Society for Ambulatory Assessment

First quarter 2014 (January to March)

Text message program improves outcomes, decreases ED utilization among ED patients with poorly controlled diabetes (2014). In: ED Manag 26 (2), S. 20–23.

Diabetic patients who lack access to primary care tend to frequent the ED, often with complications from their disease that could have been prevented with proper management and education. To get around the problem of access, researchers tested an automated program that continuously delivered educational messaging via text to a group of patients who presented to the ED with poorly controlled diabetes. After six months, researchers noted improvements in Hb A1c levels, self-reported medication adherence, and ED utilization when compared with a control group. And the impact was particularly noteworthy among Latinos, according to the researchers. The text messaging program, dubbed TExT-Med, was developed by four physicians and two diabetes educators. The messages were delivered daily, and contained educational as well motivational content derived from the National Diabetes Education Program.There were also medication reminders, healthy living challenges, and trivia questions about diabetes. At six months, Hb A1c levels decreased by 1.05% in the intervention group, compared to 0.60% in the control group, and self-reported medication adherence improved from 4.5 to 5.4 (as measured on an 8 point scale) in the intervention group versus a decrease of 0.1 in the control group. During the six-month study period, 35.9% of patients in the intervention group presented to the ED for care, as compared to 51.6% of patients in the control group.

Abdel-Kader, Khaled; Jhamb, Manisha; Mandich, Lee Anne; Yabes, Jonathan; Keene, Robert M.; Beach, Scott et al. (2014): Ecological momentary assessment of fatigue, sleepiness, and exhaustion in ESKD. In: BMC nephrology 15 (1), S. 29.

Many patients on maintenance dialysis experience significant sleepiness and fatigue. However, the influence of the hemodialysis (HD) day and circadian rhythms on patients’ symptoms have not been well characterized. We sought to use ecological momentary assessment to evaluate day-to-day and diurnal variability of fatigue, sleepiness, exhaustion and related symptoms in thrice-weekly maintenance HD patients. METHODS: Subjects used a modified cellular phone to access an interactive voice response system that administered the Daytime Insomnia Symptom Scale (DISS). The DISS assessed subjective vitality, mood, and alertness through 19 questions using 7- point Likert scales. Subjects completed the DISS 4 times daily for 7 consecutive days. Factor analysis was conducted and a mean composite score of fatigue-sleepiness-exhaustion was created. Linear mixed regression models (LMM) were used to examine the association of time of day, dialysis day and fatigue, sleepiness, and exhaustion composite scores. RESULTS: The 55 participants completed 1,252 of 1,540 (81%) possible assessments over the 7 day period. Multiple symptoms related to mood (e.g., feeling sad, feeling tense), cognition (e.g., difficulty concentrating), and fatigue (e.g., exhaustion, feeling sleepy) demonstrated significant daily and diurnal variation, with higher overall symptom scores noted on hemodialysis days and later in the day. In factor analysis, 4 factors explained the majority of the observed variance for DISS symptoms. Fatigue, sleepiness, and exhaustion loaded onto the same factor and were highly intercorrelated. In LMM, mean composite fatigue-sleepiness-exhaustion scores were associated with dialysis day (coefficient and 95% confidence interval [CI] 0.21 [0.02 - 0.39]) and time of day (coefficient and 95% CI 0.33 [0.25 - 0.41]. Observed associations were minimally affected by adjustment for demographics and common confounders. CONCLUSIONS: Maintenance HD patients experience fatigue-sleepiness-exhaustion symptoms that demonstrate significant daily and diurnal variation. The variability in symptoms may contribute to poor symptom awareness by providers and greater misclassification bias of fatigue related symptoms in clinical studies.

Abroms, Lorien C.; Lee Westmaas, J.; Bontemps-Jones, Jeuneviette; Ramani, Rathna; Mellerson, Jenelle (2013): A content analysis of popular smartphone apps for smoking cessation. In: American journal of preventive medicine 45 (6), S. 732–736.

Smartphone applications (apps) are increasingly available for smoking cessation. PURPOSE: This study examined the content of popular apps for smoking cessation for both iPhone and Android operating systems in February 2012. METHODS: A total of 252 smoking-cessation apps were identified for the iPhone and 148 for the Android. Across both operating systems, the most popular apps were identified (n=47 for the iPhone and n=51 for the Android) and analyzed for their (1) approach to smoking cessation and (2) adherence to an index based on the U.S. Public Health Service’s Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Where available, apps were coded for frequency of downloads. The analysis took place in 2012. RESULTS: Overall, popular apps have low levels of adherence, with an average score of 12.9 of a possible 42 on the Adherence Index. No apps recommended calling a quitline, and only a handful of apps recommended using approved medications (4.1%). Android apps in the sample were downloaded worldwide between 310,800 and 1,248,000 times per month. For both the iPhone and Android, user ratings were positively associated with scores on the Adherence Index. For the iPhone, display order was also positively associated with scores on the Adherence Index. CONCLUSIONS: Apps could be improved by better integration with the Clinical Practice Guidelines and other evidence-based practices.

Addy, Cheryl L.; Trilk, Jennifer L.; Dowda, Marsha; Byun, Won; Pate, Russell R. (2014): Assessing Preschool Children’s Physical Activity: How Many Days of Accelerometry Measurement. In: Pediatr Exerc Sci 26 (1), S. 103–109. DOI: 10.1123/pes.2013-0021.

The purpose of this study was to determine the minimum number of days of accelerometry required to estimate accurately MVPA and total PA in 3- to 5-year-old children. The study examined these metrics for all days, weekdays, and in-school activities. Study participants were 204 children attending 22 preschools who wore accelerometers for at least 6 hr per day for up to 12 days during most waking hours. The primary analysis considered the intraclass correlation coefficient (ICC) for each metric to estimate the number of days required to attain a specified reliability. The ICC estimates are 0.81 for MVPA-all days, 0.78 for total PA-all days, 0.83 for MVPA weekdays, 0.80 for total PA-weekdays, 0.81 for in-school MVPA, and 0.84 for in-school total PA. We recommend a full seven days of measurement whenever possible, but researchers can achieve acceptable reliability with fewer days, as indicated by the Spearman-Brown prophecy: 3-4 days for any weekday measure and 5-6 days for the all-days measures.

Adibi, Sasan (2014): Biomedical sensing analyzer (BSA) for mobile-health (mHealth)-LTE. In: IEEE J Biomed Health Inform 18 (1), S. 345–351. DOI: 10.1109/JBHI.2013.2262076.

The rapid expansion of mobile-based systems, the capabilities of smartphone devices, as well as the radio access and cellular network technologies are the wind beneath the wing of mobile health (mHealth). In this paper, the concept of biomedical sensing analyzer (BSA) is presented, which is a novel framework, devised for sensor-based mHealth applications. The BSA is capable of formulating the Quality of Service (QoS) measurements in an end-to-end sense, covering the entire communication path (wearable sensors, link-technology, smartphone, cell-towers, mobile-cloud, and the end-users). The characterization and formulation of BSA depend on a number of factors, including the deployment of application-specific biomedical sensors, generic link-technologies, collection, aggregation, and prioritization of mHealth data, cellular network based on the Long-Term Evolution (LTE) access technology, and extensive multidimensional delay analyses. The results are studied and analyzed in a LabView 8.5 programming environment.

Allen, Jerilyn K.; Stephens, Janna; Dennison Himmelfarb, Cheryl R; Stewart, Kerry J.; Hauck, Sara (2013): Randomized controlled pilot study testing use of smartphone technology for obesity treatment. In: J Obes 2013, S. 151597. DOI: 10.1155/2013/151597.

BACKGROUND\r\nThe established interventions for weight loss are resource intensive which can create barriers for full participation and ultimate translation. The major goal of this pilot study was to evaluate the feasibility, acceptability, and preliminary efficacy of theoretically based behavioral interventions delivered by smartphone technology.\r\nMETHODS\r\nThe study randomized 68 obese adults to receive one of four interventions for six months: (1) intensive counseling intervention, (2) intensive counseling plus smartphone intervention, (3) a less intensive counseling plus smartphone intervention, and (4) smartphone intervention only. The outcome measures of weight, BMI, waist circumference, and self-reported dietary intake and physical activity were assessed at baseline and six months.\r\nRESULTS\r\nThe sample was 78% female and 49% African American, with an average age of 45 years, and average BMI of 34.3 kg/m(2). There were trends for differences in weight loss among the four intervention groups. Participants in the intensive counseling plus self-monitoring smartphone group and less intensive counseling plus self-monitoring smartphone group tended to lose more weight than other groups (5.4 kg and 3.3 kg, resp.).\r\nCONCLUSIONS\r\nThe results of this pilot trial of a weight loss intervention provide preliminary support for using a smartphone application for self-monitoring as an adjunct to behavioral counseling.

Anastasopoulou, Panagiota; Tubic, Mirnes; Schmidt, Steffen; Neumann, Rainer; Woll, Alexander; Härtel, Sascha (2014): Validation and comparison of two methods to assess human energy expenditure during free-living activities. In: PLoS ONE 9 (2), S. e90606. DOI: 10.1371/journal.pone.0090606.

BACKGROUND\r\nThe measurement of activity energy expenditure (AEE) via accelerometry is the most commonly used objective method for assessing human daily physical activity and has gained increasing importance in the medical, sports and psychological science research in recent years.\r\nOBJECTIVE\r\nThe purpose of this study was to determine which of the following procedures is more accurate to determine the energy cost during the most common everyday life activities; a single regression or an activity based approach. For this we used a device that utilizes single regression models (GT3X, ActiGraph Manufacturing Technology Inc., FL., USA) and a device using activity-dependent calculation models (move II, movisens GmbH, Karlsruhe, Germany).\r\nMATERIAL AND METHODS\r\nNineteen adults (11 male, 8 female; 30.4±9.0 years) wore the activity monitors attached to the waist and a portable indirect calorimeter (IC) as reference measure for AEE while performing several typical daily activities. The accuracy of the two devices for estimating AEE was assessed as the mean differences between their output and the reference and evaluated using Bland-Altman analysis.\r\nRESULTS\r\nThe GT3X overestimated the AEE of walking (GT3X minus reference, 1.26 kcal/min), walking fast (1.72 kcal/min), walking up-/downhill (1.45 kcal/min) and walking upstairs (1.92 kcal/min) and underestimated the AEE of jogging (-1.30 kcal/min) and walking upstairs (-2.46 kcal/min). The errors for move II were smaller than those for GT3X for all activities. The move II overestimated AEE of walking (move II minus reference, 0.21 kcal/min), walking up-/downhill (0.06 kcal/min) and stair walking (upstairs: 0.13 kcal/min; downstairs: 0.29 kcal/min) and underestimated AEE of walking fast (-0.11 kcal/min) and jogging (-0.93 kcal/min).\r\nCONCLUSIONS\r\nOur data suggest that the activity monitor using activity-dependent calculation models is more appropriate for predicting AEE in daily life than the activity monitor using a single regression model.

Antypas, Konstantinos; Wangberg, Silje C. (2014): An Internet- and mobile-based tailored intervention to enhance maintenance of physical activity after cardiac rehabilitation: short-term results of a randomized controlled trial. In: J. Med. Internet Res. 16 (3), S. e77. DOI: 10.2196/jmir.3132.

BACKGROUND\r\nAn increase in physical activity for secondary prevention of cardiovascular disease and cardiac rehabilitation has multiple therapeutic benefits, including decreased mortality. Internet- and mobile-based interventions for physical activity have shown promising results in helping users increase or maintain their level of physical activity in general and specifically in secondary prevention of cardiovascular diseases and cardiac rehabilitation. One component related to the efficacy of these interventions is tailoring of the content to the individual.\r\nOBJECTIVE\r\nOur trial assessed the effect of a longitudinally tailored Internet- and mobile-based intervention for physical activity as an extension of a face-to-face cardiac rehabilitation stay. We hypothesized that users of the tailored intervention would maintain their physical activity level better than users of the nontailored version.\r\nMETHODS\r\nThe study population included adult participants of a cardiac rehabilitation program in Norway with home Internet access and a mobile phone. The participants were randomized in monthly clusters to a tailored or nontailored (control) intervention group. All participants had access to a website with information regarding cardiac rehabilitation, an online discussion forum, and an online activity calendar. Those using the tailored intervention received tailored content based on models of health behavior via the website and mobile fully automated text messages. The main outcome was self-reported level of physical activity, which was obtained using an online international physical activity questionnaire at baseline, at discharge, and at 1 month and 3 months after discharge from the cardiac rehabilitation program.\r\nRESULTS\r\nIncluded in the study were 69 participants. One month after discharge, the tailored intervention group (n=10) had a higher median level of overall physical activity (median 2737.5, IQR 4200.2) than the control group (n=14, median 1650.0, IQR 2443.5), but the difference was not significant (Kolmogorov-Smirnov Z=0.823, P=.38, r=.17). At 3 months after discharge, the tailored intervention group (n=7) had a significantly higher median level of overall physical activity (median 5613.0, IQR 2828.0) than the control group (n=12, median 1356.0, IQR 2937.0; Kolmogorov-Smirnov Z=1.397, P=.02, r=.33). The median adherence was 45.0 (95% CI 0.0-169.8) days for the tailored group and 111.0 (95% CI 45.1-176.9) days for the control group; however, the difference was not significant (P=.39). There were no statistically significant differences between the 2 groups in stage of change, self-efficacy, social support, perceived tailoring, anxiety, or depression.\r\nCONCLUSIONS\r\nBecause of the small sample size and the high attrition rate at the follow-up visits, we cannot make conclusions regarding the efficacy of our approach, but the results indicate that the tailored version of the intervention may have contributed to the long-term higher physical activity maintained after cardiac rehabilitation by participants receiving the tailored intervention compared with those receiving the nontailored intervention.\r\nTRIAL REGISTRATION\r\ NCT01223170; (Archived by WebCite at

Appel, Hoa B.; Huang, Bu; Cole, Allison; James, Rosalina; Ai, Amy L. (2014): Starting the Conversation - A Childhood Obesity Knowledge Project Using an App. In: Br J Med Med Res 4 (7), S. 1526–1538.

PURPOSE: Starting the Conversation was a pilot project to test an intervention for childhood obesity, a major public health epidemic, using a free smartphone application (app). The primary aim was to assess students’ knowledge of nutritional indicators, physical exercise and use of screen time before and after the intervention. METHODS: The study was conducted in 2011-2012. The sample, recruited from seven high schools in Snohomish County, Washington, was 65.3% minority participants. Of the 118 participants in the sample (n=118), 79 handwrote their responses (n=78) and 36 responded via the app (n=39). We compared the frequency and types of physical exercise, frequency of screen time, and nutritional variables of high school students. Participants used the cell phone app or a handwritten log to record their daily entries for 20 days. RESULTS: Both males (n=43) and females (n=75) grades 9-12 used the app or handwritten entries. Participants who used the app ate less fast food and exercised more, as compared with those who recorded their entries by hand. Screen time usage decreased over the course of the study, based on a comparison of the post-survey level and the pre-survey level. Knowledge of recommended daily consumption of vegetables increased post-test in the app group and knowledge of water consumption increased significantly in both groups. There was no significant difference in BMI pre and post-test. CONCLUSIONS: Patterns of nutritional intake, physical exercise and knowledge of these issues varied pre and post-test. It is critical to further examine factors associated with lack of physical activity and food intake patterns of youth using social media to further address the childhood obesity epidemic. Future research should focus on specific ethnic subgroups and an intervention at the school level aimed at the students with BMI >/= 95th percentile.

Atkin, Andrew J.; Corder, Kirsten; van Sluijs, Esther M F (2013): Bedroom media, sedentary time and screen-time in children: a longitudinal analysis. In: Int J Behav Nutr Phys Act 10, S. 137. DOI: 10.1186/1479-5868-10-137.

BACKGROUND\r\nHaving electronic media in the bedroom is cross-sectionally associated with greater screen-time in children, but few longitudinal studies exist. The aim of this study was to describe longitudinal patterns of ownership and examine cross-sectional and longitudinal associations of bedroom media with children’s sedentary behaviour.\r\nMETHODS\r\nData are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY) study, collected at 3 time-points: baseline (2007, T0; age 10.3 ± 0.3 years), 1-year (T1y) and 4-year (T4y) follow-up. For each assessment, 1512 (44.9% male), 715 (41.0% male), and 319 (48.3% male) participants provided valid accelerometer data. Outcome variables were accelerometer-assessed sedentary time and self-reported screen-time. The presence of a television or computer in the bedroom was self-reported by participants and a combined bedroom media score calculated as the sum of such items. Cross-sectional and longitudinal associations between bedroom media and each outcome were examined using multi-level linear regression.\r\nRESULTS\r\nBedroom TV ownership fell from 70.9% at T0 to 42.5% at T4y. Having a TV in the bedroom (beta; 95% CI*100, T0: -1.17; -1.88, -0.46. T1y: -1.68; -2.67, -0.70) and combined bedroom media (T0: -0.76; -1.26, -0.27. T1y: -0.79; -1.51, -0.07) were negatively associated with objectively measured weekly sedentary time at T0 and T1y. Having a computer in the bedroom (beta; 95% CI, T0: 0.15; 0.02, 0.29. T4y: 0.35; 0.10, 0.60) and combined bedroom media (T0: 0.09: 0.01, 0.18. T4y: 0.20; 0.05, 0.34) were positively associated with screen-time at T0 and T4y. Relative to participants without a computer throughout the study, children that had a computer in their bedroom at T0 but not at T4y (beta; 95% CI for change in screen-time: -8.02; -12.75, -3.29) reported smaller increases in screen-time.\r\nCONCLUSIONS\r\nThe bedroom media environment changes with age and exhibits a complex relationship with children’s sedentary behaviour. Modifying children’s bedroom media environment may impact upon screen-time but appears unlikely to influence overall sedentary time.

Audrey, Suzanne; Bell, Sarah; Hughes, Rachael; Campbell, Rona (2013): Adolescent perspectives on wearing accelerometers to measure physical activity in population-based trials. In: Eur J Public Health 23 (3), S. 475–480. DOI: 10.1093/eurpub/cks081.

BACKGROUND\r\nAccelerometers are increasingly used in health research to measure physical activity, but few published studies document participants’ views and experiences of wearing accelerometers, preferring to focus on measurement decisions and outcomes, and fewer still have reported the views and experiences of adolescent participants.\r\nPURPOSE\r\nThe purpose of this study is to examine the use of accelerometers with young people including recruitment, retention and adherence to protocol.\r\nMETHODS\r\nThe AHEAD (Activity and Healthy Eating in Adolescence) feasibility study, involving over 1000 students aged 12/13 years, took place in south-west England between 2007 and 2009. Piloting work was followed by an exploratory trial, incorporating a process evaluation, in six schools. Students were asked to wear accelerometers for 7 days at baseline and follow-up.\r\nRESULTS\r\nEighty-nine percent of students provided some accelerometer data at baseline and 87% at follow-up. However, adherence (recording ≥ 600 minutes per day for ≥ 3 days) fell from 75% at baseline to 56% at follow-up. Factors affecting adherence included the following: the use and type of incentives, appearance, discomfort and unforeseen changes to the school timetable.\r\nCONCLUSIONS\r\nIf worn properly, accelerometers can provide an important objective measure of physical activity in population-based studies promoting physical activity. But to achieve generalizable results, it is important to maximize recruitment, retention and adherence to protocol across the study population. For adolescents, adherence may be improved by the following: a ‘two-part’ reward (part one for returns, part two for adherence), personal activity graphs, and less obtrusive belts and monitors.

Azar, Kristen M J; Lesser, Lenard I.; Laing, Brian Y.; Stephens, Janna; Aurora, Magi S.; Burke, Lora E.; Palaniappan, Latha P. (2013): Mobile applications for weight management: theory-based content analysis. In: Am J Prev Med 45 (5), S. 583–589. DOI: 10.1016/j.amepre.2013.07.005.

BACKGROUND\r\nThe use of smartphone applications (apps) to assist with weight management is increasingly prevalent, but the quality of these apps is not well characterized.\r\nPURPOSE\r\nThe goal of the study was to evaluate diet/nutrition and anthropometric tracking apps based on incorporation of features consistent with theories of behavior change.\r\nMETHODS\r\nA comparative, descriptive assessment was conducted of the top-rated free apps in the Health and Fitness category available in the iTunes App Store. Health and Fitness apps (N=200) were evaluated using predetermined inclusion/exclusion criteria and categorized based on commonality in functionality, features, and developer description. Four researchers then evaluated the two most popular apps in each category using two instruments: one based on traditional behavioral theory (score range: 0-100) and the other on the Fogg Behavioral Model (score range: 0-6). Data collection and analysis occurred in November 2012.\r\nRESULTS\r\nEligible apps (n=23) were divided into five categories: (1) diet tracking; (2) healthy cooking; (3) weight/anthropometric tracking; (4) grocery decision making; and (5) restaurant decision making. The mean behavioral theory score was 8.1 (SD=4.2); the mean persuasive technology score was 1.9 (SD=1.7). The top-rated app on both scales was Lose It! by Fitnow Inc.\r\nCONCLUSIONS\r\nAll apps received low overall scores for inclusion of behavioral theory-based strategies.

Bania, Theofani (2014): Measuring Physical Activity in Young People with Cerebral Palsy: Validity and Reliability of the ActivPAL™ Monitor. In: Physiother Res Int. DOI: 10.1002/pri.1584.

BACKGROUND AND PURPOSE\r\nWe determined the criterion validity and the retest reliability of the ActivPAL™ monitor in young people with diplegic cerebral palsy (CP).\r\nMETHODS\r\nActivity monitor data were compared with the criterion of video recording for 10 participants. For the retest reliability, activity monitor data were collected from 24 participants on two occasions. Participants had to have diplegic CP and be between 14 and 22 years of age. They also had to be of Gross Motor Function Classification System level II or III. Outcomes were time spent in standing, number of steps (physical activity) and time spent in sitting (sedentary behaviour).\r\nRESULTS\r\nFor criterion validity, coefficients of determination were all high (r(2)  ≥ 0.96), and limits of group agreement were relatively narrow, but limits of agreement for individuals were narrow only for number of steps (≥5.5%). Relative reliability was high for number of steps (intraclass correlation coefficient = 0.87) and moderate for time spent in sitting and lying, and time spent in standing (intraclass correlation coefficients = 0.60-0.66). For groups, changes of up to 7% could be due to measurement error with 95% confidence, but for individuals, changes as high as 68% could be due to measurement error.\r\nDISCUSSION\r\nThe results support the criterion validity and the retest reliability of the ActivPAL™ to measure physical activity and sedentary behaviour in groups of young people with diplegic CP but not in individuals. Copyright © 2014 John Wiley & Sons, Ltd.

Baquet, Georges; Ridgers, Nicola D.; Blaes, Aurélie; Aucouturier, Julien; van Praagh, Emmanuel; Berthoin, Serge (2014): Objectively assessed recess physical activity in girls and boys from high and low socioeconomic backgrounds. In: BMC Public Health 14, S. 192. DOI: 10.1186/1471-2458-14-192.

BACKGROUND\r\nThe school environment influences children’s opportunities for physical activity participation. The aim of the present study was to assess objectively measured school recess physical activity in children from high and low socioeconomic backgrounds.\r\nMETHODS\r\nFour hundred and seven children (6-11 years old) from 4 primary schools located in high socioeconomic status (high-SES) and low socioeconomic status (low-SES) areas participated in the study. Children’s physical activity was measured using accelerometry during morning and afternoon recess during a 4-day school week. The percentage of time spent in light, moderate, vigorous, very high and in moderate- to very high-intensity physical activity were calculated using age-dependent cut-points. Sedentary time was defined as 100 counts per minute.\r\nRESULTS\r\nBoys were significantly (p < 0.001) more active than girls. No difference in sedentary time between socioeconomic backgrounds was observed. The low-SES group spent significantly more time in light (p < 0.001) and very high (p < 0.05) intensity physical activity compared to the high-SES group. High-SES boys and girls spent significantly more time in moderate (p < 0.001 and p < 0.05, respectively) and vigorous (p < 0.001) physical activity than low-SES boys.\r\nCONCLUSIONS\r\nDifferences were observed in recess physical activity levels according to socioeconomic background and sex. These results indicate that recess interventions should target children in low-SES schools.

Barreira, Tiago V.; Brouillette, Robert M.; Foil, Heather C.; Keller, Jeffrey N.; Tudor-Locke, Catrine (2013): Comparison of older adults’ steps per day using NL-1000 pedometer and two GT3X+ accelerometer filters. In: J Aging Phys Act 21 (4), S. 402–416.

The purpose of this study was to compare the steps/d derived from the ActiGraph GT3X+ using the manufacturer’s default filter (DF) and low-frequency-extension filter (LFX) with those from the NL-1000 pedometer in an older adult sample. Fifteen older adults (61-82 yr) wore a GT3X+ (24 hr/day) and an NL-1000 (waking hours) for 7 d. Day was the unit of analysis (n = 86 valid days) comparing (a) GT3X+ DF and NL-1000 steps/d and (b) GT3X+ LFX and NL-1000 steps/d. DF was highly correlated with NL-1000 (r = .80), but there was a significant mean difference (-769 steps/d). LFX and NL-1000 were highly correlated (r = .90), but there also was a significant mean difference (8,140 steps/d). Percent difference and absolute percent difference between DF and NL-1000 were -7.4% and 16.0%, respectively, and for LFX and NL-1000 both were 121.9%. Regardless of filter used, GT3X+ did not provide comparable pedometer estimates of steps/d in this older adult sample.

Barreira, Tiago V.; Harrington, Deirdre M.; Katzmarzyk, Peter T. (2014): Cardiovascular health metrics and accelerometer-measured physical activity levels: National Health and Nutrition Examination Survey, 2003-2006. In: Mayo Clin. Proc. 89 (1), S. 81–86. DOI: 10.1016/j.mayocp.2013.10.001.

OBJECTIVE\r\nTo determine whether relationships exist between accelerometer-measured moderate-to-vigorous physical activity (MVPA) and other cardiovascular (CV) health metrics in a large sample.\r\nPATIENTS AND METHODS\r\nData from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) collected from January 1, 2003, through December 31, 2006, were used. Overall, 3454 nonpregnant adults 20 years or older who fasted for 6 hours or longer, with valid accelerometer data and with CV health metrics, were included in the study. Blood pressure (BP), body mass index (BMI), smoking status, diet, fasting plasma glucose level, and total cholesterol level were defined as ideal, intermediate, and poor on the basis of American Heart Association criteria. Results were weighted to account for sampling design, oversampling, and nonresponse.\r\nRESULTS\r\nSignificant increasing linear trends in mean daily MVPA were observed across CV health levels for BMI, BP, and fasting plasma glucose (P<.001). Those with a poor BMI and BP had significantly lower mean daily MVPA than those with intermediate and ideal BMIs and BPs (all P<.001). In addition, individuals with an intermediate fasting plasma glucose level had significantly lower mean daily MVPA than individuals at the ideal levels (P<.001). No significant linear trends were observed for cholesterol, smoking, and diet. A significant linear trend was observed for mean daily MVPA and the overall number of other CV health metrics (P<.001).\r\nCONCLUSION\r\nObjectively measured MVPA was related to other CV health metrics in this large sample. These results support the inclusion of physical activity in the overall definition of ideal CV health.

Beaty, Roger E.; Burgin, Chris J.; Nusbaum, Emily C.; Kwapil, Thomas R.; Hodges, Donald A.; Silvia, Paul J. (2013): Music to the inner ears: exploring individual differences in musical imagery. In: Conscious Cogn 22 (4), S. 1163–1173. DOI: 10.1016/j.concog.2013.07.006.

In two studies, we explored the frequency and phenomenology of musical imagery. Study 1 used retrospective reports of musical imagery to assess the contribution of individual differences to imagery characteristics. Study 2 used an experience sampling design to assess the phenomenology of musical imagery over the course of one week in a sample of musicians and non-musicians. Both studies found episodes of musical imagery to be common and positive: people rarely wanted such experiences to end and often heard music that was personally meaningful. Several variables predicted musical imagery, including personality, musical preferences, and positive mood. Musicians tended to hear musical imagery more often, but they reported less frequent episodes of deliberately-generated imagery. Taken together, the present research provides new insights into individual differences in musical imagery, and it supports the emerging view that such experiences are common, positive, and more voluntary than previously recognized.

Belton, Sarahjane; O’Brien, Wesley; Wickel, Eric E.; Issartel, Johann (2013): Patterns of noncompliance in adolescent field-based accelerometer research. In: J Phys Act Health 10 (8), S. 1181–1185.

