Refinement and Pilot Testing Social Networks for Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social POD) Study

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the Social POD app based on participant feedback; and conduct a multi-site randomized clinical trial to pilot test the second iteration of the Social POD app. Overweight and obese adults with Android smartphones (BMI 25-49.9 kg/m2; N=9) were recruited for a two-month weight loss pilot intervention and iterative usability testing of the Social POD app. The app prompted participants via notification to track daily weight, diet, and PA behaviors. Participants received the content of the behavioral weight loss intervention via podcast. In order to re-engage infrequent users, the app prompted frequent app users to select one of three messages to send to infrequent users targeting one of three behavioral theory constructs: 1) social support, 2) self-efficacy, or 3) negative outcome expectations. Body weight and dietary intake (two 24-hr recalls) were assessed at baseline and two months. All participants attended one of two focus groups to provide feedback on use of the app. Based on the usability testing, the Social POD app was refined and a point-based incentive system was incorporated into the app and used in a larger randomized controlled trial. Overweight and obese adults (N=51, mean BMI=34.7 ± 6.0, 38% black) in Charleston and Columbia, SC who owned an Android phone or tablet were recruited to participate in a 12-week behavioral weight loss intervention delivered via mobile app and podcast. All participants received the behavioral content of the weight loss intervention via twice weekly podcasts and were randomized to download and use either a standard calorie tracking app (Fat Secret) or the Social POD app. Main outcomes included kilograms lost at 12-weeks and secondary outcomes included change in psychosocial variable scores from pre- to post-test, association between points earned and percent weight loss at 12-weeks, and reengagement based on message-type received. Following the usability testing participants lost a mean of -0.94 kg (±2.22 kg, p=0.24) and consumed significantly fewer kcals post-intervention (1570±508 kcal/day) as compared to baseline (2384±993 kcal/day, p=0.01). Mean number of app entries was 77.2 ± 73.8 per person with a range of 2 to 219. Messages selected and sent to infrequent users targeting social support were sent most frequently (n=32, 46%), followed by self-efficacy (n=29, 40%), and negative outcome expectations (n=10, 14%). Themes from the focus groups included functionality issues, revisions to the messaging system, and the addition of a point system with rewards for achieving goals. Participant attrition for the RCT was 12% (n=3 experimental and n=3 comparison). Experimental group participants lost significantly more weight (-5.3kg, CI: vi i -7.5, -3.0) than comparison group participants (-2.23kg, CI: -3.6, -1.0; p=0.02) and had a greater reduction in BMI (p=0.02). These outcomes were significant for both intentionto- treat (using baseline observation carried forward) and complete case. While there were significant differences in final positive outcome expectations scores between groups [4.56 experimental, 3.57 comparison (scale range from 1 to 7, maximum); p=0.04], other secondary outcomes (e.g., caloric intake and social support) were not significantly different by group assignment while controlling for baseline values. Among experimental group participants only, total points earned significantly predicted percent weight loss (B=-0.02, p=0.01). In addition, higher scores for the conscientiousness personality trait was significantly associated with total points earned (B=9.07, p=0.03), but other personality characteristics and demographics were not. Messages most frequently sent to infrequent users of the Social POD app were social support (n=119), followed by outcome expectations (n=99), and then messages targeting self-efficacy (n=97). There was a significant difference between the type of message received and re-engagement among infrequent users (p=0.03) with self-efficacy messages prompting the most engagement (n=7), followed by outcome expectation messages (n=5) and social support messages (n=1). In conclusion, use of the Social POD app led to greater weight loss than a standard diet-tracking app (Fat Secret). This mobile health intervention has the potential to be widely disseminated to reduce the risk of chronic disease associated with overweight and obesity

Effect of Values and Technology Use on Exercise: Implications for Personalized Behavior Change Interventions

Technology has recently been recruited in the war against the ongoing obesity crisis; however, the adoption of Health & Fitness applications for regular exercise is a struggle. In this study, we present a unique demographically representative dataset of 15k US residents that combines technology use logs with surveys on moral views, human values, and emotional contagion. Combining these data, we provide a holistic view of individuals to model their physical exercise behavior. First, we show which values determine the adoption of Health & Fitness mobile applications, finding that users who prioritize the value of purity and de-emphasize values of conformity, hedonism, and security are more likely to use such apps. Further, we achieve a weighted AUROC of .673 in predicting whether individual exercises, and we also show that the application usage data allows for substantially better classification performance (.608) compared to using basic demographics (.513) or internet browsing data (.546). We also find a strong link of exercise to respondent socioeconomic status, as well as the value of happiness. Using these insights, we propose actionable design guidelines for persuasive technologies targeting health behavior modification

