Assessing Decision Fatigue in General Practitioners' Prescribing Decisions Using the Australian BEACH Data Set.

Background: General practitioners (GPs) make numerous care decisions throughout their workdays. Extended periods of decision making can result in decision fatigue, a gradual shift toward decisions that are less cognitively effortful. This study examines whether observed patterns in GPs' prescribing decisions are consistent with the decision fatigue phenomenon.

Free-living physical activity and executive function: A multi-study analysis of age groups and times of day.

Background: Executive Function (EF) is a potential mechanism linking physical activity (PA) and mental health. However, evidence regarding the association between free-living PA and EF is limited with mixed results. Across two studies, we examined associations between accelerometer-assessed moderate-to-vigorous PA (MVPA) and facets of EF in different age groups (Study 1) and at different times of day (Study 2).

Barriers and facilitators of adherence to the use of ASICA, a digital app designed to support people previously treated for melanoma: concise report of a qualitative study.

We developed the Achieving Self-directed Integrated Cancer Aftercare (ASICA) in melanoma app to support monthly total-skin self-examinations (TSSE) by people previously treated for melanoma. A randomized 12-month trial demonstrated ASICA supported optimal monthly TSSE adherence in a third of participants (ClinicalTrials.gov NCT03328247).

Describing, predicting and explaining adherence to total skin self-examination (TSSE) in people with melanoma: a 12-month longitudinal study.

Objectives: To describe trajectories in melanoma survivors' adherence to monthly total skin self-examination (TSSE) over 12 months, and to investigate whether adherence trajectories can be predicted from demographic, cognitive or emotional factors at baseline.

Design: A longitudinal observational study nested within the intervention arm of the ASICA (Achieving Self-Directed Integrated Cancer Aftercare) randomised controlled trial.

Setting: Follow-up secondary care in Aberdeen and Cambridge UK.

Healthy snacks in hospitals: Testing the potential effects of changes in availability.

Background: Hospitals offer snacks for sale to patients, staff and visitors.

Aim: As food choice is heavily influenced by the options available, the present study (a) audited snack availability and purchase in NHS hospital sites across a large UK city; and (b) tested the potential effects of changes to this availability in an online choice experiment.

Methods: In Study 1 (audit), single-serve snacks (=376) available in 76 hospital food retail units were audited.

Development of a behaviour change workplace-based intervention to improve nurses' eating and physical activity.

Background: There is a critical need for an intervention to improve nurses' eating and physical activity behaviours. As nurses spend a substantial proportion of their waking hours at work, concerted efforts to deliver such interventions in the workplace is growing. This study formed part of a multiphase programme of research that aimed to systematically develop an evidence-based and theory-informed workplace intervention to promote changes in eating and physical activity among nurses.

Performance pay and low-grade stress: An experimental study.

Background: Although recent economics literature suggests a link between performance-related pay (PRP) and ill health, this finding is contested on the grounds that this link is plagued by endogeneity between the two variables of interest.

Objective: This study investigates the adverse effects of performance-related pay on stress which is an important determinant of physical health.

Methods: Forty subjects were randomly assigned to two equal groups: either being paid by performance or being paid a flat fee.

Prompting consumers to make healthier food choices in hospitals: a cluster randomised controlled trial.

Background: Hospitals in the UK offer snacks for sale to patients, staff and visitors. Despite the NHS's health promoting role, and tightening of regulations around which foods can be sold in hospitals, many snacks purchased in this setting are unhealthy. The present project tests the effectiveness of theory-based point of purchase prompts (PPPs; a form of cognitive nudge) designed to make it cognitively easier for consumers to compare available products and choose healthier options.

Clinical decisions and time since rest break: An analysis of decision fatigue in nurses.

Objective: The present study investigates whether nurses working for a national medical telephone helpline show evidence of "decision fatigue," as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases.

Method: In an observational, repeated-measures study, data from approximately 4,000 calls to 150 nurses working for the Scottish NHS 24 medical helpline (37% of the national workforce) were modeled to determine whether the likelihood of a nurse's decision to refer a patient to another health professional the same day (the clinically safest but most conservative and resource inefficient decision) varied according to the number of calls taken/time elapsed since a nurse's last rest break and/or since the start of shift. Analyses used mixed-effect logistic regression.

Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12-hour shifts.

Background: One of the striking regularities of human behavior is that a prolonged physical, cognitive, or emotional activity leads to feelings of fatigue. Fatigue could be due to (1) depletion of a finite resource of physical and/or psychological energy or (2) changes in motivation, attention, and goal-directed effort (e.g.

Time Perspective and All-Cause Mortality: Evidence From the English Longitudinal Study of Ageing.

