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Background: Mechanical thrombectomy is standard of care for acute ischemic stroke secondary to LVO however MT failure (MTF) occurs in approximately 15% of cases. Objective: Investigate patient and procedural characteristics that predict MTF. Methods: Retrospective review of prospectively collected, Stroke Thrombectomy and Aneurysm Registry. Patients who underwent MT for LVO were included and categorized by MT Success (MTS) or MTF, defined as mTICI≥2b or Results: A total of 8452 patients were analyzed, and 1301(15.4%) experienced MTF.MTF patients were older(73 vs.71, p=0.008)had higher poor premorbid mRS(10.8% vs 8.4%, p=0.17).Onset to puncture was greater in MTF group(442 vs.411 min, p=0.006).There were more ICA occlusions(15.6% vs. 13.5%)and basilar occlusions(7.8% vs.6.2%)in the MTF group and more M1 occlusions(42.2%vs.37.5%)in the MTS group (p Conclusion: MTF is associated with more complications and worse outcome. Final use of aspiration and rescue intracranial stenting may increase chances of recanalization.

Background and aims The current study aimed to assess how sports bettors respond to advertised bets on social media and whether this differs dependent upon bet complexity and social media account type. Methods Employing a 3 × 2 repeated measures design, 145 regular football bettors were recruited to take part in an online study requiring them to rate bets advertised upon social media, providing indications of their likelihood to bet, confidence in the bet and how much they would stake on the bet. Advertised bets differed in terms of complexity (low, medium and high) and each bet was presented separately on both an operator account and an affiliate account. Results Data analysis highlighted a significant interaction between bet complexity and account type, with bettors rating themselves as being more likely to bet and more confident in bets which were presented on an affiliate account for medium complexity bets but not for low or high complexity bets. Discussion and conclusions This study provides initial evidence that affiliate marketing of sports betting increases bettor's confidence in certain types of bets. This heightens previously addressed concerns around affiliate marketing, given that affiliates are financially incentivised to attract custom toward gambling operators. Future research should explore risk factors for increased uptake of affiliate marketing, and the impact on gambling behaviour.

This study assessed bets advertised on Twitter by betting operators and affiliates, as well as their success. Bets advertised by 10 Twitter accounts were tracked over two weeks. Information recorded included: bet odds, bet type, number of times advertised, and bet success. The success of bets was calculated based upon placing equal stakes on each bet and running four sets of 10,000 simulations, each of an increasing number of randomly chosen bets with fixed bet stake per bet from those recorded. Both operators and affiliates advertised around 140 bets per day at average decimal odds of 6.0, however affiliates posted each bet three-times more than operators. Only one-in-five bets advertised won. Affiliate bets led to a 12% loss of original stakes, whilst operator bets led to a 20% loss. Only 30% of 10,000 simulations of 14 randomly chosen bets led to profit, decreasing to 19% when the number of bets included in the simulation increased to 140. Findings raise concerns about the volume of bets advertised on social media with large expected losses. Simulation data demonstrates how the chance of making a profit decreases the more advertised bets are bet upon. Future research should explore bettors’ responses to such marketing.

OBJECTIVE Although younger adults have been shown to have better functional outcomes after mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the significance of this relationship in the adolescent and young adult (AYA) population is not well defined given its undefined rarity. Correspondingly, the goal of this study was to determine the prognostic significance of age in this specific demographic following MT for large-vessel occlusions. METHODS A prospectively maintained international multi-institutional database, STAR (Stroke Thrombectomy and Aneurysm Registry), was reviewed for all patients aged 12–18 (adolescent) and 19–25 (young adult) years. Parameters were compared using chi-square and t-test analyses, and associations were interrogated using regression analyses. RESULTS Of 7192 patients in the registry, 41 (0.6%) satisfied all criteria, with a mean age of 19.7 ± 3.3 years. The majority were male (59%) and young adults (61%) versus adolescents (39%). The median prestroke modified Rankin Scale (mRS) score was 0 (range 0–2). Strokes were most common in the anterior circulation (88%), with the middle cerebral artery being the most common vessel (59%). The mean onset-to–groin puncture and groin puncture–to-reperfusion times were 327 ± 229 and 52 ± 42 minutes, respectively. The mean number of passes was 2.2 ± 1.2, with 61% of the cohort achieving successful reperfusion. There were only 3 (7%) cases of reocclusion. The median mRS score at 90 days was 2 (range 0–6). Between the adolescent and young adult subgroups, the median mRS score at last follow-up was statistically lower in the adolescent subgroup (1 vs 2, p = 0.03), and older age was significantly associated with a higher mRS at 90 days (coefficient 0.33, p < 0.01). CONCLUSIONS Although rare, MT for AIS in the AYA demographic is both safe and effective. Even within this relatively young demographic, age remains significantly associated with improved functional outcomes. The implication of age-dependent stroke outcomes after MT within the AYA demographic needs greater validation to develop effective age-specific protocols for long-term care across both pediatric and adult centers.

BackgroundReducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy.MethodsThis is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database. All patients who underwent AIS thrombectomy with available ICH data were included. Multivariable regression models were developed to identify predictors of ICH after thrombectomy. Subgroup analyses were performed stratified by symptom status and European Cooperative Acute Stroke Study (ECASS) grade.ResultsThe study cohort comprised 6860 patients. Any ICH and symptomatic ICH (sICH) occurred in 25% and 7% of patients, respectively. Hemorrhagic infarction 1 (HI1) occurred in 36%, HI2 in 24%, parenchymal hemorrhage 1 (PH1) in 22%, and PH2 in 17% of patients classified by ECASS grade. Intraprocedural complications independently predicted any ICH (OR 3.8083, PConclusionsThis study identified ICH risk factors after AIS thrombectomy using real-world data. There was a propensity towards a reduced sICH risk with direct aspiration. Procedural complications and ethnicity were predictors congruent between categories of any ICH, sICH, PH1, and PH2. Further investigation of technique and ethnicity effects on ICH and outcomes after AIS thrombectomy is warranted.

BackgroundRecent clinical trials have shown that mechanical thrombectomy is superior to medical management for large vessel occlusion for up to 24 hours from onset. Our objective is to examine the safety and efficacy of thrombectomy beyond the standard of care window.MethodsA retrospective review was undertaken of the multicenter Stroke Thrombectomy and Aneurysm Registry (STAR). We identified patients who underwent mechanical thrombectomy for large vessel occlusion beyond 24 hours. We selected a matched control group from patients who underwent thrombectomy in the 6–24-hour window. We used functional independence at 3 months as our primary outcome measure.ResultsWe identified 121 patients who underwent thrombectomy beyond 24 hours and 1824 in the 6–24-hour window. We selected a 2:1 matched group of patients with thrombectomy 6–24 hours as a comparison group. Patients undergoing thrombectomy beyond 24 hours were less likely to be independent at 90 days (18 (18.8%) vs 73 (34.9%), P=0.005). They had higher odds of mortality at 90 days in the adjusted analysis (OR 2.34, P=0.023). Symptomatic intracerebral hemorrhage and other complications were similar in the two groups. In a multivariate analysis only lower number of attempts was associated with good outcomes (OR 0.27, P=0.022).ConclusionsMechanical thrombectomy beyond 24 hours appears to be safe and tolerable with no more hemorrhages or complications compared with standard of care thrombectomy. Outcomes and mortality in this time window are worse compared with an earlier time window, but the rates of good outcomes may justify this therapy in selected patients.

The growing awareness of gambling as a public health issue, whereby harm extends far beyond an individual disordered gambler (Wardle, Reith, Langham, & Rogers, 2019), has led to an increased focus ...

ImportanceThere is substantial controversy with regards to the adequacy and use of noncontrast head computed tomography (NCCT) for late-window acute ischemic stroke in selecting candidates for mechanical thrombectomy.ObjectiveTo assess clinical outcomes of patients with acute ischemic stroke presenting in the late window who underwent mechanical thrombectomy stratified by NCCT admission in comparison with selection by CT perfusion (CTP) and diffusion-weighted imaging (DWI).Design, Setting, and ParticipantsIn this multicenter retrospective cohort study, prospectively maintained Stroke Thrombectomy and Aneurysm (STAR) database was used by selecting patients within the late window of acute ischemic stroke and emergent large vessel occlusion from 2013 to 2021. Patients were selected by NCCT, CTP, and DWI. Admission Alberta Stroke Program Early CT Score (ASPECTS) as well as confounding variables were adjusted. Follow-up duration was 90 days. Data were analyzed from November 2021 to March 2022.ExposuresSelection by NCCT, CTP, or DWI.Main Outcomes and MeasuresPrimary outcome was functional independence (modified Rankin scale 0-2) at 90 days.ResultsAmong 3356 patients, 733 underwent late-window mechanical thrombectomy. The median (IQR) age was 69 (58-80) years, 392 (53.5%) were female, and 449 (65.1%) were White. A total of 419 were selected with NCCT, 280 with CTP, and 34 with DWI. Mean (IQR) admission ASPECTS were comparable among groups (NCCT, 8 [7-9]; CTP, 8 [7-9]; DWI 8, [7-9]; P = .37). There was no difference in the 90-day rate of functional independence (aOR, 1.00; 95% CI, 0.59-1.71; P = .99) after adjusting for confounders. Symptomatic intracerebral hemorrhage (NCCT, 34 [8.6%]; CTP, 37 [13.5%]; DWI, 3 [9.1%]; P = .12) and mortality (NCCT, 78 [27.4%]; CTP, 38 [21.1%]; DWI, 7 [29.2%]; P = .29) were similar among groups.Conclusions and RelevanceIn this cohort study, comparable outcomes were observed in patients in the late window irrespective of neuroimaging selection criteria. Admission NCCT scan may triage emergent large vessel occlusion in the late window.

