Designing Online Interventions in Consideration of Young People's Concepts of Well-Being: Exploratory Qualitative Study

BACKGROUND

A key challenge in developing online well-being interventions for young people is to ensure that they are based on theory and reflect adolescent concepts of well-being.

OBJECTIVE

This exploratory qualitative study aimed to understand young people's concepts of well-being in Australia.

METHODS

Data were collected via workshops at five sites across rural and metropolitan sites with 37 young people from 15 to 21 years of age, inclusive. Inductive, data-driven coding was then used to analyze transcripts and artifacts (ie, written or image data).

RESULTS

Young adults' conceptions of well-being were diverse, personally contextualized, and shaped by ongoing individual experiences related to physical and mental health, along with ecological accounts acknowledging the role of family, community, and social factors. Key emerging themes were (1) positive emotions and enjoyable activities, (2) physical wellness, (3) relationships and social connectedness, (4) autonomy and control, (5) goals and purpose, (6) being engaged and challenged, and (7) self-esteem and confidence. Participants had no difficulty describing actions that led to positive well-being; however, they only considered their own well-being at times of stress.

CONCLUSIONS

In this study, young people appeared to think mostly about their well-being at times of stress. The challenge for online interventions is to encourage young people to monitor well-being prior to it becoming compromised. A more proactive focus that links the overall concept of well-being to everyday, concrete actions and activities young people engage in, and that encourages the creation of routine good habits, may lead to better outcomes from online well-being interventions.

Efficacy of a Web-Based Guided Recommendation Service for a Curated List of Readily Available Mental Health and Well-Being Mobile Apps for Young People: Randomized Controlled Trial

Background

Mental disorders are highly prevalent for the people who are aged between 16 and 25 years and can permanently disrupt the development of these individuals. Easily available mobile health (mHealth) apps for mobile phones have great potential for the prevention and early intervention of mental disorders in young adults, but interventions are required that can help individuals to both identify high-quality mobile apps and use them to change health and lifestyle behavior.

Objectives

The study aimed to assess the efficacy of a Web-based self-guided app recommendation service (“The Toolbox”) in improving the well-being of young Australians aged between 16 and 25 years. The intervention was developed in collaboration with young adults and consists of a curated list of 46 readily available health and well-being apps, assessed and rated by professionals and young people. Participants are guided by an interactive quiz and subsequently receive recommendations for particular apps to download and use based on their personal goals.

Methods

The study was a waitlist, parallel-arm, randomized controlled trial. Our primary outcome measure was change in well-being as measured by the Mental Health Continuum-Short Form (MHC-SF). We also employed ecological momentary assessments (EMAs) to track mood, energy, rest, and sleep. Participants were recruited from the general Australian population, via several Web-based and community strategies. The study was conducted through a Web-based platform consisting of a landing Web page and capabilities to administer study measures at different time points. Web-based measurements were self-assessed at baseline and 4 weeks, and EMAs were collected repeatedly at regular weekly intervals or ad hoc when participants interacted with the study platform. Primary outcomes were analyzed using linear mixed-models and intention-to-treat (ITT) analysis.

Results

A total of 387 participants completed baseline scores and were randomized into the trial. Results demonstrated no significant effect of “The Toolbox” intervention on participant well-being at 4 weeks compared with the control group (P=.66). There were also no significant differences between the intervention and control groups at 4 weeks on any of the subscales of the MHC-SF (psychological: P=.95, social: P=.42, emotional: P=.95). Repeat engagement with the study platform resulted in a significant difference in mood, energy, rest, and sleep trajectories between intervention and control groups as measured by EMAs (P<.01).

Conclusions

This was the first study to assess the effectiveness of a Web-based well-being intervention in a sample of young adults. The design of the intervention utilized expert rating of existing apps and end-user codesign approaches resulting in an app recommendation service. Our finding suggests that recommended readily available mental health and well-being apps may not lead to improvements in the well-being of a nonclinical sample of young people, but might halt a decline in mood, energy, rest, and sleep.

Trial Registration

Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000710628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366145 (Archived by WebCite at http://www.webcitation.org/ 6pWDsnKme)

Phonons in iron: from the bulk to an epitaxial monolayer

The confinement of materials in low-dimensional structures has significant impact on propagating excitations like phonons. Using the isotope-specific 57Fe nuclear resonant vibrational spectroscopy we were able to determine elastic and thermodynamic properties of ultrathin Fe films on W(110). With decreasing thickness one observes a significant increase of the mean atomic displacement that goes along with an enhancement of vibrational modes at low energies as compared to the bulk. The analysis reveals that these deviations result from atomic vibrations of the single atomic layers at the two boundaries of the film, while the atoms inside the films vibrate almost bulklike.

