Effect of visualising and re-expressing evidence of policy effectiveness on perceived effectiveness: a population-based survey experiment

Communicating evidence that a policy is effective can increase public support although the effects are small. In the context of policies to increase healthier eating in out-of-home restaurants, we investigate two ways of presenting evidence for a policy's effectiveness: (i) visualising and (ii) re-expressing evidence into a more interpretable form. We conducted an online experiment in which participants were randomly allocated to one of five groups. We used a 2 (text only vs visualisation) × 2 (no re-expression vs re-expression) design with one control group. Participants (n = 4500) representative of the English population were recruited. The primary outcome was perceived effectiveness and the secondary outcome was public support. Evidence of effectiveness increased perceptions of effectiveness (d = 0.14, p < 0.001). There was no evidence that visualising, or re-expressing, changed perceptions of effectiveness (respectively, d = 0.02, p = 0.605; d = −0.02, p = 0.507). Policy support increased with evidence but this was not statistically significant after Bonferroni adjustment (d = 0.08, p = 0.034, α = 0.006). In conclusion, communicating evidence of policy effectiveness increased perceptions that the policy was effective. Neither visualising nor re-expressing evidence increased perceived effectiveness of policies more than merely stating in text that the policy was effective

Do supersymmetric anti-de Sitter black rings exist?

We determine the most general near-horizon geometry of a supersymmetric, asymptotically anti-de Sitter, black hole solution of five-dimensional minimal gauged supergravity that admits two rotational symmetries. The near-horizon geometry is that of the supersymmetric, topologically spherical, black hole solution of Chong et al. This proves that regular supersymmetric anti-de Sitter black rings with two rotational symmetries do not exist in minimal supergravity. However, we do find a solution corresponding to the near-horizon geometry of a supersymmetric black ring held in equilibrium by a conical singularity, which suggests that nonsupersymmetric anti-de Sitter black rings may exist but cannot be "balanced" in the supersymmetric limit.Comment: Latex, 18 pages, 1 figure. v2: minor change

Pinpointing needles in giant haystacks: use of text mining to reduce impractical screening workload in extremely large scoping reviews.

In scoping reviews, boundaries of relevant evidence may be initially fuzzy, with refined conceptual understanding of interventions and their proposed mechanisms of action an intended output of the scoping process rather than its starting point. Electronic searches are therefore sensitive, often retrieving very large record sets that are impractical to screen in their entirety. This paper describes methods for applying and evaluating the use of text mining (TM) technologies to reduce impractical screening workload in reviews, using examples of two extremely large-scale scoping reviews of public health evidence (choice architecture (CA) and economic environment (EE)). Electronic searches retrieved >800,000 (CA) and >1 million (EE) records. TM technologies were used to prioritise records for manual screening. TM performance was measured prospectively. TM reduced manual screening workload by 90% (CA) and 88% (EE) compared with conventional screening (absolute reductions of ≈430 000 (CA) and ≈378 000 (EE) records). This study expands an emerging corpus of empirical evidence for the use of TM to expedite study selection in reviews. By reducing screening workload to manageable levels, TM made it possible to assemble and configure large, complex evidence bases that crossed research discipline boundaries. These methods are transferable to other scoping and systematic reviews incorporating conceptual development or explanatory dimensions

Increasing the proportion of healthier foods available with and without reducing portion sizes and energy purchased in worksite cafeterias:protocol for a stepped-wedge randomised controlled trial

BACKGROUND: Overconsumption of energy from food contributes to high rates of overweight and obesity in many populations. A promising set of interventions tested in pilot studies in worksite cafeterias, suggests energy intake may be reduced by increasing the proportion of healthier - i.e. lower energy - food options available, and decreasing portion sizes. The current study aims to assess the impact on energy purchased of i. increasing the proportion of lower energy options available; ii. combining this with reducing portion sizes, in a full trial. METHODS: A stepped-wedge randomised controlled trial in 19 worksite cafeterias, where the proportion of lower energy options available in targeted food categories (including main meals, snacks, and cold drinks) will be increased; and combined with reduced portion sizes. The primary outcome is total energy (kcal) purchased from targeted food categories using a pooled estimate across all sites. Follow-up analyses will test whether the impact on energy purchased varies according to the extent of intervention implementation. DISCUSSION: This study will provide the most reliable estimate to date of the effect sizes of two promising interventions for reducing energy purchased in worksite cafeterias. TRIAL REGISTRATION: The study was prospectively registered on ISRCTN (date: 24.05.19; TRN: ISRCTN87225572; doi: https://doi.org/10.1186/ISRCTN87225572)

Impact of decreasing the proportion of higher energy foods and reducing portion sizes on food purchased in worksite cafeterias: A stepped-wedge randomised controlled trial.