The Assessment of Mentalization: Measures for the Patient, the Therapist and the Interaction

Mentalization has been clearly defined in the literature as a relational concept and yet in surveys and transcript-based measures it is almost universally treated as an individual capacity. That approach has value but may not capture the emergent nature of mentalization, as it is jointly constructed within a relational context. We report here on a critical evaluation of measurement approaches commonly used to conceptualize and assess mentalization and argue for the value of conversation analysis (CA) as an alternative approach. A variety of approaches have been shown to have utility in assessing mentalization as an individual capacity. We illustrate how conversation analysis allows for an in-depth-analysis of mentalization as it is co-created across different contexts in real-life therapy sessions. This method of analysis shifts the focus from content to process. Conversation analysis is a potentially valuable tool to support training, to assess treatment integrity, and to improve outcomes with mentalization-based interventions

Systematyczny przegląd narzędzi pomiaru jakości umierania i śmierci

Aby odpowiedzieć na pytanie, czy współczesna medycyna może zapewnić „dobrą” śmierć, trzeba opracować i wdrożyć odpowiednie narzędzia pomiaru jakości umierania i śmierci. Niniejsza praca ma na celu zidentyfikowanie takich narzędzi oraz określenie ich jakości. Przeszukano bazy danych MEDLINE (1950–2008), Healthstar (1966–2008) oraz CINAHL (1982–2008) według słów kluczowych „jakość umierania/śmierci” oraz „»dobra«/ /»zła« śmierć”. Do analizy wybrano prace, które opisywały narzędzie pomiaru jakości umierania i śmierci lub miały na celu zmierzenie tej jakości. Kryteria oceny obejmowały: informację, czy narzędzie zostało oparte na wcześniejszych teoriach czy też zostało skonstruowane na potrzeby badania (ad hoc), obecność definicji jakości umierania i śmierci, empiryczną podstawę narzędzia, uwzględnienie licznych dziedzin i subiektywnego charakteru jakości umierania i śmierci oraz czułość w wykrywaniu zmian. Wymagane kryteria spełniło 18 narzędzi pomiaru. Sześć z nich opierało się na wcześniejszych teoriach, natomiast 12 zostało skonstruowanych na potrzeby badania. Mniej niż połowa miała określoną wyraźną definicję jakości umierania i śmierci, natomiast jeszcze mniej — model pojęciowy uwzględniający wielowymiarowe podejście i subiektywną ocenę. Czas trwania fazy umierania i śmierci wahał się w granicach od ostatnich miesięcy do ostatnich godzin życia. Z 6 poddanych analizie narzędzi, które oparto na wcześniejszych teoriach, najlepiej przebadany jest kwestionariusz Quality of Dying and Death questionnaire (QODD). Sposoby pomiaru jakości umierania i śmierci cechują się coraz większą dokładnością. Niezbędne są dalsze badania, które pozwolą lepiej zrozumieć czynniki wpływające na oceny jakości umierania i śmierci

