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

BACKGROUND: This primary analysis evaluated the "PREVenting the impairment of primary Osteoarthritis by high-impact long-term Physical exercise regimen-Psychological Adherence Program" (PrevOP-PAP), designed to support patients with osteoarthritis of the knee (OAK) to engage in regular moderate-to-vigorous physical activity (MVPA) to reduce OAK symptoms (WOMAC scores). Theory-based on the health action process approach (HAPA), the intervention targeted volitional precursors of MVPA change: action and coping planning, maintenance and recovery self-efficacy, action control, and social network formation. We hypothesized that compared to an active control condition, increases in MVPA at the end of the 12-month intervention would translate into lower WOMAC scores at 24 months in the intervention condition. METHODS: Participants with radiographically verified moderate OAK (N = 241; 62.66% female; M(SD) = 65.60(7.61) years) were randomly assigned to the intervention (51%) or the active control condition. WOMAC scores (24 months) were the primary -, accelerometer-assessed MVPA (12 months) the key secondary outcomes. The PrevOP-PAP was a 12-month intervention with computer-assisted face-to-face and phone-based sessions designed to increase HAPA-proposed volitional precursors of MVPA change (up to 24 months; secondary outcomes). Intent-to-treat analyses included multiple regression and manifest path models. RESULTS: MVPA (12 months) did not mediate effects of the PrevOP-PAP on WOMAC scores (24 months). Compared to the active control condition, WOMAC scores (24 months) were lower in the intervention condition, but this effect did not remain stable in sensitivity analyses (b(SE) = -8.41(4.66), 95%-CI [-17.53; 0.71]). However, exploratory analyses revealed significantly stronger reductions in WOMAC-pain (24 months) in the intervention condition (b(SE) = -2.99(1.18), 95%-CI [-5.36; -0.63]). Groups did not differ in MVPA at 12 months (b(SE) = -3.78(3.42), 95%-CI [-10.80; 2.58]). Of the proposed precursors of MVPA change, action planning was higher in the intervention than in the control condition (24 months; b(SE) = 0.64(0.26), 95%-CI [0.14; 1.15]). CONCLUSIONS: Compared to an active control condition, the PrevOP-PAP did not produce reliable effects on WOMAC scores and none on preceding MVPA. Of the HAPA-proposed volitional precursors, only action planning was sustainably increased. Future interventions should use m-health applications to digitally support long-term changes in proposed volitional precursors of MVPA change. TRIAL REGISTRATION: German Clinical Trials Register; https://drks.de/search/de/trial/DRKS00009677 ; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677; date of registration: 26/01/2016.

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

Chalcopyrite Cu(In,Ga)Se2 (CIGSe) solar absorbers are renowned for delivering high solar power conversion efficiency despite containing high concentration of lattice defects amounting to copper deficiencies of several atomic percent. The unique ability to incorporate this deficiency without triggering decomposition (i.e. "tolerance to off-stoichiometry") is viewed by many as the key feature of CIGSe. In principle, this property could benefit any solar absorber, but remarkably little attention has been paid to it so far. In this study, we assess the tolerance to off-stoichiometry of thin-film photovoltaic materials by carrying out ab initio analysis of group-I-poor ordered defect compounds (ODCs) in the extended family of I-III-VI systems (where I = Cu, Ag, III = Al, Ga, In, and VI = S, Se, Te). We analyze convex hulls and structural evolution with respect to group-I content, link them with experimental phase diagrams, and determine two empirical principles for the future identification of solar energy materials with high tolerance to off-stoichiometry. Practical implications for the deposition of I-III-VI absorbers are also discussed in light of our computational results and recent experimental findings.

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

BACKGROUND: Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA). PURPOSE: This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions. METHODS: The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection). RESULTS: Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring. CONCLUSIONS: When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.

