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PurposeFruit and vegetable (F&V) intakes amongst Scottish schoolchildren are lower than recommended. The purpose of this paper is to describe an intervention which combined F&V with peer‐modelling and rewards to influence consumption of F&V.Design/methodology/approachA school‐based initiative was implemented in 19 primary schools. The evaluation of 8 schools (n = 1,477 pupils aged 4.5‐12 years) is reported. The three‐week intervention included free F&V (80 g portions), a peer‐modelling video and a series of small rewards followed by a four to six week maintenance phase during which time free F&V continued. Questionnaires were completed at baseline (T1) and up to two months after the end of the maintenance phase (T2) to assess changes in F&V consumption.FindingsAt T2, children in years 1 and 2 consumed F&V at school more often compared with T1, and ate a greater number of portions each time. There were no significant differences in home consumption. The picture was similar for children in years 3‐7 with no change in the reported number of portions.Originality/valueFew behavioural interventions have been carried out in the public health arena to increase F&V consumption. This paper shows that a peer‐modelling intervention significantly increased consumption of F&V at school, while home consumption remained stable.

Background Hospital malnutrition (undernutrition) continues to attract concern. The implementation of standards for food and fluids in Scotland provided the stimulus for an audit of current practices in NHS Fife hospitals in order to provide baseline data with which to evaluate progress. Methods One hundred and fifty in-patients were recruited from wards likely to yield those with a high risk of malnutrition. Using patient records and anthropometry, data were collected on weight, weight change, body mass index (BMI), mid-upper-arm circumference (MUAC), dietetic referral, therapeutic diets and patients’ perceptions of nutritional status. Malnutrition was estimated by comparing BMI, weight change and MUAC with the Malnutrition Universal Screening Tool (MUST) and standards published by the Scottish Intercollegiate Guidelines Network (SIGN). Results Depending upon the standard used, the minimum risk of malnutrition varied from 14 to 25%. The prevalence was lower than that reported previously, although methods were not directly comparable. Obesity was also evident with 42% of patients having a BMI > 25. Mean weight change from admission to audit was +0.4 kg, with a wide range (−11 kg to +13 kg). Most patients identified as malnourished were referred to the dietitian or given nutritional support. Conclusions Fewer patients were at risk of malnutrition than expected. However, improving the provision of food and fluids remains a priority in Fife as malnutrition and eating problems can occur across the entire BMI spectrum.

PurposeThere are many herbal supplements on the market claiming to aid weight loss but few are evidence‐based. This study aims to test one such formulation.Design/methodology/approachAn over‐the‐counter herbal supplement containing yerba maté, guarana and damiana (YGD) was tested in 73 overweight health professionals for six weeks. Subjects were not asked to make any lifestyle changes.FindingsSelf‐reported weight, waist circumference and hip circumference reduced significantly, while 22 per cent of subjects experienced a clinically significant weight loss. The anthropometric changes were in line with other commercial diet and exercise programmes. Reported between‐meal hunger, and consumption of snacks reduced across the six weeks. Reported satiety after meals increased and subjects claimed to be more in control of snacking, emotional eating and portion sizes. A follow‐up at week ten, when 82 per cent of subjects had stopped taking YGD, revealed no additional reductions in weight or hip circumference. Fullness ratings had stabilised, while hunger ratings had increased. There were no consistent adverse effects that could reasonably be related to YGD.Research limitations/implicationsTaken alongside a 2001 randomised, placebo‐controlled trial, this study provides evidence that a YGD supplement can aid weight loss and reduce waist and hip circumference, probably by increasing satiety.Originality/valueThe growing market in weight management products brings with it a responsibility for manufacturers to provide evidence that their products work. This paper adds to the evidence base.

