Does intentional asphyxiation by strangulation have addictive properties?

Background and aims: Intentional asphyxiation leads to cerebral hypoxia, starving the brain of oxygen and inducing hypoxic euphoria, but carries a serious risk of accidental death, especially if practised alone. This article raises the question as to whether it could usefully be regarded as having addictive properties. Methods and results: A review of the literature, together with eight case study vignettes, are presented. Intentional asphyxiation can occur with or without sexual activity. Initiation often occurs in adolescence, with development in some cases of an entrenched behaviour pattern, driven by a strong euphoriant effect, without adequate safeguarding from serious harm, and being undertaken by people with comorbidities. There does not appear to be strong evidence of seeking support for cessation of the practice. Conclusions: Intentional asphyxiation behaviours may have addictive properties, and understanding this aspect of the problem may be fruitful in guiding research and interventions aimed at addressing it

A prospective study exploring the construct and predictive validity of the COM-B model for physical activity

The final, definitive version of this paper has been published in Journal of Health Psychology, November 2017, doi: https://doi.org/10.1177/1359105317739098, published by SAGE Publishing, All rights reserved.This study examined the constructs of Capability, Opportunity, and Motivation from the COM-B model and their influence on moderate-to-vigorous physical activity (MVPA). Using a prospective survey design, 186 healthy adults completed measures representing the Theoretical Domains Framework mapped to the COM-B, and MVPA one week later. The main indicators for the COM constructs were ‘habits’ (Capability), ‘subjective norms’ (Opportunity), and ‘exercise self-identity’ (Motivation). Motivation (77%) and MVPA (50%) were strongly predicted, with Capability and Motivation as key drivers of behaviour. Motivation was a strong mediator for Capability on behaviour. Future research should consider this approach for other populations and behaviours.Peer reviewe

How effective is community physical activity promotion in areas of deprivation for inactive adults? A pragmatic observational evaluation of the 'Active Herts' physical activity programme

Background There is a high prevalence of inactivity in UK adults and many suffer from comorbid conditions. These frequently co-exist in areas of higher socio-economic deprivation. There is a need to test the effectiveness, acceptability, and sustainability of physical activity programmes in this population. Method Active Herts recruited inactive adults (N=435) with one or more risk factors for cardiovascular disease and/or mild-to-moderate mental health conditions, and followed up at 3 and 6 months after baseline. In two areas programme-users received a behaviour change technique booklet, consultations, a booster phone call, motivational text messages, and signposting to 12 weeks of exercise classes (standard intervention). In another two areas programme-users also received 12 weeks of free tailored exercise classes, with optional exercise ‘buddies’ (enhanced intervention). Mixed ANOVAs analysed changes in physical activity, sporting participation, sitting (primary outcomes), mental wellbeing, health perception, and COM-B measures (secondary outcomes). Secondary analyses explored whether COM-B measures predicted moderate-to-vigorous physical activity (MVPA) at baseline, 3, and 6 months, and changes at 3 and 6 months using path analyses. Results At both timepoints, physical activity (3 months, η2 = .17; 6 months, η2 = .18), sporting participation (3 months, η2 = .22; 6 months, η2 = .17), sitting time (3 months, η2 = .08; 6 months, η2 = .06), and several secondary outcomes (e.g. wellbeing) improved regardless of group. COM-B related indicators explained MVPA performance better after 3 (R2=18%) and 6 (R2=15%) months than at baseline (R2=8%), but changes in MVPA were weakly predicted (3 months, R2=5%; 6 months, R2=7%). Self-monitoring was key in driving MVPA performance and change. Conclusions and Implications Active Herts improved activity levels at 3 and 6 months providing preliminary evidence that such interventions, delivered in real world settings, can change the behaviour and wellbeing of residents living in areas of deprivation.Peer reviewedFinal Published versio

The impact of active workstations on workplace productivity and performance: a systematic review

Active workstations have been recommended for reducing sedentary behavior in the workplace. It is important to understand if the use of these workstations has an impact on worker productivity. The aim of this systematic review was to examine the effect of active workstations on workplace productivity and performance. A total of 3303 articles were initially identified by a systematic search and seven articles met eligibility criteria for inclusion. A quality appraisal was conducted to assess risk of bias, confounding, internal and external validity, and reporting. Most of the studies reported cognitive performance as opposed to productivity. Five studies assessed cognitive performance during use of an active workstation, usually in a single session. Sit-stand desks had no detrimental effect on performance, however, some studies with treadmill and cycling workstations identified potential decreases in performance. Many of the studies lacked the power required to achieve statistical significance. Three studies assessed workplace productivity after prolonged use of an active workstation for between 12 and 52 weeks. These studies reported no significant effect on productivity. Active workstations do not appear to decrease workplace performance