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

BACKGROUND: Effective hand washing (for at least 20 s, with water and soap) is one of the health behaviors protecting against infection transmissions. Behavior change interventions supporting the initiation and maintenance of hand washing are crucial to prevent infection transmissions. Based on the Health Action Process Approach, the aim of this research was to conduct a pre-post analysis of hand washing and related cognitions (i.e., intention, self-efficacy, self-monitoring), measured up to 100 days following an intervention. METHODS: A convenience sample of N = 123 participants (age: M = 23.96 years; SD = 5.82; 80% women) received a brief intervention (key behavior change techniques: information about health consequences of hand washing; action planning) and responded to daily diaries and questionnaires up to a 100-day follow-up. Two-level models were used to analyze data of n = 89 participants who provided longitudinal data. RESULTS: Hand washing and self-monitoring increased, whereas intention and self-efficacy decreased over time. Only self-monitoring was a consistent positive correlate of hand washing on a between-person level. CONCLUSIONS: Hand washing and self-monitoring considerably increased over several weeks following the intervention. Future research testing the intervention against a control condition is needed to rule out that changes in behavior and cognitions might have been prompted by completing the daily diaries. TRIAL REGISTRATION: German Clinical Trials Register;  https://www.drks.de ; registration number: DRKS00022067.

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

BACKGROUND: High automaticity in healthy nutrition behaviors is related to long-term maintenance of these behaviors. Drawing upon theoretical frameworks of habit formation, proposed antecedents such as intrinsic reward, anticipated regret, and self-efficacy are important correlates of automaticity, but not much is known about their day-by-day relationships with automaticity in healthy nutrition behaviors. This study tested previous-day within-person (i.e., from one day to the next) and same-day within-person associations of intrinsic reward, anticipated regret, and self-efficacy with automaticity of a healthy nutrition behavior, for which participants attempted to form a new habit. METHODS: Secondary analyses of a randomized controlled trial with two planning intervention conditions including a longitudinal sample of n = 135 participants (age: M = 24.82 years; SD = 7.27) are reported. Participants formed a plan on a self-selected healthy nutrition behavior to become a new habit and were followed up over 12 weeks assessing daily levels of plan-specific intrinsic reward, anticipated regret, self-efficacy, and automaticity. Lagged multilevel models with 84 study days nested in participants estimated previous-day within-person, same-day within-person, and between-person relationships of intrinsic reward, anticipated regret, and self-efficacy with automaticity. FINDINGS: Regarding within-level relationships, higher-than-usual levels of intrinsic reward, anticipated regret, and self-efficacy of the same day but not of the previous day were associated with higher within-person automaticity. With respect to between-level relationships, higher between-levels (i.e., higher person mean levels across the study period) of intrinsic reward, anticipated regret, and self-efficacy were linked with higher automaticity. DISCUSSION: Findings point towards the potential to intervene on intrinsic reward, anticipated regret, and self-efficacy when aiming to promote a new healthy nutrition habit.

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

BACKGROUND: The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier). METHODS: The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports. RESULTS: Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence. CONCLUSIONS: To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic. TRIAL REGISTRATION: Clinical Trials.Gov, # NCT04367337.

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

BACKGROUND: Overall time spent in moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior are both correlated in couples. Knowledge about the nature and psychosocial correlates of such dyadic covariation could inform important avenues for physical activity promotion. PURPOSE: The present study investigates hour-by-hour covariation between partners (i.e., synchrony) in MVPA and sedentary behavior as partners engage in their daily lives and links it with person-level MVPA/sedentary behavior, temporal characteristics, and relationship variables. METHODS: We used 7-day accelerometer data from two couple studies (Study 1, n = 306 couples, aged 18-80 years; Study 2, n = 108 couples, aged 60-87 years) to estimate dyadic covariation in hourly MVPA and sedentary behavior between partners. Data were analyzed using coordinated multilevel modeling. RESULTS: In both studies, hourly MVPA and sedentary behavior exhibited similarly sized dyadic covariation between partners in the low-to-medium range of effects. Higher MVPA synchrony between partners was linked with higher individual weekly MVPA and higher individual weekly sedentary levels, whereas higher sedentary synchrony between partners was associated with higher individual weekly MVPA but lower individual weekly sedentary levels. MVPA and sedentary synchrony were higher in the morning and evening, more pronounced on weekends, and associated with more time spent together, longer relationship duration, and time-varying perceptions of higher partner closeness. CONCLUSIONS: This study demonstrates that MVPA and sedentary behaviors do not occur in a social vacuum. Instead, they are linked with close others such as partners. Thus, capitalizing on social partners may increase the effectiveness of individual-level physical activity interventions.