BACKGROUND: The primary purpose of this study was to investigate patterns of noncompliance in an adolescent field based accelerometer study. A further purpose was to investigate the effect of a cost efficient strategy (SMS reminder message) on the compliance of adolescents METHOD: The research carried out in 2010 involved 117 second level students (12.41 +/- .53 yrs) from 4 schools in a rural Irish town. The Actigraph accelerometer data were processed over 7 days to determine compliance level. RESULTS: Students were more likely to remove their monitor in the evening period than at any other time, however if students removed their monitor after school it remained unworn for a significantly longer duration than in any other time period. Students who received a SMS message were significantly more likely (P = .008) to wear their monitor in the morning than those that did not. CONCLUSIONS: Sending an SMS message each morning is effective for improving the number of students wearing monitors to school. The after school period is a critical period for nonwear time and should be targeted in future studies wishing to improve compliance.

Bender, Jacqueline Lorene; Yue, Rossini Ying Kwan; To, Matthew Jason; Deacken, Laetitia; Jadad, Alejandro R. (2013): A lot of action, but not in the right direction: systematic review and content analysis of smartphone applications for the prevention, detection, and management of cancer. In: J. Med. Internet Res. 15 (12), S. e287. DOI: 10.2196/jmir.2661.

BACKGROUND\r\nMobile phones have become nearly ubiquitous, offering a promising means to deliver health interventions. However, little is known about smartphone applications (apps) for cancer.\r\nOBJECTIVE\r\nThe purpose of this study was to characterize the purpose and content of cancer-focused smartphone apps available for use by the general public and the evidence on their utility or effectiveness.\r\nMETHODS\r\nWe conducted a systematic review of the official application stores for the four major smartphone platforms: iPhone, Android, Nokia, and BlackBerry. Apps were included in the review if they were focused on cancer and available for use by the general public. This was complemented by a systematic review of literature from MEDLINE, Embase, and the Cochrane Library to identify evaluations of cancer-related smartphone apps.\r\nRESULTS\r\nA total of 295 apps from the smartphone app stores met the inclusion criteria. The majority of apps targeted breast cancer (46.8%, 138/295) or cancer in general (28.5%, 84/295). The reported app purpose was predominantly to raise awareness about cancer (32.2%, 95/295) or to provide educational information about cancer (26.4%, 78/295), followed by apps to support fundraising efforts (12.9%, 38/295), assist in early detection (11.5%, 34/295), promote a charitable organization (10.2%, 30/295), support disease management (3.7%, 11/295), cancer prevention (2.0%, 6/295), or social support (1.0%, 3/295). The majority of the apps did not describe their organizational affiliation (64.1%, 189/295). Apps affiliated with non-profit organizations were more likely to be free of cost (χ(2) 1=16.3, P<.001) and have a fundraising or awareness purpose (χ(2) 2=13.3, P=.001). The review of the health literature yielded 594 articles, none of which reported an evaluation of a cancer-focused smartphone application.\r\nCONCLUSIONS\r\nThere are hundreds of cancer-focused apps with the potential to enhance efforts to promote behavior change, to monitor a host of symptoms and physiological indicators of disease, and to provide real-time supportive interventions, conveniently and at low cost. However, there is a lack of evidence on their utility, effectiveness, and safety. Future efforts should focus on improving and consolidating the evidence base into a whitelist for public consumption.

Ben-Zeev, Dror; Brenner, Christopher J.; Begale, Mark; Duffecy, Jennifer; Mohr, David C.; Mueser, Kim T. (2014): Feasibility, Acceptability, and Preliminary Efficacy of a Smartphone Intervention for Schizophrenia. In: Schizophr Bull. DOI: 10.1093/schbul/sbu033.

The FOCUS smartphone intervention was developed to provide automated real-time/real-place illness management support to individuals with schizophrenia. The system was specifically designed to be usable by people with psychotic disorders who may have cognitive impairment, psychotic symptoms, negative symptoms, and/or low reading levels. FOCUS offers users both prescheduled and on-demand resources to facilitate symptom management, mood regulation, medication adherence, social functioning, and improved sleep. In this study, 33 individuals with schizophrenia or schizoaffective disorder used FOCUS over a 1-month period in their own environments. Participants were able to learn how to use the intervention independently, and all but one participant completed the trial successfully and returned the smartphones intact. Completers used the system on 86.5% of days they had the device, an average of 5.2 times a day. Approximately 62% of use of the FOCUS intervention was initiated by the participants, and 38% of use was in response to automated prompts. Baseline levels of cognitive functioning, negative symptoms, persecutory ideation, and reading level were not related to participants’ use of the intervention. Approximately 90% of participants rated the intervention as highly acceptable and usable. Paired samples t tests found significant reductions in psychotic symptoms, depression, and general psychopathology, after 1 month of FOCUS use. This study demonstrated the feasibility, acceptability, and preliminary efficacy of the FOCUS intervention for schizophrenia and introduces a new treatment model which has promise for extending the reach of evidence-based care beyond the confines of a physical clinic using widely available technologies.

Berry, Rebecca Rialon; Lai, Betty (2014): The Emerging Role of Technology in Cognitive–Behavioral Therapy for Anxious Youth: A Review. In: J Rat-Emo Cognitive-Behav Ther 32 (1), S. 57–66. DOI: 10.1007/s10942-014-0184-5.

Research documents the application of cognitive–behavioral therapy (CBT) with technology either as therapeutic adjuncts or stand-alone interventions. The literature evaluating the feasibility and efficacy of using technology with CBT for youth experiencing internalizing disorders is small though steadily emerging. Technological approaches offer cost-effective and efficient service to an increased number of anxious youth for whom a CBT treatment would be otherwise unavail- able. The present article aims to review the use of two broad types of technology in CBT for anxious children and adolescents: computer- and internet-based CBT and mobile mental health applications (i.e., mobile phone, smartphone, and tablet technology). Within each section, we provide an overview of the advantages and general principles of each type of technology, and review evidence for the use of each type of technology along with examples of current applications. Finally, we discuss ethical issues, barriers, and future directions for the use of technology in facilitating dissemination of effective treatments. Keywords: Technology, Cognitive–behavior therapy, Youth, Anxiety

Bieg, Madeleine; Goetz, Thomas; Hubbard, Kyle (2013): Can I master it and does it matter? An intraindividual analysis on control-value antecedents of trait and state academic emotions. In: Learning and Individual Differences 28, S. 102–108. Online verfügbar unter

The present study explored the relations between cognitive appraisal antecedents and academic emotions as stated in Pekrun’s control–value theory (2006). The appraisals of control and value, and the interaction of the two as predictors of emotions, were studied while using both trait and state (via experience sampling) assessments in one sample. Control and value appraisals, and the discrete emotions of pride, anxiety, and boredom, were assessed in four subject domains in a sample of N = 120 students in grades 8 and 11. Multilevel analyses showed that control, value, and their interaction predict the respective emotions in the expected direction while using an intraindividual approach in analyzing the data. Furthermore, results revealed that appraisal–emotion relationships are quite similar in trait and state data. Implications for future research are outlined regarding the use of intraindividual approaches and for educational practice with respect to the promotion of control and value appraisals. Keywords: Control–value theory; Cognitive appraisal; Experience sampling; Intraindividual approach; Multilevel analysis

Bieg, Madeleine; Goetz, Thomas; Lipnevich, Anastasiya A. (2014): What students think they feel differs from what they really feel-academic self-concept moderates the discrepancy between students’ trait and state emotional self-reports. In: PLoS ONE 9 (3), S. e92563. DOI: 10.1371/journal.pone.0092563.

This study investigated whether there is a discrepancy pertaining to trait and state academic emotions and whether self-concept of ability moderates this discrepancy. A total of 225 secondary school students from two different countries enrolled in grades 8 and 11 (German sample; n = 94) and grade 9 (Swiss sample; n = 131) participated. Students’ trait academic emotions of enjoyment, pride, anger, and anxiety in mathematics were assessed with a self-report questionnaire, whereas to assess their state academic emotions experience-sampling method was employed. The results revealed that students’ scores on the trait assessment of emotions were generally higher than their scores on the state assessment. Further, as expected, students’ academic self-concept in the domain of mathematics was shown to partly explain the discrepancy between scores on trait and state emotions. Our results indicate that there is a belief-driven discrepancy between what students think they feel (trait assessment) and what they really feel (state assessment). Implications with regard to the assessment of self-reported emotions in future studies and practical implications for the school context are discussed.

Bortkiewicz, Alicja; Gadzicka, Elżbieta; Stroszejn-Mrowca, Grażyna; Szyjkowska, Agata; Szymczak, Wiesław; Koszada-Włodarczyk, Wiesława; Szadkowska-Stańczyk, Irena (2014): Cardiovascular changes in workers exposed to fine particulate dust. In: Int J Occup Med Environ Health 27 (1), S. 78–92. DOI: 10.2478/s13382-014-0234-3.

OBJECTIVES\r\nEpidemiological studies provide evidence that airborne particulate matter may contribute to the increased incidence and mortality rates due to pulmonary and cardiovascular diseases. Only some of them address the problem of occupational exposure to particulate air pollution. The aim of our study was to assess cardiovascular reaction and autonomic regulation in workers exposed to fine particles.\r\nMATERIALS AND METHODS\r\nAll workers had medical examination, resting ECG with heart rate variability analysis (HRV), 24-h ECG, and ambulatory blood pressure monitoring (ABPM) performed. The subjects were 20 male workers (mean age: 32.14.0 year) of a ceramic ware factory exposed to the dust and 20 workers who were not exposed (mean age: 39.4±7.8 year). The period of employment under exposure amounted to 5.6±2.1 year. Dust exposure was measured using individual dosimeters.\r\nRESULTS\r\nThe geometric mean total dust concentration was 44±1.5 mg/m(3) and the FPD (fine particulate dust) concentration amounted to 11.5±1.6 mg/m(3). No abnormalities were noted in the resting ECG in both groups, in 24-h ECG 2 subjects, both from exposed and control groups, had ventricular heart rhythm and repolarization disturbances. Blood pressure in ABPM, both systolic as well as diastolic, was normal and did not differ between the groups. Resting heart rate in the exposed group was significantly lower (p = 0.038) than in the control group. In the exposed group STD R-R from short-term records was significantly higher (p = 0.01). Fast Fourier Transform (FFT) analysis showed that the low frequency power spectrum (LF) did not differ in the exposed and the control group, while high frequency (HF) was significantly higher in the exposed group. LF/HF ratio was significantly lower in the exposed in comparison with the control group.\r\nCONCLUSIONS\r\nAlthough we did not reveal significant abnormalities in ECG as well as in ABPM in the exposed group, it seems that neurovegetative disturbances (parasympathetic predominance) may serve as an early indicator of fine particulate dust effect on cardiovascular system.

Bort-Roig, Judit; Gilson, Nicholas D.; Puig-Ribera, Anna; Contreras, Ruth S.; Trost, Stewart G. (2014): Measuring and influencing physical activity with smartphone technology: a systematic review. In: Sports Med 44 (5), S. 671–686. DOI: 10.1007/s40279-014-0142-5.

BACKGROUND\r\nRapid developments in technology have encouraged the use of smartphones in physical activity research, although little is known regarding their effectiveness as measurement and intervention tools.\r\nOBJECTIVE\r\nThis study systematically reviewed evidence on smartphones and their viability for measuring and influencing physical activity.\r\nDATA SOURCES\r\nResearch articles were identified in September 2013 by literature searches in Web of Knowledge, PubMed, PsycINFO, EBSCO, and ScienceDirect.\r\nSTUDY SELECTION\r\nThe search was restricted using the terms (physical activity OR exercise OR fitness) AND (smartphone* OR mobile phone* OR cell phone*) AND (measurement OR intervention). Reviewed articles were required to be published in international academic peer-reviewed journals, or in full text from international scientific conferences, and focused on measuring physical activity through smartphone processing data and influencing people to be more active through smartphone applications.\r\nSTUDY APPRAISAL AND SYNTHESIS METHODS\r\nTwo reviewers independently performed the selection of articles and examined titles and abstracts to exclude those out of scope. Data on study characteristics, technologies used to objectively measure physical activity, strategies applied to influence activity; and the main study findings were extracted and reported.\r\nRESULTS\r\nA total of 26 articles (with the first published in 2007) met inclusion criteria. All studies were conducted in highly economically advantaged countries; 12 articles focused on special populations (e.g. obese patients). Studies measured physical activity using native mobile features, and/or an external device linked to an application. Measurement accuracy ranged from 52 to 100% (n = 10 studies). A total of 17 articles implemented and evaluated an intervention. Smartphone strategies to influence physical activity tended to be ad hoc, rather than theory-based approaches; physical activity profiles, goal setting, real-time feedback, social support networking, and online expert consultation were identified as the most useful strategies to encourage physical activity change. Only five studies assessed physical activity intervention effects; all used step counts as the outcome measure. Four studies (three pre-post and one comparative) reported physical activity increases (12-42 participants, 800-1,104 steps/day, 2 weeks-6 months), and one case-control study reported physical activity maintenance (n = 200 participants; >10,000 steps/day) over 3 months.\r\nLIMITATIONS\r\nSmartphone use is a relatively new field of study in physical activity research, and consequently the evidence base is emerging.\r\nCONCLUSIONS\r\nFew studies identified in this review considered the validity of phone-based assessment of physical activity. Those that did report on measurement properties found average-to-excellent levels of accuracy for different behaviors. The range of novel and engaging intervention strategies used by smartphones, and user perceptions on their usefulness and viability, highlights the potential such technology has for physical activity promotion. However, intervention effects reported in the extant literature are modest at best, and future studies need to utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better explore the physical activity measurement and intervention capabilities of smartphones.

Broderick, J. M.; Ryan, J.; O’Donnell, D. M.; Hussey, J. (2014): A guide to assessing physical activity using accelerometry in cancer patients. In: Support Care Cancer 22 (4), S. 1121–1130. DOI: 10.1007/s00520-013-2102-2.

Increased physical activity (PA) has been associated with a decreased risk for the occurrence and recurrence of many cancers. PA is an important outcome measure in rehabilitation interventions within cancer and may be used as a proxy measure of recovery or deterioration in health status following treatment and in the palliative care setting. PA is a complex multi-dimensional construct which is challenging to measure accurately. Factors such as technical precision and feasibility influence the choice of PA measurement tool. Laboratory-based methods are precise and mainly used for validation purposes, but their clinical applicability is limited. Self-report methods such as questionnaires are widely used due to their simplicity and reasonable cost; however, accuracy can be questionable. Objective methods such as pedometers measure step count but do not measure intensity, frequency or duration of activity. Accelerometers can measure PA behaviour at both ends of the movement spectrum from sedentary to vigorous levels of activity and can also provide objective data about the frequency, intensity, type and duration of PA. Balancing precision with ease of use, accelerometry may be the best measure of PA in cancer-based studies, but only a small number of studies have incorporated this measurement. This review will provide a background to PA and an overview of accelerometer measurement as well as technical and practical considerations, so this useful tool could be more widely incorporated into clinical trial research within cancer.

Bromberg, Maggie H.; Connelly, Mark; Anthony, Kelly K.; Gil, Karen M.; Schanberg, Laura E. (2014): Self-reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: an electronic diary study. In: Arthritis & rheumatology (Hoboken, N.J.) 66 (2), S. 462–469. DOI: 10.1002/art.38223.

OBJECTIVE\r\nTo use electronic diaries (e-diaries) to determine whether pain, stiffness, and fatigue continue to be common, disabling symptoms in children with juvenile idiopathic arthritis (JIA) despite the use of aggressive treatments in contemporary medical management.\r\nMETHODS\r\nFifty-nine children with JIA (ages 8-18 years) provided ratings of pain, stiffness, and fatigue intensity and functional limitations using a smartphone e-diary 3 times each day for 1 month. Medication information was collected via parent report and checked for accuracy by chart review. Descriptive analyses were conducted to determine typical symptom intensity, frequency, and variability. Multilevel modeling was used to analyze associations between symptoms and functional outcomes and between medication use and symptom intensity.\r\nRESULTS\r\nChildren reported moments of pain in 66% of e-diary entries. No children were entirely pain-free across the reporting period. In 31% of all e-diary entries the visual analog scale score for pain was >40 (high pain intensity), with 86% of children reporting a high level of pain at least once during the study period. The mean ratings of pain, stiffness, and fatigue intensity were in the mild-to-moderate range. Medication class was not a reliable predictor of differences in symptom intensity, even though 79% of children were prescribed a disease-modifying antirheumatic drug and 47% were prescribed a biologic agent. Moments of higher pain intensity and higher stiffness intensity were each uniquely predictive of higher concurrent functional limitations.\r\nCONCLUSION\r\nSelf-reported pain, stiffness, and fatigue continue to be common in children with JIA, despite contemporary advances in treatment strategies, including use of biologic agents. These findings are surprisingly consistent with previous results from research using daily paper diaries in the pre-biologics era. There remains a pressing and ongoing need to optimize pain and symptom management in JIA.

Brunet, Jennifer; Burke, Shaunna M.; Sabiston, Catherine M. (2013): The benefits of being self-determined in promoting physical activity and affective well-being among women recently treated for breast cancer. In: Psychooncology. DOI: 10.1002/pon.3287.

PURPOSE: In this study, changes in motivational regulations in women following treatment for breast cancer were described. Changes in motivational regulations as predictors of subsequent change in light and moderate-to-vigorous physical activity (PA) and affect were also examined. METHODS: Women [n = 150; Mage  = 54.41 (SD = 10.87) years] completed self-report questionnaires and wore an accelerometer for 7 days at Time 1 [M = 3.94 (SD = 3.08) months following primary treatment], as well as 3 (Time 2) and 6 (Time 3) months later. Data were analyzed using repeated-measures analysis of variance and path analysis using residual change scores. RESULTS: Identified regulation and self-determined motivation (i.e., combined intrinsic motivation and identified regulation) scores decreased over time (p < 0.05). In the path model [χ(2) (4) = 5.66, p = 0.22, root mean square error of approximation = 0.05 (90% CI: 0.0; 0.15), comparative fit index = 0.99, standardized root mean square of the residuals = 0.03], ΔTime1-2 in external regulation was associated with ΔTime2-3 in positive affect (β = -0.16), ΔTime1-2 in introjected (β = 0.25) and amotivation (β = 0.19) were related to ΔTime2-3 in negative affect, and ΔTime1-2 in self-determined motivation was related to ΔTime2-3 in positive affect (β = 0.40) and moderate-to-vigorous PA (β = 0.21). CONCLUSIONS: Changes in motivational regulations were related to changes in PA and affect in the aftermath of breast cancer. Given the benefits of self-determined motivation, additional research is needed to develop and test interventions aimed at enhancing this type of motivation. Copyright © 2013 John Wiley & Sons, Ltd.

Burrow, Anthony L.; Hill, Patrick L. (2013): Derailed by diversity? Purpose buffers the relationship between ethnic composition on trains and passenger negative mood. In: Pers Soc Psychol Bull 39 (12), S. 1610–1619. DOI: 10.1177/0146167213499377.

Many individuals feel socially isolated and distressed in ethnically diverse settings. Purpose in life may buffer this form of distress by fostering one’s sense of having a meaningful direction, which may also be of significance to others. In two experience-sampling studies with ethnically diverse participants, we examined associations between the ethnic composition of urban trains and passenger distress, and tested purpose as a moderator of these relationships. Study 1 showed that participants of all ethnic backgrounds reported greater negative mood when the percentage of ethnic out-group members aboard their train increased. However, individual differences in purpose significantly attenuated this effect. Study 2 replicated and extended these findings experimentally by showing that relative to a control condition, briefly writing about purpose prior to boarding trains also diminished the impact of ethnic composition on negative mood. The discussion addresses strategies for promoting positive adjustment in our increasingly diverse society.

Burton, Suzan; Spanjaard, Daniela; Hoek, Janet (2013): An investigation of tobacco retail outlets as a cue for smoking. In: Australasian Marketing Journal (AMJ) 21 (4), S. 234–239. DOI: 10.1016/j.ausmj.2013.08.003.

Evidence suggests that widespread distribution of tobacco and point of sale (POS) displays of tobacco prompt impulse purchases and cue smoking. As a result, health researchers have argued for a reduction in the number of tobacco retail outlets. However, with tobacco products now removed from display in many countries, there has been very little evidence to indicate whether decreasing the number of tobacco retail outlets will result in reduced smoking prevalence. Using a combination of in-depth interviews and near-real-time electronic diary data collected from 31 smokers and attempting quitters, we examined their responses to exposure to tobacco outlets. The findings provide the first evidence that even in the absence of POS displays, the mere sight of tobacco retail outlets can trigger impulse tobacco purchases and increase smoking frequency. The findings support calls to restrict tobacco distribution. Keywords: Tobacco; Point of sale (POS); Smoking; Environment; Trigger; Electronic diary

Cain, Kelli L.; Sallis, James F.; Conway, Terry L.; van Dyck, Delfien; Calhoon, Lynn (2013): Using accelerometers in youth physical activity studies: a review of methods. In: J Phys Act Health 10 (3), S. 437–450.

BACKGROUND: In 2005, investigators convened by the National Cancer Institute recommended development of standardized protocols for accelerometer use and reporting decision rules in articles. A literature review was conducted to document accelerometer methods and decision rule reporting in youth physical activity articles from 2005-2010. METHODS: Nine electronic databases identified 273 articles that measured physical activity and/or sedentary behavior using the most-used brand of accelerometer (ActiGraph). Six key methods were summarized by age group (preschool, children, and adolescents) and trends over time were examined. RESULTS: Studies using accelerometers more than doubled from 2005-2010. Methods included 2 ActiGraph models, 6 epoch lengths, 6 nonwear definitions, 13 valid day definitions, 8 minimum wearing day thresholds, 12 moderate-intensity physical activity cut points, and 11 sedentary cut points. Child studies showed the most variation in methods and a trend toward more variability in cut points over time. Decision rule reporting improved, but only 54% of papers reported on all methods. CONCLUSION: The increasing diversity of methods used to process and score accelerometer data for youth precludes comparison of results across studies. Decision rule reporting is inconsistent, and trends indicate declining standardization of methods. A methodological research agenda and consensus process are proposed.

Campana, Kristie L.; Hammoud, Sammira (2013): Incivility from patients and their families: can organisational justice protect nurses from burnout? In: J Nurs Manag. DOI: 10.1111/jonm.12201.

AIM\r\nTo determine whether interpersonal and informational justice influence the association between daily experiences of incivility and burnout among nurses.\r\nBACKGROUND\r\nResearch has suggested that incivility is a concern for managers. Nurses regularly experience incivility, particularly from their patients and patients’ families. Incivility, in turn, can increase symptoms of burnout.\r\nMETHOD\r\nSeventy-five nurses provided data on interpersonal and informational justice within their organisation. During five working days, nurses completed a twice-daily survey assessing incivility and burnout. Hierarchical linear modelling analyses examined the main effects and interaction effects of the three variables on burnout.\r\nRESULT\r\nIncivility was positively associated with burnout. In addition, interpersonal justice strengthened the incivility-burnout relationship. Informational justice did not significantly affect the incivility-burnout relationship.\r\nCONCLUSION\r\nIncivility is associated with more burnout. The work environment also influences burnout; when organisations provide informational justice, nurses experience less burnout. In organisations where interpersonal justice is high, nurses are more likely to experience burnout.\r\nIMPLICATIONS FOR NURSING MANAGEMENT\r\nNursing managers can help employees by ensuring that management’s decisions are transparent. In addition, managers should be aware that in organisations with higher interpersonal justice, nurses might be more likely to experience symptoms of burnout as a result of incivility from patients and their families.

Cantudo-Cuenca, Ma R.; Robustillo-Cortes, Ma A.; Cantudo-Cuenca, Ma D.; Morillo-Verdugo, R. (2014): A better regulation is required in viral hepatitis smartphone applications. In: Farm Hosp 38 (2), S. 112–117.

AIM: To describe the characteristics and content of the available viral hepatitis mobile applications, as well as assess the level of participation of medical professionals in their development. METHODS: A descriptive observational study was carried out in September 2013. We searched smartphone apps specifically relating to the viral hepatitis for using a keyword search with the following terms; <<hepatitis>>, <<hepatology>>, <<hbv>> and <<hcv>> in the Google Play Store (Android) and the Apple App Store (iOS). Data recorded included: name, platform, category, cost, user star rating, number of downloads, date the app was updated by the developer and target audience. We analysed the content of the applications, and these were then categorised based on the viral hepatitis type into three groups. We conducted an analysis in which we specifically examined the authorship in order to assess the prevalence of health professional participation in their development. RESULTS: A total of 33 apps were included (from 232 that were identified), among which there were 10 duplicates. Most of these apps were uploaded under the medical category. Three had ratings less than 3.9 stars (out of 5). Only 6 apps had exceeded 1000 downloads. A total of 12 apps were aimed at health professionals, while 4 focused on patients (7 for both of them). The participation of health professionals in the development of apps was 56.6%. CONCLUSIONS: Viral hepatitis apps are available for both professionals and patients; however, much of the information contained within them is often not validated. They should be certificated.

Charani, Esmita; Castro-Sánchez, Enrique; Moore, Luke S P; Holmes, Alison (2014): Do smartphone applications in healthcare require a governance and legal framework? It depends on the application! In: BMC Med 12, S. 29. DOI: 10.1186/1741-7015-12-29.

The fast pace of technological improvement and the rapid development and adoption of healthcare applications present crucial challenges for clinicians, users and policy makers. Some of the most pressing dilemmas include the need to ensure the safety of applications and establish their cost-effectiveness while engaging patients and users to optimize their integration into health decision-making. Healthcare organizations need to consider the risk of fragmenting clinical practice within the organization as a result of too many apps being developed or used, as well as mechanisms for app integration into the wider electronic health records through development of governance framework for their use. The impact of app use on the interactions between clinicians and patients needs to be explored, together with the skills required for both groups to benefit from the use of apps. Although healthcare and academic institutions should support the improvements offered by technological advances, they must strive to do so within robust governance frameworks, after sound evaluation of clinical outcomes and examination of potential unintended consequences.

Choi, Jounghwa; Noh, Ghee-Young; Park, Dong-Jin (2014): Smoking cessation apps for smartphones: content analysis with the self-determination theory. In: J. Med. Internet Res. 16 (2), S. e44. DOI: 10.2196/jmir.3061.

BACKGROUND\r\nSmartphones are increasingly receiving attention from public health scholars and practitioners as a means to assist individuals’ health management. A number of smartphone apps for smoking cessation are also available; however, little effort has been made to evaluate the content and functions of these apps employing a theoretical framework.\r\nOBJECTIVE\r\nThe present study aims to analyze and evaluate the contents of smoking cessation apps available in South Korea employing the self-determination theory (SDT) as a theoretical framework for analysis. This study analyzes the extent to which smoking cessation apps have features that satisfy the basic needs identified in the SDT, which stimulate autonomous motivation. The type of motivational goal content manifested in the apps and how the goal content was framed are also explored. By assessing the features of smoking cessation apps based on the SDT, this study aims to offer direction for improvement for these apps.\r\nMETHODS\r\nOut of 309 apps identified from the iTunes store and Google Play (excluding 27 duplications), 175 apps were randomly drawn and analyzed. The coding scheme was drafted by the authors based on the SDT and gain/loss framing theory and was further finely tuned through the process of coder training and by establishing intercoder reliability. Once the intercoder reliability was established, the coders divided up the rest of the sample and coded them independently.\r\nRESULTS\r\nThe analysis revealed that most apps (94.3%, 165/175) had at least one feature that tapped at least 1 of the 3 basic needs. Only 18 of 175 apps (10.3%) addressed all 3 basic needs. For goal content, money (53.7%, 94/175) showed the highest frequency, followed by health (32.0%, 56/175), time (7.4%, 13/175), and appearance (1.1%, 2/175), suggesting that extrinsic goals are more dominantly presented in smoking cessation apps. For the framing of goal content, gain framing appeared more frequently (41.7%, 73/175).\r\nCONCLUSIONS\r\nThe results suggest that these smoking cessation apps may not sufficiently stimulate autonomous motivation; a small number of apps addressed all 3 basic needs suggested by the SDT (ie, autonomy, competence, and relatedness). The apps also tended to present extrinsic goal content (primarily in terms of money) over intrinsic ones (ie, health) by primarily adopting gain framing. Implications of these findings for public health practitioners and consumers are discussed.