Immune evasion by acquisition of complement inhibitors: the mould Aspergillus binds both factor H and C4b binding protein

Pathogenic fungi represent a major threat particularly to immunocompromised hosts, leading to severe, and often lethal, systemic opportunistic infections. Although the impaired immune status of the host is clearly the most important factor leading to disease, virulence factors of the fungus also play a role. Factor H (FH) and its splice product FHL-1 represent the major fluid phase inhibitors of the alternative pathway of complement, whereas C4b-binding protein (C4bp) is the main fluid phase inhibitor of the classical and lectin pathways. Both proteins can bind to the surface of various human pathogens conveying resistance to complement destruction and thus contribute to their pathogenic potential. We have recently shown that Candida albicans evades complement by binding both Factor H and C4bp. Here we show that moulds such as Aspergillus spp. bind Factor H, the splicing variant FHL-1 and also C4bp. Immunofluorescence and flow cytometry studies show that the binding of Factor H and C4bp to Aspergillus spp. appears to be even stronger than to Candida spp. and that different, albeit possibly nearby, binding moieties mediate this surface attachment.

Probing single jumps of surface atoms

Jumps of single atoms can be followed on their time and space scale (nanoseconds and Angstroms) by applying nuclear resonance scattering of synchrotron radiation. Here we develop the theory for jump diffusion in two-dimensional systems. Two types of phenomena are noteworthy: apparent acceleration of the nuclear decay and relaxation of hyperfine interactions, in particular, electric quadrupole interactions. The latter effect becomes for the first time one of significance and well measurable due to the inherent anisotropy of the surface. We show how, by way of motional narrowing, to distinguish between the motion of the probe atom itself and the motion of adatoms.

Angiogenic potential of ductal carcinoma in situ (DCIS) of human breast

AIMS

Comedo carcinoma is generally regarded as the subtype of ductal carcinoma in situ (DCIS) most likely to progress to invasive carcinoma. Increased angiogenesis could be associated with an enhanced risk of progression and might therefore be a marker of poor prognosis, as can be demonstrated for invasive breast tumours. Therefore, the present study investigates the correlations between the expression of oncoproteins (HER2, HER1/EGFR), angiogenic growth factors (VEGF and PD-ECGF/TP) and microvessel density (MVD) in DCIS.

METHODS AND RESULTS

Forty-six breast cancer specimens of DCIS were tested immunohistochemically for the expression of angiogenic factors and oncoproteins. Different vascular distribution patterns of DCIS were examined semiquantitatively. Our results showed a significantly inverse correlation between HER1/EGFR and comedo-type DCIS (P = 0.048), but HER1/EGFR expression seemed to be independent of HER2 overexpression. VEGF expression was significantly associated with endoglin expression (P = 0.031) and the cuffing phenomenon (P = 0.017).

CONCLUSIONS

The significantly inverse correlation between HER1/EGFR and comedo-type DCIS and the observation that VEGF and the other angiogenic factors tested are independent of HER2 overexpression, suggest that progression of comedo-type DCIS and angiogenesis in breast carcinoma are not regulated via the HER1/EGFR or HER2 pathway.

Probing jump diffusion in crystalline solids with neutron spin-echo spectroscopy

Neutron spin-echo spectroscopy has been applied to jump diffusion in a crystalline solid. Definite advantages of spin-echo spectroscopy over quasielastic neutron scattering are the direct visual discrimination of fast and slow diffusion processes and the high resolution in the time-energy domain. The potential of the method is demonstrated by way of Ni diffusion in the intermetallic alloy NiGa.

