May 2018 ESM Literature

Adolescent Studies

“Although research supports associations between anxiety and emotional reactivity in adults (Cisler, J. M., Olatunji, B. O., Feldner, M. T., & Forsyth, J. P. (2010). Emotion regulation and the anxiety disorders: an integrative review. Journal of Psychopathology and Behavioral Assessment, 32(1), 68-82.), few studies have examined emotional reactivity in anxious youth (e.g., Carthy et al., 2010; Tan, P. Z., Forbes, E. E., Dahl, R. E., Ryan, N. D., Siegle, G. J., Ladouceur, C. D., & Silk, J. S. (2012). Emotional reactivity and regulation in anxious and nonanxious youth: a cell-phone ecological momentary assessment study. Journal of Child Psychology and Psychiatry, 53(2), 197-206.).”

“The present study used youth’s in vivo reports of subjective responses to cannabis while smoking in their natural environments to identify real-world mechanisms of topiramate treatment for cannabis misuse.”

“The digital landscape is evolving more quickly than research on the effects of screen media on the development, learning and family life of young children. This statement examines the potential benefits and risks of screen media in children younger than 5 years, focusing on developmental, psychosocial and physical health. Evidence-based guidance to optimize and support children’s early media experiences involves four principles: minimizing, mitigating, mindfully using and modelling healthy use of screens. Knowing how young children learn and develop informs best practice strategies for health care providers.”

“Physical activity is known to preserve both physical and mental health. However, the physical activity levels of a large proportion of adolescents are insufficient. This is critical, since physical activity levels in youth have been shown to translate into adulthood. Whereas in adult populations, mood has been supposed to be one important psychological factor that drives physical activity in everyday life, this issue has been poorly studied in adolescent populations. Ambulatory Assessment is the state-of-the-art approach to investigate how mood and non-exercise activity fluctuate within persons in everyday life. Through assessments in real time and real life, this method provides ecological validity, bypassing several limitations of traditional assessment methods (e.g., recall biases).”

“Contextual factors related to maladaptive eating behavior in youth with overweight/obesity are poorly understood. This pilot study sought to elucidate immediate internal and external cues related to perceptions of overeating and loss of control (LOC) over eating in a heterogeneous sample of children and adolescents with overweight/obesity assessed in their natural environments.”

“The harmful effects of victimization on mental health have been demonstrated in several age groups, cultures, and populations, but there is wide variability in the resulting psychopathology. Ecological momentary assessment (EMA) allows the expression of an emotional state to be recorded at any given time and linked to a situation or context. This study aimed to analyze the contextual variables (where, with whom, and what), momentary satisfaction, and perception of momentary emotional and behavioral symptoms in a cohort of adolescents by the level of victimization, using EMA.”

“In light of expanding legalization of cannabis and swelling debate about the potential risks, particularly for younger users, understanding acute cannabis effects among adolescents and emerging adults is more important than ever. Contemporary models of addiction development identify subjective drug responses as central to the developmental unfolding of drug use disorders. Despite this, surprisingly little is known about cannabis’s acute subjective effects in human youths.”

“Test the acceptability and feasibility of ecological momentary assessment (EMA) of mood and injection risk behavior among young people who inject drugs (PWID), using mobile phones.”

“Youth are an important target group for social network interventions, because they are particularly susceptible to the adaptation of healthy and unhealthy habits and behaviors of others. They are surrounded by ‘social influence agents’ (i.e., role models such as family, friends and peers) that co-determine their dietary intake and physical activity. However, there is a lack of systematic and comprehensive research on the implementation of a social network approach in health campaigns. The MyMovez research project aims to fill this gap by developing a method for effective social network campaign implementation. This protocol paper describes the design and methods of Phase I of the MyMovez project, aiming to unravel youth’s social network structures in combination with individual, psychosocial, and environmental factors related to energy intake and expenditure. In addition, the Wearable Lab is developed to enable an attractive and state-of-the-art way of collecting data and online campaign implementation via social networks.”

“Medical advances continue to improve morbidity and mortality of serious pediatric diseases, including cancer, driving research addressing diminished physical and psychological quality of life in children with these chronic conditions. Empowerment enhances resilience and positively influences health, disease, and therapy understanding. We describe the development and usability assessment of a prototype Empower Stars! mobile video game grounded in behavioral and exercise theories with the purpose of coupling physical exercise with empowerment over disease in children with cancer.”

“This study examined the associations between friend conflict, defined as arguments with friends, and affective states using a daily diary design in a community sample of adolescents.”

Alcohol & Drugs

“Timeline Followback (TLFB) interview methods are used to assess a variety of health behaviors, including alcohol use, drug use, and sexual behavior. While several online TLFBs have been developed, most focus on single behaviors, and few studies have explored their validity in assessing multiple risk behaviors using a single online TLFB.


To examine the validity of a customizable web application (Timeline) for assessing alcohol use, drug use, and sexual behavior among high-risk men who have sex with men.”

“Drug-related cues evoke craving and stimulate motivational systems in the brain. The acoustic startle reflex captures activation of these motivational processes and affords a unique measure of reactivity to drug cues.


This study examined the effects of cannabis-related cues on subjective and eye blink startle reactivity in the human laboratory and tested whether these effects predicted youth’s cue-elicited cannabis craving in the natural environment.”

“The rise in opioid use and overdose has increased the importance of improving data collection methods for the purpose of targeting resources to high-need populations and responding rapidly to emerging trends.


To determine whether Twitter data could be used to identify geographic differences in opioid-related discussion and whether opioid topics were significantly correlated with opioid overdose death rate.”

“Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations.


We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity.”

“Responses to stress and drug craving differ between men and women. Differences in the momentary experience of stress in relation to craving are less well-understood.


Using ecological momentary assessment (EMA), we examined sex differences in real-time in two areas: (1) causes and contexts associated with stress, and (2) the extent to which stress and drug cues are associated with craving.”

“A key component of relapse prevention is to self-monitor the internal (feelings or cravings) and external (people, places, activities) factors associated with relapse. Smartphones can deliver ecological momentary assessments (EMA) to help individuals self-monitor. The purpose of this exploratory study was to develop a model for predicting an individual’s risk of future substance use after each EMA and validate it using a multi-level model controlling for repeated measures on persons.”

“Effective treatment for cocaine use disorder should dampen hypersensitive cue-induced motivational processes and/or strengthen executive control. Using a randomized, double-blind, placebo-controlled intervention, the primary aim of this study was to investigate the effect of N-Acetylcysteine (NAC) and working memory (WM)-training to reduce cocaine use and craving and to improve inhibition assessed in the laboratory and during Ecological Momentary Assessment (EMA). The second aim was to examine correspondence between laboratory and EMA data.”

“Stress is a known factor related to alcohol use. However, how the relationship between alcohol craving and stress varies across the day is not fully understood. As craving is a consistent predictor of alcohol use disorder (AUD), understanding stress and craving patterns across the day in routine, non-dependent, moderate-heavy alcohol consumers may help in understanding those who may be vulnerable to transitioning into AUD.”

“College drinking and its negative consequences remain a major public health concern. Yet, many prevention efforts targeting college drinkers are expensive, are difficult to implement, use indicated approaches targeting only high-risk drinkers, and/or are only marginally effective. An alternative strategy taken explicitly or implicitly by many colleges is campus-led alcohol-free programming which provides students with attractive leisure alternatives to drinking on weekend nights. This study aimed to extend work by Patrick et al. (Prevention Science, 11, 155–162, 2010), who found that students drank less on weekend nights they attended LateNight Penn State (LNPS) activities during their first semester of college.”

Diet & Nutrition

“Dieting is often recommended as a means of weight loss, yet research consistently shows that self-reported dieting does not result in weight loss. Toward resolving this discrepancy, this study assessed the daily dietary intake and weight control strategies of people who self-identified as dieting. College women (N = 266) provided a report of their eating pattern (dieting, “watching what I eat,” and/or “eating healthy”) followed by three daily diaries (24-hour recalls of dietary intake and weight control strategies) elicited on randomly selected days during a one-month period. Dieters were expected to report fewer daily calories, more daily exercise, and more daily weight control strategies than non-dieters.”

“NutriNet-Salud Mexico is a digital health information system, e-epidemiology instrument, online, open and free, to recording and analysis the determinants of dietary habits and nutritional status of the Mexican population, for the prevention of overweight, obesity and noncommunicable diseases for the period 2018-2028.”


To examine the associations between high-fat/high-sugar foods (HFHS) and fruit and vegetable (FV) consumption and affective states in women.


The researchers used electronic ecological momentary assessment to capture HFHS and FV consumption in the past 2 hours (predictor) and current affective states (outcome) across 1 week among 202 women. Multilevel linear regression was conducted. Weight status was tested as a moderator.”

“A key component of relapse prevention is to self-monitor the internal (feelings or cravings) and external (people, places, activities) factors associated with relapse. Smartphones can deliver ecological momentary assessments (EMA) to help individuals self-monitor. The purpose of this exploratory study was to develop a model for predicting an individual’s risk of future substance use after each EMA and validate it using a multi-level model controlling for repeated measures on persons.”

“To improve weight management in pregnant women, there is a need to deliver specific, data-based recommendations on energy intake.


This cross-sectional study evaluated the accuracy of an electronic reporting method to measure daily energy intake in pregnant women compared with total daily energy expenditure (TDEE).”

Emotion & Regulation

“Difficulties in emotion regulation are associated with addictive behaviors, including smoking. Difficulties in emotion regulation may underlie large, rapid changes in negative affect that can increase likelihood of relapse. We investigated the association between emotion regulation ability and negative affect in smokers assessed both in the laboratory and in the field using Ecological Momentary Assessment.”

“Studies have examined the associations between emotions and overeating but have only rarely considered associations between emotions and specific food choices. The purpose of this secondary data analysis was to use mobile ecological momentary assessments (mEMAs) to examine associations between emotions and food choices among first-year college students living in residence halls.”

“Psychologists have long debated whether it is possible to assess how people subjectively feel without asking them. The recent proliferation of online social networks has recently added a fresh chapter to this discussion, with research now suggesting that it is possible to index people’s subjective experience of emotion by simply counting the number of emotion words contained in their online social network posts. Whether the conclusions that emerge from this work are valid, however, rests on a critical assumption: that people’s usage of emotion words in their posts accurately reflects how they feel. Although this assumption is widespread in psychological research, here we suggest that there are reasons to challenge it.”

