A qualitative perspective on multiple health behaviour change: views of smoking cessation advisors who promote physical activity

There are mixed views on whether smoking cessation advisors should focus only on quitting smoking or also promote simultaneous health behaviour changes (e.g. diet, physical activity), but no studies have qualitatively examined the views and vicarious experiences of such health professionals. Semi-structured interviews were conducted with 11 trained smoking cessation advisors who promote physical activity to their clients. The data were categorised into themes using thematic analysis supported by qualitative data analysis software. We report themes that were related to why advisors promote multiple health behaviour change and issues in timing. Physical activity could be promoted as a cessation aid and also as part of a holistic lifestyle change consistent with a non-smoker identity, thereby increasing feelings of control and addressing fear of weight gain. Multiple changes were promoted pre-quit, simultaneously and post-quit, and advisors asserted that it is important to focus on the needs and capabilities of individual clients when deciding how to time multiple changes. Also, suggesting that PA was a useful and easily performed cessation aid rather than a new behaviour (i.e. structured exercise that may seem irrelevant) may help some clients to avoid a sense of overload

Determinants of physical activity promotion by smoking cessation advisors as an aid for quitting: Support for the Transtheoretical Model

Objectives: Physical activity (PA) can reduce cigarette cravings and aid quitting but little is known about its promotion by smoking cessation advisors. This study aimed to: (1) determine the extent to which smoking cessation advisors promote PA; and (2) examine the relationship between PA promotion as a cessation aid and advisor characteristics and cognitions, within the Transtheoretical Model (TM) framework. Methods: Self-report surveys assessing PA promotion, TM variables, advisors’ own PA levels and demographics were completed by 170 advisors in England and Scotland. Results: Advisors reported spending 29 minutes promoting PA over a 6/7-week clinic. Those in later stages of readiness for promoting PA as a cessation aid and those spending more time promoting PA held more positive beliefs regarding pros and cons, self-efficacy, outcome efficacy and importance of PA within smoking cessation. Time spent promoting PA and stage of readiness were strongly associated. There was a trend for the more physically active advisors to promote PA more often. Conclusions: About half the advisors promoted PA and TM variables predicted this variability. Practice Implications: PA promotion among smoking cessation advisors may be facilitated by enhancing self-efficacy, outcome efficacy and pro and con-beliefs related to PA promotion

Readiness to use physical activity as a smoking cessation aid: a multiple behaviour change application of the Transtheoretical Model among quitters attending Stop Smoking Clinics

Objective: Physical activity (PA) reduces cigarette cravings during smoking abstinence. However, little is known about quitters’ use of PA. This study aimed to: (1) determine the extent of quitters’ past and current use of PA as a cessation aid, while attempting to quit; (2) examine the relationship between use of PA and quitter characteristics and cognitions, within the Transtheoretical Model framework. Methods: Self-report surveys were completed by 181 smokers attending Stop Smoking Services in England and Scotland. Results: Twenty-two percent of quitters reported currently using PA to control their smoking, and 35% had used it during a previous quit attempt. Those in a more advanced stage of readiness for using PA as a cessation aid, held more positive beliefs regarding self-efficacy and outcome efficacy. Conclusion: Quitters were more likely to use PA to help them quit when they had greater belief in their own ability to use PA and in the efficacy of PA to help them to quit, and were also meeting weekly PA targets for health. Practice implications: Strategies by stop smoking advisors that aim to enhance client self-efficacy and outcome efficacy beliefs regarding PA as a cessation aid may help to increase the use of this behavioural strategy, since it seems that most quitters do not use PA

How do brochures encourage walking in natural environments in the UK? A content analysis.

