Biobehavioral survey using time location sampling among female sex workers living in Ghana in 2020.

Background: The HIV epidemic in Ghana is characterized as a mix of a low-level generalized epidemic with significant contributions from transmission among female sex workers (FSW) and their clients. This study seeks to identify and describe key characteristics and sexual behaviors of FSW and estimate the prevalence of HIV, syphilis, gonorrhea, chlamydia, and hepatitis B virus (HBV) among FSW in Ghana. Method: A total of 7,000 FSW were recruited for the study using Time Location Sampling (TLS) approach with 5,990 (85.6%) participants completing both biological and the behavioral aspects of the study. A structured questionnaire was administered to respondents to assess several factors, such as background characteristics, sexual risk behaviors, condom usage, HIV/AIDS knowledge, opinions, and attitudes. Trained staff conducted face-to-face interviews using mobile data collection software (REDCap) after provision of specimens for HIV and STI testing. Descriptive statistics such as medians, ranges, charts, and percentages are performed and presented. Also included, are bivariate analyses to establish relationships between FSW type and other relevant characteristics of the study. Results: Among the 7,000 (100%) FSW sampled from all regions, 6,773 took part in the behavioral and 6,217 the biological. There were 783 (11.2%) respondents who took part only in the behavioral and 227 (3.2%) only in the biological. Most were young, with a median age of 26 years, majority had never been married or were widowed/divorced and a quarter had no education or had only primary education. Majority (74.8%) of FSW first sold sex at age 25 years or less with a median age of 20 years. Most (84.8%) of the FSW indicated that they entered sex work for money, either for self or family and had an average of eleven (11) sexual partners per week. More than half (55.2%) of the FSW were new entrants who had been in sex work for less than 5 years before the study. Consistent condom use with paying clients was generally unsatisfactory (71%), and was however, very low (24%) with their intimate partners or boyfriends. Only about half (54.6%) of FSW have been exposed to HIV prevention services in the last three months preceding the survey, and this varies across regions. Overall, comprehensive knowledge about HIV and AIDS was low. Only 35% of FSW had comprehensive knowledge. HIV prevalence was 4.6% and was higher among seaters (brothel-based) and older FSW who had been sex work for a longer period. The HIV prevalence from the previous bio-behavioral survey (BBS) in 2015 and 2011 were estimated to be 6.9 and 11.1%, respectively. Conclusion: Compared to the results from the previous studies, the findings give an indication that Ghana is making significant progress in reducing the burden of HIV among FSW in the country. However, risky behaviors such as low consistent condom use, low coverage of HIV services across the regions, and low comprehensive knowledge could reverse the gains made so far. Immediate actions should be taken to expand coverage of HIV services to all locations. Efforts must be made to reach out to the new entrants while also addressing strongly held myths and misconceptions about HIV.

Examining Passively Collected Smartphone-Based Data in the Days Prior to Psychiatric Hospitalization for a Suicidal Crisis: Comparative Case Analysis.

