Increasing vaccinations through an on-site school-based education and vaccination program: A city-wide cluster randomized controlled trial

Vaccination rates for mumps, measles, and rubella (MMR) and tetanus, diphtheria, pertussis, and polio (Tdap-IPV) fall short of global targets, highlighting the need for vaccination interventions. This study examines the effectiveness of a city-wide school-based educational vaccination intervention as part of an on-site vaccination program aimed at increasing MMR and Tdap-IPV vaccination rates versus on-site vaccination alone among sociodemographically diverse students from Berlin, Germany. The study was a 1:1 two-arm cluster randomized controlled trial, with schools randomly assigned to either the Educational Class Condition (ECC) or the Low-Intensity Information Condition (LIIC). Both received an on-site vaccination program, while students in the ECC received an additional educational unit. Primary outcomes were MMR and Tdap-IPV vaccination rates. In total, 6512 students from 25 randomly selected urban area secondary schools participated. For students providing their vaccination documents on the day of the intervention (2273, 34.9%), adjusted Poisson mixed models revealed significant between-group differences in favor of the ECC (MMR: logRR = 0.47, 95%CI [0.01,0.92], RR = 1.59; Tdap-IPV: logRR = 0.28, 95%CI [0.10,0.47], RR = 1.32). When adjusting for socioeconomic and migration background, between-group differences became non-significant for MMR but remained significant for Tdap-IPV. Findings suggest that educational, school-based on-site vaccination appears to be a promising strategy for increasing vaccination uptake in adolescents.

A rotationally-driven dynamic solid phase sodium bisulfite conversion disc for forensic epigenetic sample preparation

The approaches to forensic human identification (HID) are largely comparative in nature, relying upon the comparison of short tandem repeat profiles to known reference materials and/or database profiles. However, many profiles are generated from evidence materials that either do not have a reference material for comparison or do not produce a database hit. As an alternative to individualizing analysis for HID, researchers of forensic DNA have demonstrated that the human epigenome can provide a wealth of information. However, epigenetic analysis requires sodium b̲is̲ulfite c̲onversion (BSC), a sample preparation method that is time-consuming, labor-intensive, prone to contamination, and characterized by DNA loss and fragmentation. To provide an alternative method for BSC that is more amenable to integration with the forensic DNA workflow, we describe a rotationally-driven, microfluidic method for dynamic solid phase-BSC (dSP-BSC) that streamlines the sample preparation process in an automated format, capable of preparing up to four samples in parallel. The method permitted decreased incubation intervals by ∼36% and was assessed for relative DNA recovery and conversion efficiency and compared to gold-standard and enzymatic approaches.

Anxiety in response to the climate and environmental crises: validation of the Hogg Eco-Anxiety Scale in Germany

Background

As the climate and environmental crises unfold, eco-anxiety, defined as anxiety about the crises' devastating consequences for life on earth, affects mental health worldwide. Despite its importance, research on eco-anxiety is currently limited by a lack of validated assessment instruments available in different languages. Recently, Hogg and colleagues proposed a multidimensional approach to assess eco-anxiety. Here, we aim to translate the original English Hogg Eco-Anxiety Scale (HEAS) into German and to assess its reliability and validity in a German sample.

Methods

Following the TRAPD (translation, review, adjudication, pre-test, documentation) approach, we translated the original English scale into German. In total, 486 participants completed the German HEAS. We used Bayesian confirmatory factor analysis (CFA) to assess whether the four-factorial model of the original English version could be replicated in the German sample. Furthermore, associations with a variety of emotional reactions towards the climate crisis, general depression, anxiety, and stress were investigated.

Results

The German HEAS was internally consistent (Cronbach's alphas 0.71-0.86) and the Bayesian CFA showed that model fit was best for the four-factorial model, comparable to the factorial structure of the original English scale (affective symptoms, rumination, behavioral symptoms, anxiety about personal impact). Weak to moderate associations were found with negative emotional reactions towards the climate crisis and with general depression, anxiety, and stress.

Discussion

Our results support the original four-factorial model of the scale and indicate that the German HEAS is a reliable and valid scale to assess eco-anxiety in German speaking populations.

Stress buffering after physical activity engagement: An experience sampling study

OBJECTIVES

While encountering daily hassles is a normative experience, it poses a threat to individuals' daily affective well-being. However, physical activity engagement may help to reduce the current stress-related impact on affective well-being (i.e. stress buffering), which we investigate in this study. Furthermore, we examined the possible moderating role of people's global stress context (i.e. exposure to major life events and chronic stress) on this within-person stress-buffering effect.

DESIGN

We approached these ideas using six-times-a-day experience sampling assessments over a period of 22 days.

METHODS

Drawing on a broad national sample of 156 middle-aged adults from the EE-SOEP-IS study, we aimed to elucidate the naturally occurring within-person dynamics of current stress, physical activity engagement, and momentary affect within individuals' everyday lives. Major life events and chronic stress were measured as between-person variables.

RESULTS

Multilevel analyses revealed significant within-person associations of current stress and physical activity engagement with momentary affect. Stress-related negative affect was lower when individuals engaged in physical activity, in accordance with the idea of a within-person stress-buffering effect of physical activity engagement. For individuals exposed to more severe major life events, the stress-buffering effect of physical activity engagement for negative affect was lower. Chronic stress did not moderate the within-person stress-buffering effect.

CONCLUSIONS

Overall, results add to the existing literature that links physical activity to increased stress resilience and emphasizes the need for taking the global between-person stress context into account.

Enhancing physical activity and reducing symptoms of patients with osteoarthritis of the knee: a randomized controlled trial of the PrevOP-Psychological Adherence Program

BACKGROUND

This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition.

METHODS

Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models.

RESULTS

MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]).

CONCLUSIONS

Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change.

TRIAL REGISTRATION

German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016.

Within-person associations between psychological and contextual factors and lapse incidence in smokers attempting to quit: A systematic review and meta-analysis of ecological momentary assessment studies

AIMS

When attempting to stop smoking, discrete smoking events ('lapses') are strongly associated with a return to regular smoking ('relapse'). No study has yet pooled the psychological and contextual antecedents of lapse incidence, captured in ecological momentary assessment (EMA) studies. This systematic review and meta-analysis aimed to synthesize within-person psychological and contextual predictor-lapse associations in smokers attempting to quit.

METHODS

We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science. A narrative synthesis and multi-level, random-effects meta-analyses were conducted, focusing on studies of adult, non-clinical populations attempting to stop smoking, with no restrictions on setting. Outcomes were the association between a psychological (e.g. stress, cravings) or contextual (e.g. cigarette availability) antecedent and smoking lapse incidence; definitions of 'lapse' and 'relapse'; the theoretical underpinning of EMA study designs; and the proportion of studies with pre-registered study protocols/analysis plans and open data.

RESULTS

We included 61 studies, with 19 studies contributing ≥ 1 effect size(s) to the meta-analyses. We found positive relationships between lapse incidence and 'environmental and social cues' [k = 12, odds ratio (OR) = 4.53, 95% confidence interval (CI) = 2.02, 10.16, P = 0.001] and 'cravings' (k = 10, OR = 1.71, 95% CI = 1.34, 2.18, P < 0.001). 'Negative feeling states' was not significantly associated with lapse incidence (k = 16, OR = 1.10, 95% CI = 0.98, 1.24, P = 0.12). In the narrative synthesis, negative relationships with lapse incidence were found for 'behavioural regulation', 'motivation not to smoke' and 'beliefs about capabilities'; positive relationships with lapse incidence were found for 'positive feeling states' and 'positive outcome expectancies'. Although lapse definitions were comparable, relapse definitions varied widely across studies. Few studies explicitly drew upon psychological theory to inform EMA study designs. One of the included studies drew upon Open Science principles.