“Research has shown that how well people can differentiate between different emotional states is an essential requirement for adaptive emotion regulation. People with low levels of emotion differentiation tend to be more vulnerable to develop emotional disorders. Although we know quite a lot about the correlates of emotion differentiation, research on factors or interventions which could improve emotion differentiation skills is scarce. Here, we hypothesize, and study empirically, whether a mindfulness-based intervention (MBI) may impact the differentiation of negative and positive emotions.”

“The study of visual perception has largely been completed without regard to the influence that an individual’s emotional status may have on their performance in visual tasks. However, there is a growing body of evidence to suggest that mood may affect not only creative abilities and interpersonal skills but also the capacity to perform low-level cognitive tasks. Here, we sought to determine whether rudimentary visual search processes are similarly affected by emotion. Specifically, we examined whether an individual’s perceived happiness level affects their ability to detect a target in noise.”

“Work-related stressors are known to adversely affect employees’ stress physiology, including the cortisol awakening response (CAR) – or the spike in cortisol levels shortly after people wake up that aids in mobilizing energy. A flat or blunted CAR has been linked to chronic stress and burnout. This daily diary study tested the effects of a workplace intervention on employed parents’ CAR. Specifically, we tested whether the effects of the intervention on CAR were moderated by the type of days (workday versus non-work day).”

“Low-income Latino youth display disproportionate rates of mood problems compared with peers in other ethnic groups. Dysregulation of the stress reactivity system, reflected by involuntary engagement stress responses (IESRs), contributes to mood problems. However, two important family constructs—parent-child conflict and familism—may moderate the association between IESRs and negative mood. Parent-child conflict might exacerbate the link between IESRs and negative mood. Fortunately, low-income Latino youth may benefit from the cultural value of familism. Familism might weaken the tie between IESRs and negative mood and the tie between parent-child conflict and negative mood. The present study used a daily diary methodology and time-lagged models to examine these processes among low-income Latino adolescents.”

“Polling suggested that the 2016 United States presidential election affected citizens’ mood and stress levels. Yet, polling often fails to employ repeated measurement designs that can capture pre- and post-levels of change within the same person. In this study, undergraduate students (N = 85) completed a 14-day daily diary where mood, stress, and mental health outcomes were assessed before and after the election.”

“Based on the “broaden and build” theory of positive emotions, we explored daily dynamics of teachers’ emotions and their regulation, expecting positive emotions to promote teachers’ use of adaptive emotion regulation strategies, and trigger upward spirals leading to further use of these strategies and increased teacher well-being. Negative emotions were expected to have opposite effects. Sixty-two teachers completed daily measures of emotions, emotion regulation, burnout, and job satisfaction during 10 workdays.”

“Recent research has investigated how adaptive emotion regulation (ER) strategies and maladaptive ER strategies interact to predict symptoms, but little is known about how specific strategies interact with one another when used in daily life. The present investigation used daily diary data collected over two weeks from an unselected student sample (N = 109) to examine how reappraisal, a putatively adaptive ER strategy, interacts on a given occasion (within-person) and across occasions (between-person) with putatively maladaptive ER strategies (rumination, experiential avoidance, expressive suppression) to predict daily depression and social anxiety symptoms.”

General Psychological Topics

“The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data.


We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores.”

“With the growing popularity of intensive longitudinal research, the modeling techniques and software options for such data are also expanding rapidly. Here we use dynamic multilevel modeling, as it is incorporated in the new dynamic structural equation modeling (DSEM) toolbox in Mplus, to analyze the affective data from the COGITO study.”

“For most partnered adults, sleep is not an individual-level behavior-it is a shared health behavior with a partner. This study examined whether perceived nightly sleep duration and sleep quality covaried within couples and whether the unique influence of partner sleep on individual sleep differed by gender.”

“Prior researchers have found consistent links between financial issues and relationship outcomes. Yet, because most research is cross-sectional or examines these constructs over longer periods of time (e.g., years), the microlevel processes of how and when these changes occur are unclear. In the present study, we use interdependence theory as a guide to examine the daily fluctuations of financial satisfaction and stress as well as their daily associations with relationship quality in married and unmarried heterosexual couples.”

“In this investigation of cultural differences in the experience of obligation, we distinguish between Confucian Role Ethics versus Relative Autonomy lay theories of motivation and illustrate them with data showing relevant cultural differences in both social judgments and intrapersonal experience. First, when judging others, Western European heritage culture (WEHC) participants (relative to Confucian heritage culture [CHC] participants) judged obligation-motivated actors more negatively than those motivated by agency (Study 1, N = 529). Second, in daily diary and situation sampling studies, CHC participants (relative to WEHC participants) perceived more congruency between their own agentic and obligated motivations, and more positive emotional associations with obligated motivations (Study 2, N = 200 and Study 3, N = 244). Agentic motivation, however, was universally associated with positive emotions.”

“Objectives Aggression and social tension among housemate cats is common and puts cats at risk of injury or relinquishment. The aim of this study was to evaluate the effectiveness of a new pheromone product in reducing aggression between housemate cats. Methods A new pheromone product (Feliway Friends) containing a proprietary cat-appeasing pheromone was evaluated for efficacy in reducing aggression between housemate cats via a randomized, double-blind, placebo-controlled pilot trial of 45 multi-cat households (pheromone [n = 20], placebo [n = 25]) reporting aggression for at least 2 weeks.”

“Mobile technologies may be able to provide service members and veterans with the knowledge necessary to transition to civilian life successfully in a cost-effective and accessible manner. Although a number of transition applications (apps) currently exist in the marketplace, to our knowledge, none of them has been evaluated for quality or effectiveness.”

“Digital health interventions in the form of smartphone apps aim to improve mental health and enable people access to support as and when needed without having to face the stigma they may experience in accessing services. If we are to evaluate mobile health (mHealth) apps and advance scientific understanding, we also need tools to help us understand in what ways mHealth interventions are effective or not. The concept of therapeutic alliance, a measure of the quality of the relationship between a health care provider and a service user, is a key factor in explaining the effects of mental health interventions. The Agnew Relationship Measure (ARM) is a well-validated measure of therapeutic alliance in face-to-face therapy.”

“There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress.


The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy.”

“To identify home environment factors associated with toddler dietary behaviours using ecological momentary assessment(EMA).”

“Close relationships play an integral role in human development, and robust evidence links marital separation and divorce to poor health outcomes. Social integration may play a key role in this association. In many ways, the study of marital separation and divorce provides an ideal model system for a more complete understanding of the association between life stress and physical health.”

“Existing evidence on the beneficial effects of nature on mental health comes from studies using cross-sectional designs. We developed a smartphone-based tool (Urban Mind; to examine how exposure to natural features within the built environment affects mental well-being in real time.”

“Inconsistent parental discipline is a robust correlate of child attention-deficit/hyperactivity disorder (ADHD) symptoms, but few studies have considered the role of inconsistent positive parenting on ADHD, as well as the effects of stress on negative and positive parental consistency. This study advanced a novel ecological momentary assessment (EMA) using participant smartphones to measure parental consistency, and examined its associations with family, social, and parenting-related dimensions of stress and child ADHD symptoms.”

“Homeless youth continue to be disproportionately affected by HIV compared with their housed peers, with prevalence rates as high as 13%. Yet, HIV prevention in this high-risk population has been only marginally effective.


The aim of this study was to use ecological momentary assessments to examine real-time factors to determine the predictors of sexual activity among homeless youth.”

“In this work, we attempt to determine whether the contextual information of a participant can be used to predict whether the participant will respond to a particular Ecological Momentary Assessment (EMA) trigger. We use a publicly available dataset for our work, and find that by using basic contextual features about the participant’s activity, conversation status, audio, and location, we can predict if an EMA triggered at a particular time will be answered with a precision of 0.647, which is significantly higher than a baseline precision of 0.41. Using this knowledge, the researchers conducting field studies can efficiently schedule EMAs and achieve higher response rates.”

“Current measures of parent feeding practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations in these behaviors across time and context. The current study uses ecological momentary assessment to examine variability of, and predictors of, parent feeding practices within a low-income, racially/ethnically diverse, and immigrant sample.”

“Our mood often fluctuates without warning. Recent accounts propose that these fluctuations might be preceded by changes in how we process reward. According to this view, the degree to which reward improves our mood reflects not only characteristics of the reward itself (e.g., its magnitude) but also how receptive to reward we happen to be. Differences in receptivity to reward have been suggested to play an important role in the emergence of mood episodes in psychiatric disorders [1-16]. However, despite substantial theory, the relationship between reward processing and daily fluctuations of mood has yet to be tested directly. In particular, it is unclear whether the extent to which people respond to reward changes from day to day and whether such changes are followed by corresponding shifts in mood. Here, we use a novel mobile-phone platform with dense data sampling and wearable heart-rate and electroencephalographic sensors to examine mood and reward processing over an extended period of one week.”

“Prevailing research has suggested that social relationships get better with age, but this evidence has been largely based on studies with lengthy reporting intervals. Using an ecological momentary assessment approach, the present study examined age differences in several characteristics of social interactions as reported in near-real time: the frequency, quality, and partner type.”

“Suboptimal outcomes from behavioral weight loss (BWL) treatments are partially attributable to accumulated instances of non-adherence to dietary prescriptions (i.e., dietary lapses). Results identifying negative internal triggers for dietary lapses are inconsistent, potentially due to individual differences that impact how individuals respond to cues. Impulsivity is one factor that likely influences reactivity to internal states. We examined three dimensions of impulsivity (delay discounting, inhibitory control, and negative urgency) as moderators of the relation between affective and physical states and subsequent dietary lapses at the beginning of BWL.”

“Stress, and specifically perseverative cognition, is considered to have considerable detrimental effects on mental and physical health. Interventions that can offer temporary stress relief could, therefore, bring considerable health benefits. Previous research has pointed to stress-reducing effects of exposure to nature after acute stressors, but has not yet investigated effects in the realm of everyday life. The present pilot study explores whether an ecological momentary intervention using exposure to natural images could be effective in lowering stress and improve mood.”

“Despite the growing research on work recovery and its well-being outcomes, surprisingly little attention has been paid to at-work recovery and its job performance outcomes. The current study extends the work recovery literature by examining day-level relationships between prototypical microbreaks and job performance as mediated by state positive affect. Furthermore, general work engagement is tested as a cross-level moderator weakening the indirect effects of microbreaks on job performance via positive affect.”