Colley, Rachel C.; Harvey, Alysha; Grattan, Kimberly P.; Adamo, Kristi B. (2014): Impact of accelerometer epoch length on physical activity and sedentary behaviour outcomes for preschool-aged children. In: Health Rep 25 (1), S. 3–9.

BACKGROUND: The Canadian Health Measures Survey uses accelerometry to collect physical activity and sedentary behaviour data. Between cycles 2 and 3, a transition was made from 60-second to 15-second epochs in accelerometry data for children aged 3 to 5. This study examines the impact of epoch length on physical activity and sedentary behaviour outcomes. DATA AND METHODS: Twenty-nine children aged 3 to 5 wore two accelerometers at the same time, one initialized to collect data in 60-second epochs, and the other, in 15-second epochs. Comparisons between epoch settings were made for several physical activity variables. RESULTS: Compared with the 60-second epoch setting, the 15-second setting captured more moderate-to-vigorous physical activity (MVPA) and sedentary time, but fewer steps and less light and total physical activity. The correlation between epoch settings was high for all variables except steps. INTERPRETATION: The epoch length used in accelerometer data collection affects physical activity and sedentary behaviour data for preschool-aged children.

Coombs, Ngaire; Shelton, Nicola; Rowlands, Alex; Stamatakis, Emmanuel (2013): Children’s and adolescents’ sedentary behaviour in relation to socioeconomic position. In: J Epidemiol Community Health 67 (10), S. 868–874. DOI: 10.1136/jech-2013-202609.

BACKGROUND\r\nSedentary behaviour is an emerging cardiometabolic risk factor in young people. Little is known about how socioeconomic position (SEP) and sedentary behaviour are associated in children and adolescents. This study examines associations between SEP and sedentary behaviour in school-age children and adolescents.\r\nMETHODS\r\nThe core sample comprised 3822 Health Survey for England 2008 participants aged 5-15 years with complete information on SEP (household income, head of household occupational social class and area deprivation) and self-reported sedentary time (television viewing and other sitting during non-school times). Accelerometer-measured total sedentary time was measured in a subsample (N=587). We examined multivariable associations between SEP (including a composite SEP score) and sedentary time using generalised linear models, adjusting for age, sex, body mass index, physical activity, accelerometer wear time and mutually adjusting for the other SEP indicators.\r\nRESULTS\r\nParticipants in the highest SEP category spent 16 min/day less (95% CI 6 to 25, p=0.003) watching TV than participants in the lowest SEP category; yet they spent 7 (2 to 16, p=0.010) and 17 (5 to 29, p<0.000) min/day more in non-TV sitting and total (accelerometry-measured) sedentary time, respectively. Associations across individual SEP components varied in strength. Area deprivation was not associated with sedentary time.\r\nCONCLUSIONS\r\nLow SEP is linked with higher television times but with lower total (accelerometer-measured) sedentary time, and non-TV sitting during non-school time in children and adolescents. Associations between sedentary time and SEP differ by type of sedentary behaviour. TV viewing is not a good proxy for total sedentary time in children.

Creary, Susan E.; Gladwin, Mark T.; Byrne, Melissa; Hildesheim, Mariana; Krishnamurti, Lakshmanan (2014): A pilot study of electronic directly observed therapy to improve hydroxyurea adherence in pediatric patients with sickle-cell disease. In: Pediatr Blood Cancer 61 (6), S. 1068–1073. DOI: 10.1002/pbc.24931.

BACKGROUND\r\nPoor hydroxyurea (HU) adherence limits effective HU use in patients with sickle cell disease (SCD). Electronic directly observed therapy (DOT) may limit costs and achieve high HU adherence in children with SCD. This study aimed to determine if electronic DOT was feasible, acceptable, and could achieve ≥ 90% HU adherence.\r\nPROCEDURE\r\nChildren with SCD were recruited for this single institution, 6-month pilot study if they had been prescribed HU for ≥ 6 months and had daily access to a smartphone or computer. Participants submitted HU administration videos daily and received electronic reminder alerts, personalized feedback, and incentives to encourage adherence as part of electronic DOT. Primary outcomes were feasibility, participant satisfaction with electronic DOT, and HU adherence. Secondary outcomes included mean corpuscular volume (MCV), hemoglobin F percentage (HbF), and overall participant satisfaction with HU therapy.\r\nRESULTS\r\nOf 15 enrolled participants, 14 completed the study. Satisfaction surveys showed electronic DOT reminded participants to take HU and could be completed in fewer than 5 minutes daily. Participants’ median medication possession ratio at study entry improved from 0.75 (0.59-0.82) to 0.91 (0.85-1.00) (P = 0.02) at the end of the study. Overall median observed HU adherence with electronic DOT was 93.3%. Median MCV and HbF increased from 96.0 to 107.2 (P = 0.009) and 10.5 to 11.4 (P = 0.03), respectively.\r\nCONCLUSIONS\r\nThis study demonstrates electronic DOT is feasible, acceptable, and can achieve high HU adherence. Further study is needed to confirm that electronic DOT can improve HU adherence and impact clinical outcomes in children with SCD.

Demiralp, Emre (2012): Structure and Dynamics of Emotional Experience in Depression: Northeastern University.

Human emotional experience is extremely complex and dynamic. Multiple factors contribute to the ever changing subjective experience of emotion. Exteroceptive information from our senses, interoceptive information from muscles, internal organs and conceptual information about the past, the present and future get combined allowing a person to experience discrete states of happiness, sadness, anger, elation or a variety of other emotional states. While our verbal descriptions of our emotional experiences are invaluable, they rarely capture the elusive richness and role of emotion in daily life. First of all, no two moments of happiness, sadness or anger are the same. Second, emotional experience is not static. It fluctuates within the ebb and flow of daily life. In this dissertation, I introduce two new methods to characterize the rich structural complexity of emotion as well as its elusive temporal dynamics. I use these methods to identify seemingly contradictory results regarding the impact of Major Depressive Disorder on structural and dynamic properties of human emotional experience. Furthermore, in order to ensure ecological validity, I use mobile computerized experience sampling which allows people to provide information about multiple facets of their emotional experiences during daily life longitudinally across time with minimal interference. I conclude with a discussion of the implications of the findings for basic and clinical science as well as future directions. Subject(s): Emotion, Depression, Mathematical Modeling, High Dimensional Dynamical Systems Modeling

Deng, Xinmei; Sang, Biao; Luan, Ziyan (2013): Up- and down-regulation of daily emotion: an experience sampling study of Chinese adolescents’ regulatory tendency and effects. In: Psychol Rep 113 (2), S. 552–565.

The present study examined Chinese adolescents’ emotion regulatory tendency and its effect, using an Experience Sampling Method. Participants comprised 72 Chinese adolescents (M age = 15.2 yr., SD = 1.7; 36 girls). Momentary emotional experience and regulation was assessed up to 5 or 6 times each day for two weeks. Results showed that participants tended to use up-regulation when they experienced positive emotion and habitually regulated their negative emotion by down-regulation. Also, adolescents who utilized down-regulation in a certain sampling moment reported higher positive emotion at the subsequent sampling moment. Moreover, adolescents who utilized down-regulation more frequently reported higher positive emotion at the subsequent sampling moment. Overall, down-regulation seemed to be a more adaptive regulatory strategy than up-regulation in Chinese adolescents’ emotional lives.

Derks, Daantje; ten Brummelhuis, Lieke L.; Zecic, Dino; Bakker, Arnold B. (2014): Switching on and off … Does smartphone use obstruct the possibility to engage in recovery activities? In: European Journal of Work and Organizational Psychology 23 (1), S. 80–90. DOI: 10.1080/1359432X.2012.711013.

This study examines the impact of work-related smartphone use on daily recovery from work-related efforts. The literature shows that work–home interference (WHI) is an important inhibitor of the recovery process. We propose that the extensive use of smartphones with its implicit request of 24/7 availability inhibits the process of engaging in activities that are required for daily recovery. A total of 80 employees (40 smartphone users, 40 controls) completed a 6-day diary questionnaire over a time period of 2 weeks. Contrary to our hypothesis, smartphone users did not experience more overall WHI than nonusers. Furthermore, four activities aimed at recovery were examined. We predicted that daily WHI would increase employees’ engagement in recovery activities, but only if they did not use a smartphone. Results showed that, for the control group, WHI was positively related to psychological detachment, relaxation, mastery, and control activities, whereas smartphone users facing high WHI did not succeed in engaging in these recovery activities. This implies that being connected to work in the evening hours through smartphones has consequences for the extent to which employees succeed in undertaking recovery activities

Doherty, Sean T.; Lemieux, Christopher J.; Canally, Culum (2014): Tracking human activity and well-being in natural environments using wearable sensors and experience sampling. In: Soc Sci Med 106, S. 83–92. DOI: 10.1016/j.socscimed.2014.01.048.

A growing range of studies have begun to document the health and well-being benefits associated with contact with nature. Most studies rely on generalized self-reports following engagement in the natural environment. The actual in-situ experience during contact with nature, and the environmental features and factors that evoke health benefits have remained relatively unexplored. Smartphones offer a new opportunity to monitor and interact with human subjects during everyday life using techniques such as Experience Sampling Methods (ESM) that involve repeated self-reports of experiences as they occur in-situ. Additionally, embedded sensors in smartphones such as Global Positioning Systems (GPS) and accelerometers can accurately trace human activities. This paper explores how these techniques can be combined to comprehensively explore the perceived health and well-being impacts of contact with nature. Custom software was developed to passively track GPS and accelerometer data, and actively prompt subjects to complete an ESM survey at regular intervals throughout their visit to a provincial park in Ontario, Canada. The ESM survey includes nine scale questions concerning moods and emotions, followed by a series of open-ended experiential questions that subjects provide recorded audio responses to. Pilot test results are used to illustrate the nature, quantity and quality of data obtained. Participant activities were clearly evident from GPS maps, including especially walking, cycling and sedate activities. From the ESM surveys, participants reported an average of 25 words per question, taking an average of 15 s to record them. Further qualitative analysis revealed that participants were willing to provide considerable insights into their experiences and perceived health impacts. The combination of passive and interactive techniques is sure to make larger studies of this type more affordable and less burdensome in the future, further enhancing the ability to understand how contact with nature enhances health and well-being.

Downs, Andrew; van Hoomissen, Jacqueline; Lafrenz, Andrew; Julka, Deana L. (2014): Accelerometer-measured versus self-reported physical activity in college students: implications for research and practice. In: J Am Coll Health 62 (3), S. 204–212. DOI: 10.1080/07448481.2013.877018.

OBJECTIVE\r\nTo determine the level of moderate-vigorous-intensity physical activity (MVPA) assessed via self-report and accelerometer in the college population, and to examine intrapersonal and contextual variables associated with physical activity (PA).\r\nPARTICIPANTS\r\nParticipants were 77 college students at a university in the northwest sampled between January 2011 and December 2011.\r\nMETHODS\r\nParticipants completed a validated self-report measure of PA and measures of athletic identity and benefits and barriers to exercise. Participants’ PA levels were assessed for 2 weeks via accelerometry.\r\nRESULTS\r\nParticipants’ estimations of their time spent engaged in MVPA were significantly higher when measured via self-report versus accelerometry. Stronger athletic identity, perceived social benefits and barriers, and time-effort barriers were related to PA levels.\r\nCONCLUSIONS\r\nEstimation of college students’ level of PA may require interpretation of data from different measurement methods, as self-report and accelerometry generate different estimations of PA in college students who may be even less active than previously believed.

Dunton, Genevieve Fridlund; Almanza, Estela; Jerrett, Michael; Wolch, Jennifer; Pentz, Mary Ann (2014): Neighborhood park use by children: use of accelerometry and global positioning systems. In: Am J Prev Med 46 (2), S. 136–142. DOI: 10.1016/j.amepre.2013.10.009.

BACKGROUND\r\nAlthough having a greater number of neighborhood parks may be associated with greater overall physical activity in children, information is lacking about the extent to which children actually use parks for physical activity.\r\nPURPOSE\r\nThis study combined accelerometer, GPS, GIS, and self-report methods to examine neighborhood park availability, perceived proximity, and use for physical activity in children.\r\nMETHODS\r\nLow- to middle-income children (aged 8-14 years) (n=135) from suburban communities in Southern California wore an Actigraph accelerometer and GlobalSat BT-335 GPS device across 7 days to measure physical activity and park use, respectively. ArcGIS identified parks within a 500-m residential buffer of children’s homes. Parents reported perceptions of neighborhood park proximity through the Neighborhood Environment Walkability Survey (NEWS). Data were collected from March 2009 to December 2010, and analyzed in 2013.\r\nRESULTS\r\nFifty-four percent of families lived within 500 m of a park. Of these children, GPS data indicated that 16% used it more than 15 minutes and an additional 11% of children used it between 5 and 15 minutes during the 7-day study period. The odds of extended park use (>15 minutes) increased fourfold when the distance between home and the nearest neighborhood park decreased by 100 m. Additionally, the odds of any park use (>5 minutes) doubled when moving from the 25th to the 75th percentile for park greenness/vegetation density.\r\nCONCLUSIONS\r\nAlthough children’s use of neighborhood parks was generally low, it increased substantially when parks were closer to children’s homes and had greater vegetation density.

Dunton, Genevieve Fridlund; Dzubur, Eldin; Kawabata, Keito; Yanez, Brenda; Bo, Bin; Intille, Stephen (2014): Development of a smartphone application to measure physical activity using sensor-assisted self-report. In: Front Public Health 2, S. 12. DOI: 10.3389/fpubh.2014.00012.

Introduction: Despite the known advantages of objective physical activity monitors (e.g., accelerometers), these devices have high rates of non-wear, which leads to missing data. Objective activity monitors are also unable to capture valuable contextual information about behavior. Adolescents recruited into physical activity surveillance and intervention studies will increasingly have smartphones, which are miniature computers with built-in motion sensors. Methods: This paper describes the design and development of a smartphone application (\”app\”) called Mobile Teen that combines objective and self-report assessment strategies through (1) sensor-informed context-sensitive ecological momentary assessment (CS-EMA) and (2) sensor-assisted end-of-day recall. Results: The Mobile Teen app uses the mobile phone’s built-in motion sensor to automatically detect likely bouts of phone non-wear, sedentary behavior, and physical activity. The app then uses transitions between these inferred states to trigger CS-EMA self-report surveys measuring the type, purpose, and context of activity in real-time. The end of the day recall component of the Mobile Teen app allows users to interactively review and label their own physical activity data each evening using visual cues from automatically detected major activity transitions from the phone’s built-in motion sensors. Major activity transitions are identified by the app, which cues the user to label that \”chunk,\” or period, of time using activity categories. Conclusion: Sensor-driven CS-EMA and end-of-day recall smartphone apps can be used to augment physical activity data collected by objective activity monitors, filling in gaps during non-wear bouts and providing additional real-time data on environmental, social, and emotional correlates of behavior. Smartphone apps such as these have potential for affordable deployment in large-scale epidemiological and intervention studies.

Edmondson, Donald; Shaffer, Jonathan A.; Chaplin, William F.; Burg, Matthew M.; Stone, Arthur A.; Schwartz, Joseph E. (2013): Trait anxiety and trait anger measured by ecological momentary assessment and their correspondence with traditional trait questionnaires. In: J Res Pers 47 (6). DOI: 10.1016/j.jrp.2013.08.005.

Ecological momentary assessments (EMA) of anxiety and anger/hostility were obtained every 25-30 minutes over two 24-hour periods, separated by a median of 6 months, from 165 employees at a university in the Northeast. We used a multilevel trait-state-error structural equation model to estimate: (1) the proportion of variance in EMA anxiety and anger/hostility attributable to stable trait-like individual differences; (2) the correspondence between these trait-like components of EMA anxiety and anger/hostility and traditional questionnaire measures of each construct; and (3) the test-retest correlation between two 24-hour averages obtained several months apart. After adjustment for measurement error, more than half the total variance in EMA reports of anxiety and anger/hostility is attributable to stable trait-like individual differences; however, the trait-like component of each construct is only modestly correlated with questionnaire measures of that construct. The 6-month \”test-retest\” correlations of latent variables representing the true 24-hour EMA average anxiety and average anger are quite high (r ≥ 0.83). This study represents the longest follow-up period over which EMA-based estimates of traits have been examined. The results suggest that although the trait component (individual differences) of EMA momentary ratings of anxiety and anger is larger than the state component, traditional self-report questionnaires of trait anxiety and anger correspond only weakly with EMA-defined traits.

Engelen, Lina; Bundy, Anita C.; Bauman, Adrian; Naughton, Geraldine; Wyver, Shirley; Baur, Louise (2014): Young Children’s After-School Activities - There’s More to it Than Screen Time: A Cross-Sectional Study of Young Primary School Children. In: J Phys Act Health. DOI: 10.1123/jpah.2013-0075.

BACKGROUND: Children can spend substantial amounts of leisure time in sedentary activities, dominated by TV/screen time. However, objective real-time measurement of activities after school among young school children is seldom described. METHODS: School children (n=246, aged 5-7 years, mean 6.0) randomly selected from 14 schools across Sydney, Australia and their parents were recruited. Parents used a real-time objective measure (Experience Sampling Method, ESM) to record children’s activities, and whether they were indoors or outdoors at three random times each day after school. Data were collected across four week days in each of two weeks separated by 13 weeks. RESULTS: Results based on 2940 responses from 214 child-parent dyads showed that 25% of behaviour involved physical activity; 51% was spent in sedentary activities; and 22% TV/screen time. Most instances (81%) occurred indoors. CONCLUSION: Despite a high proportion of TV/screen time, children were also engaged in a range of other sedentary and physically active pursuits after school. Hence TV/screen time is not a suitable proxy for all sedentary behaviour, and it is important to gather information on other non-screen based sedentary and physically active behaviors. Future research is warranted to further investigate after-school activities in young primary school children.

Epler, Amee J.; Tomko, Rachel L.; Piasecki, Thomas M.; Wood, Phillip K.; Sher, Kenneth J.; Shiffman, Saul; Heath, Andrew C. (2014): Does hangover influence the time to next drink? An investigation using ecological momentary assessment. In: Alcohol. Clin. Exp. Res. 38 (5), S. 1461–1469. DOI: 10.1111/acer.12386.

BACKGROUND\r\nMeasures of hangover are associated with current and future problematic alcohol use. At present, it is not known whether these associations reflect any direct influence of hangover events on near-term drinking behaviors. The current study aimed to determine whether hangover following a drinking episode influences time to next drink (TTND) and, if so, to determine the direction of this effect and identify any moderating personal or contextual factors.\r\nMETHODS\r\nCommunity-recruited, frequent drinkers oversampled for current smoking (N = 386) carried electronic diaries for 21 days, reporting on drinking behaviors and other experiences. Survival analysis was used to model data from 2,276 drinking episodes, including 463 episodes that were followed by self-reported hangover in morning diary entries.\r\nRESULTS\r\nWhen tested as the sole predictor in a survival model, hangover was associated with increased TTND. The median survival time was approximately 6 hours longer after episodes with hangovers compared to those without. In a multivariate model, hangover was only significant in the presence of interaction effects involving craving at the end of the index drinking episode and the occurrence of financial stressors. Additional predictors of TTND in the final multivariate model included age, lifetime alcohol use disorder diagnosis, typical drinking frequency, day of the week, and morning reports of craving, negative affect, and stressors after the index episode. There was no association between morning reports of hangover and contemporaneous diary ratings of likelihood of drinking later the same day.\r\nCONCLUSIONS\r\nThe findings suggest that hangover has, at best, a modest or inconsistent influence on the timing of subsequent alcohol use among frequent drinkers.

Faurholt-Jepsen, Maria; Frost, Mads; Vinberg, Maj; Christensen, Ellen Margrethe; Bardram, Jakob E.; Kessing, Lars Vedel (2014): Smartphone data as objective measures of bipolar disorder symptoms. In: Psychiatry Res 217 (1-2), S. 124–127. DOI: 10.1016/j.psychres.2014.03.009.

The daily electronic self-monitoring Smartphone software \”MONARCA\” was used by 17 patients with bipolar disorder for 3 consecutive months. Patients were rated fortnightly using Hamilton Depression rating Scale 17 items (HDRS-17) and Young Mania rating Scale (YMRS) (102 ratings) with blinding for Smartphone data. Objective Smartphone measures such as physical and social activity correlated with clinically rated depressive symptoms. Self-monitored depressive symptoms correlated significantly with HDRS-17 items score.

Fraley, R. Chris; Hudson, Nathan W. (2014): Review of Intensive Longitudinal Methods: An Introduction to Diary and Experience Sampling Research. In: The Journal of Social Psychology 154 (1), S. 89–91. DOI: 10.1080/00224545.2013.831300.


Franklin, Michael S.; Mrazek, Michael D.; Anderson, Craig L.; Smallwood, Jonathan; Kingstone, Alan; Schooler, Jonathan W. (2013): The silver lining of a mind in the clouds: interesting musings are associated with positive mood while mind-wandering. In: Front Psychol 4, S. 583. DOI: 10.3389/fpsyg.2013.00583.

The negative effects of mind-wandering on performance and mood have been widely documented. In a recent well-cited study, Killingsworth and Gilbert (2010) conducted a large experience sampling study revealing that all off-task episodes, regardless of content, have equal to or lower happiness ratings, than on-task episodes. We present data from a similarly implemented experience sampling study with additional mind-wandering content categories. Our results largely conform to those of the Killingsworth and Gilbert (2010) study, with mind-wandering generally being associated with a more negative mood. However, subsequent analyses reveal situations in which a more positive mood is reported after being off-task. Specifically when off-task episodes are rated for interest, the high interest episodes are associated with an increase in positive mood compared to all on-task episodes. These findings both identify a situation in which mind-wandering may have positive effects on mood, and suggest the possible benefits of encouraging individuals to shift their off-task musings to the topics they find most engaging.

Fulcher, Krysten K.; Alosco, Michael L.; Miller, Lindsay; Spitznagel, Mary Beth; Cohen, Ronald; Raz, Naftali et al. (2014): Greater Physical Activity Is Associated With Better Cognitive Function in Heart Failure. In: Health Psychol. DOI: 10.1037/hea0000039.

Objective: Nearly 6 million Americans have heart failure (HF), up to 80% of which exhibit cognitive deficits on testing. Physical inactivity is common in HF, yet little is known about the possible contribution of physical inactivity to cognitive dysfunction in this population. Method: Older adults with HF (N = 93; Mage = 68.5 years, 33.7% women) completed neuropsychological testing, as well as cardiac and physical activity assessment as part of a larger protocol. HF severity was measured via impedance cardiography. Physical activity was assessed via an Actigraph accelerometer and operationalized using daily step count and time engaged in moderate-vigorous activity (minutes/day). Results: Linear regression analyses controlling for sex, high blood pressure, diabetes, depressive symptomatology, and HF severity showed that greater physical activity (both step count and minutes spent in moderate-vigorous activity) was associated with better executive function/attention, processing speed, and scores on a screening measure of cognition. Conclusions: These findings indicate that physical activity is an independent predictor of cognitive function in persons with HF. Future work is needed to clarify the mechanisms by which physical activity benefits cognitive function in HF and determine whether interventions to promote physical activity can attenuate cognitive decline over time.

Gerber, Markus; Jonsdottir, Ingibjörg H.; Kalak, Nadeem; Elliot, Catherine; Pühse, Uwe; Holsboer-Trachsler, Edith; Brand, Serge (2013): Objectively assessed physical activity is associated with increased hair cortisol content in young adults. In: Stress 16 (6), S. 593–599. DOI: 10.3109/10253890.2013.823599.

Assessing long-term cortisol secretion presents difficulties when cortisol measurement is carried out by saliva, plasma and urine analyses. Hair cortisol has gained increased interest as an alternative biological marker. So far, one study has been published studying hair cortisol in endurance athletes, showing higher levels compared to controls. Using accelerometer data in the present study, we cross-sectionally explored the relationship between moderate physical activity (MPA) and vigorous physical activity (VPA) levels and hair cortisol concentrations after taking into account age, gender, and perceived stress. Hair specimens were collected from 46 university students (20 males, 26 females, Mage ± SD =21.2 ± 1.87 years). Participants provided information about their socio-demographic background and levels of perceived stress. Accelerometer data were collected to assess physical activity. Cortisol concentrations were measured in the first 3-cm hair segment nearest to the scalp. MPA was not correlated with hair cortisol content (r = -0.08). A significant correlation was found between VPA and hair cortisol (r = 0.34, p < 0.05). A regression analysis revealed that participants with higher VPA had elevated hair cortisol concentrations even after taking into account age, gender and perceived stress (β = 0.33, p < 0.05, ΔR(2 )= 0.106). This is the first study showing that objectively assessed VPA is associated with increased hair cortisol levels in young adults. As VPA can be regarded as a physical stressor, it seems imperative that researchers consider participants’ levels of VPA if they examine the relationship between stress exposure, hair cortisol and health.

Gibson, Carolyn; Matthews, Karen; Thurston, Rebecca (2014): Daily physical activity and hot flashes in the Study of Women’s Health Across the Nation (SWAN) Flashes Study. In: Fertil. Steril. 101 (4), S. 1110–1116. DOI: 10.1016/j.fertnstert.2013.12.029.

OBJECTIVE\r\nTo examine the role of physical activity in menopausal hot flashes.\r\nDESIGN\r\nPhysiologic hot flash monitor and activity monitor over two 48-hour periods, with self-report in an electronic diary.\r\nSETTING\r\nCommunity.\r\nPATIENT(S)\r\n51 midlife women.\r\nINTERVENTION(S)\r\nNone.\r\nMAIN OUTCOME MEASURE(S)\r\nPhysiologically detected hot flashes and reported hot flashes with and without physiologic corroboration.\r\nRESULT(S)\r\nCompeting models conceptualize physical activity as a risk or protective factor for hot flashes, but few studies have examined this relationship prospectively using physiologic measures of hot flashes and physical activity. When physiologic hot flashes, reported hot flashes, and reported hot flashes without physiologic corroboration were related to activity changes using hierarchic generalized linear modeling, adjusting for potential confounders, hot flash reports without physiologic corroboration were more likely after activity increases, particularly among women with higher levels of depressive symptoms. No other types of hot flashes were related to physical activity.\r\nCONCLUSION(S)\r\nAcute increases in physical activity were associated with increased reporting of hot flashes that lacked physiologic corroboration, particularly among women with depressive symptoms. Clinicians should consider the role of symptom perception and reporting in relations between physical activity and hot flashes.

Giesbrecht, Gerald F.; Poole, Julia C.; Letourneau, Nicole; Campbell, Tavis; Kaplan, Bonnie J. (2013): The buffering effect of social support on hypothalamic-pituitary-adrenal axis function during pregnancy. In: Psychosom Med 75 (9), S. 856–862. DOI: 10.1097/PSY.0000000000000004.

OBJECTIVE\r\nRecent studies suggest that effective social support during pregnancy may buffer adverse effects of maternal psychological distress on fetal development. The mechanisms whereby social support confers this protective advantage, however, remain to be clarified. The aim of this study was to assess whether individual differences in social support alter the covariation of psychological distress and cortisol during pregnancy.\r\nMETHODS\r\nEighty-two pregnant women’s psychological distress and cortisol were prospectively assessed in all three trimesters using an ecological momentary assessment strategy. Appraisal of partner social support was assessed in each trimester via the Social Support Effectiveness questionnaire.\r\nRESULTS\r\nIn multilevel analysis, ambulatory assessments of psychological distress during pregnancy were associated with elevated cortisol levels (unstandardized β = .023, p < .001). Consistent with the stress-buffering hypothesis, social support moderated the association between psychological distress and cortisol (unstandardized β = -.001, p = .039), such that the covariation of psychological distress and cortisol increased with decreases in effective social support. The effect of social support for women with the most effective social support was a 50.4% reduction in the mean effect of distress on cortisol and a 2.3-fold increase in this effect for women with the least effective social support scores.\r\nCONCLUSIONS\r\nPregnant women receiving inadequate social support secrete higher levels of cortisol in response to psychological distress as compared with women receiving effective social support. Social support during pregnancy may be beneficial because it decreases biological sensitivity to psychological distress, potentially shielding the fetus from the harmful effects of stress-related increases in cortisol.

Goetz, Thomas; Lüdtke, Oliver; Nett, Ulrike E.; Keller, Melanie M.; Lipnevich, Anastasiya A. (2013): Characteristics of teaching and students’ emotions in the classroom: Investigating differences across domains (PSYNDEXalert). In: Contemporary Educational Psychology 38 (4), S. 383–394. Online verfügbar unter


Gonzalez, Robert; Tamminga, Carol A.; Tohen, Mauricio; Suppes, Trisha (2014): The relationship between affective state and the rhythmicity of activity in bipolar disorder. In: J Clin Psychiatry 75 (4), S. e317-22. DOI: 10.4088/JCP.13m08506.