CONCLUSIONS

In smokers attempting to stop, environmental and social cues and cravings appear to be key within-person antecedents of smoking lapse incidence. Due to low study quality, the confidence in these estimates is reduced.

Seropositivity and flight-associated risk factors for SARS-CoV-2 infection among asylum seekers arriving in Berlin, Germany - a cross-sectional study

Introduction

Refugees and asylum seekers might be at increased risk of SARS-CoV-2 infection due to precarious living conditions during flight.

Methods

Between March 24th and June 15th 2021, we conducted a cross-sectional study among adult asylum seekers arriving in Berlin. Each participant was tested for acute SARS-CoV-2 infection with a nasopharyngeal swab using reverse transcriptase PCR (rt-PCR), and for anti-SARS-CoV-2-S1 IgG antibodies using ELISA. Seropositivity, antibody avidity, and data on flight history were used to categorize individuals into two groups according to the estimated time of infection before or during flight. Sociodemographic characteristics, COVID-19 related symptoms, hygiene behaviors, and living conditions during transit were assessed using two self-report questionnaires.

Results

Among 1041 participants (34·5% female, mean age 32·6 years), most frequently reported countries of origin were Moldova (20·5%), Georgia (18·9%), Syria (13·0%), Afghanistan (11·3%), and Vietnam (9·1%). Seropositivity rate was 25·1% and incidence rate of acute SARS-CoV-2 infection was 2·8%. A higher likelihood for seropositivity was observed in women (OR [95%CI]=1·64 [1·05-2·57]) but reduced by frequent hygiene behaviors (OR [95%CI]=0·75 [0·59-0·96]) or traveling by plane (OR [95%CI]=0·58 [0·35-0·96]). Other associated factors were lower educational level, accommodation in refugee shelters, traveling with children or by foot, and COVID-19 information seeking.

Conclusion

Flight-associated risk factors such as accommodation in a refugee shelter and poor hygiene behaviors are associated with an elevated risk of infection, which should be addressed by public health interventions.

Clinical trial registration

[https://doi.org/10.1186/ISRCTN17401860], identifier [17401860].

Developing habit-based health behaviour change interventions: twenty-one questions to guide future research

OBJECTIVE

Habitual behaviours are triggered automatically, with little conscious forethought. Theory suggests that making healthy behaviours habitual, and breaking the habits that underpin many ingrained unhealthy behaviours, promotes long-term behaviour change. This has prompted interest in incorporating habit formation and disruption strategies into behaviour change interventions. Yet, notable research gaps limit understanding of how to harness habit to change real-world behaviours.

METHODS

Discussions among health psychology researchers and practitioners, at the 2019 European Health Psychology Society 'Synergy Expert Meeting', generated pertinent questions to guide further research into habit and health behaviour.

RESULTS

In line with the four topics discussed at the meeting, 21 questions were identified, concerning: how habit manifests in health behaviour (3 questions); how to form healthy habits (5 questions); how to break unhealthy habits (4 questions); and how to develop and evaluate habit-based behaviour change interventions (9 questions).

CONCLUSIONS

While our questions transcend research contexts, accumulating knowledge across studies of specific health behaviours, settings, and populations will build a broader understanding of habit change principles and how they may be embedded into interventions. We encourage researchers and practitioners to prioritise these questions, to further theory and evidence around how to create long-lasting health behaviour change.

Nuclear Equation of State for Arbitrary Proton Fraction and Temperature Based on Chiral Effective Field Theory and a Gaussian Process Emulator

We calculate the equation of state of asymmetric nuclear matter at finite temperature based on chiral effective field theory interactions to next-to-next-to-next-to-leading order. Our results assess the theoretical uncertainties from the many-body calculation and the chiral expansion. Using a Gaussian process emulator for the free energy, we derive the thermodynamic properties of matter through consistent derivatives and use the Gaussian process to access arbitrary proton fraction and temperature. This enables a first nonparametric calculation of the equation of state in beta equilibrium, and of the speed of sound and the symmetry energy at finite temperature. Moreover, our results show that the thermal part of the pressure decreases with increasing densities.

Standard values of the upper body posture in healthy adults with special regard to age, sex and BMI

In order to classify and analyze the parameters of upper body posture in clinical or physiotherapeutic settings, a baseline in the form of standard values with special regard to age, sex and BMI is required. Thus, subjectively healthy men and women aged 21-60 years were measured in this project. The postural parameters of 800 symptom-free male (n = 397) and female (n = 407) volunteers aged 21-60 years (Ø♀: 39.7 ± 11.6, Ø ♂: 40.7 ± 11.5 y) were studied. The mean height of the men was 1.8 ± 0.07 m, with a mean body weight of 84.8 ± 13.1 kg and an average BMI of 26.0 ± 3.534 kg/m². In contrast, the mean height of the women was 1.67 ± 0.06 m, with a mean body weight of 66.5 ± 12.7 kg and an average BMI of 23.9 ± 4.6 kg/m². By means of video rasterstereography, a 3-dimensional scan of the upper back surface was measured when in a habitual standing position. The means or medians, confidence intervals, tolerance ranges, the minimum, 2.5, 25, 50, 75, 97.5 percentiles and the maximum, plus the kurtosis and skewness of the distribution, were calculated for all parameters. Additionally, ANOVA and a factor analyses (sex, BMI, age) were conducted. In both sexes across all age groups, balanced, symmetrical upper body statics were evident. Most strikingly, the females showed greater thoracic kyphosis and lumbar lordosis angles (kyphosis: Ø ♀ 56°, Ø♂ 51°; lordosis: Ø ♀ 49°, Ø♂ 32°) and lumbar bending angles (Ø ♀ 14°, Ø♂ 11°) than the males. The distance between the scapulae was more pronounced in men. These parameters also show an increase with age and BMI, respectively. Pelvic parameters were independent of age and sex. The upper body postures of women and men between the ages of 21 and 60 years were found to be almost symmetrical and axis-conforming with a positive correlation for BMI or age. Consequently, the present body posture parameters allow for comparisons with other studies, as well as for the evaluation of clinical (interim) diagnostics and applications.

Handwashing adherence during the COVID-19 pandemic: A longitudinal study based on protection motivation theory

RATIONALE

The associations between the number of COVID-19 cases/deaths and subsequent uptake of protective behaviors may reflect cognitive and behavioral responses to threat-relevant information.

OBJECTIVE

Applying protection motivation theory (PMT), this study explored whether the number of total COVID-19 cases/deaths and general anxiety were associated with cross-situational handwashing adherence and whether these associations were mediated by PMT-specific self-regulatory cognitions (threat appraisal: perceived vulnerability, perceived illness severity; coping appraisal: self-efficacy, response efficacy, response costs).

METHOD

The study (#NCT04367337) was conducted in March-September 2020 among 1256 adults residing in 14 countries. Self-reports on baseline general anxiety levels, handwashing adherence across 12 situations, and PMT-related constructs were collected using an online survey at two points in time, four weeks apart. Values of COVID-19 cases and deaths were retrieved twice for each country (one week prior to the individual data collection).