“The Cognitive-Affective Processing System (CAPS) was used to examine effortful control (EC) as a moderator of daily interpersonal behavior. Participants (N = 240) were nonclinical young adults who completed a 7-day event-contingent experience sampling study of interpersonal perception and affect. Multilevel linear models indicated that EC moderated within-person covariation of interpersonal warmth and affect activation; high EC individuals reported greater momentary warm behaviors when perceiving others as affectively activated. EC also amplified between-person covariation of interpersonal warmth between self and others; high EC individuals generally responded to perceptions of another’s warmth with a greater degree of warm behavior. Varying levels of EC predict responses to interpersonal perceptions and affect in daily life, suggesting an important dimension for interpersonal functioning.”

“Previous research showed that perceptions of psychological contract (PC) breach have undesirable individual and organizational consequences. Surprisingly, the PC literature has paid little to no attention to the relationship between PC breach perceptions and stress. A better understanding of how PC breach may elicit stress seems crucial, given that stress plays a key role in employees’ physical and mental well-being.”

“Several studies demonstrated effects of light on affect via projections from the retina of the eye to the circadian clock or via projections to areas involved in mood and reward. Few field studies investigated how naturally fluctuating light levels affect positive and negative mood in everyday life, but none addressed two key components of the reward system: wanting and liking. To elucidate diurnal profiles and immediate effects of dynamically changing light intensity in everyday life, subjective wanting and liking were assessed using experience sampling, while continuously monitoring environmental illuminance.”

“The authors’ aim was to first provide an alternative methodology in the assessment of procrastination and flow that would not reply on retrospective or prospective self-reports. Using real-time assessment of both procrastination and flow, the authors investigated how these factors impact academic performance by using the Experience Sampling Method. They assessed flow by measuring student self-reported skill versus challenge, and procrastination by measuring the days to completion of an assignment.”

“Although there is a robust connection between dispositional personality traits and well-being, relatively little research has comprehensively examined the ways in which all Big Five personality states are associated with short-term experiences of well-being within individuals.”

“Despite their immense relevance, the neurocognitive mechanisms underlying real-life self-control failures (SCFs) are insufficiently understood. Whereas previous studies have shown that SCFs were associated with decreased activity in the right inferior frontal gyrus (rIFG; a region involved in cognitive control), here we consider the possibility that the reduced implementation of cognitive control in individuals with low self-control may be due to impaired performance monitoring. Following a brain-as-predictor approach, we combined experience samplingof daily SCFs with functional magnetic resonance imaging (fMRI) in a Stroop task.”

“Research on abusive supervision has predominantly focused on the consequences for victims while overlooking how leaders respond to their own abusive behavior. Drawing from the literature on moral cleansing, we posit that supervisors who engage in abusive behavior may paradoxically engage in more constructive leadership behaviors subsequently as a result of feeling guilty and perceiving loss of moral credits. Results from two experience sampling studies show that, within leaders on a daily basis, perpetrating abusive supervisor behavior led to an increase in experienced guilt and perceived loss of moral credits, which in turn motivated leaders to engage in more constructive person-oriented (consideration) and task-oriented (initiating structure) leadership behaviors. In addition, leader moral attentiveness and moral courage strengthen these indirect effects by amplifying leaders’ awareness of their immoral behavior and their willingness and determination to make reparations for such behavior.”

“Daily diary studies use the same set of measures repeatedly for several days. Within the work stress domain, these studies are able to isolate the effects of daily exposure to stressors within people from the general level of stressors between people. This meta-analysis investigated both content-related and methodological aspects of workplace stressor–strain relationships in diary studies.”

“Incorporation of details from waking life events into Rapid Eye Movement (REM) sleep dreams has been found to be highest on the two nights after, and then 5-7 nights after events. These are termed, respectively, the day-residue and dream-lag effects. This study is the first to categorize types of waking life experiences and compare their incorporation into dreams across multiple successive nights.”

“This study aimed, first, to determine whether the intra-individual variability in positive affect was related to the intra-individual variability in career decision-making self-efficacy, and career choice anxiety. The second objective was to examine whether social support moderates the relationship between affect and these outcome variables. The third objective was to find out how career decision-making self-efficacy and career choice anxiety change according to self-esteem and future time perspective.”

“Self-compassion is a kind, reassuring way of relating to the self when faced with setbacks and personal difficulties. Not surprisingly, self-compassion is associated with positive psychological functioning and is protective against psychopathology. Despite the robust evidence for the well-being benefits of self-compassion, its underlying or causal mechanisms are not well understood. According to Gilbert (1989, 2000), self-compassion is rooted in careseeking and caregiving social mentalities which originally evolved to guide interpersonal behaviour, but have now been co-opted for intrapersonal relating. The purpose of the current thesis is to systematically test social mentality theory using a range of study designs.”

“Though research has demonstrated that gay men suffer stress-related mental health disparities compared with heterosexuals, little is known about factors that protect gay individuals from poor mental health and that buffer them in the face of minority stress. Using a daily diary approach, the current study examined three factors that may protect individuals from poor mental health: social support from friends, social support from family, and gay identity.”

“Intensive longitudinal methods (ILMs), in which data are gathered from participants multiple times with short intervals (typically 24 hours or less apart), have gained considerable ground in personality research and may be useful in exploring causality in both classic personality trait models and more novel contextualized personality state models.”

“When we are accurate regarding our partners’ negative moods, are we seen as more responsive (and do we see them as such) as a function of the presence/absence of conflict? In two daily diary studies, empathic accuracy (EA) was assessed by comparing targets’ daily negative moods with perceivers’ inferences of these moods. We hypothesized that conflict will be associated with reductions in perceived partner responsiveness (PPR) for both parties; that on no-conflict days, EA will be positively associated with both parties’ PPR; that on conflict days, this positive association will be stronger for targets but will become negative for perceivers; and that regardless of conflict, overestimation (vs. underestimation) of negative moods will be tied with higher PPR for targets but with lower PPR for perceivers.”

“The purpose of this study is to examine the conditions under which daily stressful and positive events are associated with alcohol use among heavy drinking sexual minority men (SMM). Specifically, we examined the moderating effects of two indicators of alcohol addiction severity (i.e., alcohol dependence severity and negative drinking consequences) on the associations between daily stressful events and alcohol use and between daily positive events and alcohol use among heavy drinking SMM.”

“Our understanding of how community-level context impacts care of persons living with HIV (PLWH), including antiretroviral therapy (ART) adherence and retention in care, is limited. The objective of this study was to characterize the activity spaces of PLWH from an urban area in Southeastern U.S., where the epidemic is among the nation’s highest, and to examine how such activity spaces are associated with daily mood and health behaviors. In this small, pilot study, 11 participants were tracked with a global positioning system (GPS)-enabled application on their smartphones for 2 weeks. Activity spaces were created by connecting GPS points sequentially and adding buffers. Contextual exposure data (e.g., alcohol outlets) were connected to activity spaces. Participants also completed daily diary entry through texts 3 times per day regarding outcomes of substance use behaviors, mood, and medication adherence.”

“Numerous studies have shown differences in the functioning in the areas of the frontal-limbic circuitry between depressed patients and controls. However, current knowledge on frontal-limbic neural substrates of individual differences in mood states in everyday life in healthy individuals is scarce. The present study investigates anatomical, resting-state and functional neural correlates of daily mood states in healthy individuals. We expected to observe associations between mood and the frontal-limbic circuitry and the default-mode network [DMN].”

“The purpose of the present studies was to examine the connections that narcissistic admiration and narcissistic rivalry had with various aspects of status.”

“Sexual assault is a troubling epidemic that plagues college campuses across the United States, and is often proceeded by drinking by the perpetrator and/or victim. The goal of this study was to examine the effect of level of intoxication, history of alcohol-related blackouts, and childhood sexual abuse (CSA) on the likelihood of being a victim or perpetrator of coercive sexual activities.”

“This article models the chain of risk that links life course socioeconomic status (SES), daily stressor exposure and severity, and daily well-being.”

“We focused on the temporal space before stressor exposure and examined two constructs– daily stressor forecasting and anticipatory coping – for daily emotional well-being.”

“For many years, work-life literature has focused almost exclusively on the interaction between the work and family domains, without much consideration for the time spent in-between. This daily diary study examines the influence of time spent engaged in daily leisure activities on the health and well-being of full-time workers through its observed effect on daily mood, as well as day-to-day perceptions of stress, work-family conflict (WFC), and work-family balance (WFB). This study contributes to previous literature by providing day-level analysis of these variables, thereby offering a closer examination of their interrelated natures.”

Medical Topics

“The effects of H4 R antagonists in preclinical asthma models support the study of antagonists of the H4 R in the treatment of asthma in humans. JNJ-39758979 is a potent and highly-selective oral H4 R antagonist.


We sought to evaluate the safety and efficacy of the H4 R-antagonist JNJ-39758979 in adult patients with uncontrolled asthma.”

“To develop a patient-reported outcome (PRO) questionnaire for symptoms of Clostridium difficile infection (CDI) following the US Food and Drug Administration PRO guidelines.”

“We aimed to further the understanding of the low rates of sun protection in young women at risk for skin cancer. Six-hundred-sixty-one daily diary entries were received via text message over 14 days from 56 young women at moderate to high risk of developing skin cancer. Women reported whether or not they used sun protection and also listed what their reasons were for using protection or not using sun protection each day.”

“Bone adapts to loading in several ways, including redistributing bone mass and altered geometry and microarchitecture. Because of previous methodological limitations, it is not known how the bone material strength is affected by mechanical loading in humans. The aim of this study was to investigate the effect of a 3-month unilateral high-impact exercise program on bone material properties and microarchitecture in healthy postmenopausal women.”

“Chronic spontaneous urticaria (CSU), also known as chronic idiopathic urticaria (CIU), may produce hives, itch, and angioedema. The Urticaria Activity and Impact Measure (U-AIM) is a newly developed 9-item patient-reported measure designed for use in routine clinical practice to assess CSU activity and impact over the previous 7 days.


To evaluate validity, responsiveness, and clinically meaningful change of the U-AIM.”