OBJECTIVE\r\nThe aim of this study was to test the relationships between mood state and rhythm disturbances as measured via actigraphy in bipolar disorder by assessing the correlations between manic and depressive symptoms as measured via Young Mania Rating Scale (YMRS) and 30-item Inventory for Depressive Symptomatology, Clinician-Rated (IDS-C-30) scores and the actigraphic measurements of rhythm, the 24-hour autocorrelation coefficient and circadian quotient.\r\nMETHOD\r\nThe research was conducted at the University of Texas Southwestern Medical Center at Dallas from February 2, 2009, to March 30, 2010. 42 patients with a DSM-IV-TR diagnosis of bipolar I disorder were included in the study. YMRS and the IDS-C-30 were used to determine symptom severity. Subjects wore the actigraph continuously for 7 days. The 24-hour autocorrelation coefficient was used as an indicator of overall rhythmicity. The circadian quotient was used to characterize the strength of a circadian rhythm.\r\nRESULTS\r\nA greater severity of manic symptoms correlated with a lower degree of rhythmicity and less robust rhythms of locomotor activity as indicated by lower 24-hour autocorrelation (r = -0.3406, P = .03) and circadian quotient (r = -0.5485, P = .0002) variables, respectively. No relationship was noted between the degree of depression and 24-hour autocorrelation scores (r = -0.1190, P = .45) or circadian quotient (r = 0.0083, P = .96). Correlation was noted between the 24-hour autocorrelation and circadian quotient scores (r = 0.6347, P < .0001).\r\nCONCLUSIONS\r\nThese results support the notion that circadian rhythm disturbances are associated with bipolar disorder and that these disturbances may be associated with clinical signatures of the disorder. Further assessment of rhythm disturbances in bipolar disorder is warranted.

Gregoski, Mathew J.; Vertegel, Alexey; Shaporev, Aleksey; Treiber, Frank A. (2013): Tension Tamer: delivering meditation with objective heart rate acquisition for adherence monitoring using a smart phone platform. In: J Altern Complement Med 19 (1), S. 17–19. DOI: 10.1089/acm.2011.0772.

OBJECTIVES\r\nThis brief report demonstrates the proof of concept of the Tension Tamer (TT) smartphone application, which integrates photoplethysmograph capabilities with breathing awareness meditation (BAM), to reduce stress and measure heart rate and adherence.\r\nDESIGN\r\nMethods for objectively measuring heart rate and adherence to BAM were developed as part of a future randomized controlled trial.\r\nSETTING/LOCATION\r\nThe study was conducted at Jerry Zucker Middle School of Science and the Medical University of South Carolina, Charleston.\r\nSUBJECTS\r\nThe subjects were three prehypertensive male teachers.\r\nINTERVENTION\r\nThe method used was smartphone delivered BAM.\r\nOUTCOME MEASURES\r\nObjective measures included heart rate, adherence, and ambulatory blood pressure (BP).\r\nRESULTS\r\nAdherence data was successfully collected by the TT application. Increased adherence to TT coincided with increased improvements in ambulatory BP over a 3-month period.\r\nCONCLUSIONS\r\nTT shows promise as a simple inexpensive program for administering BAM and capturing adherence data in future clinical trials.

Gustafson, David H.; McTavish, Fiona M.; Chih, Ming-Yuan; Atwood, Amy K.; Johnson, Roberta A.; Boyle, Michael G. et al. (2014): A smartphone application to support recovery from alcoholism: a randomized clinical trial. In: JAMA Psychiatry 71 (5), S. 566–572. DOI: 10.1001/jamapsychiatry.2013.4642.

Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. OBJECTIVE: To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients. DESIGN, SETTING, AND PARTICIPANTS: An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders. INTERVENTIONS: Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively. MAIN OUTCOMES AND MEASURES: Risky drinking days-the number of days during which a patient’s drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. RESULTS: For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003). CONCLUSIONS AND RELEVANCE: The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders.

Hasin, Deborah S.; Aharonovich, Efrat; Greenstein, Eliana (2014): HealthCall for the smartphone: technology enhancement of brief intervention in HIV alcohol dependent patients. In: Addict Sci Clin Pract 9 (1), S. 5. DOI: 10.1186/1940-0640-9-5.

BACKGROUND\r\nHeavy drinking jeopardizes the health of patients in HIV primary care. In alcohol dependent patients in HIV primary care, a technological enhancement of brief intervention, HealthCall administered via interactive voice response (HealthCall-IVR) was effective at reducing heavy drinking. The smartphone offered a technology platform to improve HealthCall.\r\nMETHODS\r\nWorking with input from patients, technology experts, and HIV clinic personnel, we further developed HealthCall, harnessing smartphone technological capacities (HealthCall-S). In a pilot study, we compared rates of HealthCall-S daily use and drinking outcomes in 41 alcohol dependent HIV-infected patients with the 43 alcohol dependent HIV-infected patients who used HealthCall-IVR in our previous efficacy study. Procedures, clinic, personnel, and measures were largely the same in the two studies, and the two groups of patients were demographically similar (~90% minority).\r\nRESULTS\r\nPilot patients used HealthCall-S a median of 85.0% of the 60 days of treatment, significantly greater than the corresponding rate (63.8%) among comparison patients using HealthCall-IVR (p < .001). Mean end-of-treatment drinks per drinking day was similar in the two groups. Patients were highly satisfied with HealthCall-S (i.e., 92% reported that they liked using HealthCall-S).\r\nCONCLUSIONS\r\nAmong alcohol dependent patients in HIV primary care, HealthCall delivered via smartphone is feasible, obtains better patient engagement than HealthCall-IVR, and is associated with decreased drinking. In HIV primary care settings, HealthCall-S may offer a way to improve drinking outcomes after brief intervention by extending patient engagement with little additional demands on staff time.

Heo, Jinmoo; Kim, Junhyoung; Kim, Byung-Gook; Heo, Seongmoo (2014): Weekend experiences and subjective well-being of retired older adults. In: Am J Health Behav 38 (4), S. 598–604. DOI: 10.5993/AJHB.38.4.13.

OBJECTIVES\r\nTo examine how involvement in activities is related to subjective well-being (SWB) among older adults in particular during weekends. To explore the situational and behavioral factors such as day of week, type of activities, and social context and their impact on subjective well being of older adults.\r\nMETHODS\r\nThe experience sampling method (ESM) was used with retired older adults.\r\nRESULTS\r\nParticipants reported lower levels of SWB on the weekend. They experienced higher levels of SWB when they were engaged in active leisure on the weekend. Social contexts were significant predictors of older adults’ SWB on the weekend.\r\nCONCLUSION\r\nThese findings extend the body of knowledge that involvement in active leisure and socializing with friends improve SWB of older adults.

Hesketh, Kathryn R.; Goodfellow, Laura; Ekelund, Ulf; McMinn, Alison M.; Godfrey, Keith M.; Inskip, Hazel M. et al. (2014): Activity levels in mothers and their preschool children. In: Pediatrics 133 (4), S. e973-80. DOI: 10.1542/peds.2013-3153.

OBJECTIVES\r\nTo investigate the association between objectively measured maternal and preschool-aged children’s physical activity, determine how this association differs by demographic and temporal factors, and identify factors associated with maternal activity levels.\r\nMETHODS\r\nIn the UK Southampton Women’s Survey, physical activity levels of 554 4-year-olds and their mothers were measured concurrently by using accelerometry for ≤7 days. Two-level mixed-effects linear regression was used to model the association between maternal and children’s minutes spent sedentary, in light (LPA) and moderate-to-vigorous physical activity (MVPA). Linear regression was used to investigate correlates of maternal activity.\r\nRESULTS\r\nMother-child daily activity levels were positively associated at all activity intensities (sedentary, LPA, and MVPA; all P < .001). The association for sedentary time was stronger for normal-weight children (versus those who were overweight/obese), and those attending preschool part-time (versus full-time). The mother-child association for LPA differed by maternal education and was stronger at the weekend (versus weekdays). The opposite was true for MVPA. Sedentary time and MVPA were most strongly associated in mornings, with LPA most strongly associated in the evenings. Maternal BMI, age leaving school, number and age of children at home, and working hours were independently associated with maternal daily sedentary time and LPA.\r\nCONCLUSIONS\r\nPhysical activity levels in mothers and their 4-year-old children are directly associated, with associations at different activity intensities influenced by temporal and demographic factors. Influences on maternal physical activity levels also differ by activity intensity. Providing targeted interventions for mothers of young children may increase both groups’ activity.

Hollier, Carly A.; Harmer, Alison R.; Maxwell, Lyndal J.; Menadue, Collette; Willson, Grant N.; Black, Deborah A.; Piper, Amanda J. (2014): Validation of respiratory inductive plethysmography (LifeShirt) in obesity hypoventilation syndrome. In: Respir Physiol Neurobiol 194, S. 15–22. DOI: 10.1016/j.resp.2014.01.014.

Validation of respiratory inductive plethysmography (LifeShirt system) (RIPLS) for tidal volume (VT), minute ventilation (V˙E), and respiratory frequency (fB) was performed among people with untreated obesity hypoventilation syndrome (OHS) and controls. Measures were obtained simultaneously from RIPLS and a spirometer during two tests, and compared using Bland Altman analysis. Among 13 OHS participants (162 paired measures), RIPLS-spirometer agreement was unacceptable for VT: mean difference (MD) 3 mL (1%); limits of agreement (LOA) -216 to 220 mL (±36%); V˙E MD 0.1 L min(-1) (2%); LOA -4.1 to 4.3 L min(-1) (±36%); and fB: MD 0.2 br min(-1) (2%); LOA -4.6 to 5.0 br min(-1) (±27%). Among 13 controls (197 paired measures), RIPLS-spirometer agreement was acceptable for fB: MD -0.1 br min(-1) (-1%); LOA -1.2 to 1.1 br min(-1) (±12%), but unacceptable for VT: MD 5 mL (1%); LOA -160 to 169 mL (±20%) and V˙E: MD 0.1 L min(-1) (1%); LOA -1.4 to 1.5 L min(-1) (±20%). RIPLS produces valid measures of fB among controls but not OHS patients, and is not valid for quantifying respiratory volumes among either group.

Hurlburt, Russell T.; Heavey, Christopher L.; Kelsey, Jason M. (2013): Toward a phenomenology of inner speaking. In: Conscious Cogn 22 (4), S. 1477–1494. DOI: 10.1016/j.concog.2013.10.003.

Inner speaking is a common and widely discussed phenomenon of inner experience. Based on our studies of inner experience using Descriptive Experience Sampling (a qualitative method designed to produce high fidelity descriptions of randomly selected pristine inner experience), we advance an initial phenomenology of inner speaking. Inner speaking does occur in many, though certainly not all, moments of pristine inner experience. Most commonly it is experienced by the person as speaking in his or her own naturally inflected voice but with no sound being produced. In addition to prototypical instances of inner speaking, there are wide-ranging variations that fit the broad category of inner speaking and large individual differences in the frequency with which individuals experience inner speaking. Our observations are discrepant from what many have said about inner speaking, which we attribute to the characteristics of the methods different researchers have used to examine inner speaking.

Hurvitz, Philip M.; Moudon, Anne Vernez; Kang, Bumjoon; Saelens, Brian E.; Duncan, Glen E. (2014): Emerging technologies for assessing physical activity behaviors in space and time. In: Front Public Health 2, S. 2. DOI: 10.3389/fpubh.2014.00002.

Precise measurement of physical activity is important for health research, providing a better understanding of activity location, type, duration, and intensity. This article describes a novel suite of tools to measure and analyze physical activity behaviors in spatial epidemiology research. We use individual-level, high-resolution, objective data collected in a space-time framework to investigate built and social environment influences on activity. First, we collect data with accelerometers, global positioning system units, and smartphone-based digital travel and photo diaries to overcome many limitations inherent in self-reported data. Behaviors are measured continuously over the full spectrum of environmental exposures in daily life, instead of focusing exclusively on the home neighborhood. Second, data streams are integrated using common timestamps into a single data structure, the \”LifeLog.\” A graphic interface tool, \”LifeLog View,\” enables simultaneous visualization of all LifeLog data streams. Finally, we use geographic information system SmartMap rasters to measure spatially continuous environmental variables to capture exposures at the same spatial and temporal scale as in the LifeLog. These technologies enable precise measurement of behaviors in their spatial and temporal settings but also generate very large datasets; we discuss current limitations and promising methods for processing and analyzing such large datasets. Finally, we provide applications of these methods in spatially oriented research, including a natural experiment to evaluate the effects of new transportation infrastructure on activity levels, and a study of neighborhood environmental effects on activity using twins as quasi-causal controls to overcome self-selection and reverse causation problems. In summary, the integrative characteristics of large datasets contained in LifeLogs and SmartMaps hold great promise for advancing spatial epidemiologic research to promote healthy behaviors.

Hutto, Brent; Howard, Virginia J.; Blair, Steven N.; Colabianchi, Natalie; Vena, John E.; Rhodes, David; Hooker, Steven P. (2013): Identifying accelerometer nonwear and wear time in older adults. In: Int J Behav Nutr Phys Act 10, S. 120. DOI: 10.1186/1479-5868-10-120.

BACKGROUND\r\nFive accelerometer-derived methods of identifying nonwear and wear time were compared with a self-report criterion in adults ≥ 56 years of age.\r\nMETHODS\r\nTwo hundred participants who reported wearing an Actical™ activity monitor for four to seven consecutive days and provided complete daily log sheet data (i.e., the criterion) were included. Four variables were obtained from log sheets: 1) dates the device was worn; 2) time(s) the participant put the device on each day; 3) time(s) the participant removed the device each day; and 4) duration of self-reported nonwear each day. Estimates of wear and nonwear time using 60, 90, 120, 150 and 180 minutes of consecutive zeroes were compared to estimates derived from log sheets.\r\nRESULTS\r\nCompared with the log sheet, mean daily wear time varied from -84, -43, -24, -14 and -8 min/day for the 60-min, 90-min, 120-min, 150-min and 180-min algorithms, respectively. Daily log sheets indicated 8.5 nonwear bouts per week with 120-min, 150-min and 180-min algorithms estimating 8.2-8.9 nonwear bouts per week. The 60-min and 90-min methods substantially overestimated number of nonwear bouts per week and underestimated time spent in sedentary behavior. Sensitivity (number of compliant days correctly identified as compliant) improved with increasing minutes of consecutive zero counts and stabilized at the 120-min algorithm. The proportion of wear time being sedentary and absolute and proportion of time spent in physical activity of varying intensities were nearly identical for each method.\r\nCONCLUSIONS\r\nUtilization of at least 120 minutes of consecutive zero counts will provide dependable population-based estimates of wear and nonwear time, and time spent being sedentary and active in older adults wearing the Actical™ activity monitor.

Jibb, Lindsay A.; Stevens, Bonnie J.; Nathan, Paul C.; Seto, Emily; Cafazzo, Joseph A.; Stinson, Jennifer N. (2014): A smartphone-based pain management app for adolescents with cancer: establishing system requirements and a pain care algorithm based on literature review, interviews, and consensus. In: JMIR Res Protoc 3 (1), S. e15. DOI: 10.2196/resprot.3041.

BACKGROUND\r\nPain that occurs both within and outside of the hospital setting is a common and distressing problem for adolescents with cancer. The use of smartphone technology may facilitate rapid, in-the-moment pain support for this population. To ensure the best possible pain management advice is given, evidence-based and expert-vetted care algorithms and system design features, which are designed using user-centered methods, are required.\r\nOBJECTIVE\r\nTo develop the decision algorithm and system requirements that will inform the pain management advice provided by a real-time smartphone-based pain management app for adolescents with cancer.\r\nMETHODS\r\nA systematic approach to algorithm development and system design was utilized. Initially, a comprehensive literature review was undertaken to understand the current body of knowledge pertaining to pediatric cancer pain management. A user-centered approach to development was used as the results of the review were disseminated to 15 international experts (clinicians, scientists, and a consumer) in pediatric pain, pediatric oncology and mHealth design, who participated in a 2-day consensus conference. This conference used nominal group technique to develop consensus on important pain inputs, pain management advice, and system design requirements. Using data generated at the conference, a prototype algorithm was developed. Iterative qualitative testing was conducted with adolescents with cancer, as well as pediatric oncology and pain health care providers to vet and refine the developed algorithm and system requirements for the real-time smartphone app.\r\nRESULTS\r\nThe systematic literature review established the current state of research related to nonpharmacological pediatric cancer pain management. The 2-day consensus conference established which clinically important pain inputs by adolescents would require action (pain management advice) from the app, the appropriate advice the app should provide to adolescents in pain, and the functional requirements of the app. These results were used to build a detailed prototype algorithm capable of providing adolescents with pain management support based on their individual pain. Analysis of qualitative interviews with 9 multidisciplinary health care professionals and 10 adolescents resulted in 4 themes that helped to adapt the algorithm and requirements to the needs of adolescents. Specifically, themes were overall endorsement of the system, the need for a clinical expert, the need to individualize the system, and changes to the algorithm to improve potential clinical effectiveness.\r\nCONCLUSIONS\r\nThis study used a phased and user-centered approach to develop a pain management algorithm for adolescents with cancer and the system requirements of an associated app. The smartphone software is currently being created and subsequent work will focus on the usability, feasibility, and effectiveness testing of the app for adolescents with cancer pain.

Johansson, E.; Ekelund, U.; Nero, H.; Marcus, C.; Hagströmer, M. (2014): Calibration and cross-validation of a wrist-worn Actigraph in young preschoolers. In: Pediatr Obes. DOI: 10.1111/j.2047-6310.2013.00213.x.

OBJECTIVE\r\nTo calibrate the Actigraph GT3X+ accelerometer for wrist-worn placement in young preschoolers by developing intensity thresholds for sedentary, low- and high-intensity physical activity. Furthermore, to cross-validate the developed thresholds in young preschoolers.\r\nMETHODS\r\nActigraph GT3X+ was used to measure physical activity during structured activities and free play in 38 children (15-36 months). Activity was video recorded and scored into sedentary, low- and high-intensity physical activity based on Children’s Activity Rating Scale (CARS) and combined with accelerometer data using a 5 s epoch. Receiver operating characteristic analysis was used to develop intensity thresholds in 26 randomly selected children. The remaining 12 children were used for cross-validation.\r\nRESULTS\r\nIntensity thresholds for sedentary were ≤89 vertical counts (Y) and ≤221 vector magnitude (VM) counts per 5 s and ≥440 Y counts and ≥730 VM counts per 5 s for high-intensity physical activity. Sensitivity and specificity were 60-100% for the developed intensity thresholds. Strong correlations (Spearman rank correlation 0.69-0.91) were found in the cross-validation sample between the developed thresholds for the accelerometer and CARS scoring time in all intensity categories.\r\nCONCLUSION\r\nThe developed intensity thresholds appear valid to categorize sedentary behaviour and physical activity intensity categories in children 2 years of age.

Kerr, Jacqueline; Marshall, Simon J.; Godbole, Suneeta; Chen, Jacqueline; Legge, Amanda; Doherty, Aiden R. et al. (2013): Using the SenseCam to improve classifications of sedentary behavior in free-living settings. In: Am J Prev Med 44 (3), S. 290–296. DOI: 10.1016/j.amepre.2012.11.004.

BACKGROUND\r\nStudies have shown relationships between important health outcomes and sedentary behavior, independent of physical activity. There are known errors in tools employed to assess sedentary behavior. Studies of accelerometers have been limited to laboratory environments.\r\nPURPOSE\r\nTo assess a broad range of sedentary behaviors in free-living adults using accelerometers and a Microsoft SenseCam that can provide an objective observation of sedentary behaviors through first person-view images.\r\nMETHODS\r\nParticipants were 40 university employees who wore a SenseCam and Actigraph accelerometer for 3-5 days. Images were coded for sitting and standing posture and 12 activity types. Data were merged and aggregated to a 60-second epoch. Accelerometer counts per minute (cpm) of <100 were compared with coded behaviors. Sensitivity and specificity analyses were performed. Data were collected in June and July 2011 and analyzed in April 2012.\r\nRESULTS\r\nTV viewing, other screen use, and administrative activities were correctly classified by the 100-cpm cutpoint. However, standing behaviors also fell under this threshold, and driving behaviors exceeded it. Multiple behaviors occurred simultaneously. A nearly 30-minute per day difference was found in sedentary behavior estimates based on the accelerometer versus the SenseCam.\r\nCONCLUSIONS\r\nResearchers should be aware of the strengths and weaknesses of the 100-cpm accelerometer cutpoint for identifying sedentary behavior. The SenseCam may be a useful tool in free-living conditions to better understand health behaviors such as sitting.

Kim, Soo-Chan; Kim, Mi Joo; Kim, Nambeom; Hwang, Jong Hyun; Han, Gyu Cheol (2013): Ambulatory balance monitoring using a wireless attachable three-axis accelerometer. In: J Vestib Res 23 (4-5), S. 217–225. DOI: 10.3233/VES-130489.

BACKGROUND AND OBJECTIVES\r\nThe ability of conventional diagnostic equipment to monitor feelings of dizziness experienced during daily activities is limited. Our goal is to develop an ambulatory multipurpose device for monitoring balance to prevent falling in daily life.\r\nMATERIALS AND METHODS\r\nA three-axis accelerometers and gyroscope sensors were attached to the head, pelvis, and legs of vestibular neuritis (VN) patients or age-, height-, and body weight-matched healthy volunteers. The sum of the deviations for the scalar value of acceleration [signal vector magnitude, SVM (g)] and angular velocity (°/s) was measured using the modified Romberg test.\r\nRESULTS\r\nThe repeated measure ANOVA model with acceleration showed a greater group difference (p < 0.001) than that with angular velocity (p < 0.01). There was no significant interaction effect within-subjects factor between replication and groups (p < 0.178). SVM within the VN group significantly increased for all sensor locations compared to the control group (p < 0.01). Strong correlations between measurements taken at head and pelvis as sensor location were observed for both groups (VN/control, r=0.68/r=072).\r\nCONCLUS ION\r\nThe SVM appears to accurately assess balance while standing, even repetitive measurement or any location in body.

Kimhy, David; Vakhrusheva, Julia; Khan, Samira; Chang, Rachel W.; Hansen, Marie C.; Ballon, Jacob S. et al. (2014): Emotional granularity and social functioning in individuals with schizophrenia: an experience sampling study. In: J Psychiatr Res 53, S. 141–148. DOI: 10.1016/j.jpsychires.2014.01.020.

Previous research has shown that healthy individuals who fail to differentiate among emotional states (i.e., those with low emotional granularity; EG) have poorer social functioning (SF) than those with high EG. It is unknown, however, whether these associations extend to clinical disorders characterized by impaired SF, such as schizophrenia. In the present study, we compared SF and EG in individuals with schizophrenia and healthy controls, and then, within the schizophrenia group, we examined the links between EG and SF. Employing an Experience Sampling Method approach, 77 individuals with schizophrenia and 27 healthy controls rated their momentary emotions (sadness, anxiety, anger, and happiness) up to 10 times/day over a two-day period using mobile electronic devices. For each participant, we then calculated the within-subject average correlations among the momentary emotion ratings, producing two EG indices - EGIall for all emotions and EGIneg for negative ones. A subsample of participants with schizophrenia also completed self-report, interview, and ability-based measures of SF. Compared to healthy controls, individuals with schizophrenia displayed significantly poorer SF and lower EGIall, but comparable EGIneg. Within the schizophrenia group, hierarchical multiple regression analyses indicated that EGIall, but not EGIneg, significantly predicted social dysfunction after controlling for emotional awareness, symptoms, and emotional intensity and variability. Our findings indicate that individuals with schizophrenia have a relatively intact ability to differentiate among negative emotions in everyday life. However, they experience significant difficulties differentiating between positive and negative emotions, and this may contribute to their social difficulties.

Kirwan, Morwenna; Vandelanotte, Corneel; Fenning, Andrew; Duncan, Mitch J. (2013): Diabetes self-management smartphone application for adults with type 1 diabetes: randomized controlled trial. In: J. Med. Internet Res. 15 (11), S. e235. DOI: 10.2196/jmir.2588.

BACKGROUND\r\nPersistently poor glycemic control in adult type 1 diabetes patients is a common, complex, and serious problem initiating significant damage to the cardiovascular, renal, neural, and visual systems. Currently, there is a plethora of low-cost and free diabetes self-management smartphone applications available in online stores.\r\nOBJECTIVE\r\nThe aim of this study was to examine the effectiveness of a freely available smartphone application combined with text-message feedback from a certified diabetes educator to improve glycemic control and other diabetes-related outcomes in adult patients with type 1 diabetes in a two-group randomized controlled trial.\r\nMETHODS\r\nPatients were recruited through an online type 1 diabetes support group and letters mailed to adults with type 1 diabetes throughout Australia. In a 6-month intervention, followed by a three-month follow-up, patients (n=72) were randomized to usual care (control group) or usual care and the use of a smartphone application (Glucose Buddy) with weekly text-message feedback from a Certified Diabetes Educator (intervention group). All outcome measures were collected at baseline and every three months over the study period. Patients’ glycosylated hemoglobin levels (HbA1c) were measured with a blood test and diabetes-related self-efficacy, self-care activities, and quality of life were measured with online questionnaires.\r\nRESULTS\r\nThe mean age of patients was 35.20 years (SD 10.43) (28 male, 44 female), 39% (28/72) were male, and patients had been diagnosed with type 1 diabetes for a mean of 18.94 years (SD 9.66). Of the initial 72 patients, 53 completed the study (25 intervention, 28 control group). The intervention group significantly improved glycemic control (HbA1c) from baseline (mean 9.08%, SD 1.18) to 9-month follow-up (mean 7.80%, SD 0.75), compared to the control group (baseline: mean 8.47%, SD 0.86, follow-up: mean 8.58%, SD 1.16). No significant change over time was found in either group in relation to self-efficacy, self-care activities, and quality of life.\r\nCONCLUSIONS\r\nIn adjunct to usual care, the use of a diabetes-related smartphone application combined with weekly text-message support from a health care professional can significantly improve glycemic control in adults with type 1 diabetes.\r\nTRIAL REGISTRATION\r\nAustralian New Zealand Clinical Trials Registry: ACTRN12612000132842; (Archived by WebCite at

Koval, Peter; Ogrinz, Barbara; Kuppens, Peter; Van den Bergh, Omer; Tuerlinckx, Francis; Sütterlin, Stefan (2013): Affective instability in daily life is predicted by resting heart rate variability. In: PLoS ONE 8 (11), S. e81536. DOI: 10.1371/journal.pone.0081536.

Previous research has shown that being affectively unstable is an indicator of several forms of psychological maladjustment. However, little is known about the mechanisms underlying affective instability. Our research aims to examine the possibility that being prone to extreme fluctuations in one’s feelings is related to maladaptive emotion regulation. We investigated this hypothesis by relating affective instability, assessed in daily life using the experience sampling method, to self-reported emotion regulation strategies and to parasympathetically mediated heart rate variability (HRV), a physiological indicator of emotion regulation capacity. Results showed that HRV was negatively related to instability of positive affect (as measured by mean square successive differences), indicating that individuals with lower parasympathetic tone are emotionally less stable, particularly for positive affect.

Kramer, Ingrid; Simons, Claudia J P; Hartmann, Jessica A.; Menne-Lothmann, Claudia; Viechtbauer, Wolfgang; Peeters, Frenk et al. (2014): A therapeutic application of the experience sampling method in the treatment of depression: a randomized controlled trial. In: World Psychiatry 13 (1), S. 68–77. DOI: 10.1002/wps.20090.

