The conceptualization of a Just-In-Time Adaptive Intervention (JITAI) for the reduction of sedentary behavior in older adults

Low physical activity and high sedentary behavior in older adults can be addressed with interventions that are delivered through modern technology. Just-In-Time Adaptive Interventions (JITAIs) are an emerging technology-driven behavior-change intervention type and capitalize on data that is collected via mobile sensing technology (e.g., smartphones) to trigger appropriate support in real-life. In this paper we integrated behavior change and aging theory and research as well as knowledge around older adult's technology use to conceptualize a JITAI targeting the reduction of sedentary behavior in older adults. The JITAIs ultimate goal is to encourage older adults to take regular activity breaks from prolonged sitting. As a proximal outcome, we suggest the number of daily activity breaks from sitting. Support provided to interrupt sitting time can be based on tailoring variables: (I) the current accumulated sitting time; (II) the location of the individual; (III) the time of the day; (IV) the frequency of daily support prompts; and (V) the response to previous support prompts. Data on these variables can be collected using sensors that are commonly inbuilt into smartphones (e.g., accelerometer, GPS). Support prompts might be best delivered via traditional text messages as older adults are usually familiar and comfortable with this function. The content of the prompts should encourage breaks from prolonged sitting by highlighting immediate benefits of sitting time interruptions. Additionally, light physical activities that could be done during the breaks should also be presented (e.g., walking into the kitchen to prepare a cup of tea). Although the conceptualized JITAI can be developed and implemented to test its efficacy, more work is required to identify ways to collect, aggregate, organize and immediately use dense data on the proposed and other potentially important tailoring variables. Machine learning and other computational modelling techniques commonly used by computer scientists and engineers appear promising. With this, to develop powerful JITAIs and to actualize the full potential of modern sensing technologies transdisciplinary approaches are required

Inhibition of Notch2 by Numb/Numblike controls myocardial compaction in the heart

Aims The ventricular wall of the heart is composed of trabeculated and compact layers, which are separated by yet unknown processes during embryonic development. Here, we wanted to explore the role of Notch2 and Numb/Numblike for myocardial trabeculation and compaction. Methods and results We found that Notch2 activity is specifically down-regulated in the compact layer during cardiac development in the mouse. The biological role of Notch2 down-regulation was investigated by the expression of constitutively active Notch2 in the myocardium of transgenic mice, resulting in hypertrabeculation, reduced compaction, and ventricular septum defects. To disclose the mechanism that inhibited Notch2 activity during the formation of myocardial layers, we analysed potential suppressors of Notch signalling. We unveiled that concomitant but not separate ablation of Numb and Numblike in the developing heart leads to increased Notch2 activity along with hypertrabeculation, reduced compaction, and ventricular septum defects, phenocopying effects gained by overexpression of constitutively active Notch2. Expression profiling revealed a strong up-regulation of Bmp10 in Numb/Numblike mutant hearts, which might also interfere with trabeculation and compaction. Conclusion This study identified potential novel roles of Numb/Numblike in regulating trabeculation and compaction by inhibiting Notch2 and Bmp10 signallin

Create workshop 2014 : Leveraging Mobile Technology and Social Media in Behavioral Research

European Health Psychologist166260-26

Untersuchungen zur Störkopplung und Schirmdämpfung von Elektro- und Hybridfahrzeugen

In Elektro- und Hybridfahrzeugen wird das konventionelle 12 V-Bordnetz um ein Hochvoltbordnetz zur Realisierung des elektrischen Traktionssystems erweitert. Durch die Integration wird die Komplexität der Fahrzeugelektronik deutlich gesteigert und eine wesentlich höhere Spannungsebene (bis 1000 V) eingeführt. Aufgrund von funktionell bedingten, schnellen Schaltvorgängen erzeugen die neuen elektronischen Hochvoltkomponenten wie beispielsweise der leistungselektronische Umrichter oder der DC-DC-Wandler Störungen, die bisher im Kraftfahrzeug nicht auftraten. Damit diese Störsignale die fehlerfreie Funktion anderer Elektroniksysteme im Fahrzeug nicht beeinflussen, wird das gesamte Hochvoltsystem u. a. als vollständig geschirmtes System in das Fahrzeug integriert. Andernfalls bietet sich zwischen beiden koexistierenden Bordnetzen ein besonders hohes Verkopplungspotential. Im Mittelpunkt des Beitrags steht die Analyse des Störpotentials von elektrischen Antriebssystemen in elektrisch betriebenen Kraftfahrzeugen. Als Ergebnis zeigt sich, dass eine hochqualitative Schirmung des HV-Systems unabdingbar ist. Diese Schirmung kann dann durch Verlegungsoptionen beeinflusst werden. Daher soll im Beitrag u. a. gezeigt werden, wodurch die Schirmdämpfung real verlegter Leitungen abhängig ist. Es werden Erfahrungen mit verschiedenen Messverfahren vorgestellt, die mit Simulationen zu "worst case" Betrachtungen gegenübergestellt werden. Die EMV-Eigenschaften des Hochvoltsystems werden entscheidend durch die Leitungen und der dazugehörigen Kontaktierungen beeinflusst. Im Beitrag werden daher des Weiteren Ergebnisse und Erfahrungen zur messtechnischen Umsetzung der Untersuchungen, u. a. zur nominellen und realen Bestimmung der Transferimpedanz von Hochvoltleitungen vorgestellt. In den Vergleich werden dabei Einflüsse mechanischer Beanspruchung (Biegeradien), aufbau-bedingter Eigenschaften (Querschnitt, Schirmaufbau) sowie Steckverbindern einbezogen. Auf Basis der Leitungsuntersuchungen und Ergebnissen von Komponenten- sowie Fahrzeugtests steht im Fazit des Beitrages die Zusammenführung des Störpotentials zur Wirkung der Schirmung von Hochvoltleitungen bzw. kompletten Hochvoltsystemen in Elektro- und Hybridfahrzeugen

