Improving cardiovascular health in patients with an abdominal aortic aneurysm:development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

Background: Abdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways. Methods: Intervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention. Results: The developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance. Discussion: The developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population. Trial registration: International Clinical Trial Registration: ISRCTN93993995

The development of eye tracking in aviation (ETA) technique to investigate pilot's cognitive processes of attention and decision-making

Eye tracking device had provided researchers a promising way to investigate what pilot‘s cognitive processes when they see information present on the flight deck. There are 35 participants consisted by pilots and avionics engineers participated in current research. The research apparatus include an eye tracker and a flight simulator divided by five AOIs for data collection. The research aims are to develop cost-efficiency of eye tracking technique in order to facilitate scientific research of cognition and decision-making in aviation. The results indicated that participants’ eye movement patterns did have significant differences on the following variables including fixation count, F(4, 136) = 601.01, p < .001; average fixation duration, F(4, 136) = 100.87, p < .001; percentage of total fixations, F(4, 136) = 779.92, p < .001, and average pupil area, F(4, 136)=2.51, p < .05. The findings demonstrated that eye tracker is a suitable tool to investigate pilots’ cognitive process of attention and decision-making on flight deck. Furthermore, it can be applied to improve pilots’ SA and decision-making during flight operations

Developing an Integrated Model of Care for Veterans with Alcohol Problems

Introduction: Veterans often do not present with alcohol problems in isolation, they may have a wide range of social, physical, and sociological needs. The aim of this study was to facilitate the development of a co-designed integrated model of care for veterans with alcohol problems. Methods: Following the development model by the Agency for Clinical Innovation, a planning symposium was held in North East of England to engage health and social care planners, public health leads, clinical commissioning groups and providers. Service users were empowered in discussions to provide insights and look for solutions (N=43). Results: Using diagramming techniques, three examples of health and social care provision were created demonstrating the current commissioning landscape, one veteran’s experience of accessing services and a proposal for a new integrated model of care for veterans with alcohol problems. Discussion: By engaging stakeholders and service users, the model proposed a potential solution to reducing the number of veterans ‘falling through the gaps’ or disengaging from services. The collaborative approach highlighted the difficulties in navigating the current complex health and social care systems. The co-designed hub and spoke model aims to enable alcohol misuse services to adapt and evolve so that they better fit the needs of veterans

Do engagement and behavioural mechanisms underpin the effectiveness of the Drink Less app?

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-reported adherence’) and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.0%, 95% CI = 77.6–78.4; usual digital care: 71.5%, 95% CI = 71.0–71.9). Self-reported adherence to the intervention (average causal mediation effect [ACME] = −0.250, 95% CI = −0.42, −0.11) and self-monitoring behaviour (ACME = −0.235, 95% CI = −0.44, −0.03) both partially mediated the effect of the intervention (versus comparator) on alcohol reduction. Following the recommendation (self-reported adherence) and the tracking (self-monitoring behaviour) feature of the Drink Less app appear to be important mechanisms of action for alcohol reduction among increasing and higher risk drinkers

Magnetic fields in planetary nebulae and post-AGB nebulae

Magnetic fields are an important but largely unknown ingredient of planetary nebulae. They have been detected in oxygen-rich AGB and post-AGB stars, and may play a role in the shaping of their nebulae. Here we present SCUBA sub-millimeter polarimetric observations of four bipolar planetary nebulae and post-AGB stars, including two oxygen-rich and two carbon-rich nebulae, to determine the geometry of the magnetic field by dust alignment. Three of the four sources (NGC 7027, NGC 6537 and NGC 6302) present a well-defined toroidal magnetic field oriented along their equatorial torus or disk. NGC 6302 may also show field lines along the bipolar outflow. CRL 2688 shows a complex field structure, where part of the field aligns with the torus, whilst an other part approximately aligns with the polar outflow. It also presents marked asymmetries in its magnetic structure. NGC 7027 shows evidence for a disorganized field in the south-west corner, where the SCUBA shows an indication for an outflow. The findings show a clear correlation between field orientation and nebular structure.Comment: 9 pages, 6 figures. Accepted for publication in MNRA

Do engagement and behavioural mechanisms underpin the effectiveness of the Drink Less app?

This is a process evaluation of a large UK-based randomised controlled trial (RCT) (n = 5602) evaluating the effectiveness of recommending an alcohol reduction app, Drink Less, compared with usual digital care in reducing alcohol consumption in increasing and higher risk drinkers. The aim was to understand whether participants’ engagement (‘self-reported adherence’) and behavioural characteristics were mechanisms of action underpinning the effectiveness of Drink Less. Self-reported adherence with both digital tools was over 70% (Drink Less: 78.0%, 95% CI = 77.6–78.4; usual digital care: 71.5%, 95% CI = 71.0–71.9). Self-reported adherence to the intervention (average causal mediation effect [ACME] = −0.250, 95% CI = −0.42, −0.11) and self-monitoring behaviour (ACME = −0.235, 95% CI = −0.44, −0.03) both partially mediated the effect of the intervention (versus comparator) on alcohol reduction. Following the recommendation (self-reported adherence) and the tracking (self-monitoring behaviour) feature of the Drink Less app appear to be important mechanisms of action for alcohol reduction among increasing and higher risk drinkers