Although positive psychology interventions are generally aimed at individuals, when considering couples, a dyadic approach may be more effective. In terms of a couples’ wellbeing, their relationship is one of the most important factors. As such, interventions targeted for both members’ wellbeing via their relationship are likely to be of value. Currently, there exist limited dyadic positive activity interventions available in positive psychology, and notably, tactile intervention is lacking. Massage is the evidence based tactile health modality that has long history as a therapeutic intervention, as well as being one of the most natural human health-oriented behaviours. The current commentary argues for the link between positive psychology and massage, and that “Positive Massage” can be a bridge between the hitherto distinct entities of positive psychology and massage. Furthermore, based on the conceptual theoretical model of the link between Positive Massage and wellbeing, we propose that Positive Massage can be an effective positive intervention impacting on couples’ wellbeing and enhancing their relationships.

Objective: This study aimed to identify if a limited duration inhalation of BOOST Oxygen Beauty® would impact on blood oxygen saturation levels, and whether any observed effect would be reflected in changes to facial skin colour and tone. Methods: Ten white female participants completed this randomised double-blind placebo controlled crossover study. Each participant was free from any make-up, and provided baseline measures of haemoglobin saturation, and facial skin colour and tone based on the CIE L* a* b* colour space. Five deep inhalations from the oxygen product or air placebo canister were then taken and second readings of all variables recorded. This process was repeated three times. Following a ten-minute rest period new baseline measures were made followed by a repeat of the procedure for the second treatment canister. Results: Data were analysed using factorial repeated measures analysis of variance (Anova). A significant treatment * time point interaction effect indicated an increase in blood oxygen saturation for the oxygen treatment, p = 0.007, whereas no change was found in the placebo condition. Significant differences were found between the treatments for measurements of red following inhalation, p = 0.033, with oxygen inhalation producing higher levels. In addition, a significant treatment * time point interaction effect was evident for the blue b* dimension, p = 0.009, with oxygen inhalation producing lower values than placebo over time. Individual Typology Angle values revealed no change following oxygen treatment, indicating skin tone was not affected. Conclusion: This study shows for the first time that inhalation of a branded oxygen beauty product can significantly impact blood oxygen saturation, and facial colour, producing a redder hue. The potential for these changes to predict ratings of health, attractiveness and age is an interesting prospect.

Background: ANDHI was done to assess the efficacy of benralizumab, including onset of effect and impact on health-related quality of life (HRQOL), exacerbation rate, lung function, and nasal polyposis symptoms. Methods: This phase 3b, randomised, double-blind, parallel-group, placebo-controlled ANDHI study was completed in adults (aged 18–75 years) with severe eosinophilic asthma with at least 2 exacerbations in the previous year, despite high-dose inhaled corticosteroid plus additional controllers, screening blood eosinophil counts of at least 150 cells per μL, and an Asthma Control Questionnaire 6 (ACQ-6) score of 1·5 or more. Patients who met eligibility criteria were randomly assigned (2:1; stratified by previous exacerbation count [two, or three or more], maintenance oral corticosteroid use, and region), using an integrated web-based response system, to receive benralizumab at 30 mg every 8 weeks (first three doses given 4 weeks apart) or matched placebo for 24 weeks. Primary efficacy measure was annualised asthma exacerbation rate, with rate ratio (RR) calculated over the approximate 24-week follow-up. Secondary efficacy measures included change from baseline to end of treatment (week 24) in St George's Respiratory Questionnaire (SGRQ) total score (key secondary endpoint), FEV1, peak expiratory flow (PEF), ACQ-6, Predominant Symptom and Impairment Assessment (PSIA), Clinician Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Sino-Nasal Outcome Test-22 (SNOT-22). All efficacy analyses, except for SNOT-22, were summarised and analysed using the full analysis set on an intention-to-treat population (all randomly assigned patients receiving investigational product, regardless of protocol adherence or continued participation in the study). SNOT-22 was summarised for the subgroup of patients with physician-diagnosed nasal polyposis with informed consent. This study is registered with ClinicalTrials.gov, NCT03170271. Findings: Between July 7, 2017, and Sept 25, 2019, 656 patients received benralizumab (n=427) or placebo (n=229). Baseline characteristics were consistent with severe eosinophilic asthma. Benralizumab significantly reduced exacerbation risk by 49% compared with placebo (RR estimate 0·51, 95% CI 0·39–0·65; p5%) were nasopharyngitis (30 [7%]), headache (37 [9%]), sinusitis (28 [7%]), bronchitis (22 [5%]), and pyrexia (26 [6%]). Fewer serious adverse events were reported for benralizumab (23 [5%]) versus placebo (25 [11%]), and the only common serious adverse event (experienced by >1% of patients) was worsening of asthma, which was reported for nine (2%) patients in the benralizumab group and nine (4%) patients in the placebo group. Interpretation: Our results extend the efficacy profile of benralizumab for patients with severe eosinophilic asthma, showing early clinical benefits in patient-reported outcomes, HRQOL, lung function, and nasal polyposis symptoms. Funding: AstraZeneca.