5-HT3 receptors in GtoPdb v.2021.3

The 5-HT3 receptor (nomenclature as agreed by the NC-IUPHAR Subcommittee on 5-Hydroxytryptamine (serotonin) receptors [69]) is a ligand-gated ion channel of the Cys-loop family that includes the zinc-activated channels, nicotinic acetylcholine, GABAA and strychnine-sensitive glycine receptors. The receptor exists as a pentamer of 4 transmembrane (TM) subunits that form an intrinsic cation selective channel [7]. Five human 5-HT3 receptor subunits have been cloned and homo-oligomeric assemblies of 5-HT3A and hetero-oligomeric assemblies of 5-HT3A and 5-HT3B subunits have been characterised in detail. The 5-HT3C (HTR3C, Q8WXA8), 5-HT3D (HTR3D, Q70Z44) and 5-HT3E (HTR3E, A5X5Y0) subunits [86, 125], like the 5-HT3B subunit, do not form functional homomers, but are reported to assemble with the 5-HT3A subunit to influence its functional expression rather than pharmacological profile [127, 66, 161]. 5-HT3A, -C, -D, and -E subunits also interact with the chaperone RIC-3 which predominantly enhances the surface expression of homomeric 5-HT3A receptor [161]. The co-expression of 5-HT3A and 5-HT3C-E subunits has been demonstrated in human colon [85]. A recombinant hetero-oligomeric 5-HT3AB receptor has been reported to contain two copies of the 5-HT3A subunit and three copies of the 5-HT3B subunit in the order B-B-A-B-A [9], but this is inconsistent with recent reports which show at least one A-A interface [99, 154]. The 5-HT3B subunit imparts distinctive biophysical properties upon hetero-oligomeric 5-HT3AB versus homo-oligomeric 5-HT3A recombinant receptors [35, 44, 59, 88, 143, 132, 82], influences the potency of channel blockers, but generally has only a modest effect upon the apparent affinity of agonists, or the affinity of antagonists ([19], but see [44, 33, 38]) which may be explained by the orthosteric binding site residing at an interface formed between 5-HT3A subunits [99, 154]. However, 5-HT3A and 5-HT3AB receptors differ in their allosteric regulation by some general anaesthetic agents, small alcohols and indoles [142, 139, 73]. The potential diversity of 5-HT3 receptors is increased by alternative splicing of the genes HTR3A and HTR3E [67, 21, 127, 126, 123]. In addition, the use of tissue-specific promoters driving expression from different transcriptional start sites has been reported for the HTR3A, HTR3B, HTR3D and HTR3E genes, which could result in 5-HT3 subunits harbouring different N-termini [156, 82, 123]. To date, inclusion of the 5-HT3A subunit appears imperative for 5-HT3 receptor function

Search-Related Suppression of Hippocampus and Default Network Activity during Associative Memory Retrieval

Episodic memory retrieval involves the coordinated interaction of several cognitive processing stages such as mental search, access to a memory store, associative re-encoding, and post-retrieval monitoring. The neural response during memory retrieval is an integration of signals from multiple regions that may subserve supportive cognitive control, attention, sensory association, encoding, or working memory functions. It is particularly challenging to dissociate contributions of these distinct components to brain responses in regions such as the hippocampus, which lies at the interface between overlapping memory encoding and retrieval, and “default” networks. In the present study, event-related functional magnetic resonance imaging (fMRI) and measures of memory performance were used to differentiate brain responses to memory search from subcomponents of episodic memory retrieval associated with successful recall. During the attempted retrieval of both poorly and strongly remembered word pair associates, the hemodynamic response was negatively deflected below baseline in anterior hippocampus and regions of the default network. Activations in anterior hippocampus were functionally distinct from those in posterior hippocampus and negatively correlated with response times. Thus, relative to the pre-stimulus period, the hippocampus shows reduced activity during intensive engagement in episodic memory search. Such deactivation was most salient during trials that engaged only pre-retrieval search processes in the absence of successful recollection or post-retrieval processing. Implications for interpretation of hippocampal fMRI responses during retrieval are discussed. A model is presented to interpret such activations as representing modulation of encoding-related activity, rather than retrieval-related activity. Engagement in intensive mental search may reduce neural and attentional resources that are otherwise tonically devoted to encoding an individual’s stream of experience into episodic memory

5-HT3 receptors (version 2019.4) in the IUPHAR/BPS Guide to Pharmacology Database

