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Background: Sedentary behaviour is a risk factor for type 2 diabetes and cardiovascular disease. Objectives: The aims of this work were to systematically review the effects of workplace sedentary behaviour reduction interventions on cardiometabolic risk markers (primary aim) and identify the active behaviour change techniques (BCTs) by which these interventions work (secondary aim). Methods: A systematic search of 11 databases for articles published up to 12 April 2019 yielded a total of 4255 unique titles, with 29 articles being identified for inclusion. Interventions were rated as very promising, quite promising or non-promising based on their effects on cardiometabolic risk markers compared with baseline and/or a comparison arm. Interventions were coded for BCTs used. To assess the relative effectiveness of BCTs, a promise ratio was calculated as the frequency of a BCT appearing in all promising interventions divided by its frequency of appearance in all non-promising interventions. Results: A narrative synthesis included 29 published studies of varying study design and comprised of 30 interventions. Risk of bias was high for blinding and allocation concealment, moderate for random sequence generation, and low for outcome assessment. Nine interventions were very promising, 11 were quite promising, 10 were non-promising, and 10 active control groups did not experience cardiometabolic changes. Significant sedentary behaviour reductions were present in all but five studies where cardiometabolic risk markers improved. The BCTs of social comparison, problem solving, demonstration of the behaviour, goal setting (behaviour), behaviour substitution, and habit reversal, demonstrated moderate to high promise ratios. Conclusions: Workplace interventions show promise for improving cardiometabolic risk markers. The BCTs with the greatest promise of cardiometabolic risk marker improvements included social comparison, those related to individual habits, and behaviour goals. Registration: This systematic review was prospectively registered in PROSPERO (CRD42017072427). [ABSTRACT FROM AUTHOR]

Aim: With a number of qualified community practitioner nurse prescribers (CPNPs) not prescribing, this research aimed to understand what influences this behaviour. Design: A qualitative research design. Methods: Semi‐structured interviews, based on the theoretical domains framework (TDF) were conducted with 20 CPNPs. Data collection took place between March‐July 2018 and continued until data saturation was reached. Results: Nine themes inductively explained prescribing behaviour: 1) 'Knowledge and experience'; 2) 'Consultation and communication skills'; 3) 'Professional confidence and identity'; 4) 'Wanting the best outcome'; 5) 'NHS versus patient cost'; 6) 'Emotion‐led decisions'; 7) 'Time allocation'; 8) 'Formulary access' and 9) 'Supporting environment for patient‐centred care'. Themes were then deductively mapped to the TDF and COM‐B. Conclusion: There is an ongoing need to support community practitioner nurse prescribers' 'Capability' to prescribe in terms of knowledge and aquired skills; 'Opportunity' to make prescribing easier, such as access to a wider and up to date nurse formulary alongside effective clinical support; and 'Motivation' to feel confident in prescribing behaviour, highlighting positive patient outcomes while reducing perceived issues such as cost and non‐adherence. Impact: Findings show that Capability, Opportunity and Motivation all influence the decision to prescribe. Those responsible for professional regulation and training should ensure community practitioner nurse prescribers have access to the relevant knowledge, skills and formulary to facilitate their prescribing behaviour. Professional confidence and identity as a prescriber should be encouraged, with acknowledgment of influences such as cost and emotion. An environment that allows for patient‐centred care and the best outcome should be supported, this may mean increasing time allocated to consultations. [ABSTRACT FROM AUTHOR]

Introduction NHS Direct, a leading telephone healthcare provider worldwide, provided 24/7 health care advice and information to the public in England and Wales (1998-2014). The fundamental aim of this service was to increase accessibility, however, research has suggested a disparity in the utilisation of this service related to ethnicity. This research presents the first national study to determine how the diverse population in England have engaged with this service. Methods NHS Direct call data from the combined months of July, 2010 October, 2010, January 2011 and April, 2011 was analysed (N = 1,342, 245) for all 0845 4647 NHS Direct core service calls in England. Expected usage of NHS Direct was determined for each ethnic group of the population by age and gender and compared by actual usage using Chi-square analysis. A one-way analysis of variance (ANOVA) was used to determine variations of uptake by ethnic group and Index for Multiple Deprivation (IMD) 2010 rank. Results Results confirmed that all mixed ethnic groups (White and Black Caribbean, White and Black African, White and Asian) had a higher than expected uptake of NHS Direct which held consistent across all age groups. Lower than expected uptake was found for Black (African/Caribbean) and Asian (Bangladeshi/Indian/Chinese) ethnic group which held consistent by age and gender. For the Pakistani ethnic group usage was higher than expected in adults aged 40 years and older although was lower than expected in younger age groups (0-39). Conclusion Findings support previous research suggesting a variation in usage of NHS Direct influenced by ethnicity, which is evidenced on a national level. Further research is now required to examine the underlying barriers that contribute to the ethnic variation in uptake of this service. [ABSTRACT FROM AUTHOR]

Purpose/Objective: Standardized mindfulness-based interventions (MBIs), used for the management of physical and psychological symptoms associated with neurological impairment/injury (NI), have been problematized as lacking accessibility due to their focus on sensory presence and mindful walking. Research is needed to generate formalized recommendations regarding how MBIs may be best adapted to enhance their suitability for people with NI. Research Method/Design: A two-phase qualitative study was completed. First, semistructured interviews were undertaken with eight accredited mindfulness teachers with NI. Interviews reviewed the adaptations participants made in their personal and teaching practice, using thematic analysis, and generated recommendations for adaptations to MBIs specific to people with NI. Second, using the DELPHI method, the adapted practice recommendations were reviewed and revised via three rounds, following cognitive interviews with an expert panel (N = 5 trained mindfulness teachers with NI). Results: Ten core areas for adaptation are proposed and validated, acting as SMALL PROMPTS which can be used to adapt mindfulness-based teaching techniques to the specific requirements of people with NI: (a) Skin/bladder/bowel management; (b) mindful Movement; (c) Accessible training; (d) Language Leadership; (e) Permissive pRactice; (f) Optimizing timelines; (g) Management of posture; (h) inclusion of Pacing; (i) Teaching from experience; and (j) body Scanning. Conclusion/Implications: Mindfulness is a highly applicable approach for people with sensory loss, however significant, specific adaptations are required to improve inclusivity and accessibility. The SMALL PROMPTS adaptations increase the accessibility, applicability, and utility of MBIs for populations living with NI, enhancing effective management of physical and psychological wellbeing, and optimizing MBI delivery. [ABSTRACT FROM AUTHOR]