This experimental study evaluated the differential effects of ‘giving’ and ‘receiving’ massage on wellbeing in healthy but stressed couples. Forty-two volunteers started the study and of these, 38 (i.e. 19 couples) completed a 3-week massage course. Emotional stress and mental clarity were assessed before and after mutual massage between each pair of adults belonging to a couple at home. While massage benefitted both parties’ wellbeing within a session, critically we found no differences in wellbeing between those ‘giving’ and ‘receiving’ massage. These novel findings suggest that home-based massage may be advocated to couples as a ‘selves-care’, health-promoting behaviour.

Electroacupuncture (EA) stimulation is a supplementary therapy and commonly applied in treatment of ischemic stroke in clinic. Stroke is an important cause of long-term disability in individuals in both developing and developed countries. In our review, we show the application of EA stimulation for apoplectic pain, limbs spasticity, blood flow interruption, depression, swallowing dysfunction, aphasia, urinary incontinence, cognition and memory impairment, and constipation following stroke in patients and the related mechanisms in animals. The effectiveness of EA involves with acupoints, intensity, intervals, and duration of intervention for treatment of stroke. The combination of EA and common rehabilitation treatment may exert better effect compared with EA alone. In summary, EA might provide a potential treatment strategy for treating apoplectic patients in clinic.

Background The internet continues to offer new forms of support for health decision making. Government, charity, and commercial websites increasingly offer a platform for shared personal health experiences, and these are just some of the opportunities that have arisen in a largely unregulated arena. Understanding how people trust and act on this information has always been an important issue and remains so, particularly as the design practices of health websites continue to evolve and raise further concerns regarding their trustworthiness. Objective The aim of this study was to identify the key factors influencing US and UK citizens’ trust and intention to act on advice found on health websites and to understand the role of patient experiences. Methods A total of 1123 users took part in an online survey (625 from the United States and 498 from the United Kingdom). They were asked to recall their previous visit to a health website. The online survey consisted of an updated general Web trust questionnaire to account for personal experiences plus questions assessing key factors associated with trust in health websites (information corroboration and coping perception) and intention to act. We performed principal component analysis (PCA), then explored the relationship between the factor structure and outcomes by testing the fit to the sampled data using structural equation modeling (SEM). We also explored the model fit across US and UK populations. Results PCA of the general Web trust questionnaire revealed 4 trust factors: (1) personal experiences, (2) credibility and impartiality, (3) privacy, and (4) familiarity. In the final SEM model, trust was found to have a significant direct effect on intention to act (beta=.59; P Conclusions Credibility and impartiality continue to be key predictors of trust in eHealth websites. Websites with patient experiences can positively influence trust but only if users first corroborate the information through other sources. The need for corroboration was weaker in the United Kingdom, where website familiarity reduced the need to check information elsewhere. These findings are discussed in relation to existing trust models, patient experiences, and health literacy.

The possible positive impact of aromas of plant essential oils is an area with a long history and one that is receiving increasing interest from modern science. Previous research has demonstrated beneficial effects of acute exposure on a range of variables. The current study set out to investigate for the first time whether extended exposure to the aroma of peppermint essential oil could provide benefits to healthy young adults. One hundred participants were randomly assigned to either wear a peppermint infused non-transdermal skin patch or a blank patch, for a period of six hours during which time they went about their normal daily routine. Cognitive and mood assessments were completed and a multivariate analysis of variance indicated a significant difference to exist between the two groups when all variables were analysed together. Further analyses on the individual variables revealed small to medium positive effects of peppermint aroma on aspects of memory and attention and feelings of subjective alertness. These findings add to a growing body of evidence that suggests aroma of peppermint essential oil may act as a positive and easy intervention delivering beneficial objective and subjective outcomes. The findings are discussed in terms of putative mechanisms that might underpin the effects with a focus on possible pharmacological influences.