Objective - To quality assess a sample of health behavior change apps from the NHS Apps Library using a rating tool based on the 2014 National Institute for Health and Care Excellence behavior change guidance (NICE BCG).\ud \ud Methods - A qualitative analysis of the NICE BCG identified themes and questions for a quality assessment of health behavior change apps. These were refined by further discussion and piloting, and applied by two independent raters to a sample of NHS Library apps (N = 49). Disagreements were resolved following discussions with a third rater.\ud \ud Results - Themes identified were; purpose, planning, usability, tailoring, behavior change technique (BCT), maintenance, evaluation, data security and documentation. Overall, purpose of the apps was clear, but evidence for collaboration with users or professionals was lacking. Usability information was poor and tailoring disappointing. Most used recognized BCTs but paid less attention to behavior maintenance than initiation. Information on app evaluation and documentation was sparse.\ud \ud Conclusions - This study furthers the work of the NHS Apps Library, adapting the NICE (2014) behavior change guidance for quality assessment of behavior change apps.\ud \ud Practice implications - This study helps lay the foundations for development of a quality assurance tool for mobile health apps aimed at health behavior change.

Utilities are developing new ways to manage the connection of increasing amounts of distributed generation (DG) on the electric grid. Among other issues, DG can lead to high voltage and other power quality problems. This paper describes a field trial by Greater Sudbury Hydro of a new low voltage control device, the LV-IPR. The device controls voltage directly by way of a series voltage injection, as well as providing reactive and harmonic compensation, with a unified power flow controller [1] architecture. The device is successfully regulating the voltage at the test site, which had been experiencing high voltage excursions.

Library science textbooks typically recommend scholarly book reviews as a good source of information about recently published books and other items that may be suitable for purchase. Less attention, however, has been paid to the value of scholarly book reviews as a way for academic librarians to stay current in their areas of specialization or to learn about unfamiliar areas. This article shows that a careful analysis of scholarly book reviews can provide a wealth of knowledge about significant issues in a variety of academic subjects and fields. Results are based on a proof-of-concept questionnaire sent to experts in the fields of Popular Music and Southern Literature, who evaluated two overviews of their fields written entirely from the information contained in scholarly book reviews.

This study employed an extended theory of planned behaviour (TPB) to investigate the factors underlying smoking intentions and subsequent smoking behaviour three months later in a population of schoolchildren (N = 741). The TPB provided good predictions of both intentions (R2 = 0.518; attitude, subjective norm and perceived behavioural control significant) and smoking (R2 = 0.299; intentions and PBC significant). However, intention did not fully mediate the subjective norm–behaviour relationship. Moral norm explained additional variance in intentions but not smoking. Perceived family smoking and anticipated regret explained additional variance in both intentions and smoking. Perceived friends' smoking and past behaviour explained additional variance in smoking but not intentions. Findings are discussed in relation to how the TPB can further our understanding of adolescent smoking. Implications for additions to the theory and possible interventions are also considered.

There is clinical and research consensus that significant cognitive, social, emotional development and adjustment to physical changes occurs during young adulthood, in the period between ages 18 and 24 years.1 While three–quarters of psychiatric disorders in adults emerge before the age of 25 years, a European study, comparing access to mental health care by age bands, reported that 18–24-year-old participants were least likely to get care for mental health problems.2 In the 2016 UK National Confidential Enquiry into Suicide in Children and Young People, 43% of people aged

This study employed the theory of planned behavior (TPB) to investigate the factors underlying intentions to use and use of LSD, amphetamine, cannabis, and ecstasy over 6 months in a sample of students (N= 461). The TPB provided good predictions of both intentions (mean R2= .49) and behavior (mean R2= .45). Descriptive norms explained additional variance in intentions for all the drugs, and moral norms explained additional variance in cannabis intentions. Attitude variability moderated the impact of attitudes on intentions for LSD (p < .10) and ecstasy (p < .05). Attitude moderated the impact of perceived behavioral control (PBC) on intentions for all drugs (p < .001). PBC moderated the impact of intentions on behavior for LSD (p < .05), amphetamine (p < .10), cannabis (p < .05), and ecstasy (p < .10). These interaction effects elucidate limiting conditions among the variables in the TPB.