“Evaluate bleeding patterns for the Liletta® levonorgestrel 52 mg intrauterine system (IUS) using the World Health Organization Belsey definitions”

“To examine whether individual differences and day-to-day fluctuations in diabetes goal planning are associated with Type 1 diabetes (T1D) management during late adolescence, and whether lapses in daily diabetes goal planning are more disruptive to diabetes management among those with poorer executive functioning (EF).”

“Individual adaptation at the end of life may be characterised by how patients fluctuate in their orientation towards losses and death or engagement in meaningful activities in daily life. To describe these intraindividual patterns of change, we conducted a daily diary study over 7 days with 17 advanced cancer patients from in- and outpatient oncology and psycho-oncology clinics. Patients reported on the daily frequency of behaviours associated with loss orientation and life engagement using a standardised questionnaire.”

“The clinical course of Crohn’s disease (CD) and the effect of its treatment are monitored through patient-reported signs and symptoms (S&S), and endoscopic evidence of inflammation. The Crohn’s Disease Patient-reported Outcomes Signs and Symptoms (CD-PRO/SS) measure was developed to standardize the quantification of gastrointestinal S&S of CD through direct report from patient ratings.”

“Approximately 33% of normal-length (21⁻35 days) cycles have subclinical ovulatory disturbances and lack sufficient progesterone, although their normal length ensures enough estrogen. Subclinical ovulatory disturbances are related to significant premenopausal spine bone loss (-0.86%/year). Molimina, non-distressing premenstrual experiences, may detect ovulation within normal-length cycles. This prospective study assessed the relationship between molimina and ovulation. After 1-cycle of daily diary and first morning urine collections, women answered the Molimina Question (MQ): “Can you tell by the way you feel that your period is coming?” and were invited to share (a) predictive premenstrual experience(s). A 3-fold increase in follicular-luteal pregnanediol levels confirmed ovulation.”

“Haemorrhagic stroke is of significant healthcare concern due to its association with high mortality and lasting impact on the survivors’ quality of life. Treatment decisions and clinical outcomes depend strongly on the size, spread and location of the haematoma. Non-contrast CT (NCCT) is the primary neuroimaging modality for haematoma assessment in haemorrhagic stroke diagnosis. Current procedures do not allow convenient NCCT-based haemorrhage volume calculation in clinical settings, while research-based approaches are yet to be tested for clinical utility; there is a demonstrated need for developing effective solutions. The project under review investigates the development of an automatic NCCT-based haematoma computation tool in support of accurate quantification of haematoma volumes.”

“In-hospital fall incidence is a critical indicator of healthcare outcome. Predictive models for fall incidents could facilitate optimal resource planning and allocation for healthcare providers. In this paper, we proposed a tensor factorisation-based framework to capture the latent features for fall incidents prediction over time. Experiments with real-world data from local hospitals in Hong Kong demonstrated that the proposed method could predict the fall incidents reasonably well (with an area under the curve score around 0.9). As compared with the baseline time series models, the proposed tensor based models were able to successfully identify high-risk locations without records of fall incidents during the past few months.”

“Behavioral science is now being integrated into diabetes self-management interventions. However, the challenge that presents itself is how to translate these knowledge resources during care so that primary care practitioners can use them to offer evidence-informed behavior change support and diabetes management recommendations to patients with diabetes.


The aim of this study was to develop and evaluate a computerized decision support platform called “Diabetes Web-Centric Information and Support Environment” (DWISE) that assists primary care practitioners in applying standardized behavior change strategies and clinical practice guidelines-based recommendations to an individual patient and empower the patient with the skills and knowledge required to self-manage their diabetes through planned, personalized, and pervasive behavior change strategies.”

“Wearables, fitness apps, and patient home monitoring devices are used increasingly by patients and other individuals with lifestyle challenges. All Danish general practitioners (GPs) use digital health records and electronic health (eHealth) consultations on a daily basis, but how they perceive the increasing demand for lifestyle advice and whether they see eHealth as part of their lifestyle support should be explored further.


This study aimed to explore GPs’ perspectives on eHealth devices and apps and the use of eHealth in supporting healthy lifestyle behavior for their patients and themselves.”

“Simple, rapid tests that can be used at the point-of-care (POC) can improve access to diagnostic services and overall patient management in resource-limited settings where laboratory infrastructure is limited. Implementation of POC tests places tremendous strain on already fragile health systems as the demand for training, supply management and quality assurance are amplified. Digital health has a major role to play in ensuring effective delivery and management of POC testing services. Area covered: The ability to digitise laboratory and POC platforms, including lateral flow rapid diagnostic test results, can standardize the interpretation of results and allows data to be linked to proficiency testing to ensure testing quality, reducing interpretation and transcription errors. Remote monitoring of POC instrument functionality and utilization through connectivity, allows programs to optimize instrument placement, algorithm adoption and supply management. Alerts can be built into the system to raise alarm at unusual trends such as outbreaks.”

“UMHealthResearch is the University of Michigan’s digital health research recruitment platform. It allows health researchers to connect efficiently with potentially eligible volunteers.”

“This article was presented at the 2017 annual meeting of the American Association of Hip and Knee Surgeons to introduce the members gathered as the audience to the concepts behind artificial intelligence (AI) and the applications that AI can have in the world of health care today. We discuss the origin of AI, progress to machine learning, and then discuss how the limits of machine learning lead data scientists to develop artificial neural networks and deep learning algorithms through biomimicry. We will place all these technologies in the context of practical clinical examples and show how AI can act as a tool to support and amplify human cognitive functions for physicians delivering care to increasingly complex patients. The aim of this article is to provide the reader with a basic understanding of the fundamentals of AI. Its purpose is to demystify this technology for practicing surgeons so they can better understand how and where to apply it.”

“Medication adherence is an important but highly complex set of behaviors, which for life-threatening and infectious diseases such as HIV carry critical consequences for individual and public health. There is growing evidence that mobile phone text messaging interventions (mHealth) connecting providers with patients positively impact medication adherence, particularly two-way engagement platforms that require bidirectional communication versus one-way in which responses are not mandatory. However, mechanisms of action have not been well defined. The Behavior Change Wheel is a comprehensive framework for behavior change that includes an all-encompassing model of behavior known as Capability Opportunity Motivation-Behavior and is complemented by a taxonomy of behavior change techniques. Evaluating mHealth interventions for medication adherence using these tools could provide useful insights that may contribute to optimizing their integration into the healthcare system and successful scaling-up.”

“In 2017, the U.S. Food and Drug Administration (FDA) announced a new program for software classified as a medical device. The Digital Health Software Precertification (Pre-Cert) Program is designed to expedite regulatory review for companies that demonstrate quality and organizational excellence in software development. Although Pre-Cert is intended to promote the worthy goals of access and innovation in digital health, many questions have been raised. In particular, Pre-Cert may reduce incentives for developers to study the safety and effectiveness of their software products before patients start to rely on them. Although postmarket surveillance can mitigate risks of these products, the FDA does not have as much authority after a product’s widespread use to enforce data collection deadlines. Pre-Cert may also create confusion for patients and physicians, who may believe that marketed products were subject to rigorous study.”

“Digital technologies in health care are expected to increase in scope and to affect ever more parts of the health care system. It is important to enhance the knowledge of whether new digital methods and innovations provide value for money compared with traditional models of care.


The objective of the study was to evaluate whether a digital health care model for primary care is a less costly alternative compared with traditional in-office primary care in Sweden”

“This article presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years’ time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly.”

“There is limited evidence about the association between health literacy and use of patient web portals in patients with chronic illnesses. The objective of this review was to learn more about health literacy and use of patient web portals.


Bibliographic searches were conducted in PubMed and CINAHL using relevant MeSH search terms and Boolean algebra commands.”

“Purpose To analyze how automatic segmentation translates in accuracy and precision to morphology and relaxometry compared with manual segmentation and increases the speed and accuracy of the work flow that uses quantitative magnetic resonance (MR) imaging to study knee degenerative diseases such as osteoarthritis (OA).”

“Ostomy surgeries involving the placement of an ostomy bag (eg, colostomy, ileostomy, urostomy, etc) have been shown to have a negative impact on health-related quality of life. To date, no studies have been conducted examining what impact, if any, wearable biosensors have on the health-related quality of life of ostomy patients.


In the present study, we plan to assess the quality of life of ostomy patients using the Ostom-i alert sensor, a portable, wearable, Bluetooth-linked biosensor that facilitates easier ostomy bag output measurements. We hypothesize that using the Ostom-i alert sensor will result in an improved, ostomy-specific, health-related quality of life as compared to baseline measurement before the use of the sensor.”

“The systems biology framework was previously synthesized with the person-environment-health-nursing metaparadigm.


The purpose of this paper is to present a nursing discipline-specific perspective of the association of systems biology with big data and precision health.”

“Digital diabetes care demonstrated only modest HbA1c reduction in multiple studies and borderline cost-effectiveness, although patient satisfaction appeared to be increased.”

“Medication adherence is an expensive and damaging problem for patients and health care providers. Patients adhere to only 50% of drugs prescribed for chronic diseases in developed nations. Digital health has paved the way for innovative smartphone solutions to tackle this challenge. However, despite numerous apps available claiming to improve adherence, a thorough review of adherence apps has not been carried out to date.


The aims of this study were to (1) review medication adherence apps available in app repositories in terms of their evidence base, medical professional involvement in development, and strategies used to facilitate behavior change and improve adherence and (2) provide a system of classification for these apps.”

“A variety of different approaches to measuring contraceptive use have been used or proposed, either to assess current use or adherence over time, using subjective or objective measures. This paper reports an overview of approaches to measuring adherence to the oral contraceptive, intra-uterine device, sub-dermal implant, and injectable and describes how we assessed contraception use in the MObile Technology for Improved Family Planning (MOTIF) trial in Cambodia.”

“The Kardia Band (KB) is a novel technology that enables patients to record a rhythm strip using an Apple smartwatch. The band is paired with an app providing automated detection of atrial fibrillation (AF).

To examine whether the KB could accurately differentiate sinus rhythm (SR) from AF compared to physician-interpreted 12-lead ECGs and KB recordings.”

“Photoplethysmogram (PPG) signals collected using a pulse oximeter are increasingly being used for screening and diagnosis purposes. Because of the non-invasive, cost-effective, and easy-to-use nature of the pulse oximeter, clinicians and biomedical engineers are investigating how PPG signals can help in the management of many medical conditions, especially for global health application. The study of PPG signal analysis is relatively new compared to research in electrocardiogram signals, for instance; however, we anticipate that in the near future blood pressure, cardiac output, and other clinical parameters will be measured from wearable devices that collect PPG signals, based on the signal’s vast potential. This article attempts to organize and standardize the names of PPG waveforms to ensure consistent terminologies, thereby helping the rapid developments in this research area, decreasing the disconnect within and among different disciplines, and increasing the number of features generated from PPG waveforms.”