The current study aimed to assess the type of content posted on Twitter by British gambling operators and gambling affiliates; third-party firms who are financially incentivised to attract custom to gambling operators. Five thousand and twenty nine tweets from 5 gambling operators and 8,315 tweets from 5 gambling affiliates were collected over a 2 week period. A summative content analysis was carried out whereby each tweet was coded for its main content. Tweets were grouped together into content categories and the percentage of tweets in each content category was calculated for both operators and affiliates. The 9 categories of content found were; direct advertising, betting assistance, sports content, customer engagement, humour, update of current bet status, promotional content, safer gambling and ‘other’. Gambling operators had a higher proportion of posts in the sports content and humorous content categories, whilst affiliates had a higher proportion of posts within the direct advertising and betting assistance categories. These findings suggest that the affiliates were more direct in their posting style whereas operators followed a more indirect approach, reflective of a branding strategy. Future research should address how interacting with different types of gambling content on social media impacts upon gambling attitudes and behaviour.

Background Although extremely rare, acute bilateral large vessel occlusion (LVO) is a morbid condition that requires prompt intervention. Objective To report the technique used to achieve recanalization of bilateral internal carotid artery (ICA) terminus occlusions. Methods This is a case of bilateral ICA terminus occlusions managed with simultaneous bilateral thrombectomies with poor collateral circulation. Results Recanalization of bilateral ICA with thrombolysis in cerebral infarction (TICI) grade 0 to left TICI 2b flow with distal left A1 occlusion and right TICI 3 flow was achieved in 32 min with the use of simultaneous catheterization and aspiration thrombectomies. Conclusion The described technique offers an efficient and feasible means to reduce time to recanalization and radiation in cases of bilateral LVO.

Benralizumab is an interleukin-5 receptor α-directed cytolytic monoclonal antibody that has been shown to safely reduce exacerbations and improve lung function for patients with asthma. We assessed the long-term safety and efficacy of benralizumab for patients with severe, uncontrolled eosinophilic asthma.We conducted a randomised, double-blind, parallel-group, phase 3 extension study at 447 sites in 24 countries. Eligible patients had to have completed the SIROCCO or CALIMA trials and remained on subcutaneous benralizumab 30 mg every 4 weeks (Q4W) or every 8 weeks (Q8W). Patients who had received placebo in those trials were re-randomised in a 1:1 ratio, using an interactive web-based system, to benralizumab 30 mg either Q4W or Q8W (first three doses 4 weeks apart). Treatment lasted for 56 weeks for adult patients (age ≥18 years) and 108 weeks for adolescent patients (age 12-17 years). The primary endpoint was the safety and tolerability of the two dosing regimens of benralizumab up to 68 weeks for adult patients (including the follow-up visit post-treatment) and up to 56 weeks for adolescent patients. This endpoint was assessed in the full analysis set, which included all patients from the SIROCCO and CALIMA predecessor studies who received at least one dose of study treatment in BORA and did not continue into another trial. This study is registered with ClinicalTrials.gov (NCT02258542).Between Nov 19, 2014, and July 6, 2016, we enrolled 1926 patients, of whom 633 had received benralizumab Q4W and 639 had received benralizumab Q8W in SIROCCO or CALIMA. The remaining 654 patients had received placebo in those trials and were randomly re-assigned in this trial to receive benralizumab Q4W (n=320) or Q8W (n=334). 1576 patients, including 783 who received benralizumab Q4W (265 newly assigned) and 793 who received benralizumab Q8W (281 newly assigned), were included in the full analysis set. The most common adverse events in all groups were viral upper respiratory tract infection (14-16%) and worsening asthma (7-10%). The most common serious adverse events were worsening asthma (3-4%), pneumonia (1% to 1%), and pneumonia caused by bacterial infection (0-1%). The percentages of patients who had any on-treatment adverse event, any serious adverse event, or any adverse event leading to treatment discontinuation during BORA were similar between patients originally assigned benralizumab and those originally assigned placebo and between benralizumab treatment regimens. The percentage of patients who had any adverse event was similar between SIROCCO or CALIMA (71-75%; benralizumab group only) and BORA (65-71%), as was the percentage of patients who had an adverse event that led to treatment discontinuation (2% in SIROCCO and CALIMA vs 2-3% in BORA).The 2 years of safety results validate that observations observed in the first year of benralizumab continued through a second year of treatment. No new consequences of long-term eosinophil depletion occurred, and the incidence of other adverse events, including opportunistic infections, were similar during the second year.AstraZeneca and Kyowa Hakko Kirin.

Background: The use of herbal extracts and supplements to enhance health and wellbeing is increasing in western society. Aims: This study investigated the impact of the acute ingestion of a commercially available water containing an extract and hydrolat of rosemary ( Rosmarinus officinalis L. syn. Salvia rosmarinus Schleid.). Aspects of cognitive functioning, mood and cerebrovascular response measured by near-infrared spectroscopy provided the dependent variables. Methods: Eighty healthy adults were randomly allocated to consume either 250 mL of rosemary water or plain mineral water. They then completed a series of computerised cognitive tasks, followed by subjective measures of alertness and fatigue. Near-infrared spectroscopy monitored levels of total, oxygenated and deoxygenated haemoglobin at baseline and throughout the cognitive testing procedure. Results: Analysis of the data revealed a number of statistically significant, small, beneficial effects of rosemary water on cognition, consistent with those found previously for the inhalation of the aroma of rosemary essential oil. Of particular interest here are the cerebrovascular effects noted for deoxygenated haemoglobin levels during cognitive task performance that were significantly higher in the rosemary water condition. This represents a novel finding in this area, and may indicate a facilitation of oxygen extraction at times of cognitive demand. Conclusion: Taken together the data suggest potential beneficial properties of acute consumption of rosemary water. The findings are discussed in terms of putative metabolic and cholinergic mechanisms.