The 5-HT3 receptor (nomenclature as agreed by the NC-IUPHAR Subcommittee on 5-Hydroxytryptamine (serotonin) receptors [66]) is a ligand-gated ion channel of the Cys-loop family that includes the zinc-activated channels, nicotinic acetylcholine, GABAA and strychnine-sensitive glycine receptors. The receptor exists as a pentamer of 4TM subunits that form an intrinsic cation selective channel [5]. Five human 5-HT3 receptor subunits have been cloned and homo-oligomeric assemblies of 5-HT3A and hetero-oligomeric assemblies of 5-HT3A and 5-HT3B subunits have been characterised in detail. The 5-HT3C (HTR3C, Q8WXA8), 5-HT3D (HTR3D, Q70Z44) and 5-HT3E (HTR3E, A5X5Y0) subunits [83, 122], like the 5-HT3B subunit, do not form functional homomers, but are reported to assemble with the 5-HT3A subunit to influence its functional expression rather than pharmacological profile [124, 63, 157]. 5-HT3A, -C, -D, and -E subunits also interact with the chaperone RIC-3 which predominantly enhances the surface expression of homomeric 5-HT3A receptor [157]. The co-expression of 5-HT3A and 5-HT3C-E subunits has been demonstrated in human colon [82]. A recombinant hetero-oligomeric 5-HT3AB receptor has been reported to contain two copies of the 5-HT3A subunit and three copies of the 5-HT3B subunit in the order B-B-A-B-A [7], but this is inconsistent with recent reports which show at least one A-A interface [96, 150]. The 5-HT3B subunit imparts distinctive biophysical properties upon hetero-oligomeric 5-HT3AB versus homo-oligomeric 5-HT3A recombinant receptors [32, 41, 56, 85, 139, 129, 79], influences the potency of channel blockers, but generally has only a modest effect upon the apparent affinity of agonists, or the affinity of antagonists ([17], but see [41, 30, 35]) which may be explained by the orthosteric binding site residing at an interface formed between 5-HT3A subunits [96, 150]. However, 5-HT3A and 5-HT3AB receptors differ in their allosteric regulation by some general anaesthetic agents, small alcohols and indoles [138, 135, 71]. The potential diversity of 5-HT3 receptors is increased by alternative splicing of the genes HTR3A and E [64, 19, 124, 123, 120]. In addition, the use of tissue-specific promoters driving expression from different transcriptional start sites has been reported for the HTR3A, HTR3B, HTR3D and HTR3E genes, which could result in 5-HT3 subunits harbouring different N-termini [152, 79, 120]. To date, inclusion of the 5-HT3A subunit appears imperative for 5-HT3 receptor function

Interventions to increase access to or uptake of physical health screening in people with severe mental illness: a realist review

Objectives: To identify and evaluate interventions aimed at increasing uptake of, or access to, physical health screening by adults with severe mental illness; to examine why interventions might work. Design: Realist review. Setting: Primary, secondary and tertiary care. Results: A systematic search identified 1448 studies, of which 22 met the inclusion criteria. Studies were from Australia (n=3), Canada (n=1), Hong Kong (n=1), UK (n=11) and USA (n=6). The studies focused on breast cancer screening, infection preventive services and metabolic syndrome (MS) screening by targeting MSrelated risk factors. The interventions could be divided into those focusing on (1) health service delivery changes (12 studies), using quality improvement, randomised controlled trial, cluster randomised feasibility trial, retrospective audit, cross-sectional study and satisfaction survey designs and (2) tests of tools designed to facilitate screening (10 studies) using consecutive case series, quality improvement, retrospective evaluation and pre–post audit study designs. All studies reported improved uptake of screening, or that patients had received screening they would not have had without the intervention. No estimation of overall effect size was possible due to heterogeneity in study design and quality. The following factors may contribute to intervention success: staff and stakeholder involvement in screening, staff flexibility when taking physical measurements (eg, using adapted equipment), strong links with primary care and having a pharmacist on the ward. Conclusions: A range of interventions may be effective, but better quality research is needed to determine any effect size. Researchers should consider how interventions may work when designing and testing them in order to target better the specific needs of this population in the most appropriate setting. Behaviour-change interventions to reduce identified barriers of patient and health professional resistance to screening this population are required. Resource constraints, clarity over professional roles and better coordination with primary care need to be addresse

ALMA 1.3 Millimeter Map of the HD 95086 System

Planets and minor bodies such as asteroids, Kuiper-belt objects and comets are integral components of a planetary system. Interactions among them leave clues about the formation process of a planetary system. The signature of such interactions is most prominent through observations of its debris disk at millimeter wavelengths where emission is dominated by the population of large grains that stay close to their parent bodies. Here we present ALMA 1.3 mm observations of HD 95086, a young early-type star that hosts a directly imaged giant planet b and a massive debris disk with both asteroid- and Kuiper-belt analogs. The location of the Kuiper-belt analog is resolved for the first time. The system can be depicted as a broad ($\Delta R/R \sim$0.84), inclined (30\arcdeg$\pm$3\arcdeg) ring with millimeter emission peaked at 200$\pm$6 au from the star. The 1.3 mm disk emission is consistent with a broad disk with sharp boundaries from 106$\pm$6 to 320$\pm$20 au with a surface density distribution described by a power law with an index of --0.5$\pm$0.2. Our deep ALMA map also reveals a bright source located near the edge of the ring, whose brightness at 1.3 mm and potential spectral energy distribution are consistent with it being a luminous star-forming galaxy at high redshift. We set constraints on the orbital properties of planet b assuming co-planarity with the observed disk.Comment: accepted for publication in A