This study employed the theory of planned behaviour to investigate the factors underlying intentions to use (time 1, N = 471), and self reported use of alcohol and tobacco (time 2, N = 141) over a 6 month period in a population of students. The TPB provided good predictions of both intentions (alcohol: R2 = 0.167; attitude, and perceived behavioural control (PBC) significant; tobacco: R2 = 0.137, PBC significant) and self reported behaviour (alcohol: R2 = 0.289; tobacco: R2 = 0.423; intentions and PBC significant for both). Descriptive norms but not moral norms explained additional variance in intentions. Implications for furthering our understanding of these behaviours are discussed.

Differences in the drug use characteristics and psychosocial variables in the use and non-use of ecstasy within 845 16–25 year-olds in the UK was examined. Based on levels of ecstasy use and intentions, two groups of non-users (resistant and vulnerable), three groups of users (light, moderate and heavy) and an ex-user group were identified. It was found that there is predictive utility in this way of expanding the widely employed ‘user versus non-user’ dichotomy. Resistant non-users were more likely to be younger, female, and were characterized by lower levels of use of four other drugs (amphetamine, cannabis, cocaine and LSD). Those ‘at risk’ of using ecstasy reported more frequent use of amphetamine, LSD, and cannabis than resistant non-users. Heavy user groups reported using amphetamine, cocaine and LSD more frequently than all the other groups. Having ecstasy using friends increased the odds of being an ‘at risk’ non-user or an ecstasy user. Normative influence also differentiated between the three user groups (light, moderate, and heavy). Beliefs about ecstasy use being immoral, ecstasy offers being difficult to resist, ecstasy use making one feel guilty and ecstasy being readily available differentiated between user and non-user groups. These factors could usefully inform the content of health education materials designed to change ecstasy use. Copyright © 2003 John Wiley & Sons, Ltd.

This study examined the hypothesis that students would exhibit changes in their levels of, and cognitions about, drug use throughout their university career. Three hundred and eighty undergraduates from Years 1, 2, and 3 (174 male, 206 female) initially participated in the study (response rate 63%). Questionnaires were distributed at 6-month intervals over a period of 2 years, resulting in 4 time points. The questionnaires contained items relating to the use of, and cognitions about the use of, alcohol, amphetamine, cannabis, ecstasy, LSD, and tobacco. No evidence was found to suggest an increase in the percentage of respondents using drugs over their university career. However, a significant increase in the frequency of ecstasy use between Years 1 and 2 was found. Various cognitive measures also exhibited changes between Years 1 and 2, associated with increasingly “liberal” views toward drug use. No evidence was found to suggest that drug use tailed off toward the end of the university career. The findings point to the need for increased drugs education for students, and the need for more research to aid in the understanding of how university life affects drug use levels.

In this article the authors introduce the Librarians’ Research Partnership (LRP), founded in 2013, at McGill and Concordia University Libraries. The Partnership was inspired by the Canadian Association of Research Libraries’ Librarians’ Research Institute (CARL LRI) which was attended by three of the authors in 2012 and is described here from the point of view of the participants. The authors touch upon the research culture at McGill and Concordia Libraries and discuss barriers and supports for research as prominent themes in the literature on the research role of Canadian academic librarians. The formation of the LRP and the eight subsequent meetings are explained in detail, as well as the factors that made the LRP a successful initiative between the two universities: physical proximity, similarity of working environments, and common organizational culture. The article also includes a discussion of how the LRP’s philosophy might diverge from that of the LRI.

This study employed the theory of planned behaviour (TPB) and additional variables (descriptive norm, moral norm, self-identity) to investigate the factors underlying breastfeeding intention and subsequent breastfeeding at four time points (during hospital stay, at hospital discharge, 10 days postpartum and 6 weeks postpartum) in a sample of women selected from defined areas of economic hardship (N = 248). A model containing the TPB, additional variables and demographic factors provided a good prediction of both intention (R (2) = 0.72; attitude, perceived behavioural control, moral norm and self-identity significant predictors) and behaviour - breastfeeding at birth (88.6% correctly classified; household deprivation, intention, attitude significant), at discharge from hospital (87.3% correctly classified; intention, attitude significant), 10 days after discharge (83.1% correctly classified; education, intention, attitude, descriptive norm significant) and 6 weeks after discharge (78.0% correctly classified; age, household deprivation, ethnicity, moral norm significant). Implications for interventions are discussed, such as the potential usefulness of targeting descriptive norms, moral norms and perceived behavioural control (PBC) when attempting to increase breastfeeding uptake.