ObjectiveThis study assessed self-reported and objective prospective memory (PM) processes in smokers and a never-smoked comparison group. If persistent smoking does impair PM, then one would expect smokers recall being lower on a study that requires them to remember everyday activities when compared with a never-smoked group.MethodAn existing-groups design was used to compare a group of smokers with a never-smoked group on the self-report Prospective Memory Questionnaire (PMQ) and the Prospective Remembering Video Procedure (PRVP) measuring objective PM. An example of the location–action combination from the PRVP is ‘At Thornton's shop’ (location), ‘Buy a bag of sweets’ (action). Participants who reported using an illegal substance (e.g. ecstasy, cannabis), who drank excessively or were ‘binge drinkers’, or who reported suffering from a clinical condition, such as depression, were excluded from the study. Age, weekly ‘safe levels’ alcohol use, and strategy use were also measured and controlled for in the study. Each person was tested individually in a quiet laboratory setting on a university campus.ResultsAfter controlling for variations in age, weekly alcohol use, and strategy use, smokers recalled significantly fewer location–action combinations on the PRVP when compared with a never-smoked group, with no between-group differences on self-reported PM as measured by the PMQ.ConclusionsThe findings suggest objective PM deficits are associated with persistent smoking – a relatively unexplored area of research. This cannot be attributed to other drug use, mood, or strategy use. The findings also suggest smokers lack self-awareness of such PM deficits. This study extends the area by utilising a more naturalistic object measure of PM and incorporating strict controls into the study.

This study investigated the potential impact of the acute ingestion of No. 1 Rosemary water—a commercially available carbonated water containing an extract of Rosemary (Rosmarinus officinalis). Twenty healthy adults were randomly allocated to consume either 330 ml of No. 1 Rosemary water or plain carbonated water. They then completed a series of subjective measures and cognitive tasks including a fifteen-minute session on a stress inducing multi-tasking framework, followed by a second completion of the subjective measures. Heart rate and blood pressure were monitored throughout the procedure. Given the pilot nature of the study, analysis of the data eschewed significance testing for the calculation of Cohen’s d measure of effect sizes. These revealed a number of small enhancement effects on cognition, consistent with those found previously for the inhalation of the aroma of Rosemary essential oil, and oral administration of dried herb. Of particular interest here are the reduced subjective evaluations of stress, and the blunted physiological reactivity noted for heart rate and blood pressure, which represent novel findings in this area. Taken together the data suggest further investigation of this product is warranted with regard to its potential beneficial properties.

BACKGROUND The internet continues to offer new forms of support for health decision making. Government, charity, and commercial websites increasingly offer a platform for shared personal health experiences, and these are just some of the opportunities that have arisen in a largely unregulated arena. Understanding how people trust and act on this information has always been an important issue and remains so, particularly as the design practices of health websites continue to evolve and raise further concerns regarding their trustworthiness. OBJECTIVE The aim of this study was to identify the key factors influencing US and UK citizens’ trust and intention to act on advice found on health websites and to understand the role of patient experiences. METHODS A total of 1123 users took part in an online survey (625 from the United States and 498 from the United Kingdom). They were asked to recall their previous visit to a health website. The online survey consisted of an updated general Web trust questionnaire to account for personal experiences plus questions assessing key factors associated with trust in health websites (information corroboration and coping perception) and intention to act. We performed principal component analysis (PCA), then explored the relationship between the factor structure and outcomes by testing the fit to the sampled data using structural equation modeling (SEM). We also explored the model fit across US and UK populations. RESULTS PCA of the general Web trust questionnaire revealed 4 trust factors: (1) personal experiences, (2) credibility and impartiality, (3) privacy, and (4) familiarity. In the final SEM model, trust was found to have a significant direct effect on intention to act (beta=.59; PPP=.04). Variables specific to electronic health (eHealth; information corroboration and coping) were found to substantially improve the model fit, and differences in information corroboration were found between US and UK samples. The final model accounting for all factors achieved a good fit (goodness-of-fit index [0.95], adjusted goodness-of-fit index [0.93], root mean square error of approximation [0.50], and comparative fit index [0.98]) and explained 65% of the variance in trust and 41% of the variance in intention to act. CONCLUSIONS Credibility and impartiality continue to be key predictors of trust in eHealth websites. Websites with patient experiences can positively influence trust but only if users first corroborate the information through other sources. The need for corroboration was weaker in the United Kingdom, where website familiarity reduced the need to check information elsewhere. These findings are discussed in relation to existing trust models, patient experiences, and health literacy.