In depression, the ability to experience daily life positive affect predicts recovery and reduces relapse rates. Interventions based on the experience sampling method (ESM-I) are ideally suited to provide insight in personal, contextualized patterns of positive affect. The aim of this study was to examine whether add-on ESM-derived feedback on personalized patterns of positive affect is feasible and useful to patients, and results in a reduction of depressive symptomatology. Depressed outpatients (n=102) receiving pharmacological treatment participated in a randomized controlled trial with three arms: an experimental group receiving add-on ESM-derived feedback, a pseudo-experimental group participating in ESM but receiving no feedback, and a control group. The experimental group participated in an ESM procedure (three days per week over a 6-week period) using a palmtop. This group received weekly standardized feedback on personalized patterns of positive affect. Hamilton Depression Rating Scale - 17 (HDRS) and Inventory of Depressive Symptoms (IDS) scores were obtained before and after the intervention. During a 6-month follow-up period, five HDRS and IDS assessments were completed. Add-on ESM-derived feedback resulted in a significant and clinically relevant stronger decrease in HDRS score relative to the control group (p<0.01; -5.5 point reduction in HDRS at 6 months). Compared to the pseudo-experimental group, a clinically relevant decrease in HDRS score was apparent at 6 months (B=-3.6, p=0.053). Self-reported depressive complaints (IDS) yielded the same pattern over time. The use of ESM-I was deemed acceptable and the provided feedback easy to understand. Patients attempted to apply suggestions from ESM-derived feedback to daily life. These data suggest that the efficacy of traditional passive pharmacological approach to treatment of major depression can be enhanced by using person-tailored daily life information regarding positive affect.

Krane-Gartiser, Karoline; Henriksen, Tone Elise Gjotterud; Morken, Gunnar; Vaaler, Arne; Fasmer, Ole Bernt (2014): Actigraphic assessment of motor activity in acutely admitted inpatients with bipolar disorder. In: PLoS ONE 9 (2), S. e89574. DOI: 10.1371/journal.pone.0089574.

INTRODUCTION\r\nMania is associated with increased activity, whereas psychomotor retardation is often found in bipolar depression. Actigraphy is a promising tool for monitoring phase shifts and changes following treatment in bipolar disorder. The aim of this study was to compare recordings of motor activity in mania, bipolar depression and healthy controls, using linear and nonlinear analytical methods.\r\nMATERIALS AND METHODS\r\nRecordings from 18 acutely hospitalized inpatients with mania were compared to 12 recordings from bipolar depression inpatients and 28 healthy controls. 24-hour actigraphy recordings and 64-minute periods of continuous motor activity in the morning and evening were analyzed. Mean activity and several measures of variability and complexity were calculated.\r\nRESULTS\r\nPatients with depression had a lower mean activity level compared to controls, but higher variability shown by increased standard deviation (SD) and root mean square successive difference (RMSSD) over 24 hours and in the active morning period. The patients with mania had lower first lag autocorrelation compared to controls, and Fourier analysis showed higher variance in the high frequency part of the spectrum corresponding to the period from 2-8 minutes. Both patient groups had a higher RMSSD/SD ratio compared to controls. In patients with mania we found an increased complexity of time series in the active morning period, compared to patients with depression. The findings in the patients with mania are similar to previous findings in patients with schizophrenia and healthy individuals treated with a glutamatergic antagonist.\r\nCONCLUSION\r\nWe have found distinctly different activity patterns in hospitalized patients with bipolar disorder in episodes of mania and depression, assessed by actigraphy and analyzed with linear and nonlinear mathematical methods, as well as clear differences between the patients and healthy comparison subjects.

Kuepper, R.; Oorschot, M.; Myin-Germeys, I.; Smits, M.; van Os, J.; Henquet, C. (2013): Is psychotic disorder associated with increased levels of craving for cannabis? An Experience Sampling study. In: Acta Psychiatr Scand 128 (6), S. 448–456. DOI: 10.1111/acps.12078.

OBJECTIVE\r\nAlthough cannabis use among individuals with psychotic disorder is considerable, little is known about patterns of use and factors contributing to continuation of use. Therefore, we investigated craving in relation to cannabis use in patients with psychotic disorder and healthy controls.\r\nMETHOD\r\nThe study included 58 patients with non-affective psychotic disorder and 63 healthy controls; all were frequent cannabis users. Craving was assessed with the Obsessive Compulsive Drug Use Scale (OCDUS) for cannabis, as well as in daily life using the Experience Sampling Method (ESM).\r\nRESULTS\r\nPatients scored higher on the OCDUS (B = 1.18, P = 0.022), but did not differ from controls in ESM indices of craving (all P > 0.05). In daily life, ESM craving predicted cannabis use and this was stronger in controls (χ(2) = 4.5, P = 0.033; Bcontrols = 0.08, P < 0.001; Bpatients = 0.06, P < 0.001). In both groups ESM craving was predicted by negative affect, paranoia, and hallucinations (Bnegativeaffect = 0.12, P = 0.009; Bparanoia = 0.13, P = 0.013; Bhallucinations = 0.13, P = 0.028), and followed by an increase in negative affect at non-cannabis-using moments (B = 0.03, P = 0.002).\r\nCONCLUSION\r\nThe temporal dynamics of craving as well as craving intensity in daily life appear to be similar in patients and controls. Further research is needed to elucidate the inconsistencies between cross-sectional and daily-life measures of craving in psychosis.

Kuhn, Eric; Greene, Carolyn; Hoffman, Julia; Nguyen, Tam; Wald, Laura; Schmidt, Janet et al. (2014): Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms. In: Mil Med 179 (1), S. 12–18. DOI: 10.7205/MILMED-D-13-00271.

PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations.

Kwon, Hyung-Min; Lim, Jae-Sung; Kim, Young Seo; Moon, Jangsup; Park, Hyeri; Kim, Hyun Young et al. (2014): Cerebral microbleeds are associated with nocturnal reverse dipping in hypertensive patients with ischemic stroke. In: BMC Neurol 14, S. 8. DOI: 10.1186/1471-2377-14-8.

BACKGROUND\r\nAbnormalities in nocturnal blood pressure dipping are well known for its relationship to cardiovascular diseases. Cerebral microbleeds are frequently observed in patients with hypertension and are known to be potent risk factors for stroke. However, there are scanty reports about the relationship between nocturnal dipping and cerebral microbleeds.\r\nMETHODS\r\nWe recruited consecutive patients with both hypertension and ischemic stroke within 7 days after symptom onset, and those with cardioembolism were excluded. We applied 24-hour ambulatory blood pressure monitoring two weeks after stroke onset, and we used brain MRI to detect cerebral microbleeds. Various blood pressure parameters such as mean 24-hour blood pressure, awake/sleep blood pressure, and morning surge were compared between cerebral microbleeds (+) vs. (-) groups. Subjects were further classified according to nocturnal dipping status and were analyzed by logistic regression to determine its association with cerebral microbleeds with adjustment for age, gender, and cardiovascular risk factors.\r\nRESULTS\r\nA total of 162 patients (100 males, age 65.33 ± 10.32 years) were included. Cerebral microbleeds were detected in 65 patients (40.1%). Most ambulatory blood pressure parameters except morning surge were significantly higher in those who had cerebral microbleeds. After adjusting for the confounding factors, the reverse dippers were prone to have cerebral microbleeds (odds ratio, 3.81; 95% confidential interval, 1.36-10.65; p-value = 0.01).\r\nCONCLUSION\r\nCerebral microbleeds are independently associated with reverse dipping on ambulatory blood pressure monitoring in hypertensive stroke patients.

Laguna, María; Ruiz, Jonatan R.; Gallardo, Cristian; García-Pastor, Teresa; Lara, María-Teresa; Aznar, Susana (2013): Obesity and physical activity patterns in children and adolescents. In: J Paediatr Child Health 49 (11), S. 942–949. DOI: 10.1111/jpc.12442.

The aim of this study is to measure objectively and accurately the physical activity (PA) patterns in Spanish children and adolescents according to their obesity status, gender and age groups. METHODS: A sample of 487 children and 274 adolescents from the European Youth Heart Study participated in the study. The variables measured were anthropometric characteristics (height, weight and body mass index), and PA was measured during 6 consecutive days using the GT1M accelerometer. RESULTS: Three-way analysis of variance (age × gender × obesity status) showed significant differences in the interaction effect in age, gender and obesity status (normal-weight and overweight/obesity) for mean of moderate-to-vigorous PA (MVPA) (P = 0.02) and vigorous PA (VPA) (P = 0.014) within the sample. Nine-year-old normal-weight children achieved significantly (P < 0.05) more MVPA on weekdays than 9-year-old overweight/obesity children. During weekend days, all sample achieved significant more MVPA (P < 0.01) and significant more VPA (P < 0.05) than during weekdays. Few children (37.5% of 9-year-old normal-weight and 34.0% of 9-year-old overweight/obese) and adolescents (16.4% and 27.3% normal-weight and overweight/obese, respectively) met the current health-related recommendations of 60 min of MVPA daily. CONCLUSIONS: It is clear that activity levels are insufficient for all children, in particular overweight/obese children and adolescents, although the precise nature of the relationship appears to differ between boys and girls.

Lambert, Elisabeth A.; Chatzivlastou, Kanella; Schlaich, Markus; Lambert, Gavin; Head, Geoffrey A. (2014): Morning surge in blood pressure is associated with reactivity of the sympathetic nervous system. In: Am. J. Hypertens. 27 (6), S. 783–792. DOI: 10.1093/ajh/hpt273.

BACKGROUND\r\nAn exaggerated morning surge in blood pressure (BP) closely relates to target organ damage and cardiovascular risk, but whether the causative mechanism involves greater reactivity of the sympathetic nervous system (SNS) is unknown. We determined whether the response of the SNS to a cold pressor test predicted the BP morning surge.\r\nMETHODS\r\nAmbulatory BP recordings were obtained from 14 men and 19 women (age = 41±4 years), and the amplitude (day-night difference), rate of rise (RoR), rate by amplitude product (BPPower), and morning BP surge (MBPS; post-awake minus pre-awake) of morning mean arterial pressure (MAP) were determined. The reactivity of the SNS to CPT was assessed by recording of muscle sympathetic nerve activity (MSNA).\r\nRESULTS\r\nCPT induced a marked increase in MAP and all parameters of MSNA, including burst amplitude. Log-normalized BPPower positively correlated with the overall average CPT-induced increases in total MSNA (r = 0.38; P = 0.04) and burst amplitude (r = 0.43; P = 0.02) but was not related to the increase in MSNA frequency. Furthermore, a strong positive linear trend in the CPT-induced changes in burst amplitude across tertiles of BPPower and RoR was observed. BPPower and RoR were not related to CPT-induced hemodynamic changes. The MBPS did not correlate with any of the CPT-induced changes in vascular or MSNA variables.\r\nCONCLUSIONS\r\nThese results suggest that the central nervous system mechanisms influencing the increase in MSNA burst amplitude during arousal may also be fundamental in determining the rate and power of BP rise during the morning period.

Lambourne, K.; Hansen, D. M.; Szabo, A. N.; Lee, J.; Herrmann, S. D.; Donnelly, J. E. (2013): Indirect and direct relations between aerobic fitness, physical activity, and academic achievement in elementary school students. In: Mental Health and Physical Activity 6 (3), S. 165–171. DOI: 10.1016/j.mhpa.2013.06.002.

Background: There is evidence to suggest that increasing physical activity (PA) improves academic achievement (AA) in children and that aerobic fitness is associated with both cognitive function and AA. However, it is not known how these variables are interrelated and analyses with adequate control for socioeconomic variables are needed. It was hypothesized that PA would not directly affect AA but would have an indirect effect on AA through its effect on aerobic fitness. The purpose of this study was to test this hypothesized mediation using path analysis. Methods: Cross-sectional data including AA, aerobic fitness, and daily PA assessed through accelerometry were collected from a large sample (N = 687) of 2nd and 3rd grade students. Demographic data were assessed via parent self-report. Results: A total of 401 students wore the accelerometer for at least 10 h on 3 days or more and were included in the final path analysis to evaluate potential relations among PA (predictor), aerobic fitness (mediator), and WIAT-III subtest standard scores (outcomes; i.e., reading, spelling, and mathematics). Findings showed a direct effect of PA on aerobic fitness (b = .009, p < .001) and an indirect effect (mediation) of PA via fitness on math achievement (b = .003, p < .01) after controlling for student’s grade, gender, body mass index, mother’s education level, and household income, as well as intraclass correlations among classes and schools. Neither PA nor aerobic fitness were correlated with WIAT-III reading or spelling scores. Conclusions: Mediation analysis indicated that PA exerted an influence on math achievement through its effects on aerobic fitness but was not associated with reading or spelling achievement scores. Keywords: Path analysis; Mediation; Weschler individual achievement Test-III; Progressive aerobic cardiovascular endurance run

Landsbergis, Paul A.; Dobson, Marnie; Koutsouras, George; Schnall, Peter (2013): Job strain and ambulatory blood pressure: a meta-analysis and systematic review. In: Am J Public Health 103 (3), S. e61-71. DOI: 10.2105/AJPH.2012.301153.

We reviewed evidence of the relationship between job strain and ambulatory blood pressure (ABP) in 29 studies (1985-2012). We conducted a quantitative meta-analysis on 22 cross-sectional studies of a single exposure to job strain. We systematically reviewed 1 case-control study, 3 studies of cumulative exposure to job strain, and 3 longitudinal studies. Single exposure to job strain in cross-sectional studies was associated with higher work systolic and diastolic ABP. Associations were stronger in men than women and in studies of broad-based populations than those with limited occupational variance. Biases toward the null were common, suggesting that our summary results underestimated the true association. Job strain is a risk factor for blood pressure elevation. Workplace surveillance programs are needed to assess the prevalence of job strain and high ABP and to facilitate workplace cardiovascular risk reduction interventions.

Lange, Stefanie; Süß, Heinz-Martin (2014): Measuring slips and lapses when they occur - ambulatory assessment in application to cognitive failures. In: Conscious Cogn 24, S. 1–11. DOI: 10.1016/j.concog.2013.12.008.

Cognitive failures are lapses in attention, cognition, and actions that everybody experiences in everyday life. Self-reports are mainly used for assessment but those instruments are memory-biased and more related to personality aspects than to actual behavior. Ambulatory assessment is already used for capturing emotions or addictive behavior, but not yet for cognitive failures. The newly developed Questionnaire for Cognitive Failures in Everyday Life (KFA) was applied via mobile phones (electronic KFA) wherein an acoustic signal asked participants (N=91, 60-76 years) 4 times daily to answer 13 questions for 1 week. The new instrument showed satisfying reliability and was compared with a self-report method (Cognitive Failures Questionnaire; Broadbent, Cooper, Fitzgerald, and Parkes, 1982) in terms of correlations with cognitive abilities (working memory capacity, short-term memory, switching ability, and reasoning), personality traits, and demographical aspects. Although further validation is needed, first results are promising and eKFA enriches cognitive failures research.

Li, Ang; Li, He; Guo, Rui; Zhu, Tingshao (2013): MobileSens: A Ubiquitous Psychological Laboratory based on Mobile Device. In: International Journal of Cyber Behavior, Psychology and Learning 3 (2), S. 47–55. DOI: 10.4018/ijcbpl.2013040104.

In psychological research, it is difficult to acquire unintrusive, real-time and objective data under real-life non-experimental scenario. This article proposes a system (MobileSens) for automatically recording user behavior on Android mobile device (e.g., turning on device, sending messages, and web surfing), and uploading data to web server through General Packet Radio Service (GPRS) for subsequent analysis. During testing, MobileSens runs smoothly and efficiently on both the smartphone and tablet computer. It indicates that, in the future, this method of data acquisition can improve the performance of conducting psychological research.

Liao, Yue; Intille, Stephen S.; Dunton, Genevieve F. (2014): Using Ecological Momentary Assessment to Understand Where and With Whom Adults’ Physical and Sedentary Activity Occur. In: Int J Behav Med. DOI: 10.1007/s12529-014-9400-z.

PURPOSE: This study used Ecological Momentary Assessment (EMA), a real-time self-report strategy, to describe the physical and social contexts of adults’ physical activity and sedentary activity during their everyday lives and to determine whether these patterns and relationships differ for men and women. METHODS: Data from 114 adults were collected through mobile phones across 4 days. Eight electronic EMA surveys were randomly prompted each day asking about current activities (e.g., physical or sedentary activity), physical and social contexts, and perceived outdoor environmental features (e.g., greenness/vegetation, safety, and traffic). All participants also wore accelerometers during this period to objectively measure moderate-to-vigorous physical activity (MVPA) and sedentary activity. RESULTS: Home was the most common physical context for EMA-reported physical and sedentary activity. Most of these activities occurred when participants were alone. When alone, the most commonly EMA-reported physical activity and sedentary activity was walking and reading/using computer, respectively. When in outdoor home locations (e.g., yard and driveway) women demonstrated higher levels of MVPA, whereas men demonstrated higher levels of MVPA when in outdoor park settings (ps < .05). Men but not women demonstrated higher levels of MVPA in settings with a greater degree of perceived greenness and vegetation (p < .05). CONCLUSIONS: The current study shows how EMA via mobile phones and accelerometers can be combined to offer an innovative approach to assess the contexts of adults’ daily physical and sedentary activity. Future studies could consider utilizing this method in more representative samples to gather context-specific information to inform the development of physical activity interventions.

Lipton, Richard B.; Buse, Dawn C.; Hall, Charles B.; Tennen, Howard; Defreitas, Tiffani A.; Borkowski, Thomas M. et al. (2014): Reduction in perceived stress as a migraine trigger: testing the \”let-down headache\” hypothesis. In: Neurology 82 (16), S. 1395–1401. DOI: 10.1212/WNL.0000000000000332.

OBJECTIVE\r\nTo test whether level of perceived stress and reductions in levels of perceived stress (i.e., \”let-down\”) are associated with the onset of migraine attacks in persons with migraine.\r\nMETHODS\r\nPatients with migraine from a tertiary headache center were invited to participate in a 3-month electronic diary study. Participants entered data daily regarding migraine attack experience, subjective stress ratings, and other data. Stress was assessed using 2 measures: the Perceived Stress Scale and the Self-Reported Stress Scale. Logit-normal, random-effects models were used to estimate the odds ratio for migraine occurrence as a function of level of stress over several time frames.\r\nRESULTS\r\nOf 22 enrolled participants, 17 (median age 43.8 years) completed >30 days of diaries, yielding 2,011 diary entries including 110 eligible migraine attacks (median 5 attacks per person). Level of stress was not generally associated with migraine occurrence. However, decline in stress from one evening diary to the next was associated with increased migraine onset over the subsequent 6, 12, and 18 hours, with odds ratios ranging from 1.5 to 1.9 (all p values < 0.05) for the Perceived Stress Scale. Decline in stress was associated with migraine onset after controlling for level of stress for all time points. Findings were similar using the Self-Reported Stress Scale.\r\nCONCLUSIONS\r\nReduction in stress from one day to the next is associated with migraine onset the next day. Decline in stress may be a marker for an impending migraine attack and may create opportunities for preemptive pharmacologic or behavioral interventions.

Loprinzi, Paul D.; Cardinal, Bradley J.; Crespo, Carlos J.; Brodowicz, Gary R.; Andersen, Ross E.; Smit, Ellen (2013): Differences in demographic, behavioral, and biological variables between those with valid and invalid accelerometry data: implications for generalizability. In: J Phys Act Health 10 (1), S. 79–84.

BACKGROUND: The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population. METHODS: Ambulatory participants from NHANES (2003-2004) who were 20-85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A “valid person” was defined as those with 4 or more days of at least 10+ hrs of monitoring per day. Among adults (20-85 yrs), 3088 participants provided VAD and 987 provided IAD. Demographic, behavioral, and biological information were obtained from the household interview or from data obtained in a mobile examination center. RESULTS: Differences were observed in age, BMI, ethnicity, education, smoking status, marital status, use of street drugs, current health status, HDL-cholesterol, C-reactive protein, self-reported vigorous physical activity, and plasma glucose levels between those with VAD and IAD. CONCLUSIONS: Investigators should take into consideration the potential cut-off bias in interpreting results based on data that excludes IAD participants.

Maher, Carol; Olds, Tim; Mire, Emily; Katzmarzyk, Peter T. (2014): Reconsidering the sedentary behaviour paradigm. In: PLoS ONE 9 (1), S. e86403. DOI: 10.1371/journal.pone.0086403.

AIMS\r\nRecent literature has posed sedentary behaviour as an independent entity to physical inactivity. This study investigated whether associations between sedentary behaviour and cardio-metabolic biomarkers remain when analyses are adjusted for total physical activity.\r\nMETHODS\r\nCross-sectional analyses were undertaken on 4,618 adults from the 2003/04 and 2005/06 U.S. National Health and Nutrition Examination Survey. Minutes of sedentary behaviour and moderate-to-vigorous physical activity (MVPA), and total physical activity (total daily accelerometer counts minus counts accrued during sedentary minutes) were determined from accelerometry. Associations between sedentary behaviour and cardio-metabolic biomarkers were examined using linear regression.\r\nRESULTS\r\nResults showed that sedentary behaviour was detrimentally associated with 8/11 cardio-metabolic biomarkers when adjusted for MVPA. However, when adjusted for total physical activity, the associations effectively disappeared, except for C-reactive protein, which showed a very small, favourable association (β = -0.06) and triglycerides, which showed a very small, detrimental association (β = 0.04). Standardised betas suggested that total physical activity was consistently, favourably associated with cardio-metabolic biomarkers (9/11 biomarkers, standardized β = 0.08-0.30) while sedentary behaviour was detrimentally associated with just 1 biomarker (standardized β = 0.12).\r\nCONCLUSION\r\nThere is virtually no association between sedentary behaviour and cardio-metabolic biomarkers once analyses are adjusted for total physical activity. This suggests that sedentary behaviour may not have health effects independent of physical activity.

Markowetz, Alexander; Błaszkiewicz, Konrad; Montag, Christian; Switala, Christina; Schlaepfer, Thomas E. (2014): Psycho-informatics: Big Data shaping modern psychometrics. In: Med. Hypotheses 82 (4), S. 405–411. DOI: 10.1016/j.mehy.2013.11.030.

For the first time in history, it is possible to study human behavior on great scale and in fine detail simultaneously. Online services and ubiquitous computational devices, such as smartphones and modern cars, record our everyday activity. The resulting Big Data offers unprecedented opportunities for tracking and analyzing behavior. This paper hypothesizes the applicability and impact of Big Data technologies in the context of psychometrics both for research and clinical applications. It first outlines the state of the art, including the severe shortcomings with respect to quality and quantity of the resulting data. It then presents a technological vision, comprised of (i) numerous data sources such as mobile devices and sensors, (ii) a central data store, and (iii) an analytical platform, employing techniques from data mining and machine learning. To further illustrate the dramatic benefits of the proposed methodologies, the paper then outlines two current projects, logging and analyzing smartphone usage. One such study attempts to thereby quantify severity of major depression dynamically; the other investigates (mobile) Internet Addiction. Finally, the paper addresses some of the ethical issues inherent to Big Data technologies. In summary, the proposed approach is about to induce the single biggest methodological shift since the beginning of psychology or psychiatry. The resulting range of applications will dramatically shape the daily routines of researches and medical practitioners alike. Indeed, transferring techniques from computer science to psychiatry and psychology is about to establish Psycho-Informatics, an entire research direction of its own.

McKee, Heather C.; Ntoumanis, Nikos; Taylor, Ian M. (2014): An Ecological Momentary Assessment of Lapse Occurrences in Dieters. In: Ann Behav Med. DOI: 10.1007/s12160-014-9594-y.

PURPOSE: The aim of this study is to investigate the factors related to dietary lapse occurrence in a community sample of dieters. METHODS: An ecological momentary assessment (EMA) methodology, via mobile phone-based diaries, was employed to record dietary lapse occurrences in a group of dieters (N = 80; M age = 41.21 +/- 15.60 years; M BMI = 30.78 +/- 7.26) over 7 days. RESULTS: Analyses indicated that lapses were positively associated with the strength of dietary temptation, presence of others, coping responses, and the environment (exposure to food cues) in which the dieters were in; lapses were more likely to occur in the evening and were negatively associated with the use of coping mechanisms. Additionally, lapse occurrence was found to mediate the relationships among the above predictors of lapse and the self-efficacy to resist future dietary temptations. CONCLUSIONS: Results provide an insight into the occurrence of lapses in dieters and have implications for interventions focusing on weight loss maintenance and relapse prevention.

McNally, Richard J.; Enock, Philip M.; Tsai, Cynthia; Tousian, Mona (2013): Attention bias modification for reducing speech anxiety. In: Behav Res Ther 51 (12), S. 882–888. DOI: 10.1016/j.brat.2013.10.001.

The mechanisms mediating the anxiolytic effects of attention bias modification (ABM) remain unclear. Accordingly, we randomly assigned speech-anxious subjects to receive four sessions of one of three training conditions: ABM, inverse ABM, and control. In the ABM condition, subjects viewed pairs of photographs of models displaying facial expressions of disgust and joy on a computer screen. Probes always replaced the positive face, and subjects pushed a button to indicate the identity of the probe (E or F) as rapidly as possible. In the inverse condition, the probes always replaced the negative face, and in the control condition, the probes replaced each face type equally often. After four training sessions, all groups exhibited statistically indistinguishable, but significant, reductions on self-report, behavioral, and physiological measures of speech anxiety. Self-report and behavioral measures of attentional control improved likewise. Contrary to early studies, ABM was not superior to control procedures in producing reductions on measures of social anxiety.

Meredith, Steven E.; Robinson, Andrew; Erb, Philip; Spieler, Claire A.; Klugman, Noah; Dutta, Prabal; Dallery, Jesse (2014): A mobile-phone-based breath carbon monoxide meter to detect cigarette smoking. In: Nicotine Tob. Res. 16 (6), S. 766–773. DOI: 10.1093/ntr/ntt275.

INTRODUCTION\r\nMobile phones hold considerable promise for delivering evidence-based smoking cessation interventions that require frequent and objective assessment of smoking status via breath carbon monoxide (Breath CO) measurement. However, there are currently no commercially available mobile-phone-based Breath CO meters. We developed a mobile-phone-based Breath CO meter prototype that attaches to and communicates with a smartphone through an audio port. We then evaluated the reliability and the validity of Breath CO measures collected with the mobile meter prototype and assessed the usability and acceptability of the meter.\r\nMETHODS\r\nParticipants included 20 regular smokers (≥10 cigarettes/day), 20 light smokers (<10 cigarettes/day), and 20 nonsmokers. Expired air samples were collected 4 times from each participant: twice with the mobile meter and twice with a commercially available Breath CO meter.\r\nRESULTS\r\nMeasures calculated by the mobile meter correlated strongly with measures calculated by the commercial meter (r = .96, p < .001). Additionally, the mobile meter accurately distinguished between smokers and nonsmokers. The area under the receiver-operating characteristic curve for the mobile meter was 94.7%, and the meter had a combined sensitivity and specificity of 1.86 at an abstinence threshold of ≤6 ppm. Responses on an acceptability survey indicated that smokers liked the meter and would be interested in using it during a quit attempt.\r\nCONCLUSIONS\r\nThe results of our study suggest that a mobile-phone-based Breath CO meter is a reliable, valid, and acceptable device for distinguishing between smokers and nonsmokers.

Miranda, Robert; Monti, Peter M.; Ray, Lara; Treloar, Hayley R.; Reynolds, Elizabeth K.; Ramirez, Jason et al. (2014): Characterizing subjective responses to alcohol among adolescent problem drinkers. In: J Abnorm Psychol 123 (1), S. 117–129. DOI: 10.1037/a0035328.

Theoretical models of alcoholism emphasize the acute reinforcing properties of alcohol as chief determinants of drinking, and animal research suggests adolescents are uniquely sensitive to these effects. Human studies of these phenomena, however, are virtually nonexistent. We used ecological momentary assessment methods to capture adolescents’ subjective responses to alcohol in real time in their natural environments. Adolescent participants were 22 problem drinkers, ages 15 to 19 years (M = 18.3, SD = 0.09; 55% female; 55% alcohol dependent). Participants consumed alcohol on 38% of days during a 1-week monitoring period, with an average of 5 drinks per occasion. Momentary data revealed that adolescents experience decreased stimulation and increased sedation and \”high\” across the ascending limb of the blood alcohol curve. Notably, greater craving predicted higher volumes of subsequent alcohol consumption during the episode, whereas greater \”high\” attenuated use. To test for developmental differences in these effects, we pooled these data with data from a similarly ascertained sample of 36 adult heavy drinkers, ages 24 to 64 years (M = 38.1, SD = 11.8; 50% female; 61% alcohol dependent). Adolescents were more sensitive to the stimulant effects of alcohol than adults. This study provides novel data on how adolescent problem drinkers experience alcohol in their natural contexts and illustrates how these effects, which appear to differ from adult problem drinkers, confer liability for future drinking.

Moskowitz, D. S.; Young, Simon N. (2014): Impulsive behaviour in interpersonal encounters: Associations with quarrelsomeness and agreeableness. In: British Journal of Psychology.