BACKGROUND: Digital phenotyping has seen a broad increase in application across clinical research; however, little research has implemented passive assessment approaches for suicide risk detection. There is a significant potential for a novel form of digital phenotyping, termed screenomics, which captures smartphone activity via screenshots. OBJECTIVE: This paper focuses on a comprehensive case review of 2 participants who reported past 1-month active suicidal ideation, detailing their passive (ie, obtained via screenomics screenshot capture) and active (ie, obtained via ecological momentary assessment [EMA]) risk profiles that culminated in suicidal crises and subsequent psychiatric hospitalizations. Through this analysis, we shed light on the timescale of risk processes as they unfold before hospitalization, as well as introduce the novel application of screenomics within the field of suicide research. METHODS: To underscore the potential benefits of screenomics in comprehending suicide risk, the analysis concentrates on a specific type of data gleaned from screenshots-text-captured prior to hospitalization, alongside self-reported EMA responses. Following a comprehensive baseline assessment, participants completed an intensive time sampling period. During this period, screenshots were collected every 5 seconds while one's phone was in use for 35 days, and EMA data were collected 6 times a day for 28 days. In our analysis, we focus on the following: suicide-related content (obtained via screenshots and EMA), risk factors theoretically and empirically relevant to suicide risk (obtained via screenshots and EMA), and social content (obtained via screenshots). RESULTS: Our analysis revealed several key findings. First, there was a notable decrease in EMA compliance during suicidal crises, with both participants completing fewer EMAs in the days prior to hospitalization. This contrasted with an overall increase in phone usage leading up to hospitalization, which was particularly marked by heightened social use. Screenomics also captured prominent precipitating factors in each instance of suicidal crisis that were not well detected via self-report, specifically physical pain and loneliness. CONCLUSIONS: Our preliminary findings underscore the potential of passively collected data in understanding and predicting suicidal crises. The vast number of screenshots from each participant offers a granular look into their daily digital interactions, shedding light on novel risks not captured via self-report alone. When combined with EMA assessments, screenomics provides a more comprehensive view of an individual's psychological processes in the time leading up to a suicidal crisis.

Exposure Time Control Method for Higher Intermediate Frequency in Optical Heterodyne Imaging and Its Application to Electric-Field Imaging Based on Electro-Optic Effect.

We propose and demonstrate a method for equivalent time sampling using image sensors to selectively detect only the target frequency. Shortening the exposure time of the image sensor and using equivalent time sampling allows for the detection of frequency components that are higher than the frame rate. However, the imaging system in our previous work was also sensitive to the frequency component at 1/4 of the frame rate. In this study, we control the phase relationship between the exposure time and observed signal by inserting an additional interval once every four frames to detect the target frequency selectively. With this technique, we conducted electric field imaging based on the electro-optic effect under high noise conditions in the low-frequency band to which the conventional method is sensitive. The results demonstrated that the proposed method improved the signal-to-noise ratio.

Smartphone-based safety plan for suicidal crisis: The SmartCrisis 2.0 pilot study.

Here we present the findings of the pilot phase of the SmartCrisis 2.0 Randomized Clinical Trial. This pilot study aimed to explore the feasibility and acceptability of a safety plan contained in a smartphone app. Our sample consisted patients with a history of recent suicidal behaviour who installed a smartphone-based safety plan. To explore the satisfaction with of the safety plan, two patient satisfaction surveys were conducted: one qualitative and one quantitative. To explore the objective use of the safety plan, we gained access to texts contained in the safety plans completed by the patients. Participation rate was 77%, while 48.9% patients completed both satisfaction surveys at the end of the pilot phase. N = 105 successfully installed the safety plan. In a scale from 1 to 10, users rated the usefulness of the security plan at 7.4, the usability at 8.9, the degree to which they would recommend it to others at 8.6 and the overall satisfaction with the project including evaluations at 9.6. The most widely completed tab was warning signs. Feeling sad or lonely was the warning sign most commonly reported by patients. The second most completed tab was internal coping strategies. Walking or practicing any other exercise was the strategy most commonly resorted to. Our smartphone-based safety plan appears to be a feasible intervention. Data obtained from this pilot study showed high participation rates and high acceptability by patients. This, together with the general satisfaction with the project, supports its implementation in the clinical practice.

Everyday Pain in Middle and Later Life: Associations with Daily and Momentary Present-Moment Awareness as One Key Facet of Mindfulness.

This study investigated everyday associations between one key facet of mindfulness (allocating attention to the present moment) and pain. In Study 1, 89 community-dwelling adults (33-88 years; Mage = 68.6) who had experienced a stroke provided 14 daily end-of-day present-moment awareness and pain ratings. In Study 2, 100 adults (50-85 years; Mage = 67.0 years) provided momentary present-moment awareness and pain ratings three times daily for 10 days. Multi-level models showed that higher trait present-moment awareness was linked with lower overall pain (both studies). In Study 1, participants reported less pain on days on which they indicated higher present-moment awareness. In Study 2, only individuals with no post-secondary education reported less pain in moments when they indicated higher present-moment awareness. Findings add to previous research using global retrospective pain measures by showing that present-moment awareness might correlate with reduced pain experiences, assessed close in time to when they occur.