“National data on the epidemiology of firearm injuries and circumstances of firearm deaths are difficult to obtain and often are nonreliable. Since firearm injury and death rates and causes can vary substantially between states, it is critical to consider state-specific data sources.


In this study, we illustrate how states can systematically examine demographic characteristics, firearm information, type of wound, toxicology tests, precipitating circumstances, and costs to provide a comprehensive picture of firearm injuries and deaths using data sets from a single state with relatively low rates of firearm injury and death.”

“The International Patient Summary (IPS) standards aim to define the specifications for a minimal and non-exhaustive Patient Summary, which is specialty-agnostic and condition-independent, but still clinically relevant. Meanwhile, health systems are developing and implementing their own variation of a patient summary while, the eHealth Digital Services Infrastructure (eHDSI) initiative is deploying patient summary services across countries in the Europe. In the spirit of co-creation, flexible governance, and continuous alignment advocated by eStandards, the Trillum-II initiative promotes adoption of the patient summary by engaging standards organizations, and interoperability practitioners in a community of practice for digital health to share best practices, tools, data, specifications, and experiences. This paper compares operational aspects of patient summaries in 14 case studies in Europe, the United States, and across the world, focusing on how patient summary components are used in practice, to promote alignment and joint understanding that will improve quality of standards and lower costs of interoperability.”

“Chronic diseases are the leading cause of death worldwide. It is well understood that if modifiable risk factors are targeted, most chronic diseases can be prevented. Lifetime health is an emerging health paradigm that aims to assist individuals to achieve desired health targets, and avoid harmful lifecycle choices to mitigate the risk of chronic diseases. Early risk identification is central to lifetime health. In this paper, we present a digital health-based platform (PRISM) that leverages artificial intelligence, data visualization and mobile health technologies to empower citizens to self-assess, self-monitor and self-manage their overall risk of major chronic diseases and pursue personalized chronic disease prevention programs. PRISM offers risk assessment tools for 5 chronic conditions, 2 psychiatric disorders and 8 different cancers.”

“My Health Record (MyHR) is Australia’s national electronic health record (EHR) system. Poor usability and functionality have resulted in low utility, affecting enrollment and participation rates by both patients and clinicians alike. Similar to apps on mobile phone app stores, innovative third-party applications of MyHR platform data can enhance the usefulness of the platform, but there is a paucity of research into the processes involved in developing third-party applications that integrate and use data from EHR systems.


The research describes the challenges involved in pioneering the development of a patient and clinician Web-based software application for MyHR and insights resulting from this experience.”

“Chronic knee pain, most commonly caused by knee osteoarthritis, is a prevalent condition which in most cases can be effectively treated through conservative, non-surgical care involving exercise therapy, education, psychosocial support, and weight loss. However, most people living with chronic knee pain do not receive adequate care, leading to unnecessary use of opiates and surgical procedures.


Assess the efficacy of a remotely delivered digital care program for chronic knee pain.”

“Ubiquitous digital technologies such as smartphone sensors promise to fundamentally change biomedical research and treatment monitoring in neurological diseases such as PD, creating a new domain of digital biomarkers.


The present study assessed the feasibility, reliability, and validity of smartphone-based digital biomarkers of PD in a clinical trial setting.”

“With the ever-increasing availability of mobile apps, consumer wearables, and smart medical devices, more and more individuals are self-tracking and managing their personal health data.


The aim of this study was to investigate the diffusion of the digital self-tracking movement in Canada. It provides a comprehensive, yet detailed account of this phenomenon. It examines the profile of digital self-trackers, traditional self-trackers, and nontrackers, further investigating the primary motivations for self-tracking and reasons for nontracking; barriers to adoption of connected care technologies; users’ appreciation of their self-tracking devices, including what they perceive to be the main benefits; factors that influence people’s intention to continue using connected care technologies in the future; and the reasons for usage discontinuance.”

“Exposure to endocrine-disrupting chemicals can alter normal physiology and increase susceptibility to non-communicable diseases like obesity. Especially the prenatal and early postnatal period is highly vulnerable to adverse effects by environmental exposure, promoting developmental reprogramming by epigenetic alterations. To obtain a deeper insight into the role of prenatal bisphenol A (BPA) exposure in children’s overweight development, we combine epidemiological data with experimental models and BPA-dependent DNA methylation changes.”

“Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success.”

“Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN.”

“Investigating public perceptions of community pharmacists (CP) in public health and their use of social media (SM) and mobile health applications (MH apps) in that regard.”

“Precision medicine is making an impact on patients, health care delivery systems, and research participants in ways that were only imagined fifteen years ago when the human genome was first sequenced. Discovery of disease-causing and drug-response genetic variants has accelerated, while adoption into clinical medicine has lagged. We define precision medicine and the stakeholder community required to enable its integration into research and health care. We explore the intersection of data science, analytics, and precision medicine in the formation of health systems that carry out research in the context of clinical care and that optimize the tools and information used to deliver improved patient outcomes. We provide examples of real-world impact and conclude with a policy and economic agenda necessary for the adoption of this new paradigm of health care both in the United States and globally.”

“The objective of this study was to investigate the potential benefits of statin therapy initiation in acute stroke in patients with active cancer. This study was conducted in two parts. First, data from patients who are presented with stroke and active cancer were obtained from prospectively collected multicenter hospital-based stroke registries. Patients were classified into statin user and non-user groups; the statin group was further divided into low-potency and high-potency statin subgroups. The primary outcome was time to mortality. Second, we obtained data from the Korean National Health Information Service-National Sample Cohort (NHIS-NSC) database for external validation and analyzed the effect of statins on mortality, taking compliance into consideration.”

“Health care consumers are increasingly using online ratings to select providers, but differences in the distribution of scores across specialties and skew of the data have the potential to mislead consumers about the interpretation of ratings.


The objective of our study was to determine whether distributions of consumer ratings differ across specialties and to provide specialty-specific data to assist consumers and clinicians in interpreting ratings.”

“The purpose of this study was to compare health-related quality of life (HRQoL) of disease-free prostate (PC), kidney (KC), and bladder cancer (BC) survivors with that of the general population.”

“To achieve full potential in user-oriented eHealth projects, we need to ensure a match between the eHealth technology and the user’s eHealth literacy, described as knowledge and skills. However, there is a lack of multifaceted eHealth literacy assessment tools suitable for screening purposes.


The objective of our study was to develop and validate an eHealth literacy assessment toolkit (eHLA) that assesses individuals’ health literacy and digital literacy using a mix of existing and newly developed scales.”

“Diabetes care is undergoing a remarkable transformation by the advancements in information and communications technology (ICT). The aim of this review is to provide a general overview of various ICT-based interventions for diabetes care, challenges of their adoption, and consider future directions.”

“The review is focused on “digital health”, which means advanced analytics based on multi-modal data. The “Health Care Internet of Things”, which uses sensors, apps, and remote monitoring could provide continuous clinical information in the cloud that enables clinicians to access the information they need to care for patients everywhere. Greater standardization of acquisition protocols will be needed to maximize the potential gains from automation and machine learning.”

“Health disparities associated with chronic illness experiences of black men demonstrate widespread, systematic failures to meet an urgent need. Well-established social and behavioral determinants that have led to health disparities among black men include racism, discrimination, and stress. While advocacy work that includes community-engagement and tailoring health promotion strategies have shown local impact, evidence shows the gaps are increasing. We suspect that failure to reduce current disparities may be due to conventional public health interventions and programs; therefore, we submit that innovative interventions, ones that embrace digital technologies and their ability to harness naturally occurring social networks within groups, like black men, have particular importance and deserve attention. This commentary characterizes the current literature on chronic illness among black men as well as health interventions that use digital technology, to build a case for expanding research in this area to reduce the overwhelming burden of chronic illness among black men.”

“The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach.

OBJECTIVE:This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates.”

“The choice of doctor is an important issue for patients with cancer, and the reputation of the doctor is the single most important factor for patients to choose a doctor. Media are providing information about the ‘best cancer doctor’, but they vary widely in their selection methodology. We investigated cancer physicians’ attitudes towards the selection of the ‘best cancer doctor’ by the media, by comparing two different selection methodologies: selection by media personnel or selection through peer-review system.”

“Zika virus (ZIKV) infection is an emerging pandemic threat to humans that can be fatal in newborns. Advances in digital health systems and nanoparticles can facilitate the development of sensitive and portable detection technologies for timely management of emerging viral infections. Here we report a nanomotor-based bead-motion cellphone (NBC) system for the immunological detection of ZIKV.”

“We compared classic ECG-derived versus a mobile approach to heart rate variability (HRV) measurement.”

“The increasing use of Web-based solutions for health prevention and promotion presents opportunities to improve self-management and adherence to guideline-based therapy for individuals with type 2 diabetes (T2DM). Despite promising preliminary evidence, many users stop using Web-based solutions due to the burden of data entry, hidden costs, loss of interest, and a lack of comprehensive features. Evaluations tend to focus on effectiveness or impact and fail to evaluate the nuanced variables that may interact to contribute to outcome success (or failure).


This study aimed to evaluate a Web-based solution for improving self-management in T2DM to identify key combinations of contextual variables and mechanisms of action that explain for whom the solution worked best and in what circumstances.”

“Atrial fibrillation (AFib) is the most common form of heart arrhythmia and a potent risk factor for stroke. Nonvitamin K antagonist oral anticoagulants (NOACs) are routinely prescribed to manage AFib stroke risk; however, nonadherence to treatment is a concern. Additional tools that support self-care and medication adherence may benefit patients with AFib.


The aim of this study was to evaluate the perceived usability and usefulness of a mobile app designed to support self-care and treatment adherence for AFib patients who are prescribed NOACs.”

“Aiming for early disease detection and prompt outbreak control, digital technology with a participatory One Health approach was used to create a novel disease surveillance system called Participatory One Health Disease Detection (PODD). PODD is a community-owned surveillance system that collects data from volunteer reporters; identifies disease outbreak automatically; and notifies the local governments (LGs), surrounding villages, and relevant authorities. This system provides a direct and immediate benefit to the communities by empowering them to protect themselves.

