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Although the public transport (PT) commute can form a substantial part of the working day, there is a significant gap in our understanding of how it influences health of those who engage in it. The purpose of this systematic review was to therefore generate evidence from 1972 about the extent to which the PT commute (involving train, bus, subway, tram, or metro) impacts on the mental health, physical health and well-being of the working people. We identified 47 studies in English worldwide involving an empirical quantitative focus which met the inclusion criteria. Of these, 23 studies involved over 500 participants. Although initial multi-modal comparisons showed impact on sickness rate, self-rated health complaints, perceived stress level and reduction in sleep, a more homogeneous analysis of rail commuters showed elevation in salivary cortisol, perceived stress, and affective reactions to crowding. Findings also revealed a bias towards use of endogenous self-report measures. On this basis, we argue that it would be of benefit to test theoretical models to account for more objective measures of job and commuting stress. Recommendations were made for flexible working agendas.

Aims: E-cigarettes have been advocated as an effective smoking cessation intervention, with evidence indicating that they are substantially less harmful than conventional cigarettes. As a result, a pilot to encourage people to swap from conventional cigarettes to e-cigarettes was conducted in 2018 in a socially deprived area in the North West of England. This evaluation highlights the key findings from the pilot. Methods: An analysis of secondary data at 4 weeks ( n = 1022) was undertaken to predict those who used solely used e-cigarettes (i.e. had quit tobacco, as confirmed by a carbon monoxide test, CO < 10 ppm) from baseline characteristics, using chi-square tests and logistic regression. Baseline data were demographics, smoking levels and service provider type. Results: Of the 1022 participants who engaged with the pilot 614 were still engaged at 4 weeks, of whom 62% had quit; quitting was more likely in younger participants (aged 18–24) and less likely in those who were sick and disabled. Of those who still smoked tobacco at week 4 ( n = 226), smoking had reduced from a baseline of 19.1 cigarettes/day to 8.7. Overall, 37% (381) of those initially enrolled were confirmed to be using an e-cigarette on its own at follow-up. Successful quit was associated with occupation (unemployed, 33% vs intermediate, 47%, p = .023) and residing in the less deprived quintiles of deprivation (50% vs 34% in the most deprived quintile, p = .016). Conclusions: Making the conservative assumption that all those not in contact at 4 weeks were still smoking tobacco, for every five people entering the scheme, three people stayed on the programme and reduced their cigarette smoking and one person cut out tobacco altogether. E-cigarettes appear to be an effective nicotine replacement therapy; however, further research is required to determine whether e-cigarette users are more likely to reduce their overall nicotine consumption in the longer term.

The growth of smartphone ownership by fans around the world has continued to increase. Meanwhile, we are seeing a rise in dangerous levels of obesity, diabetes and heart disease. The most at-risk, hard-to-reach groups are often synonymous with football fans (middle aged and older males). For this population group there are also high rates of smartphone ownership – 91% of 35–54 year olds and 51% of 55–64 year olds in the UK in 2018 – providing opportunity for engagement in digital health-related projects. This chapter explores how fans can be engaged in physical activity through their support of sport teams and use of smartphones, introducing a case study of Fan Fit – a smartphone application designed to be an official sports club app, which also includes fitness tracking elements for fan engagement. Fan Fit aims to build a community of participation, and increase interaction and physical activity levels. We present the background and evidence base for Fan Fit, its implementation and the use of action research to develop and test the app. We present key learnings to develop further insight to football clubs who may wish to adopt a similar project or approach.

BACKGROUND As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. OBJECTIVE This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. METHODS The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. RESULTS The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. CONCLUSIONS Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs.

Background As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. Objective This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. Methods The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. Results The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. Conclusions Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs.

