http://bura.brunel.ac.uk/handle/2438/8616 2026-06-26T08:33:09Z 2026-06-26T08:33:09Z Yang, X Begh, R Lindson, N Albury, C Barnes, R Dyson, J Morrison, L Bradbury, K Molodynski, A Coleman, T Naughton, F Chang, MK Pokhrel, S Johnston, G Peckham, E Knight, E Joyce, J http://bura.brunel.ac.uk/handle/2438/33517 2026-06-26T08:23:53Z 2026-06-16T00:00:00Z

Title: Challenges in Advising People with Severe Mental Illness to Quit Smoking: A Conversation Analysis of Patient Resistance Authors: Yang, X; Begh, R; Lindson, N; Albury, C; Barnes, R; Dyson, J; Morrison, L; Bradbury, K; Molodynski, A; Coleman, T; Naughton, F; Chang, MK; Pokhrel, S; Johnston, G; Peckham, E; Knight, E; Joyce, J Abstract: Objectives: People experiencing severe mental illness (SMI) smoke at rates 2.5 times higher than the general population and have a reduced lifespan by 15-20 years, causing substantial health inequalities. This study examined how people with SMI resisted smoking cessation advice, delivered by primary care clinicians (general practitioners and nurses) during routine annual health reviews. Methods: Using conversation analysis (CA), we analysed 56 audio-recorded consultations from a randomised controlled trial of annual health reviews in which smoking cessation advice was discussed. We identified a core collection of 21 instances of patient resistance and conducted detailed sequential analysis to examine how resistance to smoking cessation advice was expressed, and how clinicians responded. Results: Analysis revealed two distinct patterns of resistance to smoking cessation advice: implicit rejection and explicit rejection. In implicit rejection sequences, patients foreground mental health concerns, thereby indicating that quitting cannot be acted upon at the moment. In explicit rejection sequences, patients rejected the advice with an explicit ‘no’ and expressed indifference to the health risks of smoking, presenting smoking as non-negotiable and making further discussion redundant. In both scenarios, clinicians responded with acknowledgements (e.g. “mm”, “yeah”, or “okay” indicating receipt and alignment), neither explicitly agreeing with the patient nor pushing back on their resistance. Conclusions: Addressing smoking-related health inequalities among people with SMI is challenging because quitting is often deprioritised in the context of competing mental health and social concerns. These difficulties are compounded by clinicians’ challenges in raising and sustaining smoking cessation discussions. Recognising how resistance to quitting advice is interactionally produced can support more flexible and tailored cessation approaches that better align with patients’ priorities. Practice implications: This study highlights the unique resistance sequence presented in consultations advising people with SMI to quit smoking. It provides implications for clinical professionals to adopt more responsive and tailored responses to the resistance. Description: This is a PDF of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability. This version will undergo additional copyediting, typesetting and review before it is published in its final form. As such, this version is no longer the Accepted Manuscript, but it is not yet the definitive Version of Record; we are providing this early version to give early visibility of the article. Please note that Elsevier’s sharing policy for the Published Journal Article applies to this version, see: https://www.elsevier.com/about/policies-and-standards/sharing#4-publishedjournal-article. Please also note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

2026-06-16T00:00:00Z Singh, H Shih, H-T Kal, E Bennett, T Wulf, G http://bura.brunel.ac.uk/handle/2438/33487 2026-06-23T02:00:58Z 2022-11-23T00:00:00Z

Title: A distal external focus of attention facilitates compensatory coordination of body parts Authors: Singh, H; Shih, H-T; Kal, E; Bennett, T; Wulf, G Abstract: Many studies have shown that focusing on an intended movement effect that is farther away from the body (distal external focus) results in performance benefits relative to focusing on an effect that is closer to the body (proximal external focus) or focusing on the body itself (internal focus) (see, Chua, Jimenez-Diaz, Lewthwaite, Kim & Wulf, 2021). Furthermore, the advantages of a distal external focus seem to be particularly pronounced in skilled performers (Singh & Wulf, 2020). The present study examined whether such benefits of more distal attentional focus may be associated with enhanced functional variability. Volleyball players (n = 20) performed 60 overhand volleyball serves to a target. Using a within-participants design, the effects of a distal external focus (bullseye), proximal external focus (ball) and an internal focus (hand) were compared. The distal focus condition resulted in significantly higher accuracy scores than did the proximal and internal focus conditions. In addition, uncontrolled manifold analysis showed that functional variability (as measured by the index of synergy) was greatest in the distal focus condition. These findings suggest that a distal external focus on the task goal may enhance movement outcomes by optimising compensatory coordination of body parts. Description: Correction Statement: This article has been republished with minor changes. These changes do not impact the academic content of the article.