RESULTS

Across countries and time, levels of adherence to handwashing guidelines were high. Path analysis indicated that smaller numbers of COVID-19 cases/deaths (Time 0; T0) were related to stronger self-efficacy (T1), which in turn was associated with higher handwashing adherence (T3). Lower general anxiety (T1) was related to better adherence (T3), with this effect mediated by higher response efficacy (T1, T3) and lower response cost (T3). However, higher general anxiety (T1) was related to better adherence via higher illness severity (T1, T3). General anxiety was unrelated to COVID-19 indicators.

CONCLUSIONS

We found a complex pattern of associations between the numbers of COVID-19 cases/deaths, general anxiety, PMT variables, and handwashing adherence at the early stages of the pandemic. Higher general anxiety may enable threat appraisal (perceived illness severity), but it may hinder coping appraisal (response efficacy and response costs). The indicators of the trajectory of the pandemic (i.e., the smaller number of COVID-19 cases) may be indirectly associated with higher handwashing adherence via stronger self-efficacy.

Understanding health behaviours in context: A systematic review and meta-analysis of ecological momentary assessment studies of five key health behaviours

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

White Paper: Open Digital Health - accelerating transparent and scalable health promotion and treatment

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).

What helps to form a healthy nutrition habit? Daily associations of intrinsic reward, anticipated regret, and self-efficacy with automaticity

BACKGROUND

High automaticity in healthy nutrition behaviors is related to long-term maintenance of these behaviors. Drawing upon theoretical frameworks of habit formation, proposed antecedents such as intrinsic reward, anticipated regret, and self-efficacy are important correlates of automaticity, but not much is known about their day-by-day relationships with automaticity in healthy nutrition behaviors. This study tested previous-day within-person (i.e., from one day to the next) and same-day within-person associations of intrinsic reward, anticipated regret, and self-efficacy with automaticity of a healthy nutrition behavior, for which participants attempted to form a new habit.

METHODS

Secondary analyses of a randomized controlled trial with two planning intervention conditions including a longitudinal sample of n = 135 participants (age: M = 24.82 years; SD = 7.27) are reported. Participants formed a plan on a self-selected healthy nutrition behavior to become a new habit and were followed up over 12 weeks assessing daily levels of plan-specific intrinsic reward, anticipated regret, self-efficacy, and automaticity. Lagged multilevel models with 84 study days nested in participants estimated previous-day within-person, same-day within-person, and between-person relationships of intrinsic reward, anticipated regret, and self-efficacy with automaticity.

FINDINGS

Regarding within-level relationships, higher-than-usual levels of intrinsic reward, anticipated regret, and self-efficacy of the same day but not of the previous day were associated with higher within-person automaticity. With respect to between-level relationships, higher between-levels (i.e., higher person mean levels across the study period) of intrinsic reward, anticipated regret, and self-efficacy were linked with higher automaticity.

DISCUSSION

Findings point towards the potential to intervene on intrinsic reward, anticipated regret, and self-efficacy when aiming to promote a new healthy nutrition habit.

Differences in observed and self-reported compliance with the 5 moments for hand hygiene as a function of healthcare workers' empathy

BACKGROUND

Hand hygiene at critical time-points (as established by the WHO model 'Five moments for hand hygiene') remains the leading measure for minimising the risk of healthcare-associated infections. While many interventions have been tested to improve hand hygiene compliance (HHC) of healthcare workers (HCWs), little is known about the relation between HHC and HCW empathy.

AIM

The aim of this study was to investigate the relation between moment-specific HHC rates and HCWs' empathy, at both individual and ward levels.

METHODS

HHC data was collected via observation and self-report, staffs' empathy levels were measured using an established questionnaire. The survey was conducted on 38 wards of three tertiary-care hospitals in Germany. Observation data was obtained via in-house observations which were conducted up to eight months before or after the survey.

FINDINGS

Evidence for the expected correlation between HCW empathy and moment-specific HHC was found for both observed HHC (Moment 1: r = .483, p = .031; Moment 2: r = 588, p = .006) and self-reported HHC (Moment 1: r = .093, p = .092; Moment 2: r = .145, p = .008). In analyses of variance the critical interaction effect between empathy (i.e., lower vs. higher empathy) and designated time-point of hand hygiene (i.e., before vs. after reference task) was also significant.

CONCLUSION

HCWs' empathy should be considered as an important factor in explaining differences between moment-specific HHC rates. In consequence, empathy comes into focus not only as a crucial factor for high-quality patient care, but as an important contributor to improving HHC, too.

Novel KEL allele associated with loss of Kpb identified in a white blood donor

The importance of identifying variant alleles among blood donors is significant to the safety of transfusion for recipients. Molecular methods have become more prominent in the routine process of antigen typing donor units. Some variant antigens cannot be detected using only serologic methods. Molecular testing allows the determination of nucleotide sequences that are used to predict a phenotype. Antigens of the Kell blood group system are known for being highly immunogenic and causing adverse reactions upon antibody formation. A female white blood donor who typed Kp(b-) using serologic methods on multiple donations since 2005 was the subject of a typing discrepancy investigation. Routine genotyping using a commercial genotyping kit (HemoID DQS Panel; Agena Bioscience, San Diego, CA) predicted the donor to type Kp(a+b+). Investigation of the discrepancy between these two results identified a rare single nucleotide variant in the KEL gene at nucleotide position c.948G>T that alters amino acid residue 316 from tryptophan (Trp) to cysteine (Cys). After discovery of the novel allele, adsorption and elution studies were performed to see if there was weakened Kp^b expression. The elution studies yielded negative results, which indicated that Kp^b is not expressed. The KEL transcripts expressed by the donor were determined using cDNA analysis, and the predicted amino acid sequence of the novel allele was modeled to investigate the impact of the amino acid sequence on the structure of the KEL polypeptide. Both SWISS-MODEL and Robetta software were used to evaluate the impact of the p.Trp316Cys on the three-dimensional protein structure. There was no conformational change noted with SWISS-MODEL, whereas the Robetta software showed a significant conformational change compared with the normal Kp(b+) reference sequence. Because the donor is homozygous for variants associated with k and Js^b expression, it was not possible to determine whether the novel allele is associated with loss of Kp^b only or loss of all Kell antigens.

Cambridge hybrid closed-loop algorithm in children and adolescents with type 1 diabetes: a multicentre 6-month randomised controlled trial

BACKGROUND

Closed-loop insulin delivery systems have the potential to address suboptimal glucose control in children and adolescents with type 1 diabetes. We compared safety and efficacy of the Cambridge hybrid closed-loop algorithm with usual care over 6 months in this population.

METHODS

In a multicentre, multinational, parallel randomised controlled trial, participants aged 6-18 years using insulin pump therapy were recruited at seven UK and five US paediatric diabetes centres. Key inclusion criteria were diagnosis of type 1 diabetes for at least 12 months, insulin pump therapy for at least 3 months, and screening HbA1c levels between 53 and 86 mmol/mol (7·0-10·0%). Using block randomisation and central randomisation software, we randomly assigned participants to either closed-loop insulin delivery (closed-loop group) or to usual care with insulin pump therapy (control group) for 6 months. Randomisation was stratified at each centre by local baseline HbA1c. The Cambridge closed-loop algorithm running on a smartphone was used with either (1) a modified Medtronic 640G pump, Medtronic Guardian 3 sensor, and Medtronic prototype phone enclosure (FlorenceM configuration), or (2) a Sooil Dana RS pump and Dexcom G6 sensor (CamAPS FX configuration). The primary endpoint was change in HbA1c at 6 months combining data from both configurations. The primary analysis was done in all randomised patients (intention to treat). Trial registration ClinicalTrials.gov, NCT02925299.