Pre-clinical study on a telemetric gastric sensor for recognition of acute upper gastrointestinal bleeding: the "HemoPill monitor".

BACKGROUND: Acute upper gastrointestinal bleeding is a life-threatening medical condition with a relevant risk of re-bleeding even after initial endoscopic hemostasis. The implantable HemoPill monitor contains a novel telemetric sensor to optically detect blood in the stomach allowing the surveillance of high-risk patients for re-bleedings. METHODS: In this pre-clinical porcine study, bleeding has been simulated by injecting porcine blood into the stomach of a pig through an implanted catheter using a syringe pump. The effect of the sensor position in the stomach, the gastric food content, and the bleeding intensity was investigated. RESULTS: Sensitivity and specificity of the sensor reached more than 87.5% when the sensor was positioned close to the source of bleeding. Solid food had a higher negative impact on sensitivity than liquid food but a positive impact on specificity. A heavy bleeding was more likely to be detected by the sensor but was also associated with a lower likelihood for true-negative results than weaker bleedings. CONCLUSIONS: The study clearly demonstrated the capability of the HemoPill sensor prototype to detect clinically relevant bleedings with high sensitivity and specificity (> 80%) when the sensor was positioned close to the bleeding site. The sensors proved to be robust against artefact effects from stomach content. These are favorable findings that underline the potential benefit for the use of the HemoPill sensor in monitoring patients with a risk of re-bleeding in the upper gastrointestinal tract.

Maternal practices and perceptions of child body mass status explain child energy expenditure behaviors and body mass.

This study investigated whether maternal perceptions of child body mass status would predict child body mass index (BMI) z-score via two sets of sequential mediators: (1) four maternal practices promoting child energy expenditure and (2) children's energy expenditure behaviors. The data of N = 729 mother-child dyads were collected at baseline [T1; n = 495 at 7- to 8-month follow-up (T2)]. Mothers reported perceptions of child body mass status and maternal practices (T1); children reported sedentary screen use and physical activity (T1, T2). Child body mass was assessed objectively (T1, T2). Higher stimulation to be active (T1) was related to a lower child BMI z-score (T2) via higher levels of child physical activity (T2). Higher levels of monitoring of screen use (T1) were associated with higher child BMI z-score (T2) via lower levels of child physical activity (T2). Encouraging parents to stimulate their children to be active may be beneficial for children's weight maintenance.

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

BACKGROUND: Regular physical activity (PA) was found to alleviate pain and improve functioning among patients with osteoarthritis of the knee (OAK). Heightened health demands due to OAK severity, body mass index (BMI), and depressive symptoms may require self-regulatory strategies to engage in more PA. Research on willpower-the capacity to exert self-control-suggests that believing that willpower is a nonlimited rather than a limited resource predicts effective self-regulation specifically when demands are high. The present study examines the association of OAK patients' willpower beliefs with their daily PA as a function of health demands. METHODS: To identify the moderating role of OAK severity (WOMAC), BMI, and depressive symptoms (CES-D) on the link between willpower beliefs and objectively assessed PA over a 7-day period, baseline data of a registered randomized controlled trial with 243 patients (Mage = 65.47 years, SD = 0.49) were examined in secondary analyses. RESULTS: Moderation analyses revealed that overall positive associations of willpower beliefs with PA were further qualified by OAK severity, BMI, and depressive symptoms. When patients faced less health demands, believing that willpower is nonlimited was associated with more PA. When health demands were higher, willpower beliefs were not associated with PA. CONCLUSION: OAK patients' willpower beliefs were associated with PA. However, facing more health demands seemed to erase this beneficial link. Improving willpower beliefs by way of intervention may help to shed more light on predictive direction and ways to overcome barriers to regular physical activity.

Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis.

BACKGROUND: Although the number of studies examining the relationships between sedentary behaviors (SB) and anxiety is growing, an overarching evidence, taking into account children, adolescents, and adults as well as different types of SB and different categories of anxiety outcomes, is still missing. Thus, this systematic review and meta-analysis aimed at obtaining a comprehensive overview of existing evidence. METHODS: A search in the following databases: PsycINFO, PsycARTICLES, Academic Search Complete, ERIC, HealthSource: Nursing/Academic Edition and MEDLINE, resulted in k = 31 original studies included in the systematic review (total N = 99,192) and k = 17 (total N = 27,443) included in the meta-analysis. Main inclusion criteria referred to testing the SB--anxiety relationship, the quality score (above the threshold of 65%), and the language of publications (English). The study was following the PRISMA statement and was registered at PROSPERO (CRD42017068517). RESULTS: Both the systematic review and meta-analysis indicated that overall average effects were small: higher levels of symptoms of anxiety were associated with higher levels of SB (weighted r = .093, 95% CI [.055, .130], p < .001). Moderator analyses indicated that trends for stronger effects were observed among adults, compared to children/adolescents (p = .085). CONCLUSIONS: Further longitudinal studies are necessary to elucidate the predictive direction of the anxiety-SB relationship and to clarify whether the effects depend on the type of anxiety indicators.

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

BACKGROUND: One promising intervention strategy to increase fruit and vegetable (FV) consumption is action planning. However, conditions of successful plan enactment, i.e., the translation of plans into action, have rarely been studied. Therefore, the relationship between plan characteristics and plan enactment is being examined. METHODS: Secondary analyses of an existing data set were conducted, based on a larger behavioral intervention study with a baseline assessment as well as a 2-weeks and a 4-weeks follow-up. After baseline assessment, participants completed action plan calendars for the following seven days and subsequently reported on each plan's enactment. Two independent raters coded 1732 morning, noon/afternoon, and evening plans by n = 92 individuals regarding the level of specificity (unspecific vs. specific) and type of planned behavior (fruit vs. vegetable intake). To predict plan enactment, multilevel logistic regression analyses were conducted. FINDINGS: Overall specificity of plans was unrelated to plan enactment, but interacted with time of day in predicting plan enactment. Only in the morning, specific plans were more likely being enacted than unspecific plans. Overall, plan enactment decreased during the day and throughout the seven days of the plan calendar. Furthermore, fruit plans were more likely being enacted than vegetable plans. DISCUSSION: Specific morning plans were found most beneficial for the enactment of FV plans. Here, possible underlying mechanisms such as stable morning routines should be further investigated. Moreover, the nutritional choice appeared to make a difference for plan enactment: Increasing one's fruit consumption may be easier than integrating more vegetables into one's daily diet.

Microstructural Characterization of Sulfurization Effects in Cu(In,Ga)Se2 Thin Film Solar Cells.

Surface sulfurization of Cu(In,Ga)Se2 (CIGSe) absorbers is a commonly applied technique to improve the conversion efficiency of the corresponding solar cells, via increasing the bandgap towards the heterojunction. However, the resulting device performance is understood to be highly dependent on the thermodynamic stability of the chalcogenide structure at the upper region of the absorber. The present investigation provides a high-resolution chemical analysis, using energy dispersive X-ray spectrometry and laser-pulsed atom probe tomography, to determine the sulfur incorporation and chemical re-distribution in the absorber material. The post-sulfurization treatment was performed by exposing the CIGSe surface to elemental sulfur vapor for 20 min at 500°C. Two distinct sulfur-rich phases were found at the surface of the absorber exhibiting a layered structure showing In-rich and Ga-rich zones, respectively. Furthermore, sulfur atoms were found to segregate at the absorber grain boundaries showing concentrations up to ~7 at% with traces of diffusion outwards into the grain interior.

