Cessation experiences and quitting perspectives of Jordanian cancer patients who smoke

ObjectivesTo describe quitting experiences of cancer patients in a Cancer Center in Jordan; to study patients’ perceptions regarding the process of smoking cessation; and to provide insights about patients in this difficult setting in order to inform oncology practitioners with regards to how improve perceptions and skills related to quitting.MethodsAn Arabic cross-sectional questionnaire was developed to evaluate smoking and quitting behaviors in the context of cancer. The tool used as its framework the Theoretical Domains Framework to capture quitting perceptions of cancer patients who smoke, as well as social, environmental, and system-level factors that influence quitting. Eligible patients who were treated at the Center (both in-patient and out-patient settings) and who were current smokers or who smoked up to the time of cancer diagnosis were eligible. Patients were interviewed between July, 2018 and January 2020 using two versions of the questionnaire: an ‘ex-smokers’ version, and a ‘current smokers’ version.ResultsOnly a third of subjects (104/350) had been smoke-free for at least 30 days. Both smokers and ex-smokers generally felt that quitting was important, but mean importance and confidence scores (out of 10) were significantly lower in current smokers (8.2 versus 9.1, p-value=0.002; 6.4 versus 8.7, p-value=0.000). Roughly 31% of subjects believed smoking harms were exaggerated and that smoking was not an addiction. About 62% of subjects agreed quitting required skills, and 78.5% felt the steps to quit were clear, but across several listed strategies for quitting, use of these was limited (even in ex-smokers). Among current smokers, roughly a third exhibited forms of cessation fatigue.ConclusionJordanian cancer patients who smoke present with limited knowledge about the quitting process. Even when some success is observed, low rates of utilization of specific quitting strategies were observed, highlighting the need for better counseling about quitting.     

Intersexual variation in the foraging ecology of sexually monochromatic Western Wood‐Pewees

ABSTRACT Investigators generally pool observations of males and females in studies of the foraging behavior of sexually monochromatic songbirds. However, such pooling can obscure possible intersexual differences. We compared the foraging behavior of male and female Western Wood‐Pewees (Contopus sordidulus), a sexually monochromatic species, in the Sierra Nevada Mountains of California during the breeding seasons of 2007 and 2008. We recorded 143 foraging observations (male N= 74, female N= 69). Overall, mean foraging rates of females (2.8 attacks/min) were higher (P < 0.001) than those of males (1.1 attacks/min). In addition, female foraging rates were significantly higher during incubation than during the nest building, nestling, and fledgling periods. When foraging, males perched higher above ground than females (means = 17.1 and 6.7 m, respectively). Differences between male and female Western Wood‐Pewees in foraging rates and perch heights suggest that males may spend more time on vigilance while females focus on foraging quickly during incubation and when feeding nestlings. Because metrics such as foraging attack rates are sometimes used as indicators of habitat quality and we found that rates can differ between the sexes and among nesting stages, investigators should consider the possibility of such differences when assessing habitat quality, especially for sexually monochromatic species of birds.     

REEXAMINATION OF THE ETHICS OF PLACEBO USE IN CLINICAL PRACTICE

A placebo is a substance or intervention believed to be inactive, but is administered by the healthcare professional as if it was an active medication. Unlike standard treatments, clinical use of placebo usually involves deception and is therefore ethically problematic. Our attitudes toward the clinical use of placebo, which inevitably includes deception or withholding information, have a tremendous effect on our practice regarding truth‐telling and informed consent. A casual attitude towards it weakens the current practice based on shared decision‐making and mutual trust between patients and healthcare professionals. Issues concerning the clinical use of placebo are thus intimately related to patient‐provider relationships, the public's trust in medicine, and medical education. A review of recent survey studies suggests that the clinical use of placebo appears to be fairly well accepted among healthcare professionals and is common in clinical settings in various countries. However, we think that an ethical discussion is urgently needed because of its controversial nature. If judged to be ethically wrong, the practice should end. In the present paper, we discuss the ethicality of the clinical use of placebo with deception and argue against it, concluding that it is unethical and should be banned. We will show that most arguments in favor of the clinical use of placebo can be refuted and are therefore incorrect or weak. These arguments will be presented and examined individually. Finally, we will briefly consider issues relevant to the clinical use of placebo without deception.     

