An internet survey of psychiatrists who have a particular interest in cognitive behavioural therapy: what is the place for the cognitive behavioural model in their role as a psychiatrist?

A survey of psychiatrists with a special interest in CBT was conducted by email correspondence to answer two main questions: ‘What are the uses and the usefulness of the cognitive behavioural model within the day-to-day practice of psychiatrists?’ and ‘What are the most important roles of the consultant medical psychotherapist who has specialized in CBT?’ Despite the constraints of a low response rate the results still reflected the views of 46 psychiatrists who were particularly experienced in the area of CBT. They reported that the cognitive behavioural model was useful in general psychiatric settings, in particular in the engagement of patients, improving client's insight, adherence to medications, and for trainee supervision. The responders reaffirmed previously held views about the role of the consultant medical psychotherapist (CBT), in particular the roles of the assessment and management of complex cases, of taking responsibility for patients with a combination of medical and psychological issues and of teaching CBT to psychiatrists and other mental health professionals. The challenges of translating CBT competencies into generic non-CBT psychiatric settings are discussed, with the important potential role of the medical psychotherapist in this respect. The key skill of formulating cases in secondary care is emphasized

Did hardening occur among smokers in England from 2000 to 2010?

Aims To assess trends in the prevalence of ‘hardcore’ smoking in England between 2000 and 2010, and to examine associations between hardcore smoking and socio-demographic variables. Design Secondary analysis of data from the United Kingdom's General Lifestyle Survey (GLF) and the Health Survey for England (HSE). Setting Households in England. Participants Self-reported adult current smokers resident in England aged 26 years and over. Measurements Hardcore smokers were defined in three ways: smokers who do not want to quit (D1), those who ‘usually’ smoke their first cigarette of the day within 30 minutes of waking (D2) and a combination of D1 and D2, termed D3. Multivariable logistic regression was used to explore associations between these variables and calendar year, age, sex and socio-economic status, and P-values for trends in odds were calculated. Findings The odds of smokers being defined as hardcore according to D3 increased over time in both the GLF (P < 0.001) and HSE (P = 0.04), even after adjusting for risk factors. Higher dependence (D2) was noted in men [odds ratio (OR): 1.19, 95% confidence interval (CI): 1.13–1.24], those of 50–59 years (OR: 1.94, 95% CI: 1.80–2.09) and smokers in lower occupational groups (OR: 2.11, 95% CI: (1.97–2.26). Lack of motivation to quit (D1) increased with age and was more likely in men. Conclusions The proportion of smokers in England with both low motivation to quit and high dependence appears to have increased between 2000 and 2010, independently of risk factors, suggesting that ‘hardening’ may be occurring in this smoker populatio

Nonlinear Optical Eigenmodes

In linear optics, the concept of a mode is well established. Often these modes correspond to a set of fields that are mutually orthogonal with intensity profiles that are invariant as they propagate through an optical medium. More generally, one can define a set of orthogonal modes with respect to an optical measure that is linear in intensity or quadratic/Hermitian in the fields using the method of Optical Eigenmodes (OEi). However, if the intensity of the light is large, the dipole response of an optical medium introduces nonlinear terms to Maxwell’s equations. In this nonlinear regime such terms influence the evolution of the fields and the principle of superposition is no longer valid and consequently, the method of Optical Eigenmodes breaks down. In this work, we define Optical Eigenmodes in the presence of these nonlinear source terms by introducing small perturbation fields onto a nonlinear background interaction and show how this background interaction influences the symmetries associated with the eigenmodes. In particular, by introducing orbital angular momentum (OAM) to the Hilbert space of the perturbation and background fields, we observe conservation laws and symmetries for which we derive associated operators.Publisher PD

Effect of offering different levels of support and free nicotine replacement therapy via an English national telephone quitline: randomised controlled trial

Objective To compare the effects of free nicotine replacement therapy or proactive telephone counselling in addition to standard smoking cessation support offered through a telephone quitline

Social Salience and the Sociolinguistic Monitor: A Case Study of ING and TH-fronting in Britain