OBJECTIVE:The objective of this study was to determine the effectiveness of the PODD system for the rapid detection and control of disease outbreaks.”

“Rheumatoid arthritis flares have a profound effect on patients, causing pain and disability. However, flares often occur between regularly scheduled health care provider visits and are, therefore, difficult to monitor and manage. We sought to develop a mobile phone app combined with a population management system to help track RA flares between visits.

OBJECTIVE:The objective of this study is to implement the mobile app plus the population management system to monitor rheumatoid arthritis disease activity between scheduled health care provider visits over a period of 6 months.”

“Women with breast cancer undergoing chemotherapy experience difficulty in accessing adequate cancer care in China. Mobile apps have the potential to provide easily accessible support for these women. However, there remains a paucity of randomized controlled trials to evaluate the effectiveness of app-based programs targeting specifically women with breast cancer undergoing chemotherapy. Moreover, women’s perceptions and experiences related to using and interacting within the app-based program have rarely been reported. Therefore, an app-based Breast Cancer e-Support program was developed and evaluated using a randomized controlled trial. Based on the incorporation of Bandura’s self-efficacy and social exchange theory, Breast Cancer e-Support program lasted for 12 weeks covering 4 cycles of chemotherapy and had 4 components: (1) a Learning forum, (2) a Discussion forum, (3) an Ask-the-Expert forum, and (4) a Personal Stories forum.

OBJECTIVE:As a part of the randomized controlled trial, the aim of this study was to explore the participants’ perception of Breast Cancer e-Support program, its strengths and weaknesses, and suggestions to improve the program.”

“The need for modern patient evaluation tools continues to grow. A dependable and reproducible assessment provides objective follow-up and increases the validity of collected data. This is where mobile apps come into play, as they provide a link between surgeons and patients. They also open the possibility of interacting with other healthcare staff to exchange common scientific reference systems and databases. The CJOrtho app provides fast access to 65 classification systems in orthopedics or trauma surgery, 20 clinical outcome scores and a digital goniometer. The development of free mobile apps is an opportunity for education and better follow-up, while meeting the demands of patients.”

“The early diagnosis of melanoma is associated with decreased mortality. The smartphone, with its apps and the possibility of sending photographs to a dermatologist, could improve the early diagnosis of melanoma.


The aim of our review was to report the evidence on (1) the diagnostic performance of automated smartphone apps and store-and-forward teledermatology via a smartphone in the early detection of melanoma, (2) the impact on the patient’s medical-care course, and (3) the feasibility criteria (focusing on the modalities of picture taking, transfer of data, and time to get a reply).”

“The growing interest in incorporating prevention into emergency health care make it timely to examine the use of computer technology to efficiently deliver effective education in this setting.”

“Skin cancer is the most prevalent cancer in Australia. Skin cancer prevention programs aim to reduce sun exposure and increase sun protection behaviors. Effectiveness is usually assessed through self-report.

OBJECTIVE: It was the aim of this study to test the acceptance and validity of a newly developed ultraviolet radiation (UVR) exposure app, designed to reduce the data collection burden to research participants. Physical activity data was collected because a strong focus on sun avoidance may result in unhealthy reductions in physical activity. This paper provides lessons learned from collecting data from participants using paper diaries, a mobile app, dosimeters, and accelerometers for measuring end-points of UVR exposure and physical activity.”

“Ischemic heart disease and stroke have been considered as the first global leading cause of death in last decades [1]. Blood pressure (BP) management is one of the easiest ways suggested for preventing and controlling cardiovascular diseases before the patient develops complications and death-following outcomes. Appearance of technology advancements in the health system has motivated researchers and health providers to study its different aspects and applications in order to improve disease prevention and management. Following these efforts, mobile health (mHealth) technologies were presented to provide people with fast and easier-to-use services. Although there are some unsolved challenges, these technologies have become popular among many people. As an important part of mHealth, mobile applications (apps) have been the focused subject of many studies in the last decade. The objective of this systematic review is to assess the potential effects of mobile apps designed for BP management by scrutinizing the related studies.”

“Healthcare providers who are involved in the care of patients at the end of life are at risk of developing compassion fatigue, a condition characterized by emotional exhaustion and reduced professional engagement. Research has shown that development of a meditation practice can modify stress perceptions and promote quality of life. This study aimed to evaluate perceived benefits, challenges, and recommendations following participation in a workplace mobile application- and email-based meditation research program.”

“Mobile apps are becoming an increasingly ubiquitous platform for delivery of health behavior interventions among overweight and obese perinatal women. However, only a few methodological guidelines on integrating theory, evidence, and qualitative research for their designs are available.


The aim of this study was to develop a theory-based, evidence-driven, and user-centered healthy lifestyle app targeting overweight and obese multiethnic pregnant women.”

“Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians’ appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning.”

“Although many men who have sex with men (MSM) test for HIV at least once in their lifetime, opportunities to improve regular HIV testing, particularly among Hispanic or Latino MSM, is needed. Many mHealth interventions in development, including the ones on HIV testing, have primarily focused on English-speaking white, black, and MSM of other races. To date, no studies have assessed app use, attitudes, and motivations for downloading and sustaining use of mobile apps and preferences with respect to HIV prevention among Spanish-speaking, Hispanic MSM in the United States.


The primary aims of this study were to determine what features and functions of smartphone apps do Hispanic, Spanish-speaking MSM believe are associated with downloading apps to their smartphones, (2) what features and functions of smartphone apps are most likely to influence men’s sustained use of apps over time, and (3) what features and functions do men prefer in a smartphone app aimed to promote regular testing for HIV.”

“Women undergoing chemotherapy for the treatment of breast cancer have frequently reported unmet supportive care needs. Moreover, easily accessible and innovative support is lacking.


The purpose of this trial was to determine the effectiveness of an app-based breast cancer e-support program to address women’s self-efficacy (primary outcome), social support, symptom distress, quality of life, anxiety, and depression. Secondary objectives included exploring the association between women’s health outcomes and the breast cancer e-support usage data.”

“Kidney stone disease has become an important worldwide socioeconomic issue. However, metaphylaxis fails due to low compliance rates. Therefore, we developed a mobile app (StoneMD: Kidney Stones) for patients with kidney stones to increase compliance in stone metaphylaxis.”

“In South Africa, a national-level helpdesk was established in August 2014 as a social accountability mechanism for improving governance, allowing recipients of public sector services to send complaints, compliments and questions directly to a team of National Department of Health (NDoH) staff members via text message. As demand increases, mechanisms to streamline and improve the helpdesk must be explored. This work aims to evaluate the need for and feasibility of automated message triage to improve helpdesk responsiveness to high-priority messages”

“MomConnect was designed to provide crucial health information to mothers during pregnancy and in the early years of child rearing in South Africa. The design drew on the success of the Mobile Alliance for Maternal Action’s programme in South Africa, as well as a growing list of mobile health (mHealth) interventions implemented internationally. Services such as MomConnect are dependent on user acceptability as all engagements are voluntary, meaning that tools have to be easy to use and useful to be successful. This paper describes the evaluation of the tool by pregnant women and new mothers using the tool.”

“Although the treatment of cancer is more effective now than ever, patients with cancer still face acute and chronic toxicities such as fatigue, cardiotoxicity, pain, cognitive impairment, and neurotoxicity. In this narrative review, we briefly discuss the use of exercise for toxicity management in patients with cancer, biological mechanisms underlying the toxicities and the effects of exercise, barriers that patients- especially underserved patients-face in adopting and adhering to exercise programs, and new technologies to overcome barriers to exercise.”

“Mobile devices and applications (apps) that act as access tools for health care management aid in the improvement of clinical decision making and patient outcomes. However, the tremendous amount of mobile health (mHealth) apps available in commercial app stores makes it hard for the lay users as well as health care professionals to choose the right one for their individual needs. The contents and features of these apps have not been systematically reviewed and compared. This study aims to assess the contents and features of mHealth apps for caring of older people.”

“Despite the surge in mobile health (mHealth) applications (apps) about pediatric care in commercial app stores, to our knowledge, reviews of the quality of such apps are lacking. Consequently, it is a great challenge for health care professionals (HCPs) to identify appropriate and reliable mHealth apps for delivering health care services. Thus, we performed a structured review of the extant literature about mHealth apps in pediatric care and quality assessment of selected apps found in commercial app stores.”

“Unintended pregnancies can result in poorer health outcomes for women, children and families. Young people in low and middle income countries are at particular risk of unintended pregnancies and could benefit from innovative contraceptive interventions. There is growing evidence that interventions delivered by mobile phone can be effective in improving a range of health behaviours. This paper describes the development of a contraceptive behavioural intervention delivered by mobile phone for young people in Tajikistan, Bolivia and Palestine, where unmet need for contraception is high among this group.”

“Problematic translational gaps continue to exist between demonstrating the positive impact of healthcare interventions in research settings and their implementation into routine daily practice. The aim of this qualitative evaluation of the SMART MOVE trial was to conduct a theoretically informed analysis, using normalisation process theory, of the potential barriers and levers to the implementation of a mhealth intervention to promote physical activity in primary care.”

“In Cameroon, the National Tuberculosis Control Program that applies selective directly observed treatments faces difficulties in its implementation for a lack of resources, leading to only 65% of patients with sputum smear-positive pulmonary tuberculosis being cured after 6 months of treatment. This study aimed to evaluate the effectiveness of daily Short Message Service reminders to increase adherence and the proportion of adult tuberculosis patients cured after 6 months of treatment.”

“Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important.

OBJECTIVE: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial.”

“Acute reductions in postprandial glucose excursions because of movement behaviors have been demonstrated in experimental studies but less so in free-living settings.

OBJECTIVE: The objective of this study was to explore the nature of the acute stimulus-response model between accelerometer-assessed physical activity, sedentary time, and glucose variability over 13 days in nondiabetic adults.”

As Internet and mobile phone use expands in India, there is an opportunity to develop mobile health (mHealth) interventions for marginalized populations, including men who have sex with men (MSM) and hijras (transgender women), hesitant to access traditional health care systems.

OBJECTIVE: The purpose of this study was to determine if an mHealth intervention was acceptable to MSM and hijras living in Mumbai, and if so, what features would be useful in targeting the prevention of HIV acquisition and to increase the quality of life among persons living with HIV/AIDS.”