Augmenting fruit and vegetable consumption by an online intervention: Psychological mechanisms.

OBJECTIVE: Fruit and vegetable (FV) intake was examined among men and women who participated in an online intervention. The psychological constructs involved were outcome expectancies, behavioral intention, planning, and self-efficacy. One purpose of the analyses was the evaluation of a self-efficacy treatment component. The other purpose of the analyses regarded the role of psychological mechanisms that might be responsible for individual differences in the process of behavior change. DESIGN: A two-arm online intervention with a standard and an enhanced intervention group focusing on FV planning was conducted to improve FV intake, followed up at two and four weeks. The intervention groups differed by the additional inclusion of a self-efficacy ingredient in the enhanced intervention. Linear mixed models examined the intervention effects, and a longitudinal structural equation model explored which psychological constructs were associated with changes in FV intake. Participants were N = 275 adults of whom n = 148 completed the four-week follow-up. Their age range was 18-81 years (Mage = 32.50, SDage = 14.00). RESULTS: Analyses yielded an overall increase in self-reported FV intake. Moreover, a triple interaction between time, sex, and experimental groups on self-efficacy emerged, indicating that men, independent of treatment conditions, reported an increase in their confidence to improve FV intake, whereas women developed higher FV self-efficacy when being in the enhanced group instead of the standard group. Planning, self-efficacy, and intention mediated between outcome expectancies, and follow-up FV intake. CONCLUSION: Both intervention arms produced overall improvements in FV intake. The enhanced intervention resulted in a steeper increase in self-efficacy in women compared to men, and compared to the standard intervention. A psychological mechanism transpired that included a sequence leading from initial outcome expectancies via planning, self-efficacy, and intention towards FV intake.

Facilitating physical activity and reducing symptoms in patients with knee osteoarthritis: study protocol of a randomized controlled trial to test a theory-based PrevOP-psychological adherence program (PrevOP-PAP).

BACKGROUND: The present randomized controlled trial, which is crossed with the "PREVenting the impairment of primary Osteoarthritis by high impact long-term Physical exercise regimen" Main Medical Trial (PrevOP-MMT), aims to evaluate a psychological adherence program (PrevOP-PAP), and is designed to support persons with knee osteoarthritis (OAK) in the uptake and maintenance of regular physical activity to reduce OAK symptoms. The PrevOP-PAP is based on the Health Action Process Approach (HAPA), a social-cognitive theory predicting health behavior change in individuals, extended here by social network characteristics and social exchange processes. It is expected that participants with OAK receiving the PrevOP-PAP will maintain higher levels of regular physical activity throughout a 24-month period and consequently report lower levels of OAK symptoms than participants of an active control condition. METHODS: A total of N = 240 participants with medically verified moderate OAK will be randomly assigned to an intervention condition (PrevOP-PAP-I; 50%) or an active control condition (PrevOP-PAP-CTRL). The PrevOP-PAP-I includes a motivational intervention, repeated self-regulation interventions, and a network creation intervention delivered over 12 months. Modes of intervention delivery include a paper-pencil motivation leaflet with a quiz, a computer-assisted face-to-face intervention, four computer assisted phone-based interventions, and activity calendars. The PrevOP-PAP-CTRL includes the motivational intervention only. Primary outcome will be OAK symptoms. Secondary outcomes include objectively and subjectively measured physical activity and indicators of quality of life. Other outcomes are HAPA-derived self-regulatory indicators as well as proposed social network and social exchange mechanisms of health behavior change. Assessments take place at baseline, 6 months, 12 months, 18 months, and 24 months following baseline. DISCUSSION: Based on the extended HAPA, this study seeks to reveal the self-regulatory and social mechanisms of the uptake and maintenance of physical activity and their relation to disease symptoms in persons with OAK. The design and evaluation of this program are intended to become a yardstick for future development and implementation of digitalized psychological adherence programs in this population. TRIAL REGISTRATION: German Clinical Trials Register; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677 ; date of registration: 26 January 2016.

