Barriers and motivators to gaining access to smoking cessation services amongst deprived smokers – a qualitative study

BACKGROUND: Smoking is strongly associated with disadvantage and is an important contributor to inequalities in health. Smoking cessation services have been implemented in the UK targeting disadvantaged smokers, but there is little evidence available on how to design services to attract this priority group. METHODS: We conducted focus groups with 39 smokers aged 21–75 from the most socio-economically deprived areas of Nottingham UK who had made an unsuccessful attempt to quit within the last year without using smoking cessation services, to identify specific barriers or motivators to gaining access to these services. RESULTS: Barriers to use of existing services related to fear of being judged, fear of failure, a perceived lack of knowledge about existing services, a perception that available interventions – particularly Nicotine Replacement Therapy – are expensive and ineffective, and negative media publicity about bupropion. Participants expressed a preference for a personalised, non-judgemental approach combining counselling with affordable, accessible and effective pharmacological therapies; convenient and flexible timing of service delivery, and the possibility of subsidised complementary therapies. CONCLUSION: We conclude that smokers from these deprived areas generally had low awareness of the services available to help them, and misconceptions about their availability and effectiveness. A more personalised approach to promoting services that are non-judgemental, and with free pharmacotherapy and flexible support may encourage more deprived smokers to quit smoking

Methods of connecting primary care patients with community-based physical activity opportunities:A realist scoping review

Funding: NHS Fife Endowment Fund (Grant Number(s): FIF142).Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. We aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable? We conducted a realist scoping review in which we searched Cochrane, Medline, PsycNET, Google Advanced Search, National Health Service (NHS) Evidence and NHS Health Scotland from inception until August 2020. We identified that five methods of connection from primary care to community-based physical activity opportunities had been evaluated. These were embedded in 15 processes of physical activity promotion, involving patient identification and behaviour change strategy delivery, as well as connection. In the contexts in which they were implemented, four of those processes had strong positive findings, three had moderately positive findings and eight had negative findings. The underlying theories of change were highly supported for three processes, supported to an extent for four and refuted for eight processes. Comparisons of the processes and their theories of change revealed several indications helpful for future development of effective processes. Our review also highlighted the limited evidence base in the area and the resulting need for well-designed theory-based evaluations.Publisher PDFPeer reviewe

Satellite remote sensing of land cover change in a mixed agro-silvo-pastoral landscape in the Alentejo, Portugal

Mixed agro-silvo-pastoral landscapes are typically of significant natural, economic and cultural value. The montado (wood pasture) dominated systems of southern Portugal are a prime example, and experience high rates of land cover change. Tracking these changes is of importance for landscape level conservation and management. Whilst satellite remote sensing is the most realistic approach at large spatial scales, heterogeneous landscapes can present challenges to the accurate classification of land cover and its change. In this investigation we demonstrate a novel approach to the investigation of land cover change over a 25 year period (1984-2009) in an area of importance for the conservation of the Iberian lynx, Black vulture, and other threatened biodiversity in south-east Alentejo, Portugal. We apply a Tasselled Cap Transformation (TCT) to Landsat imagery from these two years, and then Change Vector Analysis (CVA) on the transformed data to highlight areas of vegetation gain and loss during the intervening period. Using a 2009 land cover classification, and a set of rules based on these vegetation changes, we then predict the land change over the 25 year period focussing on predominant classes of vegetation physiognomy. The results are discussed in terms of probable drivers, as well as implications for biodiversity and other landscape values

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Development of an automated testing tool for identifyin

A history of Northumberland. issued under the direction of the Northumberland county history committee.

A continuation of John Hodgson's A history of Northumberland, 1820-58.Imprint varies slightly.Vols. 1-14 have also special t.-p.; v. 15 has special t.-p. only.Mode of access: Internet