Using the tools of genetic epidemiology to understand sex differences in neuropsychiatric disorders

Many neuropsychiatric disorders exhibit differences in prevalence, age of onset, symptoms or course of illness between males and females. For the most part, the origins of these differences are not well understood. In this article, we provide an overview of sex differences in psychiatric disorders including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), anxiety, depression, alcohol and substance abuse, schizophrenia, eating disorders and risk of suicide. We discuss both genetic and nongenetic mechanisms that have been hypothesized to underlie these differences, including ascertainment bias, environmental stressors, X‐ or Y‐linked risk loci, and differential liability thresholds in males and females. We then review the use of twin, family and genome‐wide association approaches to study potential genetic mechanisms of sex differences and the extent to which these designs have been employed in studies of psychiatric disorders. We describe the utility of genetic epidemiologic study designs, including classical twin and family studies, large‐scale studies of population registries, derived recurrence risks, and molecular genetic analyses of genome‐wide variation that may enhance our understanding sex differences in neuropsychiatric disorders.     

Depth‐dependent soil organic carbon dynamics of croplands across the Chengdu Plain of China from the 1980s to the 2010s

Agricultural soils have tremendous potential to sequester soil organic carbon (SOC) and mitigate global climate change. However, agricultural land use has a profound impact on SOC dynamics, and few studies have explored how agricultural land use combined with soil conditions affect SOC changes throughout the soil profile. Based on a paired soil resampling campaign in the 1980s and 2010s, this study investigated the SOC changes of the soil profile caused by agricultural land use and the correlations with parent material and topography across the Chengdu Plain of China. The results showed that the SOC content increased by 3.78 g C/kg in the topsoil (0–20 cm), but decreased in the 20–40 cm and 40–60 cm soil layers by 0.90 and 1.26 g C/kg respectively. SOC increases in topsoil were observed for all types of agricultural land. Afforestation on former agricultural land also caused SOC decreases in the 20–60 cm soil layers, while SOC decreases only occurred in the 40–60 cm soil layer for agricultural land using a traditional crop rotation (i.e. traditional rice–wheat/rapeseed rotation) and with rice–vegetable rotations converted from the traditional rotations. For each agricultural land use, SOC decreases in deep soils only occurred in high relief areas and in soils formed from Q4 (Quaternary Holocene) grey‐brown alluvium and Q4 grey alluvium that had a relatively low soil bulk density and clay content. The results indicated that SOC change caused by agricultural land use was depth dependent and that the effects of agricultural land use on soil profile SOC dynamics varied with soil characteristics and topography. Subsoil SOC decreases were more likely to occur in high relief areas and in soils with low soil bulk density and low clay content.     

Distinct controls over the temporal dynamics of soil carbon fractions after land use change

Soil organic carbon (SOC), the largest terrestrial carbon pool, plays a significant role in soil‐related ecosystem services such as climate regulation, soil fertility and agricultural production. However, its fate under land use change is difficult to predict. A major issue is that SOC comprised of numerous organic compounds with potentially distinct and poorly understood turnover properties. Here we use spatiotemporal measurements of the particulate (POC), mineral‐associated (MOC) and charred SOC (COC) fractions from 176 trials involving changes in land use to assess their underlying controls. We find that the initial pool sizes of each of the three fractions consistently and dominantly control their temporal dynamics after changes in land use (i.e. the baseline effects). The effects of climate, soil physicochemical properties and plant residues, however, are fraction‐ and time‐dependent. Climate and soil properties show similar importance for controlling the dynamics of MOC and COC, while plant residue inputs (in term of their quantity and quality) are much less important. For POC, plant residues and management practices (e.g. the frequency of pasture in crop‐pasture rotation systems) are substantially more important, overriding the influence of climate. These results demonstrate the pivotal role of measuring SOC composition and considering fraction‐specific stabilization and destabilization processes for effective SOC management and reliable SOC predictions.     

