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Helen Clare Ricketts,1 Varun Sharma,1 Femke Steffensen,2 Elaine Mackay,3 Gordon Wallace MacDonald,4 Duncan S Buchan,5 Michael Lean,6 Rekha Chaudhuri,7 Douglas C Cowan4 1College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK; 2Glasgow Clinical Research Facility, Glasgow Royal Infirmary, Glasgow, UK; 3Pulmonary Rehabilitation Team, Glasgow Royal Infirmary, Glasgow, UK; 4Respiratory Department, Glasgow Royal Infirmary, Glasgow, UK; 5Division of Sports and Exercise, University of the West of Scotland, Glasgow, UK; 6School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK; 7Respiratory Department, Gartnavel General Hospital, Glasgow, UKCorrespondence: Douglas C Cowan, Email douglas.cowan@ggc.scot.nhs.ukIntroduction: Management of difficult-to-treat asthma is particularly challenging in people with elevated body mass index (BMI). Our randomised controlled trial of pulmonary rehabilitation (PR) showed improved outcomes at 8 weeks. Here we assess immediate and one-year effects of asthma-tailored PR in participants with difficult-to-treat asthma and BMI ≥ 25 kg/m2, and identify response predictors.Methods: A prospective observational study of PR, tailored to asthma, comparing outcomes at baseline (V1), immediately after 8 weeks of PR (V2), and at 1 year (V3). Baseline characteristics were compared in responders/non-responders defined by achievement of minimum clinically important difference (MCID) for asthma control questionnaire (ACQ6) (0.5) at 8 weeks and 1 year.Results: Of 92 participants, 56 attended V2 and 45 attended V3. Mean age was 60 (SD 13) years, 60% were female, and median (IQR) BMI was 33.8 (29.5– 38.7) kg/m2. At V1, V2, and V3, respectively, there were significant differences in ACQ6 (mean (95% CI): 2.5 (2.1– 2.9), 2.2 (1.8– 2.5), and 2.3 (1.9– 2.7), p< 0.003), Borg breathlessness score post-6-minute walk test (median (IQR): 2 (0.5– 3), 1 (0– 2), and 1 (0.5– 2), p< 0.035), and annualised exacerbations requiring prednisolone (median (IQR): 3 (2– 5), 0 (0– 4.7), and 1.5 (0– 4.2), p< 0.003). A total of 27/56 (48%) had improvements >MCID for ACQ6 at V2 and 16 (33%) at V3. Participants with higher ACQ6 scores at baseline (suggesting poorer asthma control) were more likely to achieve MCID. Baseline BMI, within the range studied, was not predictive.Conclusion: Pulmonary rehabilitation induced improvements in asthma-related outcomes including perception of breathlessness, asthma control, and exacerbation frequency at 1 year. Those with poorer baseline asthma control were more likely to benefit.Keywords: asthma, difficult-to-treat asthma, obesity, pulmonary rehabilitation

Background: Cybersecurity breaches have become a growing challenge in today’s digital economy. Organisations are faced with the responsibility of protecting their information resources from cybersecurity threats, and insider threats are one of them. Organisations have sophisticated technologies to protect themselves against these attacks, and their employees are often less guarded when it comes to protecting valuable company information systems. Objectives: This research was aimed to develop and conceptualise a model to reduce cybersecurity insider threats in a South African telecommunication organisation. Method: This study was conducted using a survey research approach, where close-ended questionnaires were utilised to collect data from respondents. The collected data was then analysed using IBM Statistical Package for Social Science (SPSS). Results: The findings of the study indicated that personal norms in the domain of cybersecurity have a positive influence on individuals’ attitude towards engaging in cybersecurity misbehaviour, and this has a significant relationship with their reduction of insider threats (RIT). Conclusion: This study suggests that management should give close and thoughtful attention to factors that encourage their employees to engage in cybersecurity misbehaviour. As an efficient and effective approach to mitigate the risk of cybersecurity insider threats, identification and classification of these factors should be followed by proper planning with a goal of reducing their negative effect on employees’ behaviour.