“It is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss.”

“Medical ward rounds are critical focal points of inpatient care that call for uniquely flexible solutions to provide clinical information at the bedside. While this fact is undoubted, adoption rates of mobile IT solutions remain rather low.

OBJECTIVES: Our goal was to investigate if and how mobile IT solutions influence successful information provision at the bedside, i.e. clinical information logistics, as well as to shed light at socio-organizational factors that facilitate adoption rates from a user-centered perspective.”

“Manual skills teaching, such as physiotherapy education, requires immediate teacher feedback for the students during the learning process, which to date can only be performed by expert trainers.

OBJECTIVES:A machine-learning system trained only on correct performances to classify and score performed movements, to identify sources of errors in the movement and give feedback to the learner.”

“Voluntary blood donation rates are low in sub-Saharan Africa. Sociobehavioral factors such as a belief that donated blood would be used for performing rituals deter people from donating blood. There is a need for culturally appropriate communication interventions to encourage individuals to donate blood. Health care interventions that use mobile phones have increased in developing countries, although many of them focus on SMS text messaging (short message service, SMS). A unique feature of mobile phones that has so far not been used for aiding blood donation is caller tunes. Caller tunes replace the ringing sound heard by a caller to a mobile phone before the called party answers the call. In African countries such as Ghana, instead of the typical ringing sound, a caller may hear a message or song. Despite the popularity of such caller tunes, there is a lack of empirical studies on their potential use for promoting blood donation.”

“Care coordination can be highly challenging to carry out. When care is fragmented across health systems and providers, there is an increased likelihood of hospital readmissions and wasteful health care spending. During and after care transitions, smartphones have the potential to bolster information transfer and care coordination. However, little research has examined patients’ perceptions of using smartphones to coordinate care.

OBJECTIVE:This study’s primary objective was to explore patient acceptability of a smartphone app that could facilitate care coordination in a safety net setting. Our secondary objective was to identify how clinicians and other members of primary care teams could use this app to coordinate care.”

“Over recent decades, the field of psychiatry has allocated a vast amount of resources and efforts to make available more accurate and objective methods to diagnose, assess and monitor treatment outcomes in psychiatric disorders. Despite the optimism and some significant progress in biological markers, it has become increasingly evident that they are failing to meet initial expectations due to their lack of specificity, inconsistent reliability and limited availability. On the other hand, there is an increasingly emerging evidence of mobile technologies’ feasibility to measure mental illness activity.”

“Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs.”

“Mobile health apps have emerged as supportive tools in the management of advanced cancers. However, only a few apps have self-monitoring features, and they are not standardized and validated.

OBJECTIVE:This study aimed to develop and validate a multidisciplinary mobile care system with self-monitoring features that can be useful for patients with advanced gastrointestinal cancer.”

“Educators in all disciplines recognize the need to update tools for the modern learner. Mobile applications (apps) may be useful, but real-time data is needed to demonstrate the patterns of utilization and engagement amongst learners.”

“Digital self-management in cystic fibrosis (CF) is foreseen as a means toward better understanding of the disease and its treatment and better adherence to the treatment. Mobile apps hold the potential to provide access to information, motivate, and strengthen compliance. However, to deliver high-quality apps, the development should be based on thorough knowledge about user needs. Empirical research on the user-centered development of mobile apps for health care is, however, still limited.”

“Surgical site infections (SSIs) are a significant cause of morbidity and mortality in low-income and middle-income countries, where rates of SSIs can reach 30%. Due to limited access, there is minimal follow-up postoperatively. Community health workers (CHWs) have not yet been used for surgical patients in most settings. Advancements in telecommunication create an opportunity for mobile health (mHealth) tools to support CHWs. We aim to evaluate the use of mHealth technology to aid CHWs in identification of SSIs and promote referral of patients back to healthcare facilities.”

“The purpose of this descriptive, exploratory study was to assess the perceptions of older adults with heart failure regarding the use of mobile technology and to identify potential facilitators of and barriers to mHealth adoption.”

“Developing an optimized and user-friendly mHealth application for patients and family members in the hospital environment presents unique challenges given the diverse patient population and patients’ various states of well-being.

OBJECTIVE:This article describes user-centered design methods and results for developing the patient and family facing user interface and functionality of MySafeCare, a safety reporting tool for hospitalized patients and their family members.”

“Social interaction quality is related to cardiovascular functioning. Trait emotional reactivity may amplify cardiovascular responses to social interactions, but is often examined as a tendency to react to negative events. We took a broader approach by examining the joint effects of positive and negative emotional reactivity and social interaction quality on ambulatory blood pressure (ABP) and heart rate (HR) responses to daily social interactions.”

“In a recent clinical trial (NCT00295308), we demonstrated that clonidine decreased the association between opioid craving and moderate levels of stress and affect in patients receiving buprenorphine-based opioid agonist therapy.


To examine the relationship between illicit opioid use and craving and affect during the evaluation of clonidine as an adjunct medication in buprenorphine treatment for opioid use disorder. Secondarily, to examine whether those relationships are driven by within- or between-participant factors.”

“Fatigue is the second most common symptom in patients with chronic obstructive pulmonary disease (COPD). Despite its high prevalence, fatigue is often ignored in daily practice. For this reason, little is known about the underlying determinants of fatigue in patients with COPD. The primary objectives of this study are to chart the course of fatigue in patients with COPD, to identify the physical, systemic, psychological and behavioural factors that precipitate and perpetuate fatigue in patients with COPD, to evaluate the impact of exacerbation-related hospitalisations on fatigue and to better understand the association between fatigue and 2-year all-cause hospitalisation and mortality in patients with COPD. The secondary aim is to identify diurnal differences in fatigue by using ecological momentary assessment (EMA). This manuscript describes the protocol of the FAntasTIGUE study and gives an overview of the possible strengths, weaknesses and clinical implications.”

“Ecological momentary assessment is recommended in the management of chronic pain. Smartphone apps might be a useful tool for that purpose. This study goal was to develop and test a multidimensional smartphone app for adults with chronic pain. A multidisciplinary team developed app content after a series of meetings, considering clinical guidelines for pain measurement. Content included pain intensity and interference, fatigue, mood, perceived health status, activity level, side effects of the medication, use of rescue medication, and pain-related psychological constructs (catastrophizing, acceptance, fear, and coping).”

“Perceived growth (PG) refers to perceptions of positive changes that unfold over time after experiencing trauma. Higher PG is often associated with positive long-term health, but the processes through which PG may influence health are unclear. The present study examines two potential pathways among individuals living with asthma or RA: (1) by promoting momentary indicators of health and well-being in everyday life, and (2) by buffering against stress.”

“Symptom severity is negatively associated with physical activity in multiple sclerosis (MS). However, it is unclear how physical activity and symptoms correlate on a day-to-day basis in persons with MS.


To determine the temporal within-person associations of pain, fatigue, depressed mood, and perceived cognitive function with physical activity in MS.”

“Caregivers differ in their emotional response when facing difficult situations during the caregiving process. Individual differences in vulnerabilities and resources could play an exacerbating or buffering role in caregivers’ reactivity to daily life stress. This study examines which caregiver characteristics modify emotional stress reactivity in dementia caregivers.”

“The aim of this study was to assess awake bruxism (AB) behaviours in a sample of healthy young adults using a smartphone-based application for a real-time report (ie, ecological momentary assessment [EMA], also called experience sampling method [ESM]). Forty-six dental students used a smartphone application that sent 15 alerts at random intervals during the day for 1 week to collect AB self-reports. They had to answer on time by tapping on the display icon that refers to their current condition of jaw muscles: relaxed; teeth contact; teeth clenching; teeth grinding; jaw clenching without teeth contact (ie, bracing).”

“Evaluation of bowel habit is useful indicator of functional gastrointestinal disorders. Assessment of bowel habit is retrospective in nature and it is best done by questionnaire technique. Aims and objectives of the study was to look for the bowel habit in common benign anorectal disorder.”

“Memory problems are reported in 40%–60% of people with multiple sclerosis (MS). These problems affect independence and may limit the ability to benefit from rehabilitation. Our aim was to evaluate the effectiveness of NeuroPage for people with MS living in the community.”

“Patients with severe, uncontrolled asthma may experience symptoms that impair their ability to engage in activities and increase their perceived feelings of stress and tiredness. We evaluated treatment with the humanized, anti-eosinophilic monoclonal antibody benralizumab on asthma-related activity impairment, stress, and tiredness.”

“Beyond asthma-related quality of life (QOL), limited data are available for relationships between asthma control status and patients’ subjective well-being. We assessed the associations of degree of asthma control with lung function and different aspects of well-being for patients with severe, uncontrolled asthma.”

“To evaluate the efficacy and tolerability of a poly-herbal formulation, Herbagut, for the treatment of gastrointestinal symptoms and its effect on quality of life parameters in patients presenting with self-reported, unsatisfactory bowel habits.”

“The inFLUenza Patient Reported Outcome (FLU-PRO) measure is a daily diary assessing signs/symptoms of influenza across six body systems: Nose, Throat, Eyes, Chest/Respiratory, Gastrointestinal, Body/Systemic, developed and tested in adults with influenza. This study tested the reliability, validity, and responsiveness of FLU-PRO scores in adults with influenza-like illness (ILI).”

“Bone adapts to loading in several ways, including redistributing bone mass, and altered geometry and microarchitecture. Due to previous methodological limitations, it is not known how the bone material strength is affected by mechanical loading in humans.

The aim was to investigate the effect of 3‐month unilateral high‐impact exercise program on bone material properties and microarchitecture in healthy postmenopausal women.”

“Leveraging smartphone technology, we sought to examine the usability of the RELAXaHEAD application, which has a headache diary and PMR capability.

Background: Scalable non-pharmacologic treatment options are needed for chronic pain conditions. Migraine is an ideal condition to test smartphone-based mind body interventions (MBIs) because it is a very prevalent, costly, disabling condition. Progressive muscle relaxation (PMR) is a standardized, evidence-based MBI used for migraine which people can do independently and therefore might be best amenable for adaption in a smartphone application (app).”

“The transition to later-life caregiving roles, especially for couples caring for each other, can be rife with ambiguity. The incident discordance in spousal perceptions of one another’s role and its relationship to mental health outcomes have not been well-described.”

“Purpose: To determine, in a sample of community dwelling adults, the natural history of flare-ups in knee osteoarthritis (OA).”