Heme-solvent coupling: a Mössbauer study of myoglobin in sucrose

The Mössbauer effect of 57Fe-enriched samples was used to investigate the coupling of 80% sucrose/water, a protein-stabilizing solvent, to vibrational and diffusive modes of the heme iron of CO-myoglobin. For comparison we also determined the Mössbauer spectra of K4 57Fe (CN)6 (potassium ferrocyanide, PFC), where the iron is fully exposed in the same solvent. The temperature dependence of the Mössbauer parameters derived for the two samples proved to be remarkably similar, indicative of a strong coupling of the main heme displacements to the viscoelastic relaxation of the solvent. We show that CO escape out of the heme pocket couples to the same type of fluctuations, whereas intramolecular bond formation involves solvent-decoupled heme deformation modes that are less prominent in the Mössbauer spectrum. With respect to other solvents, however, sucrose shows a reduced viscosity effect on heme displacements and the kinetics of ligand binding due to preferential hydration of the protein. This result confirms thermodynamic predictions of the stabilizing action of sucrose by a dynamic method.

Subarachnoid hemorrhage as presenting feature of isolated neurosarcoidosis

A 35-year-old man presented with the clinical picture of spontaneous subarachnoid hemorrhage. Four weeks after the first symptoms he noticed blurred vision, and ophthalmological examination detected bitemporal hemianopia. At this time cerebral computed tomography and magnetic resonance imaging showed enlargement of the optic chiasm, and visual evoked potentials revealed delayed latencies. In the cerebrospinal fluid cells and protein content were elevated, and angiotensin-converting enzyme was detectable. Under steroid treatment the patient recovered completely and computed tomography, magnetic resonance imaging, visual evoked potentials, and cerebrospinal fluid findings became normal. Although a great variety of neurological symptoms may occur in neurosarcoidosis, to our knowledge spontaneous subarachnoid hemorrhage as the presenting feature has never been reported before.

[The CT-controlled treatment possibilities in intervertebral disk prolapses]

A CT-controlled method for the treatment of lumbar and cervical disc prolapse is described. Compared with fluoroscopically controlled percutaneous lumbar discectomy, percutaneous treatment of the L5/S1 disc by a dorsal approach is possible even in the presence of high iliac crests, as is described in this paper. In the cervical region the risk of iatrogenic damage is reduced. In a small group of 42 patients, an attempt has been made to remove disc material which is intraforaminal, intraspinal, subligamentous or sequestered. Amongst 79 patients with lumbar and 15 patients with cervical disc prolapse treatment was successful in 85% (after 17 months of observation) and 93% (after 12 months of observation). These figures refer to the early results from a new method. The success of the method will have to be assessed after a larger number of patients has been treated and there has been a longer period of observation.

Mineral crystals in calcified tissues: a comparative study by SAXS

The shape, the typical orientation, and the average size of mineral crystals in different types of mineralized tissues were investigated by means of small-angle x-ray scattering (SAXS). To rule out eventual artifacts due to sample preparation, four different standard preparation techniques were used and a comparison showed that the SAXS results were identical for all four methods. In mineralized turkey leg tendon, a frequently used model system for bone, the crystals were found to be typically plate-like with a thickness of the order of 2 nm. This stands in contrast to the case of bone (calvaria, femur, and iliac crest) from mouse, rat, and dog, where mainly needle-like crystals were found. The thickness of these crystals ranged from 3 to 4 nm but was remarkably constant for different bones of a given animal. The preferred orientation of the needle-like crystals was along the main axis of the femur and within the surface of the calvaria (for mouse, rat, and dog). The mineral plates in turkey leg tendon were located inside the hole zone and oriented along the fibril axis. Finally, no periodic arrangement of the crystals inside the hole zone of the collagen could be found.

Nucleation and growth of mineral crystals in bone studied by small-angle X-ray scattering

The mechanism of calcification in bone and related tissues is a matter of current interest. The mean size and the arrangement of the mineral crystals are important parameters difficult to obtain by electron microscopy. Furthermore, most studies have been carried out on poorly calcified model systems or chemically treated samples. In the work presented here, native bone was studied as a function of age by a quantitative small-angle X-ray scattering method (SAXS). Bone samples (calvariae and ulnae) from rats and mice were investigated. Measurements were performed on native bone immediately after dissection for samples up to 1 mm thick. The size, shape, and predominant orientation of the mineral crystals in bone were obtained for embryonal, young, and adult animals. The results indicate that the mineral nucleates as thin layers of calcium phosphate within the hole zone of the collagen fibrils. The mineral nuclei subsequently grow in thickness to about 3 nm, which corresponds to maximum space available in these holes.

Stereotactic retrobulbar anesthesia using CT

A simple technique using stereotactic needle placement for retrobulbar anesthesia is reported. The method utilizes a CT-guided stereotactic device that permits precise intraconal injection of local anesthetics; in addition, the risk of injury to muscles, vessels, eyeglobe, or optic nerve is substantially reduced.