Associations between impulsivity and interpersonal behaviours have rarely been examined, even though impulsivity may disrupt the flow of social interactions. For example, it is unknown to what extent the commonly used Barratt Impulsiveness Scale (BIS-11) predicts impulsive behaviour in social situations, and how behaving impulsively during interpersonal encounters might influence levels of quarrelsomeness and agreeableness. In this study, 48 healthy working individuals completed the BIS-11 and recorded their behaviour in social situations using event-contingent recording. Record forms included items representing quarrelsome, agreeable, and impulsive behaviours. BIS-11 motor impulsiveness scores predicted impulsive behaviour in social situations. Impulsive behaviour was associated, in different interactions, with both agreeableness and quarrelsomeness. Behaving impulsively in specific interactions was negatively associated with agreeableness in participants with higher BIS-11 motor impulsiveness and positively associated with agreeableness in participants with lower BIS-11 motor impulsiveness. Impulsive quarrelsome behaviour may cause interpersonal problems. Impulsive agreeable behaviour may have positive effects in individuals with low trait impulsivity. The idea that there are between-person differences in the effects of state impulsivity on the flow of social interaction deserves further study.

Nakano, Hiroshi; Hirayama, Kenji; Sadamitsu, Yumiko; Toshimitsu, Ayaka; Fujita, Hisayuki; Shin, Shizue; Tanigawa, Takeshi (2014): Monitoring sound to quantify snoring and sleep apnea severity using a smartphone: proof of concept. In: J Clin Sleep Med 10 (1), S. 73–78. DOI: 10.5664/jcsm.3364.

STUDY OBJECTIVES\r\nHabitual snoring is a prevalent condition that is not only a marker of obstructive sleep apnea (OSA) but can also lead to vascular risk. However, it is not easy to check snoring status at home. We attempted to develop a snoring sound monitor consisting of a smartphone alone, which is aimed to quantify snoring and OSA severity.\r\nMETHODS\r\nThe subjects included 50 patients who underwent diagnostic polysomnography (PSG), of which the data of 10 patients were used for developing the program and that of 40 patients were used for validating the program. A smartphone was attached to the anterior chest wall over the sternum. It acquired ambient sound from the built-in microphone and analyzed it using a fast Fourier transform on a real-time basis.\r\nRESULTS\r\nSnoring time measured by the smartphone highly correlated with snoring time measured by PSG (r = 0.93). The top 1 percentile value of sound pressure level (L1) determined by the smartphone correlated with the ambient sound L1 during sleep determined by PSG (r = 0.92). Moreover, the respiratory disturbance index estimated by the smartphone (smart-RDI) highly correlated with the apnea-hypopnea index (AHI) obtained by PSG (r = 0.94). The diagnostic sensitivity and specificity of the smart-RDI for diagnosing OSA (AHI ≥ 15) were 0.70 and 0.94, respectively.\r\nCONCLUSIONS\r\nA smartphone can be used for effectively monitoring snoring and OSA in a controlled laboratory setting. Use of this technology in a noisy home environment remains unproven, and further investigation is needed.

O’Toole, Mia Skytte; Jensen, Morten Berg; Fentz, Hanne Nørr; Zachariae, Robert; Hougaard, Esben (2014): Emotion Differentiation and Emotion Regulation in High and Low Socially Anxious Individuals: An Experience-Sampling Study. In: Cogn Ther Res 38 (4), S. 428–438. DOI: 10.1007/s10608-014-9611-2.

The present study explored when and how emotional difficulties and poor quality of life arise in the everyday lives of socially anxious individuals. 264 fresh- men-year college students completed an online survey for 11 consecutive days. Comparing individuals high (HSA) and low in social anxiety, results revealed that irrespective of daily positive emotion differentiation ability, HSAs engaged daily emotion suppression strategies, pointing to inflexible emotion regulation. Furthermore, HSAs with poor daily negative emotion differentiation used the least daily cognitive reappraisal. Finally, both expressive sup- pression and cognitive reappraisal showed group-specific effects on daily positive affect. Daily expressive suppression was more strongly associated with diminished daily positive affect in HSAs, and HSAs benefited less in terms of daily positive affect from daily use of cognitive reappraisal. Based on these findings, emotion differentiation ability and emotion regulation appear relevant clinical targets for individuals with social anxiety disorder. Keywords: Social phobia; Emotion differentiation; Emotion regulation; Positive affect; Quality of life

O’Malley, Grace; Clarke, Mike; Burls, Amanda; Murphy, Sinéad; Murphy, Nuala; Perry, Ivan J. (2014): A smartphone intervention for adolescent obesity: study protocol for a randomised controlled non-inferiority trial. In: Trials 15, S. 43. DOI: 10.1186/1745-6215-15-43.

BACKGROUND\r\nThere are few evidence-based mobile health solutions for treating adolescent obesity. The primary aim of this parallel non-inferiority trial is to assess the effectiveness of an experimental smartphone application in reducing obesity at 12 months, compared to the Temple Street W82GO Healthy Lifestyles intervention.\r\nMETHODS/DESIGN\r\nThe primary outcome measure is change in body mass index standardised deviation score at 12 months. The secondary aim is to compare the effect of treatment on secondary outcomes, including waist circumference, insulin sensitivity, quality of life, physical activity and psychosocial health. Adolescents with a body mass index at or above the 98th percentile (12 to 17 years) will be recruited from the Obesity clinic at Temple Street Children’s University Hospital in Dublin, Ireland. W82GO is a family-based lifestyle change intervention delivered in two phases over 12 months. In the current study, participants will be randomised for phase two of treatment to either usual care or care delivered via smartphone application. One hundred and thirty-four participants will be randomised between the two study arms. An intention-to-treat analysis will be used to compare treatment differences between the groups at 12 months.\r\nDISCUSSION\r\nThe results of this study will be disseminated via open access publication and will provide important information for clinicians, patients and policy makers regarding the use of mobile health interventions in the management of adolescent obesity.\r\nTRIAL REGISTRATION\r\ NCT01804855.

Ono, Kanako; Yamasue, Kotaro; Tochikubo, Osamu; Terauchi, Yasuo; Mizushima, Shunsaku (2014): Lifestyle monitoring with the use of an earphone-type thermometer, an ambulatory blood pressure monitoring and a new wristwatch-type pulsimeter with accelerometer. In: Clin. Exp. Hypertens. 36 (2), S. 97–102. DOI: 10.3109/10641963.2014.892120.

We investigated the relationship among 24-h blood pressure (BP), pulse rate (PR) and core temperature by using an ambulatory BP monitoring, a new wristwatch-type pulsimeter with accelerometer (WPA) and an ear thermometer simultaneously. Our results suggest that the ear temperature which reflects the core body temperature was lowest at base PR during sleep and 75% of normotensives and 54% of subjects without hypertensive medication had a significant correlation between BP and PR. Diabetic subjects showed a significantly higher PR during sleep than non-diabetic subjects. Three types of equipments, especially a new WPA, are expected to be useful for daily lifestyle monitoring to evaluate risk of complications of hypertension and diabetes.

O’Reilly, Gillian A.; Spruijt-Metz, Donna (2013): Current mHealth technologies for physical activity assessment and promotion. In: Am J Prev Med 45 (4), S. 501–507. DOI: 10.1016/j.amepre.2013.05.012.

CONTEXT\r\nNovel mobile assessment and intervention capabilities are changing the face of physical activity (PA) research. A comprehensive systematic review of how mobile technology has been used for measuring PA and promoting PA behavior change is needed.\r\nEVIDENCE ACQUISITION\r\nArticle collection was conducted using six databases from February to June 2012 with search terms related to mobile technology and PA. Articles that described the use of mobile technologies for PA assessment, sedentary behavior assessment, and/or interventions for PA behavior change were included. Articles were screened for inclusion and study information was extracted.\r\nEVIDENCE SYNTHESIS\r\nAnalyses were conducted from June to September 2012. Mobile phone-based journals and questionnaires, short message service (SMS) prompts, and on-body PA sensing systems were the mobile technologies most utilized. Results indicate that mobile journals and questionnaires are effective PA self-report measurement tools. Intervention studies that reported successful promotion of PA behavior change employed SMS communication, mobile journaling, or both SMS and mobile journaling.\r\nCONCLUSIONS\r\nmHealth technologies are increasingly being employed to assess and intervene on PA in clinical, epidemiologic, and intervention research. The wide variations in technologies used and outcomes measured limit comparability across studies, and hamper identification of the most promising technologies. Further, the pace of technologic advancement currently outstrips that of scientific inquiry. New adaptive, sequential research designs that take advantage of ongoing technology development are needed. At the same time, scientific norms must shift to accept \”smart,\” adaptive, iterative, evidence-based assessment and intervention technologies that will, by nature, improve during implementation.

Orme, Mark; Wijndaele, Katrien; Sharp, Stephen J.; Westgate, Kate; Ekelund, Ulf; Brage, Soren (2014): Combined influence of epoch length, cut-point and bout duration on accelerometry-derived physical activity. In: Int J Behav Nutr Phys Act 11 (1), S. 34. DOI: 10.1186/1479-5868-11-34.

BACKGROUND\r\nIt is difficult to compare accelerometer-derived estimates of moderate-to-vigorous physical activity (MVPA) between studies due to differences in data processing procedures. We aimed to evaluate the effects of accelerometer processing options on total and bout-accumulated time spent in MVPA in adults.\r\nMETHODS\r\n267 participants from the ProActive Trial provided 1236 days of valid physical activity (PA) data, collected using a 5-s epoch with ActiGraph GT1M accelerometers. We integrated data over 5-s to 60-s epoch lengths (EL) and applied two-level mixed effects regression models to MVPA time, defined using 1500 to 2500 counts/minute (cpm) cut-points (CP) and bout durations (BD) from 1 to 15 min.\r\nRESULTS\r\nTotal MVPA time was lower on longer EL and higher CP (47 vs 26 min/day and 26 vs 5 min/day on 1500 vs 2500 cpm on 5-s and 60-s epoch, respectively); this could be approximated as MVPA=exp[2.197+0.279*log(CP)+6.120*log(EL) - 0.869*log(CP)*log(EL)] with an 800 min/day wear-time. In contrast, EL was positively associated with time spent in bout-accumulated MVPA; the approximating equation being MVPA=exp[54.679 - 6.268*log(CP)+6.387*log(EL) - 10.000*log(BD) - 0.162*log(EL)*log(BD) - 0.626*log(CP)*log(EL)+1.033*log(CP)*log(BD)]. BD and CP were inversely associated with MVPA, with higher values attenuating the influence of EL.\r\nCONCLUSIONS\r\nEL, CP and BD interact to influence estimates of accelerometer-determined MVPA. In general, higher CP and longer BD result in lower MVPA but the direction of association for EL depends on BD. Reporting scaling coefficients for these key parameters across their frequently used ranges would facilitate comparisons of population-level accelerometry estimates of MVPA.

Poerio, Giulia L.; Totterdell, Peter; Miles, Eleanor (2013): Mind-wandering and negative mood: does one thing really lead to another? In: Conscious Cogn 22 (4), S. 1412–1421. DOI: 10.1016/j.concog.2013.09.012.

Mind-wandering is closely connected with negative mood. Whether negative mood is a cause or consequence of mind-wandering remains an important, unresolved, issue. We sought to clarify the direction of this relationship by measuring mood before and after mind-wandering. We also measured the affective content, time-orientation and relevance of mind-wandering to current concerns to explore whether the link between mind-wandering and negative mood might be explained by these characteristics. A novel experience-sampling technique with smartphone application prompted participants to answer questions about mind-wandering and mood across 7 days. While sadness tended to precede mind-wandering, mind-wandering itself was not associated with later mood and only predicted feeling worse if its content was negative. We also found prior sadness predicted retrospective mind-wandering, and prior negative mood predicted mind-wandering to current concerns. Our findings provide new insight into how mood and mind-wandering relate but suggest mind-wandering is not inherently detrimental to well-being.

Pramana, Gede; Parmanto, Bambang; Kendall, Philip C.; Silk, Jennifer S. (2014): The SmartCAT: an m-health platform for ecological momentary intervention in child anxiety treatment. In: Telemed J E Health 20 (5), S. 419–427. DOI: 10.1089/tmj.2013.0214.

INTRODUCTION\r\nCognitive behavioral therapy (CBT) for child anxiety, although efficacious, typically requires 16-20 weekly sessions with a therapist. Brief CBT (BCBT; eight sessions) for child anxiety is promising but may have less favorable outcomes owing to reduced session time. Mobile health (m-health) has the potential to improve BCBT efficacy by delivering ecological momentary intervention to engage youth in learning and practicing CBT skills in their everyday lives (in vivo).\r\nMATERIALS AND METHODS\r\nWe developed an m-health platform entitled SmartCAT (Smartphone-enhanced Child Anxiety Treatment). SmartCAT consists of (1) a smartphone application (app) that cues youth to use the CBT skills taught in sessions, (2) an online portal that allows therapists to monitor skill use, to send cues and treatment-related materials, to engage youth in real-time via secure messages, and to manage rewards, and (3) a communication protocol that allows real-time bidirectional exchange between the app and the portal. A pilot study with nine youth (9-14 years old) examined the platform’s feasibility as an adjunct to BCBT.\r\nRESULTS\r\nSmartCAT was found to be capable of supporting BCBT for child anxiety and received positive feedback from both therapists and youth patients. Patients rated the app as highly usable (mean=1.7 on a 1-7 scale, with 1=\”easy\”). Patients completed 5.36 skills coach entries per session (standard deviation=1.95) and took an average of 3.14 min (standard deviation=0.98 min) to complete the entries.\r\nCONCLUSIONS\r\nA smartphone app is feasible within CBT for child anxiety. Users found SmartCAT both acceptable and easy to use. Integrating an m-health platform within BCBT for anxious children may facilitate involvement in treatment and dissemination of effective procedures.

Read, Scott A.; Collins, Michael J.; Vincent, Stephen J. (2014): Light exposure and physical activity in myopic and emmetropic children. In: Optom Vis Sci 91 (3), S. 330–341. DOI: 10.1097/OPX.0000000000000160.

PURPOSE\r\nTo objectively assess daily light exposure and physical activity levels in myopic and emmetropic children.\r\nMETHODS\r\nOne hundred two children (41 myopes and 61 emmetropes) aged 10 to 15 years old had simultaneous objective measures of ambient light exposure and physical activity collected over a 2-week period during school term, using a wrist-worn actigraphy device (Actiwatch 2). Measures of visible light illuminance and physical activity were captured every 30 seconds, 24 hours a day over this period. Mean hourly light exposure and physical activity for weekdays and weekends were examined. To ensure that seasonal variations did not confound comparisons, the light and activity data of the 41 myopes was compared with 41 age- and gender-matched emmetropes who wore the Actiwatch over the same 2-week period.\r\nRESULTS\r\nMean light exposure and physical activity for all 101 children with valid data exhibited significant changes with time of day and day of the week (p < 0.0001). On average, greater daily light exposure occurred on weekends compared to weekdays (p < 0.05), and greater physical activity occurred on weekdays compared to weekends (p < 0.01). Myopic children (n = 41, mean daily light exposure 915 ± 519 lx) exhibited significantly lower average light exposure compared to 41 age- and gender-matched emmetropic children (1272 ± 625 lx, p < 0.01). The amount of daily time spent in bright light conditions (>1000 lx) was also significantly greater in emmetropes (127 ± 51 minutes) compared to myopes (91 ± 44 minutes, p < 0.001). No significant differences were found between the average daily physical activity levels of myopes and emmetropes (p > 0.05).\r\nCONCLUSIONS\r\nMyopic children exhibit significantly lower daily light exposure, but no significant difference in physical activity compared to emmetropic children. This suggests the important factor involved in documented associations between myopia and outdoor activity is likely exposure to bright outdoor light rather than greater physical activity.

Recio-Rodríguez, José I.; Martín-Cantera, Carlos; González-Viejo, Natividad; Gómez-Arranz, Amparo; Arietaleanizbeascoa, Maria S.; Schmolling-Guinovart, Yolanda et al. (2014): Effectiveness of a smartphone application for improving healthy lifestyles, a randomized clinical trial (EVIDENT II): study protocol. In: BMC Public Health 14, S. 254. DOI: 10.1186/1471-2458-14-254.

BACKGROUND\r\nNew technologies could facilitate changes in lifestyle and improve public health. However, no large randomized, controlled studies providing scientific evidence of the benefits of their use have been made. The aims of this study are to develop and validate a smartphone application, and to evaluate the effect of adding this tool to a standardized intervention designed to improve adherence to the Mediterranean diet and to physical activity. An evaluation is also made of the effect of modifying habits upon vascular structure and function, and therefore on arterial aging.\r\nMETHODS/DESIGN\r\nA randomized, double-blind, multicenter, parallel group clinical trial will be carried out. A total of 1215 subjects under 70 years of age from the EVIDENT trial will be included. Counseling common to both groups (control and intervention) will be provided on adaptation to the Mediterranean diet and on physical activity. The intervention group moreover will receive training on the use of a smartphone application designed to promote a healthy diet and increased physical activity, and will use the application for three months. The main study endpoints will be the changes in physical activity, assessed by accelerometer and the 7-day Physical Activity Recall (PAR) interview, and adaptation to the Mediterranean diet, as evaluated by an adherence questionnaire and a food frequency questionnaire (FFQ). Evaluation also will be made of vascular structure and function based on central arterial pressure, the radial augmentation index, pulse velocity, the cardio-ankle vascular index, and carotid intima-media thickness.\r\nDISCUSSION\r\nConfirmation that the new technologies are useful for promoting healthier lifestyles and that their effects are beneficial in terms of arterial aging will have important clinical implications, and may contribute to generalize their application in favor of improved population health.\r\nTRIAL REGISTRATION\r\nClinical Identifier: NCT02016014.

Reitzel, Lorraine R.; Kendzor, Darla E.; Nguyen, Nga; Regan, Seann D.; Okuyemi, Kolawole S.; Castro, Yessenia et al. (2014): Shelter proximity and affect among homeless smokers making a quit attempt. In: Am J Health Behav 38 (2), S. 161–169. DOI: 10.5993/AJHB.38.2.1.

OBJECTIVES\r\nTo explore the associations between shelter proximity and real-time affect during a specific smoking quit attempt among 22 homeless adults.\r\nMETHODS\r\nAffect was measured via 485 smartphone-based Ecological Momentary Assessments randomly administered during the weeks immediately before and after the quit day, and proximity to the shelter was measured via GPS. Adjusted linear mixed model regressions examined associations between shelter proximity and affect.\r\nRESULTS\r\nCloser proximity to the shelter was associated with greater negative affect only during the post-quit attempt week (p = .008). All participants relapsed to smoking by one week post-quit attempt.\r\nCONCLUSIONS\r\nAmong homeless smokers trying to quit, the shelter may be associated with unexpected negative affect/stress. Potential intervention applications are suggested.

Reynoldson, Charmian; Stones, Catherine; Allsop, Matthew; Gardner, Peter; Bennett, Michael I.; Closs, S. José et al. (2014): Assessing the quality and usability of smartphone apps for pain self-management. In: Pain Med 15 (6), S. 898–909. DOI: 10.1111/pme.12327.

OBJECTIVE\r\nTo evaluate smartphone apps intended for self-management of pain using quality assessment criteria and usability testing with prospective users.\r\nDESIGN\r\n1) Survey and content analysis of available apps; and 2) individual usability study of two apps.\r\nSETTING\r\nUniversity of Leeds, United Kingdom.\r\nPARTICIPANTS\r\nForty-one participants (aged 19-59 years) with experience of chronic or recurrent pain episodes.\r\nMETHODS\r\nWe undertook a survey, content analysis, and quality appraisal of all currently available mobile phone apps for self-management of pain. Two apps were then selected and assessed with usability testing.\r\nRESULTS\r\nTwelve apps met the inclusion criteria. The quality assessment revealed wide variation in their clinical content, interface design, and usability to support self-management of pain. Very little user or clinician involvement was identified in the development of the apps. From the usability testing, participants stated a preference for an interface design employing a lighter color scheme and particular text font. Although very few participants were aware of pain-reporting apps prior to participation, many would consider use in the future.\r\nCONCLUSIONS\r\nVariation in app quality and a lack of user and clinician engagement in development were found across the pain apps in this research. Usability testing identified a range of user preferences. Although useful information was obtained, it would be beneficial to involve users earlier in the process of development, as well as establishing ways to merge end user requirements with evidence-based content, to provide high-quality and usable apps for self-management of pain.

Rhee, Moo-Yong; Kim, Ji-Hyun; Kim, Yong-Seok; Chung, Jin-Wook; Bae, Jun-Ho; Nah, Deuk-Young et al. (2014): High sodium intake in women with metabolic syndrome. In: Korean Circ J 44 (1), S. 30–36. DOI: 10.4070/kcj.2014.44.1.30.

BACKGROUND AND OBJECTIVES\r\nMetabolic syndrome and high sodium intake are associated with frequent cardiovascular events. Few studies have estimated sodium intake in subjects with metabolic syndrome by 24-hour urine sodium excretion. We evaluated sodium intake in individuals with metabolic syndrome.\r\nSUBJECTS AND METHODS\r\nParticipants were recruited by random selection and through advertisement. Twenty four-hour urine collection, ambulatory blood pressure measurements, and blood test were performed. Sodium intake was estimated by 24-hour urine sodium excretion. Participants receiving antihypertensive medications were excluded from analysis.\r\nRESULTS\r\nAmong the 463 participants recruited, subjects with metabolic syndrome had higher levels of 24-hour urine sodium excretion than subjects without metabolic syndrome (p=0.0001). There was a significant relationship between the number of metabolic syndrome factors and 24-hour urine sodium excretion (p=0.001). The proportion of subjects with metabolic syndrome was increased across the tertile groups of 24-hour urine sodium excretion (p<0.0001). The association of high sodium intake and metabolic syndrome was significant only among women. Among the factors related to metabolic syndrome, body mass index had an independent association with 24-hour urine sodium excretion (p<0.0001).\r\nCONCLUSION\r\nWomen with metabolic syndrome exhibited significantly higher sodium intake, suggesting that dietary education to reduce sodium consumption should be emphasized for women with metabolic syndrome.

Riediger, Michaela; Wrzus, Cornelia; Klipker, Kathrin; Müller, Viktor; Schmiedek, Florian; Wagner, Gert G. (2014): Outside of the laboratory: Associations of working-memory performance with psychological and physiological arousal vary with age. In: Psychol Aging 29 (1), S. 103–114. DOI: 10.1037/a0035766.

We investigated age differences in associations among self-reported experiences of tense and energetic arousal, physiological activation indicated by heart rate, and working-memory performance in everyday life. The sample comprised 92 participants aged 14-83 years. Data were collected for 24 hr while participants pursued their normal daily routines. Participants wore an ambulatory biomonitoring system that recorded their cardiac and physical activity. Using mobile phones as assessment devices, they also provided an average of 7 assessments of their momentary experiences of tense arousal (feeling nervous) and energetic arousal (feeling wide-awake) and completed 2 trials of a well-practiced working-memory task. Experiences of higher energetic arousal were associated with higher heart rate in participants younger than 50 years of age but not in participants older than that, and energetic arousal was unrelated to within-person fluctuations in working-memory performance. Experiences of tense arousal were associated with higher heart rate independent of participants’ age. Tense arousal and physiological activation were accompanied by momentary impairments in working-memory performance in middle-aged and older adults but not in younger individuals. Results suggest that psychological arousal experiences are associated with lower working-memory performance in middle-aged and older adults when they are accompanied by increased physiological activation and that the same is true for physiological activation deriving from other influences. Hence, age differences in cognitive performance may be exaggerated when the assessment situation itself elicits tense arousal or occurs in situations with higher physiological arousal arising from affective experiences, physical activity, or circadian rhythms.

Rotenberg, Sivan; McGrath, Jennifer J. (2014): Sampling compliance for cortisol upon awakening in children and adolescents. In: Psychoneuroendocrinology 40, S. 69–75. DOI: 10.1016/j.psyneuen.2013.10.002.

Compliance with awakening salivary sampling is important for precise measurement of the diurnal cortisol profile. During childhood and adolescence, developmental factors influence sampling upon awakening (awake0) due to school routine, sleep/wake patterns, and age related cortisol changes. In the present study, children and adolescents’ sampling compliance of awakening cortisol was evaluated using accelerometry. Children and adolescents (N=201; 45.3% female; 8-18 years; Mage=12.68 years, SD=2.03) participating in the Healthy Heart Project collected saliva samples, wore a tri-axle accelerometer, and completed demographic questionnaires. Intra-class correlations derived to examine awake0 sampling compliance indicated children and adolescents were highly compliant (ICC=.98). In children, a delay in awake0 sampling was associated with a steeper diurnal slope (β=-.23, p=.037) and greater awake0 cortisol (β=.24, p=.024); this was not observed in adolescents. In summary, children and adolescents are compliant with awakening salivary sampling. Sampling delay, particularly in children, and time of awakening influenced measures of the diurnal cortisol profile. These findings inform future studies assessing the diurnal cortisol profile in children and adolescents.

Roth, Marilyn A.; Mindell, Jennifer S. (2013): Who provides accelerometry data? Correlates of adherence to wearing an accelerometry motion sensor: the 2008 Health Survey for England. In: J Phys Act Health 10 (1), S. 70–78.

BACKGROUND: Use of objective physical activity measures is rising. We investigated the representativeness of survey participants who wore an accelerometer. METHODS: 4273 adults aged 16+ from a cross-sectional survey of a random, nationally representative general population sample in England in 2008 were categorized as 1) provided sufficient accelerometry data [4-7 valid days (10+ hrs/d), n = 1724], 2) less than that (n = 237), or 3) declined (n = 302). Multinomial logistic regression identified demographic, socioeconomic, health, lifestyle, and biological correlates of participants in these latter 2 groups, compared with those who provided sufficient accelerometry data (4+ valid days). RESULTS: Those in the random subsample offered the accelerometer were older and more likely to be retired and to report having a longstanding limiting illness than the rest of the adult Health Survey for England participants. Compared with those providing sufficient accelerometry data, those wearing the accelerometer less were younger, less likely to be in paid employment, and more likely to be a current smoker. Those who declined to wear an accelerometer did not differ significantly from those who wore it for sufficient time. CONCLUSIONS: We found response bias in wearing the accelerometers for sufficient time, but refusers did not differ from those providing sufficient data. Differences should be acknowledged by data users.

Rozov-Ung, Inna; Mreyoud, Amjad; Moore, John; Wilding, Gregory E.; Khawam, Elias; Lackner, Jeffrey M. et al. (2014): Detection of drug effects on gastric emptying and contractility using a wireless motility capsule. In: BMC Gastroenterol 14, S. 2. DOI: 10.1186/1471-230X-14-2.

BACKGROUND\r\nA wireless motility capsule is a new method for ambulatory assessment of transit times and motility throughout the gastrointestinal tract. The objective of this study was to evaluate the ability of a wireless motility capsule to detect drug effects on gastric emptying time (GET) and gastric contractility.\r\nMETHODS\r\n15 healthy adults were administered in random order saline, erythromycin IV 150 mg, or morphine IV 0.05 mg/kg BW. Subjects ate a standard meal after each infusion, and subsequently ingested the motility capsule. Data were recorded for 8 hours, and the results were analyzed using the manufacturer’s software.\r\nRESULTS\r\nGET was significantly faster after erythromycin than either saline or morphine. Morphine tended to delay emptying of the capsule compared to saline. There was a trend toward a greater frequency of gastric contractions with erythromycin and a reduced frequency of gastric contractions with morphine that did not reach statistical significance.\r\nCONCLUSIONS\r\nA wireless motility capsule successfully detected acceleration of gastric emptying induced by erythromycin, and retardation of gastric motility caused by morphine. These results indicate that a wireless motility capsule is a promising technique to assess pharmacologic effects on gastric transit and contractility and aid in development of drugs for gastric motor disorders.

Rullier, Laetitia; Atzeni, Thierry; Husky, Mathilde; Bouisson, Jean; Dartigues, Jean-François; Swendsen, Joel; Bergua, Valerie (2014): Daily life functioning of community-dwelling elderly couples: an investigation of the feasibility and validity of Ecological Momentary Assessment. In: Int J Methods Psychiatr Res 23 (2), S. 208–216. DOI: 10.1002/mpr.1425.