Physical Activity

“This paper describes the design of MOVE, a mobile app to support people in forming social relations around exercise in residential areas. MOVE was developed in collaboration with residents and health professionals in a neighbourhood identified as a high-risk health area. The app is targeted to those who are motivated but challenged to do exercise and based on a conceptual model to provide users a social horizon of exercise activities in their residential area. We present the design and first evaluation of MOVE, including usability evaluations in controlled and natural settings. Results from these evaluations indicate that MOVE is a promising platform to support local social health relations once the identified usability problems are resolved.”

“The mutual dependencies between mother and infant circadian rhythms are important for examining disturbances of maternal circadian rhythms, which are considered substantial risk factors for the development of maternal depression during childrearing periods.”

Physiological Sensors


“Post-traumatic stress and other problems often occur after combat, deployment, and other military operations. Because techniques such as mindfulness meditation show efficacy in improving mental health, our team developed a mobile application (app) for individuals in the armed forces with subclinical psychological problems as secondary prevention of more significant disease. Based on the Personal Health Intervention Toolkit (PHIT), a mobile app framework for personalized health intervention studies, PHIT for Duty integrates mindfulness-based relaxation, behavioral education in sleep quality and alcohol use, and psychometric and psychophysiological data capture. We evaluated PHIT for Duty in usability and health assessment studies to establish app quality for use in health research.”

“Israel represents a complex and pluralistic society comprising two major ethno-national groups, Israeli Jews and Israeli Arabs, which differ in terms of religious and cultural values as well as social constructs. According to the so-called “diversification hypothesis”, within the framework of e-health and in the era of new information and communication technologies, seeking online health information could be a channel to increase health literacy, especially among disadvantaged groups. However, little is known concerning digital seeking behavior and, in particular, digital mental health literacy. This study was conducted in order to fill in this gap.”

“The clinical utility of the existing apps for people with eating disorders (EDs) is not clear. The TCApp has been specifically developed for people with EDs, is based on the principles of Cognitive Behavioural Treatment (CBT) and allows a bidirectional link between the patient and the therapist. The objectives of the study are, first, to assess the clinical efficacy of a combined intervention for Eating Disorders (EDs) that includes an online intervention through the TCApp plus standard face-to-face CBT in comparison to standard face-to-face CBT alone, and second, to examine the cost-effectiveness of the TCApp and identify potential predicting, moderating and mediating variables that promote or hinder the implementation of the TCApp in ED units in Spain.”

“Recent research indicates that current mHealth apps for bipolar disorders (BDs) show crucial shortcomings. They lack important functionality, are of inconsistent quality, and are insufficiently evidence-based. mHealth apps need to be better adapted to the needs of users. The perspectives of adult service users with BD regarding mHealth apps have not been well investigated.”

“Depressive symptoms are the most frequently treated psychiatric condition in the United States. Brief behavioral activation treatment for depression (BATD) is a popular, evidence-based psychotherapy with strong research support for the treatment of depression. In this paper, we describe the development and initial pilot feasibility testing of a BATD mobile application (Behavioral Apptivation) to be used by patients and therapists in conjunction with BATD therapy. We present information regarding the app development process as well as results from a small open-label feasibility trial of the app utilized in conjunction with individual BATD. We include a case series from the open-label trial highlighting how Behavioral Apptivation can be utilized in clinical practice.”

“New technologies can profoundly change the way we understand psychiatric pathologies and addictive disorders. New concepts are emerging with the development of more accurate means of collecting live data, computerized questionnaires, and the use of passive data. Digital phenotyping, a paradigmatic example, refers to the use of computerized measurement tools to capture the characteristics of different psychiatric disorders. Similarly, machine learning-a form of artificial intelligence-can improve the classification of patients based on patterns that clinicians have not always considered in the past. Remote or automated interventions (web-based or smartphone-based apps), as well as virtual reality and neurofeedback, are already available or under development.”

“The current research utilized ecological momentary assessment (EMA) methodology to test the hypotheses that: 1) engaging in greater rumination following stress (stress-reactive rumination; SRR) would lead to improved stressor recall, and 2) this improved memory for stress would predict increases in depressive symptoms.”

“Stress and affect have been implicated in the maintenance of binge eating for women with symptoms of bulimia nervosa (BN). Neuroimaging and ecological momentary assessment (EMA) have separately examined how these variables may contribute to eating disorder behavior. Though both methodologies have their own strengths, it’s unclear how either methodology might inform the other. This study examined the impact of individual differences in neural reactivity to food cues following acute stress on the trajectories of positive affect (PA) and negative affect (NA) surrounding binge eating.”

“Our study examined momentary mood and emotional instability pre- and post-loss of control (LOC) eating on non-LOC and LOC eating days, using randomly timed assessments. Community and university participants (n = 45) who endorsed LOC eating at least once per week completed 2 weeks of ecological momentary assessment. All negative moods and emotional instability were elevated on LOC eating days, but trajectories between days did not differ. Guilt exhibited an increasing trajectory prior to a LOC eating episode, but remained elevated after LOC eating episodes. Additional analyses revealed that size of the LOC eating episode did not change these results dramatically.”

“Individuals with eating disorders experience high anxiety when eating, which may contribute to the high relapse rates seen in the eating disorders. However, it is unknown if specific cognitions associated with such anxiety (e.g., fears of gaining weight) may lead to engagement in eating disorder behaviors (e.g., weighing oneself).”

“Despite recognition of the negative impact of psychiatric comorbidity on addictive disorders, the mechanisms underlying this association remain poorly understood. The present investigation applied mobile technologies to examine the effect of comorbid mood or anxiety disorders on craving intensity and substance use within the natural conditions of daily life.”

“Smartphone-based ecological momentary assessment and intervention (EMA/I) show promise for enhancing psychological treatments for psychosis. EMA has the potential to improve assessment and formulation of experiences which fluctuate day-to-day, and EMI may be used to prompt use of therapeutic strategies in daily life. The current study is an examination of these capabilities in the context of a brief, coping-focused intervention for distressing voice hearing experiences.”

“Despite growing interest in the temporal dynamics of Major Depressive Disorder (MDD), we know little about the intra-day fluctuations of key symptom constructs. In a study of momentary experience, the Experience Sampling Method captured the within-day dynamics of negative affect, positive affect, self-esteem, passive suicidality, and tiredness across clinical MDD (N= 31) and healthy control groups (N= 33).”

“Conceptualization and assessment of non-suicidal self-injury (NSSI) has evolved substantially in recent years. In both cross-sectional and longitudinal studies, NSSI and its related variables have traditionally been assessed retrospectively, leading to less precise studies of the mechanisms involved in the maintenance, cessation, or aggravation of this behavior. Ecological momentary assessment (EMA) enables real-time collection of patient states, which can be very useful in the study of the mechanisms implied in this behavior.”

“Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co-occur with chronic pain. Yet no study has prospectively considered the associations among these psychological processes and pain reports using experience sampling methods (ESM) during the acute aftermath of injury. This study applied ESM via daily text messaging to monitor and detect relationships among psychosocial factors and post-injury pain across the first 14-days after emergency department (ED) discharge.”

“Auditory verbal hallucinations (AVH) are prevalent experiences that can induce distress and impede social functioning. While most voice hearers benefit from antipsychotic medication or cognitive-behavioural therapy, additional effective interventions are needed to reduce the burden of experiencing AVH. ‘Temstem’ is an easily accessible and useable smartphone application that was developed by designers in close cooperation with voice hearers and experts. By using language games, Temstem aims to reduce distress and improve social functioning.”

“Discrepancies regarding the link between autonomic nervous system (ANS) activity and psychopathology may be due in part to inconsistent measurement of non-psychological factors, including eating, drinking, activity, posture, and interacting with others. Rather than sources of noise, behaviors like being active and being with others may be the behavioral pathways that connect psychopathology symptoms to autonomic activity. The present study examined whether behaviors mediate the association of depression, anxiety, and hypomanic traits with ANS by using experience sampling methodology and ambulatory impedance cardiography.”

“Relapse prevention strategies include continuation of antidepressant medication and preventive psychological interventions. This study aims to gain understanding that may inform tailoring of relapse prevention to individual differences, to improve their effects. Such treatment personalization may be based on repeated assessments within one individual, using experience sampling methodology. As a first step towards informing decisions based on this methodology, insight is needed in individual differences in risk of relapse and response to treatment, and how relapse prevention strategies may differentially target vulnerability for relapse.”

“Dietary restriction contributes to disordered eating (DE) behaviors and associated cognitions. However, it is unclear how these outcomes are impacted by dietary restriction for religious purposes, such as fasting observed by Muslims during Ramadan. Using ecological momentary assessment, this study assessed the impact of Ramadan fasting on DE behaviors and correlates.”

“Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions.”

“We sought to explore the daily association between shame and self-criticism, and the extent to which this association varies as a function of social anxiety symptoms.”

Smoking Cessation

“The number of mobile apps that support smoking cessation is growing, indicating the potential of the mobile phone as a means to support cessation. Knowledge about the potential end users for cessation apps results in suggestions to target potential user groups in a dissemination strategy, leading to a possible increase in the satisfaction and adherence of cessation apps.

OBJECTIVE:This study aimed to characterize potential end users for a specific mobile health (mHealth) smoking cessation app.”

“Cigarette smoking is the leading preventable cause of death and is responsible for more than 480,000 deaths per year in the United States. Smoking cessation is challenging for many patients. Regardless of available treatment options, most quit attempts are unaided, and it takes multiple attempts before a patient is successful. With the ever-increasing use of smartphones, mobile apps hold promise in supporting cessation efforts. This study evaluates the ease of use and user satisfaction with the Pfizer Meds app to support smoking cessation among patients prescribed varenicline (Chantix).”

“To determine whether augmenting standard smoking cessation treatment by wearing an active nicotine patch before the smoking quit date improves rates of smoking cessation in individuals with posttraumatic stress disorder (PTSD), and to explore mechanisms of treatment response such as decreased cigarette craving and symptom relief from smoking.”

“The use of ambulatory assessment to study behavior and physiology in daily life is becoming more common, yet barriers to implementation remain. Limitations in budget, time, and expertise may inhibit development or purchase of dedicated ambulatory assessment software. Research Electronic Data Capture (REDCap) is widely used worldwide, offering a cost-effective and accessible option for implementing research studies.”