Fast assessment of long axis strain with standard cardiovascular magnetic resonance: a validation study of a novel parameter with reference values

Background: Assessment of longitudinal function with cardiovascular magnetic resonance (CMR) is limited to measurement of systolic excursion of the mitral annulus (MAPSE) or elaborate strain imaging modalities. The aim of this study was to develop a fast assessable parameter for the measurement of long axis strain (LAS) with CMR. Methods: 40 healthy volunteers and 125 patients with different forms of cardiomyopathy were retrospectively analyzed. Four different approaches for the assessment of LAS with CMR measuring the distance between the LV apex and a line connecting the origins of the mitral valve leaflets in enddiastole and endsystole were evaluated. Values for LAS were calculated according to the strain formula. Results: LAS derived from the distance of the epicardial apical border to the midpoint of the line connecting the mitral valve insertion points (LAS-epi/mid) proved to be the most reliable parameter for the assessment of LAS among the different approaches. LAS-epi/mid displayed the highest sensitivity (81.6 %) and specificity (97.5 %), furthermore showing the best correlation with feature tracking (FTI) derived transmural longitudinal strain (r = 0.85). Moreover, LAS-epi/mid was non-inferior to FTI in discriminating controls from patients (Area under the curve (AUC) = 0.95 vs. 0.94, p = NS). The time required for analysis of LAS-epi/mid was significantly shorter than for FTI (67 ± 8 s vs. 180 ± 14 s, p < 0.0001). Additionally, LAS-epi/mid performed significantly better than MAPSE (Delta AUC = 0.09; p < 0.005) and the ejection fraction (Delta AUC = 0.11; p = 0.0002). Reference values were derived from 234 selected healthy volunteers. Mean value for LAS-epi/mid was −17.1 ± 2.3 %. Mean values for men were significantly lower compared to women (−16.5 ± 2.2 vs. -17.9 ± 2.1 %; p < 0.0001), while LAS decreased with age. Conclusions: LAS-epi/mid is a novel and fast assessable parameter for the analysis of global longitudinal function with non-inferiority compared to transmural longitudinal strain

The effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries: a systematic review

Background: Promoting physical activity and healthy eating is important to combat the unprecedented rise in NCDs in many developing countries. Using modern information-and communication technologies to deliver physical activity and diet interventions is particularly promising considering the increased proliferation of such technologies in many developing countries. The objective of this systematic review is to investigate the effectiveness of e-& mHealth interventions to promote physical activity and healthy diets in developing countries.Methods: Major databases and grey literature sources were searched to retrieve studies that quantitatively examined the effectiveness of e-& mHealth interventions on physical activity and diet outcomes in developing countries. Additional studies were retrieved through citation alerts and scientific social media allowing study inclusion until August 2016. The CONSORT checklist was used to assess the risk of bias of the included studies.Results: A total of 15 studies conducted in 13 developing countries in Europe, Africa, Latin-and South America and Asia were included in the review. The majority of studies enrolled adults who were healthy or at risk of diabetes or hypertension. The average intervention length was 6.4 months, and text messages and the Internet were the most frequently used intervention delivery channels. Risk of bias across the studies was moderate (55.7 % of the criteria fulfilled). Eleven studies reported significant positive effects of an e-& mHealth intervention on physical activity and/or diet behaviour. Respectively, 50 % and 70 % of the interventions were effective in promoting physical activity and healthy diets.Conclusions: The majority of studies demonstrated that e-& mHealth interventions were effective in promoting physical activity and healthy diets in developing countries. Future interventions should use more rigorous study designs, investigate the cost-effectiveness and reach of interventions, and focus on emerging technologies, such as smart phone apps and wearable activity trackers.Trial registration: The review protocol can be retrieved from the PROSPERO database (Registration ID: CRD42015029240)

Developing empathy in healthcare professions students: protocol of a mixed-methods non-controlled longitudinal intervention study

Despite the necessary focus on clinical skills and knowledge during the tertiary education of healthcare professionals, the literature highlights the importance of developing psycho-social competencies. Empathy, a cognitive-behavioral attribute linked to various benefits for patients and healthcare professionals, is one such competency. Pedagogical approaches to successfully develop empathy in tertiary healthcare students are available. However, these approaches are often integrated piecemeal throughout the tertiary education journey. Research on a more empathy-focused curriculum is scarce. This manuscript describes the design of a study that aims to examine the effects of a more empathy-focused curriculum on empathy in tertiary healthcare profession students in Singapore. Freshmen dentistry, medicine, nursing, and pharmacy students enrolled in a novel curriculum with a strong empathy focus will be recruited for the study and followed for the program’s extent. Mixed-methods data collection at various time points will be conducted. Quantitative data will be collected on cognitive-behavioral empathy, intentions to provide empathic care, and engagement in courses of the curriculum. Qualitative data on perceptions of patient care and empathy in relation to relevant courses of the curriculum will be collected to provide context for quantitative findings. Ethics approval was granted by the Departmental Ethics Review Committee of the Saw Swee Hock School of Public Health, National University of Singapore (Ethics ID: SSHSPH-214)