Objectives The aim was to develop a quantitative tool to measure perceived motivators and barriers to exercise amongst older adults in order to facilitate the development of bespoke interventions. Methods Focus groups conducted with participants over the age of 65 informed the initial development of a 56-item Motivators and Barriers Questionnaire (MBQ). This was administered to a second sample of 72 sedentary and active older adults (65 to 90 years). Results Principle components analysis resulted in five factors defined as motivators to exercise and six factors representing barriers to exercise. A subsequent confirmatory factor analysis provided support for the model as assessed by RMSEA criteria. Discussion These findings suggest that the MBQ may help to identify an individual’s ‘profile’ of motivators and barriers to exercise, and so inform personalized interventions that might successfully increase activity levels in adults over 65 years of age when compared to standardised approaches.

The inhalation of the aroma of Rosemary essential oil has been shown to enhance cognition in healthy adults. In this independent groups design study we exposed forty schoolchildren aged nine to eleven years to either Rosemary aroma or no aroma in a classroom setting where they completed standardised tests of working memory in fifteen minute procedure. Analysis of the data revealed that performance on the Immediate serial recall, Sentence span, and Counting span tasks were significantly better in the Rosemary aroma condition and possessed medium to large effect sizes. This is the first study to demonstrate such effects in children and suggests that the potential for enhancement is greater than in adults. The findings are discussed in terms of the potential for improving academic attainment through natural interventions and the possible mechanisms behind such effects.

Written emotional disclosure (WED), a time and cost effective intervention that can run in participants' homes, might be especially well suited for autism caregivers. This study assessed the effectiveness of directed written disclosure for coping with the stress of caring for a child with autism. 37 caregivers of children with autism wrote for 20 minutes on three days about: (1) the benefits of caregiving or (2) a control topic while at home. Anxiety and depression were assessed at baseline, one month and three months post writing. Data indicated that anxiety scores for caregivers in the benefit finding condition were less likely to fall within the clinical range at three months post writing. However, group differences in anxiety from baseline reflected deterioration in controls rather than palliative effects in the benefit finding group. In conclusion, written benefit finding might be effective for buffering against the psychological sequelae associated with caregiving stress.

The purpose of this research was to explore the relationship between fear of failure and self-talk characteristics of elite academy football players in winning and losing situations. Fear of failure was associated with the use of more negative yet less frequent self-talk in losing situations only. Implications for coaches and sport psychologists working in academy football are considered.

Research has previously demonstrated that aromas of both Salvia officinalis and Salvia lavandulaefolia are capable of modulating aspects of retrospective memory, attention and mood. This study is the first to report the potential for these aromas to enhance everyday prospective memory performance in healthy young adults. In an independent groups design, three conditions, Salvia officinalis aroma, Saliva lavandulaefolia aroma and no aroma were employed with 45 healthy volunteers in each condition. Prospective memory performance was assessed using the Prospective Remembering Video Procedure. Data analysis revealed that the Salvia officinalis aroma group performed significantly better than the control group on both event and action subscales of the prospective memory task. Saliva lavandulaefolia aroma only led to enhancement for the event measure when compared to controls. No differences were found between the aroma conditions. These findings offer support for those previously reported for the effects of the aromas of Salvia sp. on cognition and again demonstrate differential effects of the two aromas. The results are considered in terms of pharmacological mechanisms.

Purpose – The purpose of this paper is to explore client‐reported functions of deliberate self‐injury for prisoners located within a dangerous and severe personality disorder site.Design/methodology/approach – As interviews produced in‐depth data indicating a very idiosyncratic experience of the function of deliberate self‐injury, interpretative phenomenological analysis was used within a small‐scale case study design.Findings – Identified functions mirrored current quantitative research but few emerging themes were identified across the sample. Participants presented with varying levels of insight into their deliberate self‐injury.Research limitations/implications – A small sample of young males was used within the study.Originality/value – A “status‐seeking” function of deliberate self‐injury was also observed, which is not explicitly discussed within the current literature base. This study's findings can be of use to treatment providers for this population given their complex responsivity needs.