FINDINGS

Of 147 people initially screened, 133 participants (mean age 13·0 years [SD 2·8]; 57% female, 43% male) were randomly assigned to either the closed-loop group (n=65) or the control group (n=68). Mean baseline HbA1c was 8·2% (SD 0·7) in the closed-loop group and 8·3% (0·7) in the control group. At 6 months, HbA1c was lower in the closed-loop group than in the control group (between-group difference -3·5 mmol/mol (95% CI -6·5 to -0·5 [-0·32 percentage points, -0·59 to -0·04]; p=0·023). Closed-loop usage was low with FlorenceM due to failing phone enclosures (median 40% [IQR 26-53]), but consistently high with CamAPS FX (93% [88-96]), impacting efficacy. A total of 155 adverse events occurred after randomisation (67 in the closed-loop group, 88 in the control group), including seven severe hypoglycaemia events (four in the closed-loop group, three in the control group), two diabetic ketoacidosis events (both in the closed-loop group), and two non-treatment-related serious adverse events. There were 23 reportable hyperglycaemia events (11 in the closed-loop group, 12 in the control group), which did not meet criteria for diabetic ketoacidosis.

INTERPRETATION

The Cambridge hybrid closed-loop algorithm had an acceptable safety profile, and improved glycaemic control in children and adolescents with type 1 diabetes. To ensure optimal efficacy of the closed-loop system, usage needs to be consistently high, as demonstrated with CamAPS FX.

FUNDING

National Institute of Diabetes and Digestive and Kidney Diseases.

Plan pursuit in the context of daily fruit and vegetable consumption: The importance of cue detection and the execution of the planned behaviour for overall behaviour change

OBJECTIVES

In action planning interventions, individuals specify and link cues with behavioural responses to implement behaviour change. To date, not much is known about how and how much the detection of the planned cue (entering and identifying the planned situation) and the execution of the planned behaviour (behavioural response exactly as planned) contribute to overall behavioural changes (changes in target behaviour) achieved by individuals. Using data from an intervention on daily fruit and vegetable (FV) action planning, this study aimed to test whether individuals' cue detection and execution of the planned behaviour are positively related to overall FV intake.

DESIGN

Secondary data analyses examined diary data of the intervention condition of a randomized controlled trial. Ninety participants (80% female, aged 19-63 years) formed one FV plan and completed a 13-days post-intervention self-report diary assessing daily FV consumption and situational characteristics of each consumed FV serving. Based on these self-reports and participants' FV plan, day-to-day cue detection and the execution of the planned behaviour were coded.

METHODS

With two-level models, cue detection and the execution of the planned behaviour were examined as between- and within-person predictors of daily FV intake.

RESULTS

Higher between-person execution of the planned behaviour (+1.68 daily servings), higher-than-usual within-person cue detection (+0.46 daily servings), and higher-than-usual within-person execution of the planned behaviour (+0.29 daily servings) were associated with more overall FV intake.

CONCLUSIONS

Detecting planned cues (within-person) and executing the planned behaviour (between- and within-person) are important for overall FV intake.

Off-stoichiometry in I-III-VI2 chalcopyrite absorbers: a comparative analysis of structures and stabilities

Chalcopyrite Cu(In,Ga)Se2 (CIGSe) solar absorbers are renowned for delivering high solar power conversion efficiency despite containing high concentration of lattice defects amounting to copper deficiency of several atomic percent. The...

Collaborative, dyadic, and individual planning and physical activity: A dyadic randomized controlled trial

OBJECTIVE

This study was designed to investigate the effects of collaborative, dyadic, and individual planning on moderate-to-vigorous physical activity (MVPA) in target person-partner dyads. Individual planning reflects an "I-for-me" planning of one person's behavior. Collaborative planning refers to joint planning of both dyad members' behavior ("We-for-us" planning), and dyadic planning refers to joint planning of only the target person's behavior ("We-for-me" planning).

METHOD

N = 320 dyads of target persons (M age: 43.86 years old) and partners (M age: 42.32 years old) participated in a randomized controlled trial (ClinicalTrials.gov registration no. NCT03011385) with three experimental planning conditions (collaborative, dyadic, or individual planning) and an active control condition (physical activity, sedentary behavior, and nutrition education). Target persons did not meet international MVPA guidelines or were recommended to increase their MVPA due to cardiovascular disease or type II diabetes. MVPA was measured with ActiGraph wGT3X-BT accelerometers at baseline, 1-week follow-up, and 36-week follow-up (6 months after the final intervention session; the primary endpoint). Linear mixed models were fit for target persons and partners separately.

RESULTS

At 1-week follow-up, there were no significant Time × Condition interaction effects among target persons and partners. At 36-week follow-up, target persons and partners in the dyadic planning conditions increased their MVPA, compared to the control condition.

CONCLUSIONS

Individuals with insufficient physical activity or with a cardiovascular disease/type II diabetes and their partners may benefit from dyadic planning, which is a promising strategy to achieve physical activity increases. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Spotted Lanternfly (Hemiptera: Fulgoridae) Nymphal Dispersion Patterns and Their Influence on Field Experiments

The spotted lanternfly, Lycorma delicatula (Hemiptera: Fulgoridae) (White, 1845), is an invasive pest in the Mid-Atlantic region of the United States. Understanding this pest's dispersion patterns is fundamental for development of management and surveillance programs. To address this knowledge gap, we quantified spotted lanternfly nymph dispersion patterns by instar for rural and urban/suburban habitats, and we compared the number of sample units required for sticky traps and in situ visual counts to estimate population densities at several precisions. In addition, we assessed the ability of two experimental designs (completely random and randomized complete block) to detect management practices' impacts in the field. All instars typically followed an aggregated dispersion pattern. Sample size and time requirements for checking and replacing sticky traps and for conducting in situ counts were similar, but in situ counts do not require purchasing traps, installation time, or delays before treatment, and do not remove insects. Although the cost for using in situ counts is likely less than for sticky traps, early instar spotted lanternfly nymph populations are harder to visually detect than later instars because of their small size, which may negate any cost advantage when treatments are applied early. In general, using a randomized complete block design resulted in higher statistical power than a completely random design, allowing detection of proportional population reductions of 10-20% less with equal replication. Studies aiming to evaluate treatments that reduce spotted lanternfly numbers by less than 60% will require researchers to evaluate the feasibility of using the required large sample sizes.

The Interplay Between Strictness of Policies and Individuals' Self-Regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic

BACKGROUND

Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA).

PURPOSE

This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions.

METHODS

The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection).

RESULTS

Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring.

CONCLUSIONS

When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.