A Novel Equivalent Time Sampling-Based Method for Pulse Transit Time Estimation with Applications into the Cardiovascular Disease Diagnosis.

The increasing incidence of cardiovascular diseases (CVDs) is reflected in additional costs for healthcare systems all over the world. To date, pulse transit time (PTT) is considered a key index of cardiovascular health status and for diagnosis of CVDs. In this context, the present study focuses on a novel image analysis-based method for PTT estimation through the application of equivalent time sampling. The method, which post-processes color Doppler videos, was tested on two different setups: a Doppler flow phantom set in pulsatile mode and an in-house arterial simulator. In the former, the Doppler shift was due to the echogenic properties of the blood mimicking fluid only, since the phantom vessels are non-compliant. In the latter, the Doppler signal relied on the wall movement of compliant vessels in which a fluid with low echogenic properties was pumped. Therefore, the two setups allowed the measurement of the flow average velocity (FAV) and the pulse wave velocity (PWV), respectively. Data were collected through an ultrasound diagnostic system equipped with a phased array probe. Experimental outcomes confirm that the proposed method can represent an alternative tool for the local measurement of both FAV in non-compliant vessels and PWV in compliant vessels filled with low echogenic fluids.

Comparing the role of perceived burdensomeness and thwarted belongingness in prospectively predicting active suicidal ideation.

OBJECTIVE: The Interpersonal Theory of Suicide has been foundational in guiding current suicide literature. Despite recent research underscoring fluctuations of suicidal ideation within hours, there have been few studies examining the key constructs of perceived burdensomeness and thwarted belongingness within an intensive framework. Thus, the current study aimed to add cumulative knowledge regarding the within-person relationship between perceived burdensomeness, thwarted belongingness, and active suicidal ideation as assessed within an ecological momentary assessment design. METHOD: A final sample of 35 individuals with a past-year history of suicidal thoughts or behaviors completed brief surveys four times per day for 30 days. RESULTS: Findings highlighted that the addition of covariates may offer small improvements in modeling subsequent suicidal ideation, while controlling for SI at the prior time. Further, both thwarted belongingness and perceived burdensomeness were associated with next timepoint suicidal ideation, and their interaction added little incremental value. CONCLUSION: Findings demonstrate the potential importance of thwarted belongingness in predicting suicidal ideation. Further, results highlight that the main effects of thwarted belongingness and perceived burdensomeness, rather than their interaction, may be more important to consider in relation to active suicidal ideation.

A systematic review suggests marked differences in the prevalence of infant-directed vocalization across groups of populations.

Anthropological reports have long suggested that speaking to young children is very infrequent in certain populations (notably farming ones), which is in line with scattered quantitative studies. A systematic review was undertaken to use available literature in order to estimate the extent of population variation. Database searches, expert lists, and citation searches led to the discovery of 29 reports on the frequency of vocalizations directed to infants aged 24 months or younger, based on systematic observations of spontaneous activity in the infant's natural environment lasting at least 30 min in length. Together, these studies provide evidence on 1314 infants growing up in a range of communities (urban, foraging, farming). For populations located outside of North America, the frequency with which vocalization was directed to urban infants was much higher than that for rural infants (including both foraging and farming, medians = 12.6 vs. 3.6% of observations contained infant-directed vocalization behaviors). We benchmarked this effect against socio-economic status (SES) variation in the United States, which was much smaller. Infants in high SES American homes were spoken to only slightly more frequently than those in low SES homes (medians = 16.4 vs. 15.1% of observations contained infant-directed vocalization behaviors). Although published research represents a biased sample of the world's populations, these results invite further cross-population research to understand the causes and effects of such considerable population group differences.