Although walking for leisure can support health, there has been little systematic attempt to consider how recreational walking is best promoted. In the UK, local authorities create promotional materials for walking networks, but little is known about whether they effectively encourage walking through persuasive messaging. Many of these materials pertain to walks in natural environments which evidence suggests are generally visited less frequently by physically inactive individuals. Consequently the present study explores whether and how recreational walking brochures use persuasive messages in their promotion of walks in natural environments. A coding taxonomy was developed to classify text in recreational walking brochures according to five behavioural content areas and 87 categories of potentially persuasive messages. Reliability of the taxonomy was ascertained and a quantitative content analysis was applied to 26 brochures collected from Devon, UK. Brochures often provided information about an advertised route, highlighted cultural and aesthetic points of interest, and provided directions. Brochures did not use many potentially effective messages. Text seldom prompted behaviour change or built confidence for walking. Social norm related information was rarely provided and there was a general lack of information on physical activity and its benefits for health and well-being. The limited range of message strategies used in recreational walking brochures may not optimally facilitate walking in natural environments for inactive people. Future research should examine the effects of theory-informed brochures on walking intentions and behaviour. The taxonomy could be adapted to suit different media and practices surrounding physical activity in natural environments

El Niño and the delayed action oscillator

We study the dynamics of the El Niño phenomenon using the mathematical model of delayedaction oscillator (DAO). Topics such as the influence of the annual cycle, global warming, stochastic influences due to weather conditions and even off-equatorial heat-sinks can all be discussed using only modest analytical and numerical resources. Thus the DAO allows for a pedagogical introduction to the science of El Niño and La Niña while at the same time avoiding the need for large-scale computing resources normally associated with much more sophisticated coupled atmosphere-ocean general circulation models. It is an approach which is ideally suited for student projects both at high school and undergraduate level

Natural desiccated thyroid for the treatment of hypothyroidism?

Primary hypothyroidism affects about 3% of the general population in Europe. Early treatments in the late 19th Century involved subcutaneous as well as oral administration of thyroid extract. Until the early 1970s, the majority of people across the world with hypothyroidism were treated with natural desiccated thyroid (NDT) (derived from pig thyroid glands) in various formulations, with the majority of people since then being treated with levothyroxine (L-thyroxine). There is emerging evidence that may account for the efficacy of liothyronine (NDT contains a mixture of levothyroxine and liothyronine) in people who are symptomatically unresponsive to levothyroxine. While this is a highly selected group of people, the severity and chronicity of their symptoms and the fact that many patients have found their symptoms to be alleviated, can be viewed as valid evidence for the potential benefit of NDT when given after careful consideration of other differential diagnoses and other treatment options

Promoting and maintaining physical activity in the transition to retirement: a systematic review of interventions for adults around retirement age

It has been argued that transition points in life, such as the approach towards, and early years of retirement present key opportunities for interventions to improve the health of the population. Research has also highlighted inequalities in health status in the retired population and in response to interventions which should be addressed. We aimed to conduct a systematic review to synthesise international evidence on the types and effectiveness of interventions to increase physical activity among people around the time of retirement. A systematic review of literature was carried out between February 2014 and April 2015. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for identification of relevant studies included electronic database searching, reference list checking, and citation searching. Systematic search of the literature identified 104 papers which described study populations as being older adults. However, we found only one paper which specifically referred to their participants as being around the time of retirement. The intervention approaches for older adults encompassed: training of health care professionals; counselling and advice giving; group sessions; individual training sessions; in-home exercise programmes; in-home computer-delivered programmes; in-home telephone support; in-home diet and exercise programmes; and community-wide initiatives. The majority of papers reported some intervention effect, with evidence of positive outcomes for all types of programmes. A wide range of different measures were used to evaluate effectiveness, many were self-reported and few studies included evaluation of sedentary time. While the retirement transition is considered a significant point of life change, little research has been conducted to assess whether physical activity interventions at this time may be effective in promoting or maintaining activity, or reducing health inequalities. We were unable to find any evidence that the transition to retirement period was, or was not a significant point for intervention. Studies in older adults more generally indicated that a range of interventions might be effective for people around retirement age

Using A One-Class Compound Classifier To Detect In-Vehicle Network Attacks

The Controller Area Network (CAN) in vehicles provides serial communication between electronic control units that manage en- gine, transmission, steering and braking. Researchers have recently demonstrated the vulnerability of the network to cyber-attacks which can manipulate the operation of the vehicle and compromise its safety. Some proposals for CAN intrusion detection systems, that identify attacks by detecting packet anomalies, have drawn on one-class classi cation, whereby the system builds a decision surface based on a large number of normal instances. The one-class approach is discussed in this paper, together with initial results and observations from implementing a classi er new to this eld. The Compound Classier has been used in image processing and medical analysis, and holds advantages that could be relevant to CAN intrusion detection.<br/