BackgroundOverconsumption of energy from food is a major contributor to the high rates of overweight and obesity in many populations. There is growing evidence that interventions that target the food environment may be effective at reducing energy intake. The current study aimed to estimate the effect of decreasing the proportion of higher energy (kcal) foods, with and without reducing portion size, on energy purchased in worksite cafeterias.Methods and findingsThis stepped-wedge randomised controlled trial (RCT) evaluated 2 interventions: (i) availability: replacing higher energy products with lower energy products; and (ii) size: reducing the portion size of higher energy products. A total of 19 cafeterias were randomised to the order in which they introduced the 2 interventions. Availability was implemented first and maintained. Size was added to the availability intervention. Intervention categories included main meals, sides, cold drinks, snacks, and desserts. The study setting was worksite cafeterias located in distribution centres for a major United Kingdom supermarket and lasted for 25 weeks (May to November 2019). These cafeterias were used by 20,327 employees, mainly (96%) in manual occupations. The primary outcome was total energy (kcal) purchased from intervention categories per day. The secondary outcomes were energy (kcal) purchased from nonintervention categories per day, total energy purchased per day, and revenue. Regression models showed an overall reduction in energy purchased from intervention categories of -4.8% (95% CI -7.0% to -2.7%), p ConclusionsDecreasing the proportion of higher energy foods in cafeterias reduced the energy purchased. Decreasing portion sizes reduced this further. These interventions, particularly in combination, may be effective as part of broader strategies to reduce overconsumption of energy from food in out-of-home settings.Trial registrationISRCTN registry ISRCTN87225572

Uniqueness of near-horizon geometries of rotating extremal AdS(4) black holes

We consider stationary extremal black hole solutions of the Einstein-Maxwell equations with a negative cosmological constant in four dimensions. We determine all non-static axisymmetric near-horizon geometries (with non-toroidal horizon topology) and all static near-horizon geometries for black holes of this kind. This allows us to deduce that the most general near-horizon geometry of an asymptotically globally AdS(4) rotating extremal black hole, is the near-horizon limit of extremal Kerr-Newman-AdS(4). We also identify the subset of near-horizon geometries which are supersymmetric. Finally, we show which physical quantities of extremal black holes may be computed from the near-horizon limit alone, and point out a simple formula for the entropy of the known supersymmetric AdS(4) black hole. Analogous results are presented in the case of vanishing cosmological constant.Comment: 18 pages, Latex. v2: footnote added on pg. 12. v3: assumption of non-toroidal horizon topology made explicit, minor clarification

Increasing the proportion of healthier foods available with and without reducing portion sizes and energy purchased in worksite cafeterias: protocol for a stepped-wedge randomised controlled trial

Abstract: Background: Overconsumption of energy from food contributes to high rates of overweight and obesity in many populations. A promising set of interventions tested in pilot studies in worksite cafeterias, suggests energy intake may be reduced by increasing the proportion of healthier – i.e. lower energy – food options available, and decreasing portion sizes. The current study aims to assess the impact on energy purchased of i. increasing the proportion of lower energy options available; ii. combining this with reducing portion sizes, in a full trial. Methods: A stepped-wedge randomised controlled trial in 19 worksite cafeterias, where the proportion of lower energy options available in targeted food categories (including main meals, snacks, and cold drinks) will be increased; and combined with reduced portion sizes. The primary outcome is total energy (kcal) purchased from targeted food categories using a pooled estimate across all sites. Follow-up analyses will test whether the impact on energy purchased varies according to the extent of intervention implementation. Discussion: This study will provide the most reliable estimate to date of the effect sizes of two promising interventions for reducing energy purchased in worksite cafeterias. Trial registration: The study was prospectively registered on ISRCTN (date: 24.05.19; TRN: ISRCTN87225572; doi: https://doi.org/10.1186/ISRCTN87225572)

Physical activity, sleep, and fatigue in community dwelling Stroke Survivors

Stroke can lead to physiological and psychological impairments and impact individuals’ physical activity (PA), fatigue and sleep patterns. We analysed wrist-worn accelerometry data and the Fatigue Assessment Scale from 41 stroke survivors following a physical rehabilitation programme, to examine relationships between PA levels, fatigue and sleep. Validated acceleration thresholds were used to quantify time spent in each PA intensity/sleep category. Stroke survivors performed less moderate to vigorous PA (MVPA) in 10 minute bouts than the National Stroke guidelines recommend. Regression analysis revealed associations at baseline between light PA and fatigue (p = 0.02) and MVPA and sleep efficiency (p = 0.04). Light PA was positively associated with fatigue at 6 months (p = 0.03), whilst sleep efficiency and fatigue were associated at 9 months (p = 0.02). No other effects were shown at baseline, 6 or 9 months. The magnitude of these associations were small and are unlikely to be clinically meaningful. Larger trials need to examine the efficacy and utility of accelerometry to assess PA and sleep in stroke survivorsStroke Association for funding this research (TSA – 2014-03) and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter NHS Foundation Trus