This doctoral thesis details the methods of determining mechanical properties of two classes of novel thin films suspended two-dimensional crystals and electron beam irradiated microfilms of polydimethylsiloxane (PDMS). Thin films are used in a variety of surface coatings to alter the opto-electronic properties or increase the wear or corrosion resistance and are ideal for micro- and nanoelectromechanical system fabrication. One of the challenges in fabricating thin films is the introduction of strains which can arise due to application techniques, geometrical conformation, or other spurious conditions. Currently, inadequate models exist to model strain within thin films, making it difficult to produce structurally robust thin films and to prevent premature failure of a coating ordevice. It is thus imperative to understand and quantify thin film behavior under strain, both to aid in the development of new materials and processing techniques, as well as to enable the implementation of thin films into new designs. Chapters 2-4 focus on two dimensional materials. This is the intrinsic limit of thin films-being constrained to one atomic or molecular unit of thickness. These materials have mechanical, electrical, and optical properties ideal for micro- and nanoelectromechanical systems with truly novel device functionality. As such, the breadth of applications that can benefit from a treatise on two dimensional film mechanics is reason enough for exploration. This study explores the anomylously high strength of two dimensional materials. Furthermore, this work also aims to bridge four main gaps in the understanding of material science: bridging the gap between ab initio calculations and finite element analysis, bridging the gap between ab initio calculations and experimental results, nano scale to microscale, and microscale to mesoscale. A nonlinear elasticity model is used to determine the necessary elastic constants to define the strain-energy density function for finite strain. Then, ab initio calculations-density functional theory-is used to calculate the nonlinear elastic response. Chapter 2 focuses on validating this methodology with atomic force microscope nanoindentation on molybdenum disulfide. Chapter 3 explores the convergence criteria of three density functional theory solvers to further verify the numerical calculations. Chapter 4 then uses this model to investigate the role of grain boundaries on the strength of chemical vapor deposited graphene. The results from these studies suggest that two dimensional films have remarkably high strength-reaching the intrinsic limit of molecular bonds. Chapter 5 explores the viscoelastic properties of heterogeneous polydimethylsiloxane (PDMS) microfilms through dynamic nanoindentation. PDMS microfilms are irradiated with an electron beam creating a 3 m-thick film with an increased cross-link density. The change in mechanical properties of PDMS due to thermal history and accelerator have been explored by a variety of tests, but the effect of electron beam irradiation is still unknown. The resulting structure is a stiff microfilm embedded in a soft rubber with some transformational strain induced by the cross-linking volume changes. Chapter 5 employs a combination of dynamic nanoindentation and finite element analysis to determine the change in stiffness as a function of electron beam irradiation. The experimental results are compared to the literature. The results of these experimental and numerical techniques provide exciting opportunities in future research. Two dimensional materials and flexible thin films are exciting materials for novel applications with new form factors, such as flexible electronics and microfluidic devices. The results herein indicate that you can accurately model the strength of two dimsensional materials and that these materials are robust against nano-scale defects. The results also reveal local variation of mechanical properties in PDMS microfilms. This allows one to design substrates that flex with varying amounts of strain on the surface. Combining the mechanics of two dimensional materials with that of a locally irradiated PDMS film could achieve a new class of flexible microelectromechanical systems. Large-scale growth of two dimensional materials will be structurally robust-even in the presence of nanostructural defects-and PDMS microfilms can be irradiated to vary strain of the electromechanical systems. These systems could be designed to investigate electromechanical coupling in two dimensional films or for a substitute to traditional silicon microdevices.

Evidence suggests that sedentary behaviour (SB) is associated with adverse health outcomes. Children’s SB is a complex set of behaviours that includes different types of activities taking place in a variety of settings. Therefore, assessing children’s SB is challenging and currently no single method exists that captures the behaviour as a whole. This thesis aims to explore and develop new and existing methods of assessing children’s SB, by employing a range of quantitative and qualitative methods. Accelerometry has become a widely used method of estimating sedentary time (ST). Study 1 identified raw acceleration thresholds to classify children’s sedentary and stationary behaviours, using two accelerometer brands across three placements. Thresholds however, do not account for the postural element of SB, as per its definition. Study 2 validated the Sedentary Sphere method in children, allowing for the most likely posture classification from wrist-worn accelerometers. Study 3 added contextual information to accelerometer data by using a digitalised data capturing tool, the Digitising Children’s Data Collection (DCDC) for Health application (app). Children used the app to report their SBs daily through photos, drawings, voice recordings as well as answering a multiple-choice questionnaire. Results from the DCDC app identified specific SBs to be targeted in future interventions. Data showed distinct differences between boys and girls’ screen-based behaviours, suggesting gender-specific interventions are needed to reduce screen time. Using the DCDC app in combination with accelerometry often explained patterns of SB and physical activity observed in accelerometer data. Study 4 added information about parents’ perceptions of the factors that influence their children’s SBs. This study identified parents/carers as a target for future interventions in view of perceptions reported about PA and SB and their need for support to help reduce the time children spend using screen-based devices.