A simple superimposition method for anatomical adjustments of CT and SPECT images

A technique for superimposition of CT and single photon emission CT (SPECT) images is described. Regions of interest can be placed on SPECT images and projected to CT images. In this way, anatomical registration of regions of increased or decreased activity is possible. The equipment is easy to handle and available at low cost.

Diesel soot particles catalyze the production of oxy-radicals

The formation of a strong oxidant similar to the OH. radical is catalyzed by diesel soot particles in the presence of cysteine and hydrogen peroxide or in the presence of light. The oxidant(s) formed causes fragmentation of methylthioketobutyric acid measurable as ethylene release. Furthermore, the model carotenoid crocin is bleached and thiobarbituric-acid-reactive material (malondialdehyde) is produced from linolenic acid. All reactions are inhibited by scavengers (propyl gallate, alpha-tocopherol, diazobicyclooctane) and by catalase. The reactions observed suggest that the toxicity and mutagenicity of diesel soot particles is at least in part due to the formation of reactive oxygen species.

Doppler and duplex sonography of the cervical arteries and correlations with other examinations. A field study in a population over forty years

Of the population of a small Tyrolean village, 185 (56%) of the 329 inhabitants over 40 years were investigated by means of Doppler and duplex sonography, electroencephalography (EEG), electrocardiography (ECG), and neurological examination. Four subjects (2%) previously had a transitory ischemic attack (TIA) or stroke in the carotid territory. Sonographically detectable abnormalities in one or more extracranial arteries were present in 42 (23%) persons. Of the 14 subjects with more than slight abnormalities in the common or internal carotid artery two were symptomatic. Two additional cases with TIA or stroke did not show relevant lesions on sonographic examination. The presence of narrowing in the extracranial artery was not related to risk factors (hypertension, smoking, obesity) or abnormalities on ECG and EEG. This study shows 1) that the clinical relevance of ultrasound screening of the carotid arteries in an average population is 15%; 2) that significantly more patients with TIAs or strokes are found in the group with more severe sonographic findings (p = 0.001) than in the group with normal ultrasound results.

Steroid-induced complete remission in a case of primary cerebral non-Hodgkin's lymphoma

A case of a primary non-Hodgkin's lymphoma of the CNS is reported in which a complete and stable disappearance of an enhancing mass lesion on the CT scan after treatment with dexamethasone was followed by the occurrence of a high-grade malignant lymphoma in the opposite hemisphere 18 months later. The long-lasting and stable remission suggests a direct oncolytic effect of corticosteroids on lymphoma cells. Furthermore, this case illustrates the usefulness of repeated CT examinations in patients with CNS lymphoma and steroid treatment.

[Value of the dual-energy method in quantitative CT studies of the brain]

Using a dual-energy (DE) method, conventional polyenergetic and monoenergetic beams were used to obtain data in phantom and clinical CT studies and to prove the benefit of this method in quantitative cranial CT. Conventional polyenergetic (85 kVp and 125 kVp) and simulated monoenergetic images were reconstructed from the measurements. The noise in the monoenergetic images was lowest at 72 kVp. The interindividual white-gray differentiation varied less in DE forms than in polyenergetic images, whereas the noise was of the same order of magnitude in both types. As can be derived from our results, DE may be clinically useful in diagnosing abnormal lucency of the white matter in newborn and premature infants.

[Radiculography using the digital subtraction technic]

In patients with symptomatic lumbar disc disease, lumbar myelography was performed in combination with the digital subtraction technique. Contrast medium was injected during the digital subtraction procedure, and the following part of the examination was treated conventionally. In all patients the subtracted images were superior for documentation purposes and also for evaluation of the upper lumbar spine. If the contrast medium was injected epidurally, the artifact could be suppressed by the selection of a suitable mask.

[Sonographic determination of the position of the carotid bifurcation as a diagnostic aid in cerebral catheter angiography]

A simple sonographic method is described for demonstrating the position of the carotid bifurcation in the sagittal plane. As a result, it is possible to demonstrate the bifurcation by angiography without overlay, thereby improving the diagnosis of vascular abnormalities. Since non-invasive sonography of the carotid arteries should be carried out before cerebral angiography in any case, the present procedure does not involve any additional effort.