Time-varying associations between loneliness and physical activity: Evidence from repeated daily life assessments in an adult lifespan sample.

Physical activity is a behavior that promotes physical and mental health; yet physical activity has decreased during the COVID-19 pandemic. To promote health during times of challenge, it is important to identify potential barriers to this key health behavior, such as loneliness. This brief report extends previous research on physical activity and loneliness that mainly focused on between-person differences to examine their time-varying associations at the within-person level using repeated daily life assessments. From April 2020 to August 2020, data were collected from a sample of 139 community-dwelling Canadian adults (M age = 40.65 years, SD = 18.37; range = 18-83 years). Each evening for 10 consecutive days, participants reported their loneliness, number of steps, and minutes of moderate-to-vigorous physical activity. Results revealed that, in line with our hypotheses, on days when participants reported more loneliness they also engaged in less moderate-to-vigorous physical activity than on less lonely days (estimate = -0.24, p = 0.007); there was a significant negative association between loneliness and daily number of steps (estimate = -18.42, p = 0.041). In contrast, at the between-person level, overall loneliness was not associated with overall physical activity engagement after accounting for within-person differences and control variables (age, sex, day in study). From an intervention perspective, our findings suggest that it is promising to tackle loneliness on a day-to-day basis to increase physical activity one day at a time. This may be especially relevant during times mandating social-distancing, but also at other times when individuals experience greater feelings of loneliness.

Enriched Aerosol-to-Hydrosol Transfer for Rapid and Continuous Monitoring of Bioaerosols.

Bioaerosols, including infectious diseases such as COVID-19, are a continuous threat to global public safety. Despite their importance, the development of a practical, real-time means of monitoring bioaerosols has remained elusive. Here, we present a novel, simple, and highly efficient means of obtaining enriched bioaerosol samples. Aerosols are collected into a thin and stable liquid film by the unique interaction of a superhydrophilic surface and a continuous two-phase centrifugal flow. We demonstrate that this method can provide a concentration enhancement ratio of ∼2.4 × 106 with a collection efficiency of ∼99.9% and an aerosol-into-liquid transfer rate of ∼95.9% at 500 nm particle size (smaller than a single bacterium). This transfer is effective in both laboratory and external ambient environments. The system has a low limit of detection of <50 CFU/m3air using a straightforward bioluminescence-based technique and shows significant potential for air monitoring in occupational and public-health applications.

Violence exposure, posttraumatic stress, and affect variability among African American Youth: A time sampling approach.

The current study examines the immediate and short-term impact of daily exposure to community violence on same-day and next-day levels of posttraumatic stress symptomatology and various affective states (i.e., dysphoria, hostility, and anxiety), in a sample of 268 African American adolescents living in urban, low-income, high-violence neighborhoods (Mage = 11.65; 59% female). In addition, the moderating role of affective state variability on this relationship was examined. This study utilized experience sampling method and a daily sampling approach, which contributes a more robust investigation of the short-term effects of violence exposure in youth. Hierarchical linear modeling revealed that community violence exposure was positively associated with same-day and next-day symptoms of posttraumatic stress. Violence exposure also exhibited an immediate effect on dysphoria, anxiety, and hostility levels. Youth variability in dysphoria exacerbated the effect of violence exposure on concurrent or next-day posttraumatic stress, dysphoria, and hostility. Moreover, variability in anxiety and hostility exacerbated the experience of next-day hostility. The clinical implications relating to these findings, such as the importance of implementing screening for posttraumatic stress following exposure, the incorporation of preventative treatments among those at risk of exposure, and the targeting of emotion regulation in treatments with adolescents, are discussed.

Efficient Estimation of CFO-Affected OFDM BER Floor in Small Cells with Resource-Limited IoT End-Points.