Young people's use of NHS Direct: a national study of symptoms and outcome of calls for children aged 0-15

Objectives National Health Service (NHS) Direct provides 24/7 expert telephone-based healthcare information and advice to the public in England. However, limited research has explored the reasons to why calls are made on behalf of young people, as such this study aimed to examine call rate (CR) patterns in younger people to enable a better understanding of the needs of this population in England. Setting NHS Direct, England, UK. Participants and methods CRs (expressed as calls/100 persons/annum) were calculated for all calls (N=358 503) made to NHS Direct by, or on behalf of, children aged 0–15 during the combined four ‘1-month’ periods within a year (July 2010, October 2010, January 2011 and April 2011). χ² Analysis was used to determine the differences between symptom, outcome and date/time of call. Results For infants aged <1, highest CRs were found for ‘crying’ for male (n=14, 440, CR=13.61) and female (n=13 654, CR=13.46) babies, which is used as a universal assessment applied to all babies. High CRs were also found for symptoms relating to ‘skin/hair/nails’ and ‘colds/flu/sickness’ for all age groups, whereby NHS Direct was able to support patients to self-manage and provide health information for these symptoms for 59.7% and 51.4% of all cases, respectively. Variations in CRs were found for time and age, with highest peaks found for children aged 4–15 in the 15:00–23:00 period and in children aged <1 in the 7:00–15:00 period. Conclusions This is the first study to examine the symptoms and outcome of calls made to NHS Direct for and on behalf of young children. The findings revealed how NHS Direct has supported a range of symptoms through the provision of health information and self-care support which provides important information about service planning and support for similar telephone-based services

How effective is community physical activity promotion in areas of deprivation for inactive adults with cardiovascular disease risk and/or mental health concerns? Study protocol for a pragmatic observational evaluation of the ’Active Herts' physical activity programme

Introduction: There is a high prevalence of inactive adults in the UK, and many suffer from conditions such as cardiovascular disease (CVD) or poor mental health. These coexist more frequently in areas of higher socioeconomic deprivation. There is a need to test the effectiveness, acceptability and sustainability of physical activity programmes. Active Herts uses novel evidence-based behaviour change techniques to target physical inactivity. Methods and analysis: Active Herts is a community physical activity programme for inactive adults aged 16+ with one or more risk factors for CVD and/or a mild to moderate mental health condition. This evaluation will follow a mixed-methods longitudinal (baseline, and 3-month, 6-month and 12-month follow-ups) design. Pragmatic considerations mean delivery of the programme differs by locality. In two areas programme users will receive a behaviour change technique booklet, regular consultations, a booster phone call, motivational text messages and signposting to 12 weeks of exercise classes. In another two areas programme users will also receive 12 weeks of free tailored exercise classes, with optional exercise ‘buddies’ available. An outcome evaluation will assess changes in physical activity as the primary outcome, and sporting participation, sitting, well-being, psychological capability and reflective motivation as secondary outcomes. A process evaluation will explore the views of stakeholders, delivery staff and programme leads. Economic evaluation will examine the programme costs against the benefits gained in terms of reduced risk of morbidity. Ethics and dissemination: This study was been approved by the Faculty of Medicine and Health Sciences Research Ethics Committee at the University of East Anglia. Informed written consent will be obtained from programme users in the evaluation. Results will be published in peer-reviewed journals, presented at conferences, and shared through the study website and local community outlets

Who uses foodbanks and why? Exploring the impact of financial strain and adverse life events on food insecurity

Background Rising use of foodbanks highlights food insecurity in the UK. Adverse life events (e.g. unemployment, benefit delays or sanctions) and financial strains are thought to be the drivers of foodbank use. This research aimed to explore who uses foodbanks, and factors associated with increased food insecurity. Methods We surveyed those seeking help from front line crisis providers from foodbanks (N = 270) and a comparison group from Advice Centres (ACs) (N = 245) in relation to demographics, adverse life events, financial strain and household food security. Results About 55.9% of foodbank users were women and the majority were in receipt of benefits (64.8%). Benefit delays (31.9%), changes (11.1%) and low income (19.6%) were the most common reasons given for referral. Compared to AC users, there were more foodbank users who were single men without children, unemployed, currently homeless, experiencing more financial strain and adverse life events (P = 0.001). Food insecurity was high in both populations, and more severe if they also reported financial strain and adverse life events. Conclusions Benefit-related problems appear to be a key reason for foodbank referral. By comparison with other disadvantaged groups, foodbank users experienced more financial strain, adverse life events, both increased the severity of food insecurity