Steven L. Rickards (2008). Lanham, MD: Scarecrow Press. 400 pp., $100.00. ISBN: 10 0‐8108‐6103‐8, ISBN‐13 978‐0‐8108‐6103‐9 (hardcover) Until now, countertenors have been largely overlooked in bibl...

Venous thromboembolism (VTE) risk assessment for adults admitted to hospital is commonplace, but the utility of assessment tools in patients admitted to hospices or palliative care units and prediction of symptomatic VTE is unknown.To investigate the relationship between risk of VTE and development of symptoms.Retrospective consecutive admission, case-note data from seven U.K. hospices were collected during an evaluation of a VTE risk assessment protocol using the Pan Birmingham Cancer Network palliative-modified Thromboembolic Risk Factors (THRIFT) Consensus Group criteria and presence/absence of a temporary elevated risk (TER) of VTE. Symptoms/signs during admission consistent with possible VTE were documented.A total of 1164 case-notes were analyzed (age range 23-99; men 627). THRIFT risk was high in 13%, medium in 83%, and low in 4%; a TER was identified in 24%. In the "clinically relevant group" (no contraindication, not anticoagulated), where primary thromboprophylaxis could have been prescribed (n = 528), TER and symptoms were associated (21% symptoms with TER vs. 9% symptoms without TER: Chi-squared, P0.001). A high/moderate THRIFT score had a sensitivity of 98.4% (95% CI 91.3%-99.9%) and specificity of 5.8% (95% CI 3.9%-8.3%). The TER assessment had a more evenly balanced sensitivity (41.9%; 95% CI 29.5%-55.2%) and specificity (79%; 95% CI 75.0%-82.6%).Hospice inpatients are at risk for VTE. TER alone is simpler to use and may be more useful in this population than the THRIFT but still has limitations regarding ability to predict symptoms.

There is an established link between socioeconomic status (SES) and performance of health behaviors with more health protective and fewer health-risking behaviors in higher SES groups. This research is novel in testing the moderating effect of SES on the relationship among intention, self-efficacy, and subsequent behavior. Effects were tested on data from three prospective correlational studies examining smoking initiation in adolescents (N = 826), breastfeeding in primiparous women (N = 202), and physical activity in working adults (N = 509). Despite examining different behaviors, samples, time intervals, and measures of SES, each study showed significant interactions between intention and SES in predicting behavior. In all three tests, the intention–behavior relationship was attenuated among individuals from lower SES groups. No moderation effects of SES were found for self-efficacy. The intention–health behavior relationship can be attenuated in lower SES samples. This finding may contribute to our understanding of SES differences in health behaviors.

Objectives The study evaluated the interpretation of, and preferences for, numerical information on side-effect incidence when presented in three different formats. Methods It used a controlled design, with participants allocated at random to receive one of the three formats. Participants were recruited via a pop-up window on the CancerHelp UK website. The sample comprised 129 website users, of whom 96% were women and 86% had cancer, who received frequency information on four side effects of tamoxifen, using one of three risk expressions (percentages, e.g. ‘affects 25% of people’; frequencies, e.g. ‘affects 1 in 4 people’; combined, e.g. ‘affects 1 in 4 people (25%)’). They then interpreted information on tamoxifen and its effect on health, and estimates of side-effect frequency, and then stated a preference from the three risk expression formats. Key findings The results showed that the three formats did not influence participants’ ratings of the information or their side-effect estimates. However, more than half (53%) the participants preferred the combined (frequency and percentage) format. In conclusion, a combined risk expression format performed no worse than percentages or frequencies alone and was preferred by a majority. Conclusions The three risk expression formats did not differ in their effect on participants’ interpretations. However, the preferred format was the combined (frequency and percentage) risk expression.