Although ambulatory data collection techniques have been used in elderly populations, their feasibility and validity amongst elderly individuals with cognitive impairment and amongst couples remains unexplored. The main objective of this study is to examine the validity of Ecological Momentary Assessment (EMA) in elderly persons with or without cognitive impairment and their spouses. The sample included 58 retired farmers (mean 77.3 years, standard deviation [SD] 5.5) with or without cognitive impairment, recruited within a French cohort and 60 spouses (mean 73.4 years, SD 6.9). The presence of cognitive impairment determining by a panel of specialized neurologists permitted to define two groups: \”The Cognitive Impairment Group\” and \”The Control Group\”. EMA procedures consisted of repeated telephone interviews five times per day during four days for each spouse. Our results demonstrate the validity of EMA procedures through a 92.1% level of compliance, the absence of fatigue effects, and the lack of evidence for major reactivity to the methods. However, the specificity of our sample may explain the acceptance (42%) and response (75%) rates and may reduce the generalizability of the results to the general population of elderly individuals. Finally, the validation of such techniques may contribute to future research examining community-dwelling elderly individuals and their spouses.

Sacco, Paul; Smith, Cristan A.; Harrington, Donna; Svoboda, Deborah V.; Resnick, Barbara (2014): Feasibility and Utility of Experience Sampling to Assess Alcohol Consumption Among Older Adults. In: J Appl Gerontol. DOI: 10.1177/0733464813519009.

In the literature on alcohol use and aging, drinking has often been conceptualized as a means of coping with negative feelings, such as stress, yet much of the literature on older adults and drinking has utilized cross-sectional or other data ill-suited for exploring dynamic processes. Experience sampling methods have the ability to measure and analyze dynamic processes in real time, such as relations between alcohol use and mood states. Nonetheless, these approaches are intensive and may burden respondents. Therefore, this study evaluated the feasibility, acceptability, and validity of a modified daily diary to measure alcohol use and explored alternate methods of collecting diary data. Findings suggest that a modified diary was acceptable and not burdensome. Respondents were reluctant to consider technology (e.g., cellphone)-based means of data collection. Measures of alcohol use showed little within-person variation suggesting that for those who drink at all, drinking is a daily habit.

Sanders, Taren; Cliff, Dylan P.; Lonsdale, Chris (2014): Measuring adolescent boys’ physical activity: bout length and the influence of accelerometer epoch length. In: PLoS ONE 9 (3), S. e92040. DOI: 10.1371/journal.pone.0092040.

OBJECTIVES\r\nAccurate, objective measurement is important for understanding adolescents’ physical activity (PA) behaviour. When using accelerometry to objectively measure PA, a decision must be made regarding how frequently data is recorded (i.e., epoch length). The purpose of this study was to examine i) PA bout length, and ii) the effect of variations in accelerometer epoch length on PA estimates during physical education (PE) and leisure time in adolescent boys.\r\nDESIGN\r\nCross-sectional study.\r\nMETHODS\r\nYear 9 boys (N = 133; mean age ±SD  = 14.36±0.48 years) wore accelerometers during two PE lessons, and for a period of seven consecutive days. Data were reintegrated from 1s into longer periods of 2, 5, 10, 30, and 60 seconds. ANOVAs were used to test for differences in PA estimates between epochs in leisure time and PE.\r\nRESULTS\r\nThe mean length of vigorous PA (VPA) bouts was 3.5±2.0 seconds for PE and 2.5±1.7 seconds for leisure time, and mean length of moderate PA (MPA) bouts was 2.3±0.5 seconds for PE and 2.9±0.5 seconds for leisure time. During PE, estimates of MVPA, MPA, and light PA (LPA) increased as epoch increased from 1 second to 60 seconds, while VPA and sedentary behaviour estimates decreased. During leisure time, estimates of all PA intensities decreased as epoch increased from 1 second to 60 seconds, with the exception of sedentary behaviour, which increased as epoch length increased.\r\nCONCLUSION\r\nThe context in which PA occurs can influence PA bout length measurement and the effect of variations in epoch length on PA estimates. Researchers measuring PA with accelerometry should be conscious of the possible influence of context on PA estimates.

Saramäki, Jari; Leicht, E. A.; López, Eduardo; Roberts, Sam G B; Reed-Tsochas, Felix; Dunbar, Robin I M (2014): Persistence of social signatures in human communication. In: Proc. Natl. Acad. Sci. U.S.A. 111 (3), S. 942–947. DOI: 10.1073/pnas.1308540110.

The social network maintained by a focal individual, or ego, is intrinsically dynamic and typically exhibits some turnover in membership over time as personal circumstances change. However, the consequences of such changes on the distribution of an ego’s network ties are not well understood. Here we use a unique 18-mo dataset that combines mobile phone calls and survey data to track changes in the ego networks and communication patterns of students making the transition from school to university or work. Our analysis reveals that individuals display a distinctive and robust social signature, captured by how interactions are distributed across different alters. Notably, for a given ego, these social signatures tend to persist over time, despite considerable turnover in the identity of alters in the ego network. Thus, as new network members are added, some old network members either are replaced or receive fewer calls, preserving the overall distribution of calls across network members. This is likely to reflect the consequences of finite resources such as the time available for communication, the cognitive and emotional effort required to sustain close relationships, and the ability to make emotional investments.

Schaffer, Ayal; Kreindler, David; Reis, Catherine; Levitt, Anthony J. (2013): Use of mental health telemetry to enhance identification and predictive value of early changes during augmentation treatment of major depression. In: J Clin Psychopharmacol 33 (6), S. 775–781. DOI: 10.1097/JCP.0b013e31829e8359.

Standard clinical trial methodology in depression does not allow for careful examination of early changes in symptom intensity. The purpose of this study was to use daily \”Mental Health Telemetry\” (MHT) to prospectively record change in depressive and anxiety symptoms for depressed patients receiving augmentation treatment, and determine the extent and predictive capacity of early changes. We report results of a 6-week, open-label study of the addition of quetiapine XR (range, 50-300 mg) for adult patients (n = 26) with major depressive disorder who were nonresponsive to antidepressant treatment. In addition to regular study visits, all participants completed daily, wirelessly transmitted self-report ratings of symptoms on a Smartphone. Daily and 3-day moving average mean scores were calculated, and associations between early symptom change and eventual response to treatment were determined. Improvement in depressive and anxiety symptoms was identified as early as day 1 of treatment. Of the total decline in depression severity over 6 weeks, 9% was present at day 1, 28% at day 2, 39% at days 3 and 4, 65% at day 7, and 80% at day 10. Self-report rating of early improvement (≥20%) in depressive symptoms at day 7 significantly predicted responder status at week 6 (P = 0.03). Clinician-rated depressive and anxiety symptoms only became significantly associated with responder status at day 14. In conclusion, very early changes in depressive symptoms were identified using MHT, early changes accounted for most of total change, and MHT-recorded improvement as early as day 7 significantly predicted response to treatment at study end point.

Schreiber-Gregory, Deanna N.; Lavender, Jason M.; Engel, Scott G.; Wonderlich, Steve A.; Crosby, Ross D.; Peterson, Carol B. et al. (2013): Examining duration of binge eating episodes in binge eating disorder. In: Int J Eat Disord 46 (8), S. 810–814. DOI: 10.1002/eat.22164.

OBJECTIVE\r\nThe primary goal of this article is to examine and clarify characteristics of binge eating in individuals with binge eating disorder (BED), particularly the duration of binge eating episodes, as well as potential differences between individuals with shorter compared to longer binge eating episodes.\r\nMETHOD\r\nTwo studies exploring binge eating characteristics in BED were conducted. Study 1 examined differences in clinical variables among individuals (N = 139) with BED who reported a short (<2 h) versus long (≥ 2 h) average binge duration. Study 2 utilized an ecological momentary assessment design to examine the duration and temporal pattern of binge eating episodes in the natural environment in a separate sample of nine women with BED.\r\nRESULTS\r\nParticipants in Study 1 who were classified as having long duration binge eating episodes displayed greater symptoms of depression and lower self-esteem, but did not differ on other measures of eating disorder symptoms, compared to those with short duration binge eating episodes. In Study 2, the average binge episode duration was approximately 42 min, and binge eating episodes were most common during the early afternoon and evening hours, as well as more common on weekdays versus weekends.\r\nDISCUSSION\r\nPast research on binge episode characteristics, particularly duration, has been limited to studies of binge eating episodes in bulimia nervosa. This study contributes to the existing literature on characteristics of binge eating in BED.

Selby, Edward A.; Nock, Matthew K.; Kranzler, Amy (2014): How does self-injury feel? Examining automatic positive reinforcement in adolescent self-injurers with experience sampling. In: Psychiatry Res 215 (2), S. 417–423. DOI: 10.1016/j.psychres.2013.12.005.

One of the most frequently reported, yet understudied, motivations for non-suicidal self-injury (NSSI) involves automatic positive reinforcement (APR), wherein sensations arising from NSSI reinforce and promote the behavior. The current study used experience sampling methodology with a clinical sample of self-injuring adolescents (N=30) over a 2-week period during which the adolescents reported NSSI behaviors, and rated if an APR motivation was present, and if so whether that motivation pertained to feeling \”pain,\” \”stimulation,\” or \”satisfaction.\” Over 50% of the sample reported at least one instance of NSSI for APR reasons. No significant differences were found on demographic factors or psychiatric comorbidity for those with and without an APR motivation. However, those with an APR motivation reported elevated NSSI thoughts, longer duration of those thoughts, and more NSSI behaviors. They also reported more alcohol use thoughts, alcohol use, impulsive spending, and binge eating. The most commonly reported sensation following NSSI for APR was \”satisfaction.\” However those endorsing feeling pain reported the most NSSI behaviors. These findings provide new information about the APR motivations for NSSI and shed light on the different sensations felt.

Shiffman, Saul; Dunbar, Michael S.; Li, Xiaoxue; Scholl, Sarah M.; Tindle, Hilary A.; Anderson, Stewart J.; Ferguson, Stuart G. (2014): Craving in intermittent and daily smokers during ad libitum smoking. In: Nicotine Tob. Res. 16 (8), S. 1063–1069. DOI: 10.1093/ntr/ntu023.

INTRODUCTION\r\nThis study aimed to assess average and peak craving intensity among nondaily intermittent smokers (ITS) in smoking episodes and when not smoking compared to that of daily smokers (DS).\r\nMETHODS\r\nTwo hundred and twelve ITS and 194 DS monitored their smoking and craving for 3 weeks using Ecological Momentary Assessment methods. Craving was assessed (0-100 scale) when subjects lit a cigarette and at random times when not smoking; 48,469 observations were analyzed using generalized estimating equations.\r\nRESULTS\r\nITS experienced craving, including intense craving; their 95th percentile intensity averaged 77.7±22.5 out of 100 (higher among DS: 89.1±14.5). ITS reported lower craving than DS, both when smoking and when not smoking. In both groups, craving was less intense when not smoking (DS: 71.1±20.7 vs. 59.83±21.97; ITS: 59.91±23.03 vs. 26.63±19.87), but the difference was significantly greater among ITS. Among ITS, the probability of smoking rose continuously as craving increased over the full range of the scale. In contrast, among DS the probability of smoking rose until the midpoint of the scale, after which the relationship flattened. Findings were mostly similar for ITS with and without a history of past daily smoking.\r\nCONCLUSIONS\r\nITS do experience craving, including intense craving. The relationship between craving and smoking is stronger among ITS because DS experience moderate craving even between cigarettes. In contrast, ITS appear to experience craving in limited situations associated with smoking, suggesting that their craving and smoking may be driven by transient cues rather than endogenous needs.

Shiffman, Saul; Dunbar, Michael S.; Li, Xiaoxue; Scholl, Sarah M.; Tindle, Hilary A.; Anderson, Stewart J.; Ferguson, Stuart G. (2014): Smoking patterns and stimulus control in intermittent and daily smokers. In: PLoS ONE 9 (3), S. e89911. DOI: 10.1371/journal.pone.0089911.

Intermittent smokers (ITS) - who smoke less than daily - comprise an increasing proportion of adult smokers. Their smoking patterns challenge theoretical models of smoking motivation, which emphasize regular and frequent smoking to maintain nicotine levels and avoid withdrawal, but yet have gone largely unexamined. We characterized smoking patterns among 212 ITS (smoking 4-27 days per month) compared to 194 daily smokers (DS; smoking 5-30 cigarettes daily) who monitored situational antecedents of smoking using ecological momentary assessment. Subjects recorded each cigarette on an electronic diary, and situational variables were assessed in a random subset (n=21,539 smoking episodes); parallel assessments were obtained by beeping subjects at random when they were not smoking (n=26,930 non-smoking occasions). Compared to DS, ITS’ smoking was more strongly associated with being away from home, being in a bar, drinking alcohol, socializing, being with friends and acquaintances, and when others were smoking. Mood had only modest effects in either group. DS’ and ITS’ smoking were substantially and equally suppressed by smoking restrictions, although ITS more often cited self-imposed restrictions. ITS’ smoking was consistently more associated with environmental cues and contexts, especially those associated with positive or \”indulgent\” smoking situations. Stimulus control may be an important influence in maintaining smoking and making quitting difficult among ITS.

Shumow, Lee; Schmidt, Jennifer A.; Zaleski, Diana J. (2013): Multiple Perspectives on Student Learning, Engagement, and Motivation in High School Biology Labs. In: The High School Journal 96 (3), S. 232–252. DOI: 10.1353/hsj.2013.0010.

We present three studies pertaining to learning, engagement and motivation during laboratory lessons in three high school biology classrooms. In the first, quantitative methods are used to compare students’ in-the-moment reports of learning, engagement, and motivation during laboratory with other classroom activities. Data were collected with the Experience Sampling Method (ESM). Students reported equivalent learning, less engagement, lower relevance and more enjoyment and interest during lab than during other activities. In the second study, video data from one laboratory lesson pertaining to pH in those classes was coded using event sampling and discourse analysis in an effort to understand the students’ reports. A scientist with expertise in the lab topic also watched the videos while thinking aloud. Results showed that the lab was limited in terms of practices promoting learning, engagement and relevance. Finally, responses from an interview with each teacher and the scientist about the goals and relevance of the laboratory for students were analyzed to shed further light on the findings from the first two studies. Results are discussed in terms of how laboratory lessons might be improved to enhance student learning, engagement, and motivation.

Silvia, Paul J.; Beaty, Roger E.; Nusbaum, Emily C.; Eddington, Kari M.; Levin-Aspenson, Holly; Kwapil, Thomas R. (2014): Everyday creativity in daily life: An experience-sampling study of “little c” creativity. In: Psychology of Aesthetics, Creativity, and the Arts 8 (2), S. 183–188. DOI: 10.1037/a0035722.

Richards proposed that everyday creativity—creative actions that are common among ordinary people in daily life, such as drawing, making recipes, writing, and any activity done with the purpose of being creative—both fosters and reflects psychological health. To explore when people are more likely to do something creative during the day, and to see who tends to act more creatively, we conducted a week-long experience-sampling study with a sample of young adults. Throughout the day, people’s actions and feelings were randomly sampled, with an emphasis on whether people were doing something creative. Consistent with the notion of everyday creativity as a psychological strength, within-person models showed that people who reported feeling happy and active were more likely to be doing something creative at the time. Between-person models found that openness to experience and conscientiousness had large effects on whether people spent their time on creative pursuits. Neither negative states (e.g., momentary feelings of anger, stress, and self-consciousness) nor traits (e.g., neuroticism) significantly predicted creative activity. The findings support Richards’s theorizing about everyday creative behavior as a cause and effect of positive psychological processes, and they illustrate the value of experience sampling for uncovering what creativity looks like in people’s idiosyncratic environments.

Smolders, K.C.H.J.; Kort, Y.A.W. de; van den Berg, S.M. (2013): Daytime light exposure and feelings of vitality: Results of a field study during regular weekdays. In: Journal of Environmental Psychology 36, S. 270–279. DOI: 10.1016/j.jenvp.2013.09.004.

In the current study, we investigated daily light exposure and its relation with vitality in everyday settings on an hour-to-hour basis. The method consisted of experience sampling combined with continuous light measurement and a sleep diary during three consecutive days. Data collection was distributed over a full year. Results revealed substantial inter- and intra-individual differences in hourly light exposure. The amount of light experienced was significantly related to vitality, indicating that persons who were exposed to more light experienced more vitality, over and above the variance explained by person characteristics, time of day, activity patterns and sleep duration during the previous night. This relationship was more pronounced in the morning, during the darker months of the year and when participants had experienced relatively low vitality during the previous hour. Overall, the results provide support for acute effects of light exposure on feelings of vitality during daytime, even in everyday life.

Smyth, Joshua M.; Zawadzki, Matthew J.; Santuzzi, Alecia M.; Filipkowski, Kelly B. (2014): Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients. In: Psychol Health 29 (7), S. 813–831. DOI: 10.1080/08870446.2014.889139.

OBJECTIVE\r\nSocial support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.\r\nDESIGN\r\nCommunity volunteers with asthma (n = 97) or RA (n = 31) responded to EMA prompts five times daily for one week.\r\nMAIN OUTCOMES\r\nBaseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.\r\nRESULTS\r\nSupporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.\r\nCONCLUSION\r\nResults suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.

So, Suzanne Ho-wai; Peters, Emmanuelle Roisin; Swendsen, Joel; Garety, Philippa Anne; Kapur, Shitij (2014): Changes in delusions in the early phase of antipsychotic treatment - an experience sampling study. In: Psychiatry Res 215 (3), S. 568–573. DOI: 10.1016/j.psychres.2013.12.033.

It has been suggested that different aspects of delusions (conviction, distress, preoccupation) respond to treatment at different rates, and that the cognitive bias of ‘Jumping to Conclusions’ (JTC) may predict treatment outcome. This study investigates changes in delusion dimensions using Experience Sampling Methodology (ESM) and the role of JTC as a predictor of change during the initial 2 weeks of antipsychotic treatment on admission to hospital. Sixteen acute patients with delusions were assessed seven times per day for 14 days using computerised ESM. ESM assessed moment-by-moment experiences of affect, psychotic symptoms, and delusion dimensions. Clinical ratings were completed at baseline, 1 week and 2 weeks later. The ‘beads’ task was used to measure JTC at baseline. Delusion dimensions improved over the two weeks of antipsychotic treatment and admission to hospital. Different delusional dimensions changed at different rates, with distress and disruption being more responsive than conviction and preoccupation on both PSYRATS and ESM ratings. Eight out of 16 participants showed a JTC bias on the beads task at baseline. Exploratory analyses showed that JTC predicted changes in the ESM ratings of delusion conviction and distress, suggesting that reasoning biases may predict treatment response.

Spain, Rebecca I.; Mancini, Martina; Horak, Fay B.; Bourdette, Dennis (2014): Body-worn sensors capture variability, but not decline, of gait and balance measures in multiple sclerosis over 18 months. In: Gait Posture 39 (3), S. 958–964. DOI: 10.1016/j.gaitpost.2013.12.010.

Gait and balance deficits are a frequent complaint in MS but poorly captured by stopwatch-timed tests or rating scales. Body-worn accelerometers and gyroscopes are able to detect gait and balance abnormalities in people with MS who have normal walking speeds. Few longitudinal studies exist using this technology to study the evolution of mobility deficits. The purpose of this study was to determine if body-worn sensors detected any decline in gait and balance measures in people with MS over time. Twenty-seven people with MS (13 mildly disabled, self-rated expanded disability status scale 0-3.5; 14 moderately disabled, SR-EDSS 4.0-5.5) who had normal walking speeds and 18 matched control subjects underwent gait and balance testing using body-worn sensors every 6 months for 18 months. While no parameter worsened over time, the moderately disabled MS cohort performed more poorly than the mildly disabled MS cohort who, in turn, was worse than control subjects for both objective and subjective walking and balance measures. Furthermore, the moderately disabled MS cohort demonstrated greater variation in between-visit performance than did the less disabled MS cohort or controls (Bonferroni-corrected p<0.05). Variability may be a key indicator of worsening gait and balance disability in MS.

Stinson, Jennifer N.; Jibb, Lindsay A.; Lalloo, Chitra; Feldman, Brian M.; McGrath, Patrick J.; Petroz, Guy C. et al. (2014): Comparison of Average Weekly Pain Using Recalled Paper and Momentary Assessment Electronic Diary Reports in Children with Arthritis. In: Clin J Pain. DOI: 10.1097/AJP.0000000000000072.

OBJECTIVE:: The current study investigated the construct validity of a multidimensional pain diary for youth with juvenile idiopathic arthritis and also compared participants’ responses on electronic and retrospective diary measures. The purpose of the latter part of this study was to compare absolute agreement, between and within-person consistency and judged change in weekly pain between these two methods of assessing pain. METHODS:: 70 adolescents with Juvenile Idiopathic Arthritis (JIA) completed both weekly recalled and momentary reports of pain over a 2-week period and assessed their change in pain over the 2-week period using 5-point global change in pain scale. Pearson correlations and intra-class correlation coefficients were computed to demonstrate three different ways of comparing the measures on both a between-persons and within-person basis. RESULTS:: Momentary ratings of pain episodes were consistently greater than weekly ratings of recalled pain. Moderate to strong consistency and agreement correlations were computed for between-person momentary and recalled pain intensity. However, these correlations were much weaker when the within-person data were analyzed. The judged change in pain across weeks was significantly associated with computed change in both average momentary and recalled pain. DISCUSSION:: This is one of the few studies to explore the relationship between the measurement methods of pain recall and momentary assessment in adolescents. The poor within-person correlations observed have important implications for research design and practice in pediatric pain.

Stopczynski, Arkadiusz; Stahlhut, Carsten; Larsen, Jakob Eg; Petersen, Michael Kai; Hansen, Lars Kai (2014): The smartphone brain scanner: a portable real-time neuroimaging system. In: PLoS ONE 9 (2), S. e86733. DOI: 10.1371/journal.pone.0086733.

Combining low-cost wireless EEG sensors with smartphones offers novel opportunities for mobile brain imaging in an everyday context. Here we present the technical details and validation of a framework for building multi-platform, portable EEG applications with real-time 3D source reconstruction. The system-Smartphone Brain Scanner-combines an off-the-shelf neuroheadset or EEG cap with a smartphone or tablet, and as such represents the first fully portable system for real-time 3D EEG imaging. We discuss the benefits and challenges, including technical limitations as well as details of real-time reconstruction of 3D images of brain activity. We present examples of brain activity captured in a simple experiment involving imagined finger tapping, which shows that the acquired signal in a relevant brain region is similar to that obtained with standard EEG lab equipment. Although the quality of the signal in a mobile solution using an off-the-shelf consumer neuroheadset is lower than the signal obtained using high-density standard EEG equipment, we propose mobile application development may offset the disadvantages and provide completely new opportunities for neuroimaging in natural settings.

Takano, Keisuke; Sakamoto, Shinji; Tanno, Yoshihiko (2014): Repetitive thought impairs sleep quality: an experience sampling study. In: Behav Ther 45 (1), S. 67–82. DOI: 10.1016/j.beth.2013.09.004.

Although previous research has suggested that presleep negative cognitive activities are associated with poor sleep quality, there is little evidence regarding the association between negative thoughts and sleep in real-life settings. The present study used experience sampling and long-term sleep monitoring with actigraphy to investigate the relationships among negative repetitive thought, mood, and sleep problems. During a 1-week sampling period, 43 undergraduate students recorded their thought content and mood eight times a day at semirandom intervals. In addition to these subjective reports, participants wore actigraphs on their wrists in order to measure sleep parameters. Analyses using multilevel modeling showed that repetitive thought in the evening was significantly associated with longer sleep-onset latency, decreased sleep efficiency, and reduced total sleep time. Furthermore, impaired sleep quality was significantly associated with reduced positive affect the next morning, and decreased positive affect was indirectly associated with increased repetitive thought in the evening. These findings suggest the existence of a self-reinforcing cycle involving repetitive thought, mood, and impaired sleep quality, highlighting the importance of cognitive and emotional factors in enhancement and maintenance of good-quality sleep.

Takano, Keisuke; Ueno, Mayumi; Tanno, Yoshihiko (2014): Self-focused thinking predicts nighttime physiological de-arousal. In: Biol Psychol 97, S. 9–14. DOI: 10.1016/j.biopsycho.2014.01.001.

Excessive focus on the internal self has maladaptive consequences for mental and physical health. Although the emotional functions of self-focus have been well established, no study has examined physiological arousal during the daily experience of self-focused thinking. The present study investigates the association between self-focus and autonomic activity using the experience sampling method with ambulatory monitoring of heart rate variability (HRV). Forty-five students reported the content of their thoughts during their daily activities while their heart rate (HR) was being recorded. Multilevel modeling analyses showed that HRV was lower (and HR was higher) over the sampling day if participants engaged in more self-focus, while HRV increased (and HR decreased) from midday to nighttime if participants did not engage in self-focused thinking. These results suggest that self-focus at night is associated with increased physiological arousal, and leads to inhibition of de-arousal associated with normal sleep processes. Implications for insomnia are discussed.

Teacher, Amber G F; Griffiths, David J.; Hodgson, David J.; Inger, Richard (2013): Smartphones in ecology and evolution: a guide for the app-rehensive. In: Ecol Evol 3 (16), S. 5268–5278. DOI: 10.1002/ece3.888.

Smartphones and their apps (application software) are now used by millions of people worldwide and represent a powerful combination of sensors, information transfer, and computing power that deserves better exploitation by ecological and evolutionary researchers. We outline the development process for research apps, provide contrasting case studies for two new research apps, and scan the research horizon to suggest how apps can contribute to the rapid collection, interpretation, and dissemination of data in ecology and evolutionary biology. We emphasize that the usefulness of an app relies heavily on the development process, recommend that app developers are engaged with the process at the earliest possible stage, and commend efforts to create open-source software scaffolds on which customized apps can be built by nonexperts. We conclude that smartphones and their apps could replace many traditional handheld sensors, calculators, and data storage devices in ecological and evolutionary research. We identify their potential use in the high-throughput collection, analysis, and storage of complex ecological information.

Thompson, Debbe; Cantu, Dora; Bhatt, Riddhi; Baranowski, Tom; Rodgers, Wendy; Jago, Russell et al. (2014): Texting to Increase Physical Activity Among Teenagers (TXT Me!): Rationale, Design, and Methods Proposal. In: JMIR Res Protoc 3 (1), S. e14. DOI: 10.2196/resprot.3074.

BACKGROUND\r\nPhysical activity decreases from childhood through adulthood. Among youth, teenagers (teens) achieve the lowest levels of physical activity, and high school age youth are particularly at risk of inactivity. Effective methods are needed to increase youth physical activity in a way that can be maintained through adulthood. Because teens text a great deal, text messages promoting walking, a low cost physical activity, may be an effective method for promoting sustainable physical activity.\r\nOBJECTIVE\r\nThe objective of our study was to determine the effect of pedometers, self selected step goals, and texts grounded in the self-determination theory (SDT) on physical activity among the teens.\r\nMETHODS\r\n\”TXT Me!\” was a 12 week intervention that texted 14-17 year olds to increase their daily physical activity by increasing the number of steps they take each day. The intervention was grounded in the SDT. Formative research with the teens helped construct the intervention and develop the texts. A total of 84 texts were developed (12 to set a step goal, and 72 promoting autonomy, competence, and relatedness). The pilot evaluation used a four group, randomized design (n=160). After baseline data collection, the participants were randomized to one of four conditions (no treatment control, pedometer only, pedometer + weekly prompts, pedometer + weekly prompts + SDT grounded texts). Data were collected at baseline and immediately upon completion of the study. The primary outcome was physical activity, measured by 7 days of accelerometry. Basic psychological needs, physical activity motivation, process evaluation, and program satisfaction data were also collected.\r\nRESULTS\r\nTo our knowledge, this is one of the first studies to explore the use of stand alone, SDT grounded texts, supported by pedometers and prompts to set a self selected step goal, as a method for increasing physical activity among teens.\r\nCONCLUSIONS\r\nThis pilot study will contribute valuable information regarding whether theoretically grounded text messages show promise as an effective method to increase physical activity among teens.\r\nTRIAL REGISTRATION\r\ NCT01482234; (Archived by WebCite at

Tikkanen, Olli; Karkkainen, Salme; Haakana, Piia; Kallinen, Mauri; Pullinen, Teemu; Finni, Taija (2014): EMG, Heart Rate, and Accelerometer as Estimators of Energy Expenditure in Locomotion. In: Med Sci Sports Exerc. DOI: 10.1249/MSS.0000000000000298.