Background: Long-term future thinking has been associated with a range of favorable health behaviors. However, it is currently unclear whether this translates into an effect on morbidity and mortality.

Purpose: The goal of this study was to study the relationship between time perspective and all-cause mortality and to examine the role of health behavior in explaining this association.

What do self-efficacy items measure? Examining the discriminant content validity of self-efficacy items.

Objectives: Self-efficacy - an individual's judgement of their ability to successfully perform a behaviour - is commonly used to explain and predict behaviour. It is measured through self-report questionnaires. These scales require good content validity, that is must measure the full scope and content of the construct without contamination from similar constructs.

Understanding perceived determinants of nurses' eating and physical activity behaviour: a theory-informed qualitative interview study.

Background: Unhealthy eating and physical activity behaviours are common among nurses but little is known about determinants of eating and physical activity behaviour in this population. The present study used a theoretical framework which summarises the many possible determinants of different health behaviours (the Theoretical Domains Framework; TDF) to systematically explore the most salient determinants of unhealthy eating and physical activity behaviour in hospital-based nurses.

Methods: Semi-structured qualitative interviews based on the TDF were conducted with nurses ( = 16) to explore factors that behavioural theories suggest may influence nurses' eating and physical activity behaviour.

Does real time variability in inhibitory control drive snacking behavior? An intensive longitudinal study.

Objective: Laboratory eating studies and cross-sectional surveys indicate individuals with inefficient executive function (EF) consume more unhealthy snacks than others. However, the importance of EF in determining snacking behavior in the "real world" has not been established. Contemporary behavioral and self-control theories posit EF as a dynamic resource fluctuating over time.

Effect of Different Types of Physical Activity on Activities of Daily Living in Older Adults: Systematic Review and Meta-Analysis.

Physical activity is associated with greater independence in old age. However, little is known about the effect of physical activity level and activity type on activities of daily living (ADL). This review systematically analyzed the effects of physical activity level and activity type on ADL in older adults (mean age, 60+).

A Bidirectional Relationship between Executive Function and Health Behavior: Evidence, Implications, and Future Directions.

Physically active lifestyles and other health-enhancing behaviors play an important role in preserving executive function into old age. Conversely, emerging research suggests that executive functions facilitate participation in a broad range of healthy behaviors including physical activity and reduced fatty food, tobacco, and alcohol consumption. They do this by supporting the volition, planning, performance monitoring, and inhibition necessary to enact intentions and override urges to engage in health damaging behavior.

Total skin self-examination at home for people treated for cutaneous melanoma: development and pilot of a digital intervention.

Objectives: To develop a digital intervention to prompt, support, and respond to the outcomes of total skin self-examinations (TSSEs) at home by people treated for cutaneous melanoma.

Design: A complex intervention development study.

Setting: Northeast Scotland.

A bidirectional relationship between physical activity and executive function in older adults.

Physically active lifestyles contribute to better executive function. However, it is unclear whether high levels of executive function lead people to be more active. This study uses a large sample and multi-wave data to identify whether a reciprocal association exists between physical activity and executive function.

Snack purchasing is healthier when the cognitive demands of choice are reduced: A randomized controlled trial.

Objective: Individuals with inefficient executive (higher level cognitive) function have a reduced ability to resist dietary temptation. The present study aimed to design and test a theory-based point-of-purchase intervention for coffee shops that reduced the calorie content of customers' purchases by reducing the need for executive function (EF) at the moment of choice.

Methods: Key facets of EF were identified by a multidisciplinary group and used to develop a point-of-purchase intervention (signage).

The SNAPSHOT study protocol: SNAcking, Physical activity, Self-regulation, and Heart rate Over Time.

Background: The cognitive processes responsible for effortful behavioural regulation are known as the executive functions, and are implicated in several factors associated with behaviour control, including focussing on tasks, resisting temptations, planning future actions, and inhibiting prepotent responses. Similar to muscles, the executive functions become fatigued following intensive use (e.g.

Stress in telephone helpline nurses is associated with failures of concentration, attention and memory, and with more conservative referral decisions.

Nurses working for telephone-based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information-processing errors.

Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals: a systematic review of randomised controlled trials.

Background: The prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace. We conducted a systematic review to (i) examine the effectiveness of workplace-based diet and/or physical activity interventions aimed at healthcare professionals and to (ii) identify and describe key components of effective interventions. Seven electronic databases were systematically searched.

Developing a community-based intervention to improve quality of life in people with colorectal cancer: a complex intervention development study.

Objectives: To develop and pilot a theory and evidence-based intervention to improve quality of life (QoL) in people with colorectal cancer.

Design: A complex intervention development study.

Setting: North East Scotland and Glasgow.