To report an unusual case of endogenous fungal endophthalmitis due to Candida dubliniensis. Interventional case report of a 27-year-old immunocompetent male with loss of vision, dense vitritis, and chorioretinal infiltrates, who underwent a diagnostic pars plana vitrectomy. Microbiology cultures obtained by a diagnostic vitrectomy were positive for the growth of C. dubliniensis. This infectious process was then appropriately treated with intravitreal amphotericin B and systemic fluconazole with resolution of the endophthalmitis. Endogenous fungal endophthalmitis is a condition that can masquerade other more common causes of endophthalmitis. Atypical cases of endophthalmitis may benefit from diagnostic pars plana vitrectomy for prompt diagnosis and treatment.

Advances in regional anesthesia, specifically continuous peripheral nerve blocks (CPNBs), have greatly improved pain outcomes for wounded soldiers in Iraq and Afghanistan. pain management practice variations, however, do exist, depending on the availability of pain-trained military professionals deployed to combat support hospitals. an exploratory study was undertaken to examine pain and other outcomes during evacuation and at landstuhl regional medical center (lrmc), germany.a mixed-methods, semistructured interview survey design was conducted on a convenience sample of wounded u.s. soldiers evacuated from iraq and afghanistan to lrmc. setting and patients. a total of 110 wounded soldiers evacuated from IRAQ and Afghanistan from July 2007 to February 2008 completed a pain survey at LRMC. Data were collected on demographics, injury mechanism, last 24-hour average, least, and worst, and pain now by using a 0-10 scale, and percent pain relief (from 0% [No relief] to 100% [Complete relief]). Similar items and measures of anxiety, distress, and worry during flight transport were measured (from 0 [None] to 10 [Extreme]). Responses were analyzed by using descriptive and correlational statistics, multiple linear regression, Mann-Whitney U-tests, and t-tests. The Walter Reed Army Medical Center, Human Use Committee approved this investigation.Participants were typically male (99.1%), Caucasian (80%), and injured from improvised explosive devices (60%) and gunshots (21.8%). Average and worst pain scores were inversely correlated with pain relief during transport (r = -0.58 and r = -0.46, respectively; P0.001), and low to moderately positively correlated with increased anxiety, distress, and worry during transport (P0.05). Average percent pain relief achieved was 45.2% +/- 26.6% during transport and 64.5% +/- 23.5% while at LRMC (P0.001). Participants with CPNB catheters placed at LRMC reported significantly less pain right now (P = 0.031) and better pain relief (P = 0.029) than soldiers without CPNBs.Our findings underscore the value of early aggressive pain management after major combat injuries. Increased pain was associated with increased anxiety, distress, and worry during transport, suggesting the need for psychological management along with analgesia. Regional anesthesia techniques while at LRMC contributed to better pain outcomes.

Objective To investigate the effectiveness of presenting medicine side effect risk information in different forms, including that proposed by UK guidelines [ [1] Medicines and Healthcare products Regulatory Agency. Always read the leaflet—Getting the best information with every medicine. (Report of the Committee on Safety of Medicines Working Group on Patient Information). London: The Stationery Office, 2005.]. Methods 134 Cancer Research UK (CRUK) website users were recruited via a ‘pop-up’. Using a 2 × 2 factorial design, participants were randomly allocated to one of four conditions and asked to: imagine they had to take tamoxifen, estimate the risks of 4 side effects, and indicate a presentation mode preference. Results Those presented with absolute frequencies demonstrated greater accuracy in estimating 2 of 4 side effects, and of any side effect occurring, than those presented with frequency bands. Those presented with combined descriptors were more accurate at estimating the risk of pulmonary embolism than those presented with numeric descriptors only. Conclusion Absolute frequencies outperform frequency bands when presenting side effect risk information. However, presenting such exact frequencies for every side effect may be much less digestible than all side effects listed under 5 frequency bands. Combined numerical and verbal descriptors may be better than numeric only descriptors when describing infrequent side effects. Practice implications Information about side effects should be presented in ways that patients prefer, and which result in most accurate risk estimates.