Contemporary wireless networks dramatically enhance data rates and latency to become a key enabler of massive communication among various low-cost devices of limited computational power, standardized by the Long-Term Evolution (LTE) downscaled derivations LTE-M or narrowband Internet of Things (NB IoT), in particular. Specifically, assessment of the physical-layer transmission performance is important for higher-layer protocols determining the extent of the potential error recovery escalation upwards the protocol stack. Thereby, it is needed that the end-points of low processing capacity most efficiently estimate the residual bit error rate (BER) solely determined by the main orthogonal frequency-division multiplexing (OFDM) impairment-carrier frequency offset (CFO), specifically in small cells, where the signal-to-noise ratio is large enough, as well as the OFDM symbol cyclic prefix, preventing inter-symbol interference. However, in contrast to earlier analytical models with computationally demanding estimation of BER from the phase deviation caused by CFO, in this paper, after identifying the optimal sample instant in a power delay profile, we abstract the CFO by equivalent time dispersion (i.e., by additional spreading of the power delay profile that would produce the same BER degradation as the CFO). The proposed BER estimation is verified by means of the industry-standard LTE software simulator.

Minimizing and Reporting Momentary Time-Sampling Measurement Error in Single-Case Research.

Research indicates that momentary time sampling (MTS) is often the best interval-measurement system when observing duration of behavior. Several recent studies recommended considering mean duration of target behavior, as well as durations of measurement intervals and observation sessions, to minimize measurement error in MTS. This report describes the steps we used to minimize measurement error in a single-case design research study. Further, we detail our methods for monitoring and reporting MTS measurement error across conditions by intermittently collecting and analyzing duration per occurrence measurements.

Solitude in context: On the role of culture, immigration, and acculturation in the experience of time to oneself.

Older adults spend much time in solitude (without social interaction), putting them at risk of loneliness, especially if aging outside their country of origin (e.g., Chinese immigrants to Canada). Yet, cultural contextual factors that may reduce loneliness in moments of solitude are poorly understood. This study sought to disentangle the roles of culture, immigration, and acculturation in solitude-loneliness associations across two countries. Community-dwelling adults aged 51-85 in Vancouver (N = 58 East Asian, N = 37 European/North American) and in Hong Kong (N = 56 East/Southeast Asian) completed approximately 30 ecological momentary assessments over 10 days on their current affect and social situations. Participants in Vancouver spent more time in solitude, desired solitude more, and felt less lonely overall than those in Hong Kong. Multilevel models revealed that moments of solitude felt lonelier than moments spent in social interaction, but only for individuals less acculturated to their host culture or not concurrently desiring solitude. Associations held regardless of host culture, cultural heritage, or immigration status. Findings suggest that solitude need not feel lonely if it happens by choice and if individuals feel connected with their host culture, for both immigrant older adults and those aging in their birth country.

Choosing Solitude: Age Differences in Situational and Affective Correlates of Solitude-Seeking in Midlife and Older Adulthood.

OBJECTIVES: Despite a basic need for social connection, individuals across the adult lifespan sometimes seek solitude-a phenomenon that is not well understood. This study examined situational and affective correlates of solitude-seeking and how they may differ between middle-aged and older adults. METHOD: One hundred community-dwelling adults aged 50-85 years (64% female, 56% East Asian, 36% European, 8% other) completed approximately 30 electronic daily life assessments over 10 days regarding their current location, affect, activities, and current and desired social context. RESULTS: Solitude was common; 86% of solitude instances happened by individuals' own choosing. When desiring solitude, older adults were more likely to be at home and less likely to be outdoors, compared to other locations. Middle-aged adults showed no such solitude-location associations. Among middle-aged adults, desire for solitude was associated with decreased positive affect. Older adults experienced no such dip in affect. DISCUSSION: Findings suggest that compared to middle-aged adults, older adults are more likely to go to locations that match their desired social context, and also that solitude-seeking has more positive ramifications for older adults. Findings are discussed in the context of age differences in activities, social preferences, and emotion regulation.

By myself and liking it? Predictors of distinct types of solitude experiences in daily life.

