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Background and Aims: Digital smoking cessation interventions have been shown to be effective in helping individuals achieve prolonged smoking abstinence. Nonetheless, the mechanisms that drive such effects are unclear. The current study aimed to estimate a digital smoking cessation intervention's natural direct and indirect effects. Methods: This secondary analysis of mediated effects uses data from a randomised controlled trial which included participants who smoked at least one cigarette a week, had access to a mobile phone, and were 18 years or older. The comparator was existing smoking cessation support available to all members of the Swedish public. Primary outcomes were prolonged smoking abstinence and point prevalence of smoking abstinence, measured at 3- and 6-months post-randomisation. A counterfactual framework was used to estimate three hypothesised mediators of the intervention's effects: importance, knowledge of how to change (know-how), and confidence. Results: Between 18/09/20 and 16/06/22, 1012 participants were randomised. The intervention led to improved confidence and know-how, which both partially mediated the effects of the digital intervention on smoking abstinence at 3- and 6 months post-randomisation. Conclusions: A digital smoking cessation intervention was found to partially affect smoking abstinence by improving individuals' confidence in their ability to quit smoking and developing knowledge on how to quit. Face-value single-item mediator measures, lack of blinding, and attrition limit the study. Future studies should address these limitations and assess additional mechanisms mediating intervention effects. Trial registration: ISRCTN13455271. [ABSTRACT FROM AUTHOR]

Background: Digital interventions readily permit data capture of participant engagement with them. If future interventions are intended to be more interactive, tailored, or a useful resource offered to users, it may be valuable to examine such data. One module available in a digital alcohol intervention recently tested in a randomised control trial offered participants the opportunity to self-author prompts that were sent to them by a text message at a time of their choosing. This study thus aimed to evaluate these self-authored prompts to increase knowledge on how individuals negotiate behaviour change and assess whether intervention content can be improved in the future. Methods: The self-authored prompts were evaluated qualitatively using a combination of content and thematic analysis. The identified themes and subcategories are exemplified using anonymized quotes, and the frequency that each identified theme was coded for among the prompts was calculated. Associations between baseline characteristics and the odds of authoring a prompt at all, as well as a prompt within each theme, were investigated using logistic regression. Results: Five themes were identified (Encouragement Style, Level of Awareness, Reminders of reasons to reduce/quit, Strategies to reduce/quit, and Timescale), all with several subcategories. The prompts module was more likely to be used by women and older individuals, as well as those for whom reducing alcohol consumption was perceived as important, or who felt they had the know-how to do so. Participants who had immediate access to the support tool (intervention group) were more than twice as likely to author a prompt (OR = 2.36; probability of association > 99%) compared to those with 4-month delayed access (control group). Conclusions: Individuals who engaged with the prompts module showed evidence of using the information provided in the support tool in an active way, with several showing goal setting and making plans to change their drinking behaviour. Individuals also used this opportunity to remind themselves of personal and specific reasons they wanted to change their drinking, as well as to encourage themselves to do so. [ABSTRACT FROM AUTHOR]

University students report experiencing regrettable health and social outcomes following excessive alcohol consumption. Students also report experiencing regret when they are unable to attend drinking events. This study explored how such experiences influence risk appraisals and decisions about future alcohol consumption. Thirteen university students (69% female, 18–20 years old) discussed the interplay of regret with alcohol consumption, and nonattendance at drinking events, in one of three focus groups. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). IPA produced three super-ordinate themes: 'It's not something I would have done sober', 'Attitudes towards action regret' and 'Fear of Missing Out (FoMO)'. Participants reported regrettable experiences (e.g. alcohol poisoning, tattoos), and a gender difference in risk appraisals was apparent. Attitudes towards action regret affected risk appraisals and informed future drinking decisions. Participants reported experiencing FoMO when they were unable to attend drinking events. Regrettable incidents following excessive consumption were seen as common but did not affect risk appraisals or future drinking decisions. Students' reported they preferred the regrettable experiences that follow excessive consumption than the FoMO experienced when they were unable to attend drinking events, suggesting FoMO may drive attendance at future drinking events. [ABSTRACT FROM AUTHOR]

Alcohol use is a considerable public health concern, leading to negative health and adverse social consequences. Despite widespread knowledge and acceptance of these consequences many individuals continue to drink excessively. Lack of regret for these consequences may partially explain this. Objectives: To examine the prevalence of regrettable experiences and their role in future intentions to drink. Methods: In two studies (Study 1: cross-sectional; Study 2: longitudinal) participants reported on 18 regrettable experiences; from common regrets (e.g. hangover), to risky behaviors (e.g. drug taking), and serious regrets (e.g. driving under the influence), over a two-week period. Results: Prevalence of regrettable experiences was high (e.g. 79.0% of individuals in study 1 and 66.9% of individuals in study 2 experienced a hangover). Prevalence was greater for common regrets compared to risky behaviors and serious regrets. In study one, alcohol consumed over the previous fortnight predicted the number of different regrettable experiences over the same period. In study two, units consumed on a day-to-day basis predicted the number of regrets on that same basis. Neither study demonstrated evidence for the predictive utility of regrets for intentions to consume alcohol in the future. Conclusions: These findings suggest high prevalence of regrettable experiences, that are predicted by increased alcohol consumption. However, there was little evidence that increased number of experiences predicted future drinking intentions. Regrettable experiences are prevalent following consumption, however a focus on these regrets to deter future alcohol consumption may not be an effective psychological intervention. [ABSTRACT FROM AUTHOR]

Invasive ductal carcinoma of the breast with clear cell changes is a very rare pathological entity. There are <150 cases of this breast cancer subtype reported in the literature. Clear cell carcinoma could be easily missed or under-diagnosed in a breast core biopsy specimen due to the fact that this subtype tends to show a papillary pattern with clear cell and pseudo-lactating changes, especially in young female patients. Normal breast tissue may possess clear cells as a consequence of the physiological changes of pregnancy, the clearing of the cytoplasm within myoepithelial cells, or the clearing of the cytoplasm in apocrine metaplasia. Owing to its aggressive clinical course, clear cell carcinoma must be differentiated from other subtypes of breast carcinoma. Special attention given to this rare subtype by pathologists and clinicians could avoid misdiagnosis and delay of treatment. [ABSTRACT FROM AUTHOR]