Objective This study investigated the daily hassles-eating behavior relationship and its moderators in a naturalistic setting. Design A multilevel diary design was used to examine day-to-day within-person effects of daily hassles on eating behavior (N = 422), together with the individual and simultaneous influence of potential moderating variables. Main outcome measures Daily diary reports of between-meal snacking, fruit and vegetable consumption and perceived variations in daily food intake. Results The results showed daily hassles were associated with increased consumption of high fat/sugar snacks and with a reduction in main meals and vegetable consumption. Ego-threatening, interpersonal and work-related hassles were associated with increased snacking, whereas, physical stressors were associated with decreased snacking. The overall hassles-snacking relationship was significantly stronger and more positive at high compared to low levels of restraint, emotional eating, disinhibition, external eating and in females and obese participants. Simultaneous consideration of these moderators indicated that emotional eating was the pre-eminent moderator of the hassles-snacking relationship. Conclusion Daily hassles were associated with an increase in unhealthy eating behavior. These changes may indicate an important indirect pathway through which stress influences health risk.

This study investigated the impact of conscientiousness and its facets on health behaviors and daily hassles (stressors) and the moderating effects of conscientiousness on the hassles–health behavior relationship Four hundred and twenty-two employees completed daily diaries over 4 weeks. Day-to-day within-person effects of daily hassles on health behaviors were examined, together with the influence of conscientiousness. Using hierarchical multivariate linear modeling, the results showed that conscientiousness was associated with lower consumption of high-fat snacks and more fruit and higher caffeine intake and smoking (in smokers) across the 28-day study period. Facets of conscientiousness were also found to moderate the effects of daily hassles on vegetable consumption, smoking, and likelihood of exercising each day. Participants with higher levels of order exercised more on days when they experienced daily hassles, whereas participants with lower levels of self-efficacy consumed less vegetables on stressful days. Among smokers, those with higher levels of self-discipline reported smoking more on days when they encountered hassles. These findings indicate that conscientiousness and its facets may influence health status directly via changes in health behaviors and indirectly through influencing stress–health behavior relations.

Four hundred and twenty-two employees completed daily diaries measuring positive affect, negative affect, work hours, and health behaviors (snacking, smoking, exercise, alcohol, caffeine consumption) on work days over a 4-week period. In addition, measures of job demands, job control, and social support (iso-strain variables) were completed on 1 occasion. Multilevel random coefficient modeling was used to examine relationships between the job characteristics, daily work variables, and self-reported health behaviors. Results indicated a more important role for within-person daily fluctuations than for between-persons variations in predicting health behaviors. Whereas negative affect was negatively related to health behavior for both men and women, work hours had negative impacts for women only. Iso-strain variables showed few main effects and a modest number of interactions with daily variables (mainly for men). Findings point to the limited impact of stable features of work design compared to the effects of daily work stressors on health behaviors.

The Looking at Infant Feeding Today (LIFT) study examined the factors underlying the infant feeding choices of first-time mothers in the Leeds and Bradford areas of England experiencing material hardship, with a view to informing interventions aimed at increasing breastfeeding uptake amongst this group. This short report describes the novel methodology used to obtain data from a sample of pregnant women who are traditionally ‘hard-to-reach’ in deprived areas. This involved the use of trusted individuals such as midwives and multilingual health workers. A total of 449 women were approached; 441 (91.5%) agreed to participate and 303 returned completed questionnaires. Whilst 285 participants self-completed, 18 opted for interviewer assistance provided by a trained multilingual health worker. Feeding method up to 10 days after birth was obtained from the hospital records of 248 women (82.4% of eligible returns), and self-reported feeding method at six weeks was obtained from 273 women (90.7% of eligible returns). The study succeeded in obtaining data from a relatively deprived and hard-to-reach sample, with adequate numbers of participants in the subgroups of interest (teenage, left full time education age 16 or younger, household receiving income support or job seekers allowance, Asian or African-Caribbean).