Terrestrial fluxes of carbon in GCP carbon budgets

The Global Carbon Project (GCP) has published global carbon budgets annually since 2007 (Canadell et al. [2007], Proc Natl Acad Sci USA, 104, 18866–18870; Raupach et al. [2007], Proc Natl Acad Sci USA, 104, 10288–10293). There are many scientists involved, but the terrestrial fluxes that appear in the budgets are not well understood by ecologists and biogeochemists outside of that community. The purpose of this paper is to make the terrestrial fluxes of carbon in those budgets more accessible to a broader community. The GCP budget is composed of annual perturbations from pre‐industrial conditions, driven by addition of carbon to the system from combustion of fossil fuels and by transfers of carbon from land to the atmosphere as a result of land use. The budget includes a term for each of the major fluxes of carbon (fossil fuels, oceans, land) as well as the rate of carbon accumulation in the atmosphere. Land is represented by two terms: one resulting from direct anthropogenic effects (Land Use, Land‐Use Change, and Forestry or land management) and one resulting from indirect anthropogenic (e.g., CO₂, climate change) and natural effects. Each of these two net terrestrial fluxes of carbon, in turn, is composed of opposing gross emissions and removals (e.g., deforestation and forest regrowth). Although the GCP budgets have focused on the two net terrestrial fluxes, they have paid little attention to the gross components, which are important for a number of reasons, including understanding the potential for land management to remove CO₂ from the atmosphere and understanding the processes responsible for the sink for carbon on land. In contrast to the net fluxes of carbon, which are constrained by the global carbon budget, the gross fluxes are largely unconstrained, suggesting that there is more uncertainty than commonly believed about how terrestrial carbon emissions will respond to future fossil fuel emissions and a changing climate.     

Century‐long apparent decrease in intrinsic water‐use efficiency with no evidence of progressive nutrient limitation in African tropical forests

Forests exhibit leaf‐ and ecosystem‐level responses to environmental changes. Specifically, rising carbon dioxide (CO₂) levels over the past century are expected to have increased the intrinsic water‐use efficiency (iWUE) of tropical trees while the ecosystem is gradually pushed into progressive nutrient limitation. Due to the long‐term character of these changes, however, observational datasets to validate both paradigms are limited in space and time. In this study, we used a unique herbarium record to go back nearly a century and show that despite the rise in CO₂ concentrations, iWUE has decreased in central African tropical trees in the Congo Basin. Although we find evidence that points to leaf‐level adaptation to increasing CO₂—that is, increasing photosynthesis‐related nutrients and decreasing maximum stomatal conductance, a decrease in leaf δ¹³C clearly indicates a decreasing iWUE over time. Additionally, the stoichiometric carbon to nitrogen and nitrogen to phosphorus ratios in the leaves show no sign of progressive nutrient limitation as they have remained constant since 1938, which suggests that nutrients have not increasingly limited productivity in this biome. Altogether, the data suggest that other environmental factors, such as increasing temperature, might have negatively affected net photosynthesis and consequently downregulated the iWUE. Results from this study reveal that the second largest tropical forest on Earth has responded differently to recent environmental changes than expected, highlighting the need for further on‐ground monitoring in the Congo Basin.     

New evidence of unexpectedly high animal density and diet diversity will benefit the conservation of the Critically Endangered western ringtail possum

A comprehensive and contemporary understanding of habitat and resource requirements has been critical to the conservation of multiple taxa and ecosystems globally. Until recently, much of the ecological knowledge that contributes to conservation priorities and strategies for the Critically Endangered western ringtail possum (Pseudocheirus occidentalis) was largely derived from decades‐old observations in peppermint (Agonis flexuosa) and marri‐jarrah (Corymbia calophylla and Eucalyptus marginanta) woodlands in the northern parts of the species range. These observations do not account for more recent evidence of their flexible use of habitat resources in other regions of its range. This may represent a significant conservation opportunity for the species through the identification of additional habitats that warrant protection. In a region where knowledge of their ecology is scarce, we used scat analysis and quantitative spotlighting to determine the diet and density of western ringtail possums in three vegetation types: peppermint, sheoak (Allocasuarina fraseriana) and marri‐eucalypt (C. calophylla, E. marginanta and Eucalyptus staerii) woodlands. Given the species’ reported dependence on peppermint woodlands and dominant canopy species for food sources, we hypothesised that western ringtail possums would be most abundant in this habitat type and that their diet would comprise the foliage of few (≤2 species) canopy species. We found western ringtail possums consumed a higher diversity of plant species than expected (8–14), exhibited dietary preference for non‐dominant canopy species and were present in all sampled vegetation types at substantially higher densities than previously recorded for the region (as high as 17 possums ha^?1). Our results confirm (i) the western ringtail possum is flexible in its use of habitat resources and (ii) the significant conservation value of sheoak and marri‐eucalypt woodlands in the southernmost portion of its distribution.