commonly used (n=7). The review concluded that use of smartphone technology to deliver interventions was increasing, but there were mixed findings of effectiveness automatic processing tasks. There was also preliminary evidence for positive effects of gamification. Study 2 found that automatic processing of physical activity stimuli in the Flex app was not impacted by enjoyment as a moderator and that enjoyment did not contribute to amplifying the conditioning effect observed in the RCT. Conclusions: This thesis found that there were encouraging real-world results for the use of automatic processing tasks to influence people’s attitudes. The first of these two studies found that there was some evidence of automatic processing health interventions being successful at changing people’s automatic associations towards targeted stimuli in real-world settings. This is promising given that the majority of studies into these tasks have occurred in a lab-based setting and highlights the translational potential of these tasks into the real-world. In terms of why some of these tasks did not work, one possible reason could be due to the repetitive nature and lack on engagement of these tasks. The second study found that enjoyment was not a moderator for the positive associations observed in the RCT. However, encouraging process evaluation results provided insights into participant experience of the app and what elements participants found enjoyable and frustrating. This thesis has been able to contribute to the developing area of automatic processing tasks in a real-world setting. We have been able to highlight that this field, to-date, is still very small but developing and with further research, particularly around increasing engagement, these tasks could provide an innovative solution for improving existing health interventions.Thesis (MPhil) -- University of Adelaide, School of Public Health, 201

Scaled - Down Open Stoping Under Cemented Paste Fill

The principle scope of this research was to develop relationship between stope dimensions and cemented paste fill strength. Experiments in various fill thickness to span width ratios with cemented paste fill with different mechanical properties were conducted by using a constructed scaled-down open stope. Scaled-down laboratory experiments were used to understand the mechanism of fill failure when exposure is undertaken under a relatively fresh fill mass

Asthma Bronchiale and Exercise-Induced Bronchoconstriction

Exercising regularly has a wide range of beneficial health effects; in particular, it has been well documented to help in the management of chronic illnesses including asthma. However, in some individuals, exertion can also trigger an exacerbation of asthmatic episodes and subsequent acute attacks of breathlessness, coughing, tightness of the chest and wheezing. This physiological process is called exercise-induced bronchoconstriction (EIB) whereby post-exercise forced expiratory volume in 1 s is reduced by 10-15% from baseline. While EIB is highly prevalent in asthmatics and presents with similar respiratory symptoms, asthma and EIB are not mutually exclusive. The aim of this review is to present a broad overview of both conditions in order to enhance the understanding of the similarities and differences distinguishing them as two separate entities. The pathophysiology and mechanisms underlying asthma are well described with research now focussing on defining phenotypes for targeted management strategies. Conversely, the mechanistic understanding of EIB remains largely under-described. Diagnostic pathways for both are established and similar, as are pharmacologic and non-pharmacologic treatments and management approaches, which have enhanced success with early detection. Given the potential for exacerbation of asthma, exercise avoidance is common but counterproductive as current evidence indicates that it is well tolerated and improves quality of life. Literature supporting the benefit of exercise for EIB sufferers is at present favourable, yet extremely limited; therefore, future research should be directed in this area as well as towards further developing the understanding of the pathophysiology and mechanisms underpinning both EIB and asthma.</jats:p

Evidence Regarding Automatic Processing Computerized Tasks Designed For Health Interventions in Real-World Settings Among Adults: Systematic Scoping Review

Harshani Jayasinghe, Camille E Short, Annette Braunack-Mayer, Ashley Merkin, Clare Hume. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 29.07.2020. BACKGROUND: Dual process theories propose that the brain uses 2 types of thinking to influence behavior: automatic processing and reflective processing. Automatic processing is fast, immediate, nonconscious, and unintentional, whereas reflective processing focuses on logical reasoning, and it is slow, step by step, and intentional. Most digital psychological health interventions tend to solely target the reflective system, although the automatic processing pathway can have strong influences on behavior. Laboratory-based research has highlighted that automatic processing tasks can create behavior change; however, there are substantial gaps in the field on the design, implementation, and delivery of automatic processing tasks in real-world settings. It is important to identify and summarize the existing literature in this area to inform the translation of laboratory-based research to real-world settings. OBJECTIVE: This scoping review aims to explore the effectiveness of automatic training tasks, types of training tasks commonly used, mode of delivery, and impacts of gamification on automatic processing tasks designed for digital psychological health interventions in real-world settings among adults. METHODS: The scoping review methodology proposed by Arskey and O\u27Malley and Colquhoun was applied. A scoping review was chosen because of the novelty of the digital automatic processing field and to encompass a broad review of the existing evidence base. Electronic databases and gray literature databases were searched with the search terms automatic processing, computerised technologies, health intervention, real-world, and adults and synonyms of these words. The search was up to date until September 2018. A manual search was also completed on the reference lists of the included studies. RESULTS: A total of 14 studies met all inclusion criteria. There was a wide variety of health conditions targeted, with the most prevalent being alcohol abuse followed by social anxiety. Attention bias modification tasks were the most prevalent type of automatic processing task, and the majority of tasks were most commonly delivered over the web via a personal computer. Of the 14 studies included in the review, 8 demonstrated significant changes to automatic processes and 4 demonstrated significant behavioral changes as a result of changed automatic processes. CONCLUSIONS: This is the first review to synthesize the evidence on automatic processing tasks in real-world settings targeting adults. This review has highlighted promising, albeit limited, research demonstrating that automatic processing tasks may be used effectively in a real-world setting to influence behavior change