Hand Washing and Related Cognitions Following a Brief Behavior Change Intervention During the COVID-19 Pandemic: a Pre-Post Analysis

Background

Effective hand washing (for at least 20 s, with water and soap) is one of the health behaviors protecting against infection transmissions. Behavior change interventions supporting the initiation and maintenance of hand washing are crucial to prevent infection transmissions. Based on the Health Action Process Approach, the aim of this research was to conduct a pre-post analysis of hand washing and related cognitions (i.e., intention, self-efficacy, self-monitoring), measured up to 100 days following an intervention.

Methods

A convenience sample of N = 123 participants (age: M = 23.96 years; SD = 5.82; 80% women) received a brief intervention (key behavior change techniques: information about health consequences of hand washing; action planning) and responded to daily diaries and questionnaires up to a 100-day follow-up. Two-level models were used to analyze data of n = 89 participants who provided longitudinal data.

Results

Hand washing and self-monitoring increased, whereas intention and self-efficacy decreased over time. Only self-monitoring was a consistent positive correlate of hand washing on a between-person level.

Conclusions

Hand washing and self-monitoring considerably increased over several weeks following the intervention. Future research testing the intervention against a control condition is needed to rule out that changes in behavior and cognitions might have been prompted by completing the daily diaries.

Trial Registration

German Clinical Trials Register; https://www.drks.de; registration number: DRKS00022067.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12529-021-10042-w.

A Mobile Intervention for Self-Efficacious and Goal-Directed Smartphone Use in the General Population: Randomized Controlled Trial

Background

People spend large parts of their everyday life using their smartphones. Despite various advantages of the smartphone for daily life, problematic forms of smartphone use exist that are related to negative psychological and physiological consequences. To reduce problematic smartphone use, existing interventions are oftentimes app-based and include components that help users to monitor and restrict their smartphone use by setting timers and blockers. These kinds of digital detox interventions, however, fail to exploit psychological resources, such as through promoting self-efficacious and goal-directed smartphone use.

Objective

The aim of this study is to evaluate the theory-based smartphone app “Not Less But Better” that was developed to make people aware of psychological processes while using the smartphone and to support them in using their smartphone in accordance with their goals and values.

Methods

In a randomized controlled trial, effects of a 20-day intervention app consisting of five 4-day training modules to foster a goal-directed smartphone use were evaluated. In the active control condition (treatment as usual), participants received a digital detox treatment and planned daily time-outs of at least 1 hour per day. Up to a 3-week follow-up, self-reported problematic smartphone use, objectively measured daily smartphone unlocks, time of smartphone use, self-efficacy, and planning towards goal-directed smartphone use were assessed repeatedly. Linear 2-level models tested intervention effects. Mediation models served to analyze self-efficacy and planning as potential mechanisms of the intervention.

Results

Out of 232 enrolled participants, 110 (47.4%; 55 participants in each condition) provided data at postintervention and 88 (37.9%; 44 participants in each condition) at 3-week follow-up. Both conditions manifested substantial reductions in problematic smartphone use and in the amount of time spent with the smartphone. The number of daily unlocks did not change over time. Further, modelling changes in self-efficacy as a mediator between the intervention and problematic smartphone use at follow-up fit well to the data and showed an indirect effect (b=–0.09; 95% bias-corrected bootstrap CI –0.26 to –0.01), indicating that self-efficacy was an important intervention mechanism. Another mediation model revealed an indirect effect from changes in planning via smartphone unlocks at postintervention on problematic smartphone use at follow-up (b=–0.029, 95% bias-corrected bootstrap CI –0.078 to –0.003).

Conclusions

An innovative, theory-based intervention app on goal-directed smartphone use has been found useful in lowering problematic smartphone use and time spent with the smartphone. However, observed reductions in both outcomes were not superior to the active control condition (ie, digital detox treatment). Nonetheless, the present findings highlight the importance in promoting self-efficacy and planning goal-directed smartphone use to achieve improvements in problematic smartphone use. This scalable intervention app appears suitable for practical use and as an alternative to common digital detox apps. Future studies should address issues of high attrition by adding just-in-time procedures matched to smartphone users’ needs.

Trial Registration

German Clinical Trials Register DRKS00017606; https://tinyurl.com/27c9kmwy

Hygiene-Eliciting Brood Semiochemicals as a Tool for Assaying Honey Bee (Hymenoptera: Apidae) Colony Resistance to Varroa (Mesostigmata: Varroidae)

Despite numerous interventions, the ectoparasitic mite Varroa (Varroa destructor Anderson and Trueman [Mesostigmata: Varroidae]) and the pathogens it vectors remain a primary threat to honey bee (Apis mellifera Linnaeus [Hymenoptera: Apidae]) health. Hygienic behavior, the ability to detect, uncap, and remove unhealthy brood from the colony, has been bred for selectively for over two decades and continues to be a promising avenue for improved Varroa management. Although hygienic behavior is expressed more in Varroa-resistant colonies, hygiene does not always confer resistance to Varroa. Additionally, existing Varroa resistance selection methods trade efficacy for efficiency, because those achieving the highest levels of Varroa resistance can be time-consuming, and thus expensive and impractical for apicultural use. Here, we tested the hypothesis that hygienic response to a mixture of semiochemicals associated with Varroa-infested honey bee brood can serve as an improved tool for predicting colony-level Varroa resistance. In support of our hypothesis, we demonstrated that a mixture of the compounds (Z)-10-tritriacontene, (Z)-8-hentriacontene, (Z)-8-heptadecene, and (Z)-6-pentadecene triggers hygienic behavior in a two-hour assay, and that high-performing colonies (hygienic response to ≥60% of treated cells) have significantly lower Varroa infestations, remove significantly more introduced Varroa, and are significantly more likely to survive the winter compared to low-performing colonies (hygienic response to <60% of treated cells). We discuss the relative efficacy and efficiency of this assay for facilitating apiary management decisions and selection of Varroa-resistant honey bees, as well as the relevance of these findings to honey bee health, pollination services, and social insect communication.

The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries

BACKGROUND

The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier).

METHODS

The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports.

RESULTS

Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence.

CONCLUSIONS

To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic.

TRIAL REGISTRATION

Clinical Trials.Gov, # NCT04367337.

What makes implementation intentions (in)effective for physical activity among older adults?

OBJECTIVES

For most populations, implementation intentions (IIs) facilitate physical activity (PA). However, for older adults, previous studies found mixed evidence for the effectiveness of this behaviour change technique. To examine which characteristics of IIs predict successful enactment, the content of older participants' IIs formed within a self-regulatory intervention to prompt PA was analysed.

DESIGN

A sample of N = 126 German speaking adults aged 64 and older formed up to six IIs for PA and reported their enactment 5 weeks later.

METHODS

Controlling for age and sex, multilevel models tested associations between characteristics of IIs (e.g., chronological rank of II, hetero- and homogeneity, specificity, presence of certain cues) and enactment.

RESULTS

Significantly related to enactment were: the chronological rank of an II (first IIs superior to last IIs), greater heterogeneity in activities, greater specificity of when-cues, and greater use of pre-existing routines.

CONCLUSIONS

Participants were more likely to enact their IIs 5 weeks later if they planned different (heterogeneous) activities, created IIs with more specific when-cues (e.g., on Monday at 9 am), and in particular a routine (e.g., after breakfast). They also enacted the first three IIs (chronological rank of II) more often than the last three IIs. Future experimental studies should test whether providing instructions to create IIs based on the above significant characteristics lead to more effective health behaviour change among older adults.