PURPOSE: Precise measures of energy expenditure (EE) during everyday activities are needed. This study assessed the validity of novel shorts measuring electromyography (EMG) and compared this method to heart rate (HR) and accelerometry (ACC) when estimating EE. METHODS: 54 volunteers (39.4 +/- 13.9 yrs) performed a maximal treadmill test (3 min loads) including walking with different speeds uphill, downhill and on level ground and one running load. The data were categorized into all, low and level loads. EE was measured by indirect calorimetry, while HR, ACC and EMG were measured continuously. EMG from quadriceps (Q) and hamstrings (H) was measured using shorts with textile electrodes. Validity of the methods used to estimate EE was compared using Pearson correlations, regression coefficients, linear mixed models providing Akaike information criteria (AIC) and applying cross-validation at the individual and population level. RESULTS: At all loads, correlations with EE were as follows: EMG(QH) 0.94+/-0.03, EMG(Q) 0.91+/-0.03, EMG(H) 0.94+/-0.03, HR 0.96+/-0.04 and ACC 0.77+/-0.10. The corresponding correlations at low loads were 0.89+/-0.08, 0.79+/-0.10, 0.93+/-0.07, 0.89+/-0.23, 0.80+/-0.07 and at level loads they were 0.97+/-0.03, 0.97+/-0.05, 0.96+/-0.04, 0.95+/-0.08, 0.99+/-0.02, respectively. AIC ranked the methods in accordance with the individual correlations. CONCLUSIONS: It is shown for the first time that EMG shorts can be used for EE estimations across a wide range of physical activity intensities in a heterogeneous group. Across all loads HR is a superior method of predicting EE, while ACC is most accurate for level loads at the population level. At low levels of physical activity in changing terrains, thigh muscle EMG provides more accurate EE estimations than ACC and HR if individual calibrations are performed.

Timothy Church, A.; Katigbak, Marcia S.; Ching, Charles M.; Zhang, Hengsheng; Shen, Jiliang; Arias, Rina Mazuera et al. (2013): Within-individual variability in self-concepts and personality states: Applying density distribution and situation-behavior approaches across cultures. In: Journal of Research in Personality 47 (6), S. 922–935.

Within-individual variability in self-concepts and everyday personality states and affects was investigated in two experience sampling studies using density distribution and situation-behavior approaches. In all seven cultures sampled, within-individual variability was substantial and self-concept and personality state variability exhibited moderate convergence. Variability in personality and affect states was moderately predicted by perceived need satisfaction in the situations. The density distribution and situation-behavior approaches were moderately convergent in identifying the most variable individuals, but the pattern of cultural differences differed in the two methods. Contrary to cultural psychology perspectives, cultural differences in within-individual variability did not consistently correspond to cultural differences in individualism–collectivism, dialecticism, or tightness. Keywords: Within-individual variability; Personality states; Culture; Density distributions approach; Situation-behavior profiles

Toftager, Mette; Kristensen, Peter Lund; Oliver, Melody; Duncan, Scott; Christiansen, Lars Breum; Boyle, Eleanor et al. (2013): Accelerometer data reduction in adolescents: effects on sample retention and bias. In: Int J Behav Nutr Phys Act 10, S. 140. DOI: 10.1186/1479-5868-10-140.

BACKGROUND\r\nAccelerometry is increasingly being recognized as an accurate and reliable method to assess free-living physical activity (PA) in children and adolescents. However, accelerometer data reduction criteria remain inconsistent, and the consequences of excluding participants in for example intervention studies are not well described. In this study, we investigated how different data reduction criteria changed the composition of the adolescent population retained in accelerometer data analysis.\r\nMETHODS\r\nAccelerometer data (Actigraph GT3X), anthropometric measures and survey data were obtained from 1348 adolescents aged 11-14 years enrolled in the Danish SPACE for physical activity study. Accelerometer data were analysed using different settings for each of the three key data reduction criteria: (1) number of valid days; (2) daily wear time; and (3) non-wear time. The effects of the selected setting on sample retention and PA counts were investigated and compared. Ordinal logistic regression and multilevel mixed-effect linear regression models were used to analyse the impact of differing non-wear time definitions in different subgroups defined by body mass index, age, sex, and self-reported PA and sedentary levels.\r\nRESULTS\r\nIncreasing the minimum requirements for daily wear time and the number of valid days and applying shorter non-wear definitions, resulted in fewer adolescents retained in the dataset. Moreover, the different settings for non-wear time significantly influenced which participants would be retained in the accelerometer data analyses. Adolescents with a higher BMI (OR:0.93, CI:0.87-0.98, p=0.015) and older adolescents (OR:0.68, CI:0.49-0.95, p=0.025) were more likely to be excluded from analysis using 10 minutes of non-wear compared to longer non-wear time periods. Overweight and older adolescents accumulated more daily non-wear time if the non-wear time setting was short, and the relative difference between groups changed depending on the non-wear setting. Overweight and older adolescents did also accumulate more sedentary time, but this was not significant correlated to the non-wear setting used.\r\nCONCLUSIONS\r\nEven small differences in accelerometer data reduction criteria can have substantial impact on sample size and PA and sedentary outcomes. This study highlighted the risk of introducing bias with more overweight and older adolescents excluded from the analysis when using short non-wear time definitions.

Trudeau, Jeremiah; van Inwegen, Richard; Eaton, Thomas; Bhat, Gajanan; Paillard, Florence; Ng, Dik et al. (2014): Assessment of Pain and Activity Using an Electronic Pain Diary and Actigraphy Device in a Randomized, Placebo-Controlled Crossover Trial of Celecoxib in Osteoarthritis of the Knee. In: Pain Pract. DOI: 10.1111/papr.12167.

OBJECTIVE\r\nThe primary goal was to determine whether a composite measure of pain and activity is a more responsive assessment of analgesic effect than pain alone or activity alone in patients with osteoarthritis (OA) of the knee.\r\nDESIGN\r\nWe conducted a randomized, double-blind, placebo-controlled, 2-period, crossover study of celecoxib vs. placebo in subjects with chronic pain due to knee OA. Patients with knee OA and baseline pain intensity score ≥4 on a 0-10 numerical rating scale (NRS) before each period were randomized. Pain endpoints included in-clinic pain score (24-hour and 1-week recall), daily paper diary pain score, current pain on an electronic pain diary (each on NRS), and WOMAC pain subscale. Activity measures included WOMAC function subscale and actigraphy using a device. Three composite pain-activity measures were prespecified.\r\nRESULTS\r\nSixty-three patients were randomized and 47 completed the study. The WOMAC pain subscale was the most responsive of all five pain measures. Pain-activity composites resulted in a statistically significant difference between celecoxib and placebo but were not more responsive than pain measures alone. However, a composite responder defined as having 20% improvement in pain or 10% improvement in activity yielded much larger differences between celecoxib and placebo than with pain scores alone. Actigraphy was more responsive than the WOMAC function scale, possibly due to lower placebo responsiveness.\r\nCONCLUSION\r\nWe have identified composite pain-activity measures that are similarly or more responsive than pain-alone measures in patients with OA. Further research is warranted to determine the optimal method for computing these composites.

Tupper, Susan M.; Rosenberg, Alan M.; Pahwa, Punam; Stinson, Jennifer N. (2013): Pain intensity variability and its relationship with quality of life in youths with juvenile idiopathic arthritis. In: Arthritis Care Res (Hoboken) 65 (4), S. 563–570. DOI: 10.1002/acr.21850.

OBJECTIVE\r\nTo describe variability of pain intensity experienced by youths with juvenile idiopathic arthritis (JIA) and examine factors related to within-day patterns of pain and the relationship between magnitude of pain variability and quality of life.\r\nMETHODS\r\nPain intensity was self-reported on a visual analog scale (VAS; range 0-100) by 112 youths with JIA ages 8-18 years using electronic diaries 3 times per day for 7 days. Average absolute change in pain (AAC) was computed as a measure of the magnitude of pain variability for each participant. Logistic regression was used to examine the relationship between demographic and disease characteristics and the probability of having high pain variability (AAC ≥10 VAS units). Linear regression was used to examine the relationship between quality of life (assessed by the Pediatric Quality of Life Inventory) and AAC. The generalized estimating equations approach was used to examine the relationship between the time of day and pain intensity.\r\nRESULTS\r\nThe mean ± SD AAC was 15.6 ± 10.5. The majority of youths (65%) had high AAC (≥10 VAS units). Disease severity predicted high pain variability (β = 0.02, P = 0.044). Higher AAC predicted lower quality of life (adjusted R(2) = 0.194, β = -0.59, P = 0.003). Within-day patterns of pain intensity varied by JIA subtype and sex.\r\nCONCLUSION\r\nThis study characterized the pain intensity variability experienced by youths with JIA. Pain variability throughout the day was common, varied by JIA subtype and sex, and was related to quality of life. These findings have implications for future pain research, patient education, and development of clinical interventions for this population.

van der Weegen, Sanne; Verwey, Renée; Tange, Huibert J.; Spreeuwenberg, Marieke D.; de Witte, Luc P (2014): Usability testing of a monitoring and feedback tool to stimulate physical activity. In: Patient Prefer Adherence 8, S. 311–322. DOI: 10.2147/PPA.S57961.

INTRODUCTION\r\nA MONITORING AND FEEDBACK TOOL TO STIMULATE PHYSICAL ACTIVITY, CONSISTING OF AN ACTIVITY SENSOR, SMARTPHONE APPLICATION (APP), AND WEBSITE FOR PATIENTS AND THEIR PRACTICE NURSES, HAS BEEN DEVELOPED: the ‘It’s LiFe!’ tool. In this study the usability of the tool was evaluated by technology experts and end users (people with chronic obstructive pulmonary disease or type 2 diabetes, with ages from 40-70 years), to improve the user interfaces and content of the tool.\r\nPATIENTS AND METHODS\r\nTHE STUDY HAD FOUR PHASES: 1) a heuristic evaluation with six technology experts; 2) a usability test in a laboratory by five patients; 3) a pilot in real life wherein 20 patients used the tool for 3 months; and 4) a final lab test by five patients. In both lab tests (phases 2 and 4) qualitative data were collected through a thinking-aloud procedure and video recordings, and quantitative data through questions about task complexity, text comprehensiveness, and readability. In addition, the post-study system usability questionnaire (PSSUQ) was completed for the app and the website. In the pilot test (phase 3), all patients were interviewed three times and the Software Usability Measurement Inventory (SUMI) was completed.\r\nRESULTS\r\nAfter each phase, improvements were made, mainly to the layout and text. The main improvement was a refresh button for active data synchronization between activity sensor, app, and server, implemented after connectivity problems in the pilot test. The mean score on the PSSUQ for the website improved from 5.6 (standard deviation [SD] 1.3) to 6.5 (SD 0.5), and for the app from 5.4 (SD 1.5) to 6.2 (SD 1.1). Satisfaction in the pilot was not very high according to the SUMI.\r\nDISCUSSION\r\nThe use of laboratory versus real-life tests and expert-based versus user-based tests revealed a wide range of usability issues. The usability of the It’s LiFe! tool improved considerably during the study.

van Os, Jim; Lataster, Tineke; Delespaul, Philippe; Wichers, Marieke; Myin-Germeys, Inez (2014): Evidence that a psychopathology interactome has diagnostic value, predicting clinical needs: an experience sampling study. In: PLoS ONE 9 (1), S. e86652. DOI: 10.1371/journal.pone.0086652.

BACKGROUND\r\nFor the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level.\r\nMETHOD\r\nFifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN).\r\nRESULTS\r\nPsychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS measures of psychopathology, similarly moderated by momentary interactions with emotions and context.\r\nCONCLUSION\r\nThe results suggest that psychopathology, represented as an interactome at the momentary level of temporal resolution, is informative in diagnosing clinical needs, over and above traditional symptom measures.

van Remoortel, Hans; Camillo, Carlos Augusto; Langer, Daniel; Hornikx, Miek; Demeyer, Heleen; Burtin, Chris et al. (2013): Moderate intense physical activity depends on selected Metabolic Equivalent of Task (MET) cut-off and type of data analysis. In: PLoS ONE 8 (12), S. e84365. DOI: 10.1371/journal.pone.0084365.

BACKGROUND\r\nAccelerometry data are frequently analyzed without considering whether moderate-to-vigorous physical activities (MVPA) were performed in bouts of >10 minutes as defined in most physical activity guidelines. We aimed i) to quantify MVPA by using different commonly-applied physical activity guidelines, ii) to investigate the effect of bouts versus non-bouts analysis, and iii) to propose and validate a MVPA non-bouts cut-point to classify (in-) active subjects.\r\nMETHODS\r\nHealthy subjects (n=110;62±6yrs) and patients with Chronic Obstructive Pulmonary Disease (COPD) (n=113;62±5yrs) wore an activity monitor for 7 days. Three Metabolic Equivalent of Task (MET) cut-offs and one individual target (50% VO₂ reserve) were used to define MVPA. First, all minutes of MVPA were summed up (NON-BOUTS). Secondly, only minutes performed in bouts of >10 minutes continuous activity were counted (BOUTS). Receiver operating characteristic (ROC) curve analyses were used to propose and (cross-) validate new MVPA non-bout cut-points based on the criterion of 30 minutes MVPA per day (BOUTS). Likelihood ratios (sensitivity/[1-specificity]) were used to express the association between the proposed MVPA non-bout target and the MVPA bout target of 30 min*day⁻¹.\r\nRESULTS\r\nMVPA was variable across physical activity guidelines with lowest values for age-specific cut-offs. Selecting a METs cut-point corresponding to 50% VO₂ reserve revealed no differences in MVPA between groups. MVPA’s analyzed in BOUTS in healthy subjects were 2 to 4 fold lower than NON-BOUTS analyses and this was even 3 to 12 fold lower in COPD. The MVPA non-bouts cut-point of 80 min*day⁻¹ using a 3 METs MVPA threshold delivered positive likelihood ratios of 5.1[1.5-19.6] (healthy subjects) and 2.3[1.6-3.3] (COPD).\r\nCONCLUSION\r\nMVPA varies upon the selected physical activity guideline/targets and bouts versus non-bouts analysis. Accelerometry measured MVPA non-bouts target of 80 min*day⁻¹, using a 3 METs MVPA threshold, is associated to the commonly-used MVPA bout target of 30 min*day⁻¹.

Vandercammen, Leen; Hofmans, Joeri; Theuns, Peter (2014): The mediating role of affect in the relationship between need satisfaction and autonomous motivation. In: J Occup Organ Psychol 87 (1), S. 62–79. DOI: 10.1111/joop.12032.

The relationship between need satisfaction and motivation is well established within self-determination theory (SDT). However, less is known about the affective mechanism that underlies this relationship. In this study, we extend SDT by focusing on the exact role of affect in the need satisfaction–motivation relationship. To this end, we conducted a daily diary study (N = 72) and an experience sampling study (N = 37) in which we tested the mediating role of positive and negative affect in the relationship between satisfaction of the autonomy, competence, and relatedness need on the one hand and autonomous motivation on the other hand. Moreover, alternative models were tested. The results of both studies demonstrated that affect did mediate the need satisfaction–intrinsic motivation relationship. Implications for theory and practice are discussed.

Volz, Angela R.; Dennis, Paul A.; Dennis, Michelle F.; Calhoun, Patrick S.; Wilson, Sarah M.; Beckham, Jean C. (2014): The role of daily hassles and distress tolerance in predicting cigarette craving during a quit attempt. In: Nicotine Tob. Res. 16 (6), S. 872–875. DOI: 10.1093/ntr/ntt286.

INTRODUCTION\r\nEcological momentary assessment (EMA) has shown that smoking behavior is linked to transient variables in the smoker’s immediate context. Such research suggests that daily hassles (e.g., losing one’s keys) may be more likely to lead to cigarette craving and eventual lapse than infrequent, large-scale stressors (e.g., death of a loved one) among individuals attempting to quit smoking. However, individual differences in distress tolerance (DT) may moderate the relationship between daily hassles and daily cigarette craving during a quit attempt.\r\nMETHODS\r\nA sample of 56 veterans and community members drawn from a larger smoking-cessation study completed structured interviews and paper-and-pencil questionnaires during an initial laboratory visit and, directly following a quit attempt, were monitored via EMA. Multilevel modeling was used to examine the relationship between daily hassles and daily cigarette craving and to determine whether DT moderated this relationship.\r\nRESULTS\r\nDaily hassles were positively associated with daily cigarette craving, and this association was moderated by individual differences in DT, such that the lower one’s DT, the stronger the relationship between daily hassles and daily cigarette craving. This model explained 13% of the intraindividual variability and 8% of the interindividual variability in daily cigarette craving.\r\nCONCLUSIONS\r\nSmoking-cessation interventions may be strengthened by targeting smokers’ individual responses to contextual factors, such as by helping smokers develop skills to cope more effectively with distress prior to and during the quit phase.

Voogt, Carmen; Kuntsche, Emmanuel; Kleinjan, Marloes; Poelen, Evelien; Engels, Rutger (2014): Using ecological momentary assessment to test the effectiveness of a web-based brief alcohol intervention over time among heavy-drinking students: randomized controlled trial. In: J. Med. Internet Res. 16 (1), S. e5. DOI: 10.2196/jmir.2817.

BACKGROUND\r\nWeb-based brief alcohol interventions are effective in reducing alcohol use among students when measured at limited follow-up time points. To date, no studies have tested Web-based brief alcohol intervention effectiveness over time by using a large number of measurements.\r\nOBJECTIVE\r\nTesting whether the What Do You Drink (WDYD) Web-based brief alcohol intervention can sustain a reduction in alcohol use among heavy-drinking students aged 18-24 years at 1-, 3-, and 6-month follow-up intervals.\r\nMETHODS\r\nA purely Web-based, 2-arm, parallel-group randomized controlled trial applying an ecological momentary assessment approach with 30 weekly measurements was conducted in the Netherlands (2010-2011). Participants were recruited offline and online. A total of 907 participants were randomized into the experimental condition (n=456) including the single-session and fully automated WDYD intervention, or into the control condition (n=451) including assessment only. Weekly alcohol consumption and frequency of binge drinking were the self-assessed outcome measures.\r\nRESULTS\r\nAttrition rates of the 907 participants were 110 (12.1%), 130 (14.3%), and 162 (17.9%) at 1-, 3-, and 6-month follow-up intervals, respectively. Latent growth curve analyses according to the intention-to-treat principle revealed that participants in the experimental condition had significantly lower weekly alcohol consumption compared to participants in the control condition that was sustained at 3-month follow-up (intercept=-2.60, P<.001; slope=0.16, P=.08). Additional linear regression analyses indicated that this intercept difference resulted from significantly higher levels of alcohol units per week for participants in the control condition compared to those in the experimental condition at 1-month (beta=-2.56, SE 0.74, Cohen’s d=0.20, P=.001), 3-month (beta=-1.76, SE 0.60, Cohen’s d=0.13, P=.003), and 6-month (beta=-1.21, SE 0.58, Cohen’s d=0.09, P=.04) follow-up intervals. Latent growth curve analyses further indicated that participants in the experimental condition had a significantly lower frequency of binge drinking compared to participants in the control condition that was sustained at 6-month follow-up (intercept=-0.14, P=.01; slope=0.004, P=.19). This intercept difference resulted from higher levels in this outcome for participants in the control condition relative to participants in the experimental condition at 1-month (beta=-1.15, SE 0.06, Cohen’s d=0.16, P=.01), 3-month (beta=-0.12, SE 0.05, Cohen’s d=0.09, P=.01), and 6-month (beta=-0.09, SE 0.05, Cohen’s d=0.03, P=.045) follow-up intervals.\r\nCONCLUSIONS\r\nThe WDYD intervention was shown to be effective in preventing an increase in weekly alcohol consumption and frequency of binge drinking directly after the intervention. This effect was sustained 3 and 6 months after the intervention.\r\nTRIAL REGISTRATION\r\nNetherlands Trial Register NTR2665; (Archived by WebCite at

Wallace, Lorraine S.; Dhingra, Lara K. (2014): A systematic review of smartphone applications for chronic pain available for download in the United States. In: J Opioid Manag 10 (1), S. 63–68. DOI: 10.5055/jom.2014.0193.

OBJECTIVE\r\nA Smartphone app could be useful in aiding patients in self-monitoring and self-managing their chronic pain-related symptoms. The purpose of this study was to systematically review English-language pain-related Smartphone apps available for download in the United States.\r\nDESIGN\r\nDuring July 2012, official Android, BlackBerry, and iPhone Smartphone app platform stores were searched. \”Pain\” was entered into the search-bar of each Smartphone app store. Of the pain apps meeting inclusion criteria, the following were retrieved: release date, download cost (US dollars [US $], file size, documentation of a healthcare professional’s (HCP) involvement in app development, primary purpose of the app (pain education, pain self-management, or a combination of pain education and self-management), targeted pain-related condition(s), and inclusion of features that addressed four common self-monitoring and/or management strategies.\r\nRESULTS\r\nOf the 220 apps meeting inclusion criteria, the majority were available through the iPhone (80.0 percent). The cost for downloading each app ranged from US $0.00 to 89.99; however, the majority of apps were ≤US $4.99. There was no evidence of HCP involvement in the development of the majority of apps (65.0 percent). Chronic, nonspecific pain was the focus of half (50.5 percent) of the apps, followed by back and/or neck pain (25.9 percent). The primary purpose of the apps was categorized as follows: pain education (n = 53, 24.1 percent), pain self-management (n = 137, 62.3 percent), and both pain education and self management (n = 30, 13.6 percent).\r\nCONCLUSION\r\nOverall, most of the pain-related apps included within our review not only lacked evidence of HCP input regarding development but also contained few evidence-based pain management features.

Wasielewska, Anna; Rudzinska, Monika; Tomaszewski, Tomasz; Banaszkiewicz, Krzysztof; Wojcik-Pedziwiatr, Magdalena; Dec-Cwiek, Malgorzata et al. (2013): Tremor in neuropathies of different origin. In: Neurol Neurochir Pol 47 (6), S. 525–533.

BACKGROUND AND PURPOSE: Tremor accompanies some poly-neuropathies, but its prevalence and its clinical and electrophysiological manifestations are not well known. The aim of the study was to assess the occurrence and characteristics of hand tremor in patients with polyneuropathy of different origins, as well as relations between the occurrence of tremors and clinical and neurographic findings of polyneuropathy. MATERIAL AND METHODS: Eighty-nine patients diagnosed with polyneuropathy of known aetiology, and 50 age- and sex-matched healthy volunteers were included in the study. All subjects were interviewed regarding the occurrence of tremor. Tremor was assessed clinically and objectively using a triaxial accelerometer and electromyographic (EMG) recordings. A load test with a weight of 500 gamma was performed in order to differentiate between enhanced physiological tremor (EPT) and essential tremor-like (ET-L) tremor. RESULTS: Tremor was found in 59.5% of patients in clinical assessment and in 74% of patients in objective evaluation, significantly more often than in controls (12%). Tremor was detected in all types of polyneuropathy apart from paraproteinaemic IgM polyneuropathy. Tremor was postural (70%), but resting (51%) or kinetic (32%) tremor was also present. In the majority of cases, the severity of the tremor was mild. Essential tremor-like tremor prevailed in the study group. The occurrence of hand tremor was not related to the axonal or demyelinating type of polyneuropathy, nor to the conduction velocity or other electrophysiological findings of the investigated upper limb nerves. CONCLUSION: Tremor accompanies 60-70% of patients with polyneuropathy; it is mostly postural, ET-L type with mild severity, and unrelated to other typical clinical and electrophysiological findings of neuropathy.

Wearing, Jessica R.; Nollen, Nikki; Befort, Christie; Davis, Ann M.; Agemy, Carolina K. (2014): iPhone app adherence to expert-recommended guidelines for pediatric obesity prevention. In: Child Obes 10 (2), S. 132–144. DOI: 10.1089/chi.2013.0084.

BACKGROUND\r\nPediatric obesity is a serious and prevalent problem. Smartphone technology, which is becoming increasingly available to children of diverse backgrounds, presents a unique opportunity to instill healthy behaviors before the onset of obesity. Past studies have examined the use of smartphone applications as tools of health behavior modification for adults. The present study examines the content of children’s exercise and nutrition smartphone apps. Method: Sixty-two iPhone apps were identified and coded by two independent raters for adherence to expert-recommended behaviors (e.g., five fruits/vegetables per day) and strategies (e.g., self-monitoring diet/physical activity) for the prevention of pediatric obesity.\r\nRESULTS\r\nApp behavioral and strategy index scores were uniformly low. Apps were more likely to address expert-recommended behaviors for the prevention of pediatric obesity (93.5%), whereas few apps addressed recommended strategies (20.9%). The most common behaviors addressed included physical activity (53.2%) and fruit/vegetable consumption (48.3%). Other important behaviors (e.g., screen time [1.6%] and family meals together [1.6%]) were rarely addressed.\r\nCONCLUSIONS\r\nCurrent children’s diet and exercise apps could be improved with increased adherence to expert-recommended guidelines, especially expert-recommended strategies.

Witham, Miles D.; Donnan, Peter T.; Vadiveloo, Thenmalar; Sniehotta, Falko F.; Crombie, Iain K.; Feng, Zhiqiang; McMurdo, Marion E T (2014): Association of day length and weather conditions with physical activity levels in older community dwelling people. In: PLoS ONE 9 (1), S. e85331. DOI: 10.1371/journal.pone.0085331.

BACKGROUND\r\nWeather is a potentially important determinant of physical activity. Little work has been done examining the relationship between weather and physical activity, and potential modifiers of any relationship in older people. We therefore examined the relationship between weather and physical activity in a cohort of older community-dwelling people.\r\nMETHODS\r\nWe analysed prospectively collected cross-sectional activity data from community-dwelling people aged 65 and over in the Physical Activity Cohort Scotland. We correlated seven day triaxial accelerometry data with daily weather data (temperature, day length, sunshine, snow, rain), and a series of potential effect modifiers were tested in mixed models: environmental variables (urban vs rural dwelling, percentage of green space), psychological variables (anxiety, depression, perceived behavioural control), social variables (number of close contacts) and health status measured using the SF-36 questionnaire.\r\nRESULTS\r\n547 participants, mean age 78.5 years, were included in this analysis. Higher minimum daily temperature and longer day length were associated with higher activity levels; these associations remained robust to adjustment for other significant associates of activity: age, perceived behavioural control, number of social contacts and physical function. Of the potential effect modifier variables, only urban vs rural dwelling and the SF-36 measure of social functioning enhanced the association between day length and activity; no variable modified the association between minimum temperature and activity.\r\nCONCLUSIONS\r\nIn older community dwelling people, minimum temperature and day length were associated with objectively measured activity. There was little evidence for moderation of these associations through potentially modifiable health, environmental, social or psychological variables.

Yip, Tiffany; Douglass, Sara (2013): The Application of Experience Sampling Approaches to the Study of Ethnic Identity: New Developmental Insights and Directions. In: Child Dev Perspect 7 (4), S. 211–214. DOI: 10.1111/cdep.12040.

In this article, we review how the application of experience sampling methods (ESM) has advanced knowledge of the developmental importance of ethnic identity for youth outcomes. In particular, ESM approaches have allowed researchers to explore the construct of salience, the context-dependent and fluid component of ethnic identity. We highlight new information on the importance of context for variability in ethnic identity salience, and the association between ethnic identity and psychological well-being.

Zhuang, Jie; Chen, Peijie; Wang, Chao; Jin, Jing; Zhu, Zheng; Zhang, Wenjie (2013): Recovering Physical Activity Missing Data Measured by Accelerometers: A Comparison of Individual and Group-Centered Recovery Methods. In: Research Quarterly for Exercise and Sport 84 (sup2), S. S48. DOI: 10.1080/02701367.2013.851060.

Purpose: The purpose of this study was to determine which method, individual information-centered (IIC) or group information-centered (GIC), is more efficient in recovering missing physical activity (PA) data. Method: A total of 2,758 Chinese children and youth aged 9 to 17 years old (1,438 boys and 1,320 girls) wore ActiGraph GT3X/GT3X+ accelerometers for 7 consecutive days. Those with no missing data (n = 900) were used to form a nonmissing sample, which, based on a semisimulation approach, was used to create a missing data set to evaluate a set of recovery methods, including 2 IIC and 22 GIC methods. Root mean square difference (RMSD), mean signed difference, and paired t test were used to determine the effectiveness of the recovery methods. Results: The smallest RMSD values, which represent the most accurate recovery, were found with: (a) GIC-Expectation–maximization (GIC-EM) regardless of gender and by age (113,957.64); (b) GIC-EM regardless of gender and age (114,367.88); (c) GIC-EM regardless of age and by gender (114,697.06); (d) GIC-EM by gender and age (116,178.34); and (e) IIC averaging of remaining days (125,851.23). Conclusion: To recover 7-day PA accelerometer-determined activity missing data, we recommend using the GIC-EM and IIC approaches.


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