OBJECTIVE: Solitude is a ubiquitous experience, often confused with loneliness, yet sometimes sought out in daily life. This study aimed to identify distinct types of solitude experiences from everyday affect/thought patterns and to examine how and for whom solitude is experienced positively versus negatively. METHOD: One hundred community-dwelling adults aged 50-85 years (64% female; 56% East Asian, 36% European, 8% other/mixed heritage) and 50 students aged 18-28 years (92% female; 42% East Asian, 22% European, 36% other/mixed) each completed approximately 30 daily life assessments over 10 days on their current and desired social situation, thoughts, and affect. RESULTS: Multilevel latent profile analysis identified two types of everyday solitude: one characterized by negative affect and effortful thought (negative solitude experiences) and one characterized by calm and the near absence of negative affect/effortful thought (positive solitude experiences). Individual differences in social self-efficacy and desire for solitude were associated with everyday positive solitude propensity; trait self-rumination and self-reflection were associated with everyday negative solitude propensity. CONCLUSIONS: This study provides a new framework for conceptualizing everyday solitude. It identifies specific affect/thought patterns that characterize distinct solitude experience clusters, and it links these clusters with well-established individual differences. We discuss key traits associated with thriving in solitude.

Evaluation of the accuracy, reliability, efficiency, and acceptability of fast forwarding to score problem behavior.

Technological advances have allowed professionals to obtain extended recordings of caregiver-client interactions in natural settings, but scoring recorded video at normal speed to identify instances of low-rate problem behavior is impractical in terms of scoring time. Fast forwarding is a continuous measurement system in which all seconds of an observation are viewed at a speed faster than normal. In Study 1, we evaluated whether three groups of five observers could discriminate problem behavior at three fast-forwarding speeds across 10-min observations. We analyzed the efficiency of using fast forwarding compared to continuous scoring, and interobserver agreement across the fast-forwarding speeds. In Study 2, we compared the accuracy, efficiency, and social acceptability of fast forwarding (3.5x) and momentary time sampling (3.5 s) across 90-min observations. Results support the use of 3.5x fast forwarding as a viable measurement system of improving the practicality of scoring problem behavior from video.

Development of an automated wet-cyclone system for rapid, continuous and enriched bioaerosol sampling and its application to real-time detection.

We present a novel bioaerosol sampling system based on a wet-cyclone for real-time and continuous monitoring of airborne microorganisms. The Automated and Real-time Bioaerosol Sampler based on Wet-cyclone (ARBSW) continuously collects bioaerosols in a liquid medium and delivers the samples to a sensing device using a wireless remote control system. Based on a high air-to-liquid-flow-rate ratio (∼ 1.4 × 105) and a stable liquid thin film within a wet-cyclone, the system achieved excellent sampling performance as indicated by the high concentration and viability of bioaerosols (> 95% collection efficiency for > 0.5-µm-diameter particles, > 95% biological collection efficiency for Staphylococcus epidermidis and Micrococcus luteus). Furthermore, the continuous and real-time sampling performance of the ARBSW system under test-bed conditions and during a field test demonstrated that the ARBSW is capable of continuously monitoring bioaerosols in real time with high sensitivity. Therefore, the ARBSW shows promise for continuous real-time monitoring of bioaerosols and will facilitate the management of bioaerosol-related health and environmental issues.

Assessing the precision of a time-sampling-based study among GPs: balancing sample size and measurement frequency.

BACKGROUND: Our research is based on a technique for time sampling, an innovative method for measuring the working hours of Dutch general practitioners (GPs), which was deployed in an earlier study. In this study, 1051 GPs were questioned about their activities in real time by sending them one SMS text message every 3 h during 1 week. The required sample size for this study is important for health workforce planners to know if they want to apply this method to target groups who are hard to reach or if fewer resources are available. In this time-sampling method, however, standard power analyses is not sufficient for calculating the required sample size as this accounts only for sample fluctuation and