Influence of pregnancy and non-fasting conditions on the plasma metabolome in a rat prenatal toxicity study

The current parameters for determining maternal toxicity (e.g. clinical signs, food consumption, body weight development) lack specificity and may underestimate the extent of effects of test compounds on the dams. Previous reports have highlighted the use of plasma metabolomics for an improved and mechanism-based identification of maternal toxicity. To establish metabolite profiles of healthy pregnancies and evaluate the influence of food consumption as a confounding factor, metabolite profiling of rat plasma was performed by gas- and liquid-chromatography-tandem mass spectrometry techniques. Metabolite changes in response to pregnancy, food consumption prior to blood sampling (non-fasting) as well as the interaction of both conditions were studied. In dams, both conditions, non-fasting and pregnancy, had a marked influence on the plasma metabolome and resulted in distinct individual patterns of changed metabolites. Non-fasting was characterized by increased plasma concentrations of amino acids and diet related compounds and lower levels of ketone bodies. The metabolic profile of pregnant rats was characterized by lower amino acids and glucose levels and higher concentrations of plasma fatty acids, triglycerides and hormones, capturing the normal biochemical changes undergone during pregnancy. The establishment of metabolic profiles of pregnant non-fasted rats serves as a baseline to create metabolic fingerprints for prenatal and maternal toxicity studies.

Systematic review of ecological momentary assessment (EMA) studies of five public health-related behaviours: review protocol

INTRODUCTION

Ecological momentary assessment (EMA) involves repeated, real-time assessments of phenomena (eg, cognitions, emotions, behaviours) over a period of time in naturalistic settings. EMA is increasingly used to study both within-person and between-person processes. We will review EMA studies investigating key health behaviours and synthesise: (1) study characteristics (eg, frequency of assessments, adherence, incentives), (2) associations between psychological predictors and behaviours and (3) moderators of adherence to EMA protocols.

METHODS AND ANALYSIS

This review will focus on EMA studies conducted across five public health behaviours in adult, non-clinical populations: movement behaviour (including physical activity and sedentary behaviour), dietary behaviour, alcohol consumption, tobacco smoking and preventive sexual health behaviours. Studies need to have assessed at least one psychological or contextual predictor of these behaviours. Studies reporting exclusively on physiological outcomes (eg, cortisol) or those not conducted under free-living conditions will be excluded. We will search OVID MEDLINE, Embase, PsycINFO and Web of Science using terms relevant to EMA and the selected health behaviours. Reference lists of existing systematic reviews of EMA studies will be hand searched. Identified articles will be screened by two reviewers. This review is expected to provide a comprehensive summary of EMA studies assessing psychological or contextual predictors of five public health behaviours.

ETHICS AND DISSEMINATION

The results will be disseminated through peer-reviewed publications and presentations. Data from included studies will be made available to other researchers. No ethics are required.

PROSPERO REGISTRATION NUMBER

CRD42020168314.

Environmental Issues Are Health Issues

Abstract. Increasing demands on ecosystems, decreasing biodiversity, and climate change are among the most pressing environmental issues of our time. As changing weather conditions are leading to increased vector-borne diseases and heat- and flood-related deaths, it is entering collective consciousness: environmental issues are human health issues. In public health, the field addressing these issues is known as environmental health. This field addresses both the effects people have on their environment as well as the effects of the environment on people. Psychology, as a discipline concerned with explaining, predicting, and changing behavior has much to contribute to these issues because human behavior is key in promoting environmental health. To date, however, an integrative view of environmental health in psychology is lacking, hampering urgently needed progress. In this paper, we review how the environment and human health are intertwined, and that much can be gained through a systemic view of environmental health in psychology. Based on a review of the literature, we suggest that psychologists unite efforts to promote an integrative science and practice of environmental health psychology, and jointly address environmental-health related behavior. The research agenda for this field will include integrating behavior change theory and intervention approaches. Thereby, psychology can potentially make an important contribution to sustained environmental health for generations to come.

SARS-CoV-2 Infection, Risk Perception, Behaviour and Preventive Measures at Schools in Berlin, Germany, during the Early Post-Lockdown Phase: A Cross-Sectional Study

Briefly before the first peak of the COVID-19 pandemic in Berlin, Germany, schools closed in mid-March 2020. Following re-opening, schools resumed operation at a reduced level for nine weeks. During this phase, we aimed at assessing, among students and teachers, infection status, symptoms, individual behaviour, and institutional infection prevention measures. Twenty-four primary and secondary school classes, randomly selected across Berlin, were examined. Oro-nasopharyngeal swabs and capillary blood samples were collected to determine SARS-CoV-2 infection (PCR) and specific IgG (ELISA), respectively. Medical history, household characteristics, leisure activities, fear of infection, risk perception, hand hygiene, facemask wearing, and institutional preventive measures were assessed. Descriptive analysis was performed. Among 535 participants (385 students, 150 staff), one teenager was found to be infected with SARS-CoV-2 (0.2%), and seven individuals exhibited specific IgG (1.3%). Compared to pre-pandemic times, screen time (e.g., TV, gaming, social media) increased, and the majority of primary school students reported reduced physical activity (42.2%). Fear of infection and risk perception were relatively low, acceptance of adapted health behaviors was high. In this post-lockdown period of low SARS-CoV-2 incidence in Berlin, individual and school-level infection prevention measures were largely adhered to. Nevertheless, vigilance and continued preventive measures are essential to cope with future pandemic activity.

Symmetrical dental occlusion blocking - changes of body sway and weight distribution in healthy subjects across 4 age decades

Objectives

Symmetrical dental occlusion blocking is used in dentistry as a quick diagnostic tool to test for potential influences of the craniomandibular system on body sway and weight distribution. This study presents the changes of body sway and pressure distribution in healthy subjects, free of a temporomandibular dysfunction (TMD). Immediate effects between occlusal blocking and rest position on body sway and body weight distribution in general, as well as for both genders and for four age decades will be evaluated.

Materials and methods

725 (396f/329 m) subjects (neither subjective signs of TMD nor acute/chronic complaints in the musculoskeletal system) volunteered (21 to 60 years) while both genders were divided into four age groups according to decades. A pressure measuring platform was used. Body sway and weight distribution were recorded in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking (bicuspid region) by cotton rolls.

Results

Both, the frontal sway and the sagittal sway reduced by 0.67 mm (t(724) = − 3.9 (p <  0.001)) and by 0.33 mm (t(724) = − 3.4 (p <  0.001)). The relative pressure under the left forefoot increased by 0.33% (t(724) = 2.88 (p <  0.001)) and the relative pressure overall under the forefoot increased by 0.67% (t(724) = − 3.4 (p <  0.001)). Gender-specific, age-specific and BMI-specific reactions could not be identified.

Conclusions

Subjects, free of any TMD and with no complaints of the musculoskeletal system, show small changes of the body sway and weight distribution when biting symmetrically on a cotton roll. These changes are independent of age, gender or body mass index (BMI). Due to the relative large sample size, the presented results can also be seen as norm values when body sway is used as an additional assessment of a TMD.