2022-11-23T00:00:00Z Kaasgaard, M Farver-Vestergaard, I Kal, E Lewis, A Andreasson, KH http://bura.brunel.ac.uk/handle/2438/33486 2026-06-23T10:10:24Z 2026-05-20T00:00:00Z

Title: Translation of the Breathing Vigilance Questionnaire for respiratory diseases. Authors: Kaasgaard, M; Farver-Vestergaard, I; Kal, E; Lewis, A; Andreasson, KH Abstract: INTRODUCTION. Breathing vigilance – a heightened focus on breathing, which is linked to anxiety – potentially exacerbates symptoms in people with respiratory conditions, e.g., chronic obstructive pulmonary disease, asthma and breathing pattern disorder. The Breathing Vigilance Questionnaire (Breathe-VQ) was developed in English but requires translation and cross-cultural adaptation for broader use. We aimed to translate and cross-culturally adapt the Breathe-VQ into Danish. METHODS. Following established translation guidelines for patient-reported outcome measures, we conducted a six-stage adaptation process, including forward translation, backward translation, expert committee review and face validity testing. The validation process involved three interview rounds with 13 patients. RESULTS. Patient feedback prompted iterative revisions in language and phrasing, particularly to address the semantics of temporal and intergenerational aspects. Patients found the Danish version easy to understand and reflective of their breathing experiences, confirming its face validity. The expert committee confirmed equivalence and cultural alignment with the original version. CONCLUSIONS. The Danish Breathe-VQ demonstrates content equivalence and face validity, offering a suitable tool for measuring breathing vigilance in Danish-speaking populations. FUNDING. The study was funded by Brunel University of London, United Kingdom, and Novo Nordisk Foundation, Denmark (NNF22OC0077446). TRIAL REGISTRATION. Pre-registered at the Open Science Framework. Description: Supplementary materials are available online at: https://content.ugeskriftet.dk/sites/default/files/2026-03/a10250862-supplementary.pdf .

2026-05-20T00:00:00Z Grilc, N Cocks, A Kal, E Ellmers, TJ Chembila Valappil, A Bruton, AM http://bura.brunel.ac.uk/handle/2438/33482 2026-06-22T02:00:57Z 2026-06-02T00:00:00Z

Title: Action Simulation as an Intervention to Improve Balance, Mobility and Gait in Healthy Older Adults: A Scoping Review Authors: Grilc, N; Cocks, A; Kal, E; Ellmers, TJ; Chembila Valappil, A; Bruton, AM Abstract: Falls in older adults are a significant public health concern. Action simulation interventions involving action observation and/or motor imagery have been proposed as alternative or adjunct strategies to physical exercise for reducing fall risk. These approaches may minimize barriers to physical practice and may specifically target deficits in motor planning that are linked to falls. The purpose of this scoping review is to examine how action simulation interventions have been applied and evaluated in healthy older adults, and assess their effectiveness in improving balance, mobility, and gait. A systematic search of six databases and repositories was conducted. Studies were included if they used action simulation interventions in healthy, community-dwelling adults aged 60+ years and examined movement outcomes related to balance, gait or functional mobility. Nineteen studies with 587 older adults were included. Motor imagery was the most common action simulation intervention (n = 11 [58%]), and most studies were randomized controlled trials (n = 14 [74%]). Only one study examined long-term effects on balance and gait performance (i.e., 1-month post-intervention). The examined outcomes varied widely, including static and dynamic balance, gait, and mobility. Most interventions (n = 17 [71%]) reported significant improvement in at least one domain, but findings were inconsistent across studies, and none assessed intervention implementability. Overall, this review highlights some promising effects of action simulation on balance, mobility and gait in older adults. However, if action simulation techniques are to be adopted as a fall prevention strategy, more studies examining acceptability are needed. Description: A preprint version of the article is available at PsyArxiv (https://osf.io/rt4jw_v2). It has not been certified by peer review.

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