This article examines the role of social salience, or the relative ability of a linguistic variable to evoke social meaning, in structuring listeners’ perceptions of quantitative sociolinguistic distributions. Building on the foundational work of Labov et al. (2006, 2011) on the “sociolinguistic monitor” (a proposed cognitive mechanism responsible for sociolinguistic perception), we examine whether listeners’ evaluative judgments of speech change as a function of the type of variable presented. We consider two variables in British English, ING and TH-fronting, which we argue differ in their relative social salience. Replicating the design of Labov et al.’s studies, we test 149 British listeners’ reactions to different quantitative distributions of these variables. Our experiments elicit a very different pattern of perceptual responses than those reported previously. In particular, our results suggest that a variable’s social salience determines both whether and how it is perceptually evaluated. We argue that this finding is crucial for understanding how sociolinguistic information is cognitively processed

Voting on sustainable transport: communication and governance challenges in Greater Manchester's ‘congestion charge’ referendum

In December 2008, the Greater Manchester electorate voted to reject a £3 billion package of transport measures that would have included investment in the conurbation's bus, tram and rail networks and walking and cycling infrastructure, together with, and partially funded by, the introduction of a congestion charge. The proposals followed a successful bid to the UK Government Transport Innovation Fund (TIF). High levels of car use present challenges to cities, and the TIF bid can be seen as an attempt to address these by promoting and facilitating a modal shift. The paper reflects on the debates surrounding the proposals, which led to a referendum. In particular, it explores the challenges of communicating complex, controversial plans in a fragmented and contested political arena

Smoking, self-regulation and moral positioning: a focus group study with British smokers from a disadvantaged community

Smoking in many Western societies has become a both moral aand health issue in recent years, but little is known about how smokers position themselves and regulate their behaviour in this context. In this article, we report the findings from a study investigating how smokers from an economically disadvantaged community in the East Midlands (UK) respond to concerns about the health impact of smoking on others. We conducted ten focus group (FG) discussions with mixed groups (by smoking status and gender; N&thinsp;=&thinsp;58 participants) covering a range of topics, including smoking norms, self-regulation, and smoking in diverse contexts. We transcribed all FG discussions before analysing the data using techniques from discourse anlysis. Smokers in general positioned themselves as socially responsible smokers and morally upstanding citizens. This position was bolstered in two main ways: &lsquo;everyday accommodation', whereby everyday efforts to accommodate the needs of non-smokers were referenced, and &lsquo;taking a stand', whereby proactive interventions to prevent smoking in (young) others were cited. We suggest that smoking cessation campaigns could usefully be informed by this ethic of care for others

Do cravings predict smoking cessation in smokers calling a national quit line: secondary analyses from a randomised trial for the utility of ‘urges to smoke’ measures

BACKGROUND: Single-item urges to smoke measures have been contemplated as important measures of nicotine dependence This study aimed to prospectively determine the relationships between measures of craving to smoke and smoking cessation, and compare their ability to predict cessation with the Heaviness of Smoking Index, an established measure of nicotine dependence. METHODS: We conducted a secondary analysis of data from the randomised controlled PORTSSS trial. Measures of nicotine dependence, ascertained before making a quit attempt, were the HSI, frequency of urges to smoke (FUTS) and strength of urges to smoke (SUTS). Self-reported abstinence at six months after quitting was the primary outcome measure. Multivariate logistic regression and Receiver Operating Characteristic (ROC) analysis were used to assess associations and abilities of the nicotine dependence measures to predict smoking cessation. RESULTS: Of 2,535 participants, 53.5% were female; the median (Interquartile range) age was 38 (28–50) years. Both FUTS and HSI were inversely associated with abstinence six months after quitting; for each point increase in HSI score, participants were 16% less likely to have stopped smoking (OR 0.84, 95% C.I 0.78-0.89, p < 0.0001). Compared to participants with the lowest possible FUTS scores, those with greater scores had generally lower odds of cessation (p across frequency of urges categories=0.0026). SUTS was not associated with smoking cessation. ROC analysis suggested the HSI and FUTS had similar predictive validity for cessation. CONCLUSIONS: Higher FUTS and HSI scores were inversely associated with successful smoking cessation six months after quit attempts began and both had similar validity for predicting cessation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13011-015-0011-8) contains supplementary material, which is available to authorized users