Evidence Regarding Automatic Processing Computerized Tasks Designed For Health Interventions in Real-World Settings Among Adults: Systematic Scoping Review

Background Dual process theories propose that the brain uses 2 types of thinking to influence behavior: automatic processing and reflective processing. Automatic processing is fast, immediate, nonconscious, and unintentional, whereas reflective processing focuses on logical reasoning, and it is slow, step by step, and intentional. Most digital psychological health interventions tend to solely target the reflective system, although the automatic processing pathway can have strong influences on behavior. Laboratory-based research has highlighted that automatic processing tasks can create behavior change; however, there are substantial gaps in the field on the design, implementation, and delivery of automatic processing tasks in real-world settings. It is important to identify and summarize the existing literature in this area to inform the translation of laboratory-based research to real-world settings. Objective This scoping review aims to explore the effectiveness of automatic training tasks, types of training tasks commonly used, mode of delivery, and impacts of gamification on automatic processing tasks designed for digital psychological health interventions in real-world settings among adults. Methods The scoping review methodology proposed by Arskey and O’Malley and Colquhoun was applied. A scoping review was chosen because of the novelty of the digital automatic processing field and to encompass a broad review of the existing evidence base. Electronic databases and gray literature databases were searched with the search terms “automatic processing,” “computerised technologies,” “health intervention,” “real-world,” and “adults” and synonyms of these words. The search was up to date until September 2018. A manual search was also completed on the reference lists of the included studies. Results A total of 14 studies met all inclusion criteria. There was a wide variety of health conditions targeted, with the most prevalent being alcohol abuse followed by social anxiety. Attention bias modification tasks were the most prevalent type of automatic processing task, and the majority of tasks were most commonly delivered over the web via a personal computer. Of the 14 studies included in the review, 8 demonstrated significant changes to automatic processes and 4 demonstrated significant behavioral changes as a result of changed automatic processes. Conclusions This is the first review to synthesize the evidence on automatic processing tasks in real-world settings targeting adults. This review has highlighted promising, albeit limited, research demonstrating that automatic processing tasks may be used effectively in a real-world setting to influence behavior change. </jats:sec

Evidence Regarding Automatic Processing Computerized Tasks Designed For Health Interventions in Real-World Settings Among Adults: Systematic Scoping Review (Preprint)

BACKGROUND Dual process theories propose that the brain uses 2 types of thinking to influence behavior: automatic processing and reflective processing. Automatic processing is fast, immediate, nonconscious, and unintentional, whereas reflective processing focuses on logical reasoning, and it is slow, step by step, and intentional. Most digital psychological health interventions tend to solely target the reflective system, although the automatic processing pathway can have strong influences on behavior. Laboratory-based research has highlighted that automatic processing tasks can create behavior change; however, there are substantial gaps in the field on the design, implementation, and delivery of automatic processing tasks in real-world settings. It is important to identify and summarize the existing literature in this area to inform the translation of laboratory-based research to real-world settings. OBJECTIVE This scoping review aims to explore the effectiveness of automatic training tasks, types of training tasks commonly used, mode of delivery, and impacts of gamification on automatic processing tasks designed for digital psychological health interventions in real-world settings among adults. METHODS The scoping review methodology proposed by Arskey and O’Malley and Colquhoun was applied. A scoping review was chosen because of the novelty of the digital automatic processing field and to encompass a broad review of the existing evidence base. Electronic databases and gray literature databases were searched with the search terms “automatic processing,” “computerised technologies,” “health intervention,” “real-world,” and “adults” and synonyms of these words. The search was up to date until September 2018. A manual search was also completed on the reference lists of the included studies. RESULTS A total of 14 studies met all inclusion criteria. There was a wide variety of health conditions targeted, with the most prevalent being alcohol abuse followed by social anxiety. Attention bias modification tasks were the most prevalent type of automatic processing task, and the majority of tasks were most commonly delivered over the web via a personal computer. Of the 14 studies included in the review, 8 demonstrated significant changes to automatic processes and 4 demonstrated significant behavioral changes as a result of changed automatic processes. CONCLUSIONS This is the first review to synthesize the evidence on automatic processing tasks in real-world settings targeting adults. This review has highlighted promising, albeit limited, research demonstrating that automatic processing tasks may be used effectively in a real-world setting to influence behavior change. </sec