Introduction. Pancreatic cancer is an extremely virulent form of cancer with few effective treatments. Catechin and inositol hexaphosphate (IP6), two naturally occurring molecules found in green tea and high-fiber foods, respectively, are compounds that have been shown to demonstrate anti-proliferative effects when administered as single therapeutic agents against a number of cancers. We hypothesized that, alone and in combination, IP6 and catechin would be effective against pancreatic cancer. Materials and methods. Pancreatic (PANC-1 and MIAPACA) cancer cell lines were cultured and treated with IP6 (0.8 mM/well), catechin (100uM/well), and the combination of the two. Cell viability was measured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) at 24,48, and 72 h. Vascular endothelial growth factor (VEGF) was measured in the cell supernatants by ELISA. Apoptosis was evaluated by Annexin V-fluorescein isothiocyanate (FITC). Results. The combination of catechin and IP6 significantly inhibited proliferation in the PANC-1 cell line at 24, 48, and 72 h compared to single agents (P < 0.001). Growth of the MIAPACA cell line was inhibited (P < 0.01) by each agent alone, but additive inhibitory effects were not seen. An increase in early apoptosis was attributed to catechin therapy in both cell lines (P < 0.01). The combination of these agents also increased early apoptotic activity when compared to the control (P < 0.001). IP6 reduced VEGF in both cell lines (P < 0.01). In combination, catechin and IP6 amplified VEGF reduction compared to each agent in MIAPACA and control (P < 0.002). Conclusions. These results, combined with the prevalence of these compounds in safe, naturally occurring foods, make catechin and IP6 attractive therapies for treatment, and possibly in preventative trials, of pancreatic cancer.

We are currently exploring two of the concerns raised by Husain and Spence—the regulation of health apps and evidence for their effectiveness.1 Android and iOS app stores currently contain more than 100 000 health apps, and the number is constantly increasing.2 The NHS Choices Health Apps Library contains verified apps with trusted information that are clinically safe and comply with data …

Objectives To examine the impact of anticipated regret within the theory of planned behaviour (TPB) on intentions of adolescents to initiate smoking. To examine the moderating role of anticipated regret and intention stability on the relationship between intentions and smoking initiation in adolescents. Methods We conducted two studies measuring anticipated regret within the TPB applied to adolescent smoking initiation. In the first study, 347 non-smoking adolescents (between 11 and 12 years of age) completed the TPB and anticipated regret measures about smoking initiation. In the second study, 675 non-smoking adolescents (between 11 and 12 years of age) completed the TPB, anticipated regret, and intention stability measures in relation to smoking initiation. Smoking was assessed objectively by carbon monoxide breath monitor 9 months later. Results In Studies 1 and 2, regret significantly added to predictions of intentions over and above components of the TPB (p

Before becoming a medical student I worked as a health psychologist. This involved trying to explain what motivates the behaviours associated with health and illness. Medical training has steered me towards diagnosis and treatment, but perhaps there is room for more communication between these two disciplines. When taking histories many doctors do not routinely ask patients if they have considered a change in a behaviour that may play a part in their current illness and future health. Is this because we do not feel it is our role or because we do not have time? …

The study examined the effectiveness of using a group-administered self-instructional training programme (Peter Parrot) to increase reflectivity in school-age children. Forty-four children were divided into a treatment and attention-control group (mean age 7.58 and 7.75 years respectively). Each group was administered four dependent measures (pre and post) and received six training sessions over two weeks. The treatment group was given the Peter Parrot training programme while the attention-control group received their usual classroom instruction. Findings indicated that the treatment programme was effective in increasing reflectivity in children. The study also supported the use of a group training procedure to reduce impulsivity, thus increasing reflectivity. Generalization to classroom behaviour and performance is discussed. Further research utilizing group training procedures is recommended.