Alkali Dispersion in (Ag,Cu)(In,Ga)Se2 Thin Film Solar Cells-Insight from Theory and Experiment

Silver alloying of Cu(In,Ga)Se₂ absorbers for thin film photovoltaics offers improvements in open-circuit voltage, especially when combined with optimal alkali-treatments and certain Ga concentrations. The relationship between alkali distribution in the absorber and Ag alloying is investigated here, combining experimental and theoretical studies. Atom probe tomography analysis is implemented to quantify the local composition in grain interiors and at grain boundaries. The Na concentration in the bulk increases up to ∼60 ppm for [Ag]/([Ag] + [Cu]) = 0.2 compared to ∼20 ppm for films without Ag and up to ∼200 ppm for [Ag]/([Ag] + [Cu]) = 1.0. First-principles calculations were employed to evaluate the formation energies of alkali-on-group-I defects (where group-I refers to Ag and Cu) in (Ag,Cu)(In,Ga)Se₂ as a function of the Ag and Ga contents. The computational results demonstrate strong agreement with the nanoscale analysis results, revealing a clear trend of increased alkali bulk solubility with the Ag concentration. The present study, therefore, provides a more nuanced understanding of the role of Ag in the enhanced performance of the respective photovoltaic devices.

Immediate effects of a very brief planning intervention on fruit and vegetable consumption: A randomized controlled trial

Action planning interventions can effectively promote fruit and vegetable (FV) consumption, but not much is known about the day-to-day translation of intervention planning into action. In this randomized controlled trial, immediate intervention effects of a very brief planning intervention on FV consumption during the following 13 days were investigated. After a 13-day pre-intervention diary, N = 206 participants (aged 19-66 years) were randomly allocated to a waiting-list control condition or a planning condition, where they formed one FV plan. Participants from both conditions completed a 13-day post-intervention diary. Self-reported daily FV consumption, FV-specific self-efficacy, and action control were assessed. Segmented linear mixed models estimating a discrete change (i.e. "jump") between diary phases showed a positive "jump" of FV intake and self-efficacy in the planning condition when compared to the control condition. For action control, such effects were not observed. Changes in study variables throughout the post-intervention phase did not differ between both conditions. Present findings extend previous evidence on action planning interventions by showing that increases in self-regulatory (i.e. self-efficacy) and behavioral (i.e. FV intake) outcomes can occur very rapidly and already on the first day for which behavioral increases were planned.

Moving in Sync: Hourly Physical Activity and Sedentary Behavior are Synchronized in Couples

BACKGROUND

Overall time spent in moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior are both correlated in couples. Knowledge about the nature and psychosocial correlates of such dyadic covariation could inform important avenues for physical activity promotion.

PURPOSE

The present study investigates hour-by-hour covariation between partners (i.e., synchrony) in MVPA and sedentary behavior as partners engage in their daily lives and links it with person-level MVPA/sedentary behavior, temporal characteristics, and relationship variables.

METHODS

We used 7-day accelerometer data from two couple studies (Study 1, n = 306 couples, aged 18-80 years; Study 2, n = 108 couples, aged 60-87 years) to estimate dyadic covariation in hourly MVPA and sedentary behavior between partners. Data were analyzed using coordinated multilevel modeling.

RESULTS

In both studies, hourly MVPA and sedentary behavior exhibited similarly sized dyadic covariation between partners in the low-to-medium range of effects. Higher MVPA synchrony between partners was linked with higher individual weekly MVPA and higher individual weekly sedentary levels, whereas higher sedentary synchrony between partners was associated with higher individual weekly MVPA but lower individual weekly sedentary levels. MVPA and sedentary synchrony were higher in the morning and evening, more pronounced on weekends, and associated with more time spent together, longer relationship duration, and time-varying perceptions of higher partner closeness.

CONCLUSIONS

This study demonstrates that MVPA and sedentary behaviors do not occur in a social vacuum. Instead, they are linked with close others such as partners. Thus, capitalizing on social partners may increase the effectiveness of individual-level physical activity interventions.

Habit formation following routine-based versus time-based cue planning: A randomized controlled trial

OBJECTIVES

Habit formation has been identified as one of the key determinants of behaviour change. To initiate habit formation, self-regulation interventions can support individuals to form a cue-behaviour plan and to repeatedly enact the plan in the same context. This randomized controlled trial aimed to model habit formation of an everyday nutrition behaviour and examined whether habit formation and plan enactment differ when individuals plan to enact their behaviour in response to a routine-based versus time-based cue.

DESIGN

Following a baseline assessment, N = 192 adults (aged 18-77 years) were randomly assigned to a routine-based cue or a time-based cue planning intervention, in which they selected an everyday nutrition behaviour and linked it to a daily routine or a time cue.

METHODS

Participants responded to daily questionnaires over 84 days assessing plan enactment and the behaviour's automaticity (as an indicator of habit formation). Multilevel models with days nested in participants were fitted.

RESULTS

As indicated by asymptotic curves, it took a median of 59 days for participants who successfully formed habits to reach peak automaticity. Group-level analyses revealed that both routine-based and time-based cue planning led to increases in automaticity and plan enactment, but no between-condition differences were found. Repeated plan enactment was a key predictor for automaticity.

CONCLUSIONS

Linking one's nutrition behaviour to a daily routine or a specific time was similarly effective for habit formation. Interventions should encourage persons to repeatedly carry out their planned behaviour in response to the planned cue to facilitate habit formation.

Dispersion Patterns and Sample Size Estimates for Egg Masses of Spotted Lanternfly (Hemiptera: Fulgoridae)

The spotted lanternfly, Lycorma delicatula (White), is a new invasive pest in the United States. To quantify spotted lanternfly population abundance, one must understand this pest's dispersion pattern, that is, the spatial arrangement of individuals within a population. Spotted lanternflies overwinter in egg masses from late fall to May, making this life stage suitable for population assessments. We measured the dispersion pattern of egg masses at two types of sites: a suburban housing development, where we used individual trees as the sampling unit, and rural woodlots, where we used individual trees and also plots with 5.64 m radius as sampling units. Plots were the same size as those recommended for monitoring the gypsy moth, a well-studied pest with similar egg laying habit to the spotted lanternfly. Egg masses in both sampling units were counted up to a height of 3 m. With trees as the sampling unit, egg masses were aggregated in 12 of 20 rural sampling universes, randomly dispersed at 6, and completely absent at 2. Similar patterns were seen when using the 5.64-m radius rural sampling units and for suburban sampling universes. We calculated sample size requirements for a range of mean densities at a precision of 25 and 30%. Additionally, the vertical distribution of egg masses was characterized on the invasive tree of heaven [Ailanthus altissima (Mill.) Swingle], a preferred host for spotted lanternflies. For small trees, there was a positive relationship between number of egg masses in the bottom 3 m of the tree and the total count.

Systematic changes of the static upper body posture with a symmetric occlusion condition

Background

Temporary occlusal changes and their influence on the upper body statics are still controversially discussed. Furthermore, concrete statements on whether age- or gender-specific differences in neurophysiological reactions exist are missing. Therefore, it is the aim of this study to evaluate the immediate effects of a symmetrical occlusion blocking on the upper body posture. These effects shall be investigated for both genders and for a larger age range.

Methods

In this study, 800 (407f/393 m) subjects volunteered aged from 21 to 60 years. Both genders were divided into four age groups according to decades. The three-dimensional upper body posture was measured by using the rasterstereography (ABW-Bodymapper). The habitual static posture was measured in two dental occlusion conditions (a) in rest position and (b) symmetrical blocking in the bicuspid region by cotton rolls.