Liothyronine and levothyroxine prescribing in England: A comprehensive survey and evaluation

From Wiley via Jisc Publications RouterHistory: received 2021-01-06, rev-recd 2021-03-28, accepted 2021-04-12, pub-electronic 2021-07-06Article version: VoRPublication status: PublishedAbstract: Introduction: The approach to thyroid hormone replacement varies across centres, but the extent and determinants of variation is unclear. We evaluated geographical variation in levothyroxine (LT4) and liothyronine (LT3) prescribing across General Practices in England and analysed the relationship of prescribing patterns to clinical and socioeconomic factors. Methods: Data was downloaded from the NHS monthly General Practice Prescribing Data in England for the period 2011‐2020. Results: The study covered a population of 19.4 million women over 30 years of age, attending 6,660 GP practices and being provided with 33.7 million prescriptions of LT4 and LT3 at a total cost of £90million/year. Overall, 0.5% of levothyroxine treated patients continue to receive liothyronine. All Clinical Commission Groups (CCGs) in England continue to have at least one liothyronine prescribing practice and 48.5% of English general practices prescribed liothyronine in 2019‐2020. Factors strongly influencing more levothyroxine prescribing (model accounted for 62% of variance) were the CCG to which the practice belonged and the proportion of people with diabetes registered on the practice list plus antidepressant prescribing, with socioeconomic disadvantage associated with less levothyroxine prescribing. Whereas factors that were associated with increased levels of liothyronine prescribing (model accounted for 17% of variance), were antidepressant prescribing and % of type 2 diabetes mellitus individuals achieving HbA1c control of 58 mmol/mol or less. Factors that were associated with reduced levels of liothyronine prescribing included smoking and higher obesity rates. Conclusion: In spite of strenuous attempts to limit prescribing of liothyronine in general practice a significant number of patients continue to receive this therapy, although there is significant geographical variation in the prescribing of this as for levothyroxine, with specific general practice and CCG‐related factors influencing prescribing of both levothyroxine and liothyronine across England

Liothyronine and levothyroxine prescribing in England: A comprehensive survey and evaluation

Introduction The approach to thyroid hormone replacement varies across centres, but the extent and determinants of variation is unclear. We evaluated geographical variation in levothyroxine (LT4) and liothyronine (LT3) prescribing across General Practices in England and analysed the relationship of prescribing patterns to clinical and socioeconomic factors. Methods Data was downloaded from the NHS monthly General Practice Prescribing Data in England for the period 2011-2020. Results The study covered a population of 19.4 million women over 30 years of age, attending 6,660 GP practices and being provided with 33.7 million prescriptions of LT4 and LT3 at a total cost of £90million/year. Overall, 0.5% of levothyroxine treated patients continue to receive liothyronine. All Clinical Commission Groups (CCGs) in England continue to have at least one liothyronine prescribing practice and 48.5% of English general practices prescribed liothyronine in 2019-2020. Factors strongly influencing more levothyroxine prescribing (model accounted for 62% of variance) were the CCG to which the practice belonged and the proportion of people with diabetes registered on the practice list plus antidepressant prescribing, with socioeconomic disadvantage associated with less levothyroxine prescribing. Whereas factors that were associated with increased levels of liothyronine prescribing (model accounted for 17% of variance), were antidepressant prescribing and % of type 2 diabetes mellitus individuals achieving HbA1c control of 58 mmol/mol or less. Factors that were associated with reduced levels of liothyronine prescribing included smoking and higher obesity rates. Conclusion In spite of strenuous attempts to limit prescribing of liothyronine in general practice a significant number of patients continue to receive this therapy, although there is significant geographical variation in the prescribing of this as for levothyroxine, with specific general practice and CCG-related factors influencing prescribing of both levothyroxine and liothyronine across England