In many language programs, students are placed in streamed, relatively homogeneous classes according to their proficiency in the target language. However, proponents of mixed-ability classes believe that through forming mixed-ability groups lower-proficiency learners feel less stigmatized, and that both higher- and lower-proficiency learners benefit from peer tutoring. This paper reports on the results from a survey that explored the perceptions of 31 EFL teachers at four Japanese universities regarding streamed and mixedability first-year EFL classes. Most teacher-participants expressed a preference for teaching streamed classes, citing advantages related to the effectiveness of instruction, appropriateness of materials, student motivation, and the quality of learner-learner interaction. DOI: http://dx.doi.org/10.3126/nelta.v16i1-2.6131 NELTA 2011; 16(1-2): 70-81

Background Older yet still abundant munitions such as tetryl present easily forgotten health hazards and associated needs for worker protection. Case presentation Symptoms and findings from 22 workers who were exposed to tetryl are summarized. Conclusions This study highlights the health hazards from exposure to tetryl. Occupational health professionals need to maintain vigilance to protect workers from the risks of handling older munitions.

BackgroundPrimary care records have traditionally served the needs and demands of clinicians rather than those of the patient. GP contracts in England state practices must promote and offer registered patients online access to their primary care record and research has shown benefits to both patients and clinicians of doing so. Despite this, we know little about patients’ needs and expectations regarding online access.AimTo explore patients’ views about accessing online primary care records and to find out how patients would like to interact with their records and what support they may need.MethodInterviews and focus groups with a sample of 50 patients from a variety of socio-demographic backgrounds who were either; eligible for the NHS Health Check; had multimorbidities or were carers. Thematic analysis of data identified major themes impacting upon patients’ wishes and needs as well as highlighting population-specific issues.ResultsParticipants highlighted a wide range of views about the benefits and drawbacks of accessing their records online. The majority of participants indicated that they would be more likely to access their online primary care record if improvements were made to the design, reliability and functionality of existing online record services. Carers found accessing online records particularly useful.ConclusionConsultation with patients and carers about their experiences of accessing online records; support needs and preferred functions can provide useful insights to inform the future design of online record services.

This study employed the theory of planned behaviour (TPB) to investigate the factors underlying intentions and frequency of use of cannabis over a three-month period in a population of students (N = 249). In addition, several hypotheses in relation to the TPB were investigated. The TPB provided good predictions of both intentions (R2 = 0.653; attitude, injunctive norms and perceived behavioural control significant) and behaviour (R2 = 0.711; intentions significant). Other norm measures (descriptive and moral norms) explained additional variance in intentions (p < .01). In addition, habit strength and self-identity explained significant additional portions of the variance in intentions (p < .001), but not behaviour, over and above the TPB variables. Several interactions among these variables were also tested. Attitude moderated the impact of perceived behavioural control (PBC) on intentions (p < .001). Moral norms moderated the impact of attitudes on intentions (p < .001). Habit strength moderated the impact of self-identity on intentions (p < .001). PBC was found to moderate the impact of intentions on behaviour (p < .05). The findings are discussed in relation to how interaction effects further our understanding of the social processes by which variables are related in the TPB.

This research examined the impact of passenger-type on young people’s responses to a driving scenario about speeding. In the scenarios, the presence, and gender of the passenger were systematically varied. A total of 162 respondents (83 females, 79 males) completed questionnaires containing measures from the Theory of Planned Behaviour (TPB) and additional variables after reading each of two scenarios. The TPB provided good predictions of intention to speed (45% explained variance) with all TPB variables plus moral norms and past behaviour significant. Males compared to females reported significantly greater normative pressure to speed, less control over not speeding, and less moral norms not to speed. Normative pressure was a stronger predictor of intentions for men compared to women when driving alone. Normative pressure was a stronger predictor of intentions when the passenger was male.

With patients and healthcare professionals increasingly using health apps, Armstrong’s article is timely.1 At the Academic Unit of Primary Medical Care in Sheffield we examined quality assurance for health behaviour change apps by adapting the 2014 NICE behaviour change guidance.2 We identified nine areas that are important to consider when …