Results

A significant reduction of the trunk length (0.72 mm; p <  0.001), an increase of the lumbar (0.30°; p <  0.001) and the thoracic bending angle (0.14°; p = 0.001), a reduction of the spinal forward decline (0.16°; p <  0.001) and a reduction of the scapular distance (0.36 mm; p = 0.001) was found. Gender-specific reactions can only be recorded in scapular distance, in that regard men reduce this distance while over all age groups women did not show a significant change.

Discussion

Slight gender- and age-independent reactions due to a symmetric occlusion blockade are shown: A gender independent reaction of the spinal related variables in the sagittal plane (thoracic and lumbar flexion angle, trunk length, spinal forward decline). In addition, a gender specific change of the shoulder blade distance could be observed, where men reduced the distance while female did not show a change. However, since these reactions are of a minimum amount, it can be concluded that neurophysiological compensation mechanisms work equally well regardless of age and sex, and the upper body posture of healthy people changes only very slightly due to a temporarily symmetrical altered bite position.

DELLA family duplication events lead to different selective constraints in angiosperms

Gibberellic acid (GA) is a major plant hormone involved in several biological processes from the flowering to the symbiosis with microorganisms. Thus, the GA regulation is crucial for plant biology. This regulation occurs via the DELLA proteins that belong to the GRAS transcription factor family. DELLA proteins are characterised by a DELLA N-terminal and a GRAS C-terminal domains. It is well known that DELLA activity appears after the bryophytes divergence and then evolved in the vascular plant lineages. Here we present the phylogeny of DELLA across 75 species belonging to various lineages from algae, liverworts and angiosperms. Our study confirmed two main duplication events, the first occurring before the angiosperms divergence and the other specific to the eudicots lineage. Comparative analysis of DELLA subclades in angiosperms revealed the loss in Poaceae and strong alteration in other species of the DELLA functional domain in the DELLA2 clade. In addition, molecular evolution analysis suggests that each of the clades (named DELLA1.1, DELLA1.2 and DELLA2) evolved differently but copies of each subclade are under strong purifying selection. This also suggests that, although the DELLA functional domain is altered in DELLA2, DELLA2 orthologs are still functional and operate in a different way compared to DELLA1 copies. In angiosperms, additional duplication events occurred and led to duplicate copies in species, genus or family such as in the Fabaceae subfamily Papilionoideae. This duplication led to the formation of additional paralogs in the DELLA1.2 subclade (DELLA1.2.1 and DELLA1.2.2). Interestingly, both copies appeared to be under relaxing selection revealing different evolutionary fate of the DELLA duplicated copies.

Health Demands Moderate the Link Between Willpower Beliefs and Physical Activity in Patients with Knee Osteoarthritis

BACKGROUND

Regular physical activity (PA) was found to alleviate pain and improve functioning among patients with osteoarthritis of the knee (OAK). Heightened health demands due to OAK severity, body mass index (BMI), and depressive symptoms may require self-regulatory strategies to engage in more PA. Research on willpower-the capacity to exert self-control-suggests that believing that willpower is a nonlimited rather than a limited resource predicts effective self-regulation specifically when demands are high. The present study examines the association of OAK patients' willpower beliefs with their daily PA as a function of health demands.

METHODS

To identify the moderating role of OAK severity (WOMAC), BMI, and depressive symptoms (CES-D) on the link between willpower beliefs and objectively assessed PA over a 7-day period, baseline data of a registered randomized controlled trial with 243 patients (Mage = 65.47 years, SD = 0.49) were examined in secondary analyses.

RESULTS

Moderation analyses revealed that overall positive associations of willpower beliefs with PA were further qualified by OAK severity, BMI, and depressive symptoms. When patients faced less health demands, believing that willpower is nonlimited was associated with more PA. When health demands were higher, willpower beliefs were not associated with PA.

CONCLUSION

OAK patients' willpower beliefs were associated with PA. However, facing more health demands seemed to erase this beneficial link. Improving willpower beliefs by way of intervention may help to shed more light on predictive direction and ways to overcome barriers to regular physical activity.

Regional atmospheric reanalysis activities at Deutscher Wetterdienst: review of evaluation results and application examples with a focus on renewable energy

Abstract. Based on the numerical weather prediction model COSMO of Germany's national meteorological service (Deutscher Wetterdienst, DWD), regional reanalysis datasets have been developed with grid spacing of up to 2 km. This development started as a fundamental research activity within the Hans-Ertel-Centre for Weather Research (HErZ) at the University of Bonn and the University of Cologne. Today, COSMO reanalyses are an established product of the DWD and have been widely used in applications on European and national German level. Successful applications of COSMO reanalyses include renewable energy assessments as well as meteorological risk estimates. The COSMO reanalysis datasets are now publicly available and provide spatio-temporal consistent data of atmospheric parameters covering both near-surface conditions and vertical profiles. This article reviews the status of the COSMO reanalyses, including evaluation results and applications. In many studies, evaluation of the COSMO reanalyses point to an overall good quality and often an added value compared to different contemporary global reanalysis datasets. We further outline current plans for the further development and application of regional reanalyses in the HErZ research group Cologne/Bonn in collaboration with the DWD.

High Pressure Liquid Chromatographic Determination of Monoand Disaccharides in Presweetened Cereals: Collaborative Study

A collaborative study was conducted using a modified AOAC method (sugars in chocolate) for the determination of fructose, glucose, sucrose, and maltose in presweetened cereals by high pressure liquid chromatography (HPLC). Eight samples consisting of 6 products were analyzed in duplicate by the HPLC method and the AOAC Lane-Eynon method. The AOAC method was modified to use water-alcohol (1 + 1) and Sep-Pak C18 cartridges for sample cleanup. The HPLC results indicate precision comparable to the Lane-Eynon method and the chocolate method. The modified HPLC method has been adopted official first action.

What makes a good action plan? Characteristics and enactment of fruit and vegetable plans

BACKGROUND

One promising intervention strategy to increase fruit and vegetable (FV) consumption is action planning. However, conditions of successful plan enactment, i.e., the translation of plans into action, have rarely been studied. Therefore, the relationship between plan characteristics and plan enactment is being examined.

METHODS

Secondary analyses of an existing data set were conducted, based on a larger behavioral intervention study with a baseline assessment as well as a 2-weeks and a 4-weeks follow-up. After baseline assessment, participants completed action plan calendars for the following seven days and subsequently reported on each plan's enactment. Two independent raters coded 1732 morning, noon/afternoon, and evening plans by n = 92 individuals regarding the level of specificity (unspecific vs. specific) and type of planned behavior (fruit vs. vegetable intake). To predict plan enactment, multilevel logistic regression analyses were conducted.

FINDINGS

Overall specificity of plans was unrelated to plan enactment, but interacted with time of day in predicting plan enactment. Only in the morning, specific plans were more likely being enacted than unspecific plans. Overall, plan enactment decreased during the day and throughout the seven days of the plan calendar. Furthermore, fruit plans were more likely being enacted than vegetable plans.

DISCUSSION

Specific morning plans were found most beneficial for the enactment of FV plans. Here, possible underlying mechanisms such as stable morning routines should be further investigated. Moreover, the nutritional choice appeared to make a difference for plan enactment: Increasing one's fruit consumption may be easier than integrating more vegetables into one's daily diet.