Background The positive relationship between problem behaviours of children with additional complex needs and psychological distress in their caregivers has been widely evidenced. Fewer studies, however, have assessed the relationship between care recipients’ problem behaviours and key physiological processes, relevant for the physical health status of their care providers. This study examined the psychological, endocrine and health corollaries of child problem behaviours in caregivers of children with autism and attention deficit hyperactivity disorder. Methods Caregivers (n = 18) completed self-report measures of psychological distress, child problem behaviours and incidences of commonly occurring ailments. To capture important parameters of the basal diurnal cortisol pattern, caregivers collected saliva samples at waking, 30 min post waking, 1200 h and 2200 h on two consecutive weekdays. Results Data revealed a positive relationship between caregivers’ perceived levels of stress and problems with child conduct behaviours. In addition, caregivers who reported more problems with child emotional and hyperactivity behaviours displayed atypical cortisol patterns characterised by flatter diurnal cortisol slopes and reduced cortisol awakening response magnitude. Subjective reports of commonly occurring ailments were also greater in caregivers experiencing more problems with child emotional behaviours. Conclusions These findings have implications for interventions that aim to improve the psychophysiological well-being of the caregiver by targeting problem behaviours of the care recipient.

Purpose:This article outlines a small-scale exploratory study focusing upon the impact of a brief coaching intervention on participant levels of resilience in the face of organisational change. The study sought to pilot a brief, three-session resilience coaching programme and explore the impact upon participants’ reported levels of resilience and attitudes towards organisational change.Design:A programme of three 90-minute coaching sessions was delivered at three-weekly intervals over a six-week period. Luthans et al. (2007) Psychological Capital (Psycap) Questionnaire and questions relating to participants’ confidence in dealing with organisational change were administered in a test/re-test design one week prior to the commencement of coaching and within two weeks of coaching conclusion.Method:An opportunity sample of 12 middle managers from a UK public sector organisation experiencing significant organisational change participated in the study. Participants completed the pre-coaching questionnaire and participated in a brief resilience coaching programme consisting of three semi-structured sessions. The coaching programme was designed to support individuals in developing and demonstrating resilient behaviours in the face of organisational changes and progressing their well-being and/or resilience related goals. Participants were invited to repeat the study questionnaire within two weeks of their final coaching session.Results:Statistical analyses supported both study questions, with participants reporting significant (positive) changes in resilience levels and confidence in dealing with organisational change following the coaching programme. Increases in participants’ psychological capital in the areas of ‘Hope’ and ‘Optimism’ were also found although ‘Self-Efficacy’ was not found to be significantly enhanced.

Objectives The study aimed to address the paucity of research pertaining to perceptions of causes of the home advantage. The views of three key personnel groups in football (soccer) were examined with regard to their perspectives. Design and procedure Players ( n = 94), fans ( n = 116) and referees ( n = 163) completed a ten-item questionnaire on which they rated the contribution of the most prominent factors known to influence the home advantage. Results Factor analysis revealed three subscales (officials, player state and home environment) relating to explanations for the home advantage. A MANOVA examining the groups’ ratings for these three subscales found that the fans and player gave higher ratings for the contribution of officials and player state than did referees, while the fans gave higher ratings for the home environment. Conclusion The present study provides an insight into conceptualisations of the home advantage from the perspectives of different football groups. The relevance of self-enhancement, emanating from motivational and information processing mechanisms, is considered.

Research has frequently linked perceived stress with changes in subjective and objective measures of ill health; however, additional assessment should consider the physiological mechanisms mediating these effects. This study investigated whether differential patterns of cortisol secretion might partially mediate perceived stress related disparities in common health complaints in young, otherwise healthy individuals. To capture the kinds of health complaints commonly reported in this population, the Pennebaker Inventory of Limbic Languidness (PILL) was selected. To capture important parameters of the diurnal profile, cortisol was sampled at waking, 30 minutes post waking, 1200 h and 2200 h on three consecutive weekdays. Results revealed flatter diurnal cortisol slopes and elevated mean diurnal output (characterised by HPA hyperactivity in the evening) for participants in the higher stress group. Participants that reported higher perceived levels of stress also reported experiencing common health complaints with markedly greater frequency; however, these disparities were abolished when mean diurnal output of cortisol was statistically controlled. While dysregulation of basal HPA activity has been implicated in the aetiologies of chronic illness, findings reported here implicated hypersecretion of cortisol as one physiological pathway, partially mediating perceived stress related disparities in the kinds of common health complaints that typically affect young, otherwise healthy individuals.

Background: Self-help materials can be effective for anxiety and depression in community settings, but there is little research on their use in prisons.Aim: A pilot study to investigate the effectiveness of self-help materials for the treatment of anxiety and depression in an adult male prison population.Method: Participants were assigned to the depression or anxiety group depending on their symptom profile. Within these groups they were randomly assigned to the intervention (received self-help immediately) or waiting list control group (received self-help after 4 weeks). Participants completed self-report outcome measures at baseline, 4 weeks and 8 weeks.Results: For most of the prisoners referred into the study, anxiety, not depression, was their predominant symptom. The study suggests that prisoners can receive at least short-term benefits in anxiety reduction through a self-help booklet delivered in a healthcare setting. The effect size of the anxiety booklet intervention was large.Conclusions: Self-h...