Nanoscopy with more than 100,000 'doughnuts'.

We show that nanoscopy based on the principle called RESOLFT (reversible saturable optical fluorescence transitions) or nonlinear structured illumination can be effectively parallelized using two incoherently superimposed orthogonal standing light waves. The intensity minima of the resulting pattern act as 'doughnuts', providing isotropic resolution in the focal plane and making pattern rotation redundant. We super-resolved living cells in 120 µm × 100 µm-sized fields of view in <1 s using 116,000 such doughnuts.

Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

BACKGROUND: To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). PURPOSE: Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. METHOD: Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. RESULTS: Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. CONCLUSION: Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

Volunteer Case Series of a New Telemetric Sensor for Blood Detection in the Upper Gastrointestinal Tract: The HemoPill.

BACKGROUND: An acute upper gastrointestinal bleeding event is an emergency situation which requires immediate endoscopic assessment and treatment. A new telemetric real-time intracorporeal bleeding sensor can help in the timely diagnosis of an acute upper gastrointestinal bleeding event: The sensor capsule, HemoPill, is swallowed by the patient if gastrointestinal bleeding is suspected. Information about the bleeding status is displayed by telemetric communication of the capsule with an extracorporeal receiver. This is the first evaluation of the HemoPill to detect blood in the upper human gastrointestinal tract. METHODS: A voluntary test person ate a defined meal with or without the adjunct of his own blood for a total of eight times and afterward swallowed the sensor capsule. The collected spectrometric receiver data were analyzed to assess whether the sensor system was capable of detecting blood and to evaluate the effect of stomach content as an artifact. RESULTS: With its optical sensor, the HemoPill was able to reliably indicate the ingested blood in the stomach. The data transmission from the swallowed sensor capsule to the extracorporeal receiver was achieved consistently. The evaluation of diverse concentrations of ingested blood and the respective sensor signals led to an exponential relationship of these variables. This relationship allows to define thresholds for categories indicating the likelihood of blood presence in the gastrointestinal tract. CONCLUSIONS: The HemoPill is a valuable tool to detect an acute upper gastrointestinal bleeding event without the need of endoscopy.

Comparison of Acoustic Structure Quantification (ASQ), shearwave elastography and histology in patients with diffuse hepatopathies.

BACKGROUND: Objective of the study was to evaluate the diagnostic value of novel ultrasonographic modalities in comparison with simultaneously performed liver biopsy. METHODS: The results of simultaneously performed examinations using Acoustic Structure Quantification (ASQ), Virtual Touch Imaging and Quantification (VTIQ) and Virtual Touch Tissue Quantification (VTTQ) were compared with the findings of liver biopsy in patients with a wide variety of diffuse hepatopathies (n = 51). The histologically determined fibrosis stage according to Desmet and Scheuer was compared with quantitative measurements returned by the ultrasonographic imaging modalities. RESULTS: No statistically significant correlation with histologically determined fibrosis stage could be identified for any measurements returned using ASQ. Increasing severity of hepatic steatosis, however, was associated with a reduction in the focal disturbance (FD) ratio (r = -0.55; p < 0.0001). The shearwave velocities measured using VTTQ satisfyingly correlated with fibrosis stage (r = 0.56; p > 0.0001). Fibrosis stages > F2 were associated with an area under the curve (AUC) of 0.94 (95%-CI:0.84-0.99). A cut-off value for shearwave velocity of 1.66 m/s was determined with a sensitivity of 100% and a specificity of 84 %. VTIQ showed a less pronounced but acceptable correlation with fibrosis stage (r = 0.35; p = 0.0154). For fibrosis stages > F2 analysis showed an AUC of 0.84 (95%-CI:0.70-0.93). The cut-off value was 1.82 m/s with a sensitivity of 100% and a specificity of 58 %. CONCLUSION: While ASQ showed no diagnostic advantage in our patient collective, VTTQ showed high reliability for determining severe liver fibrosis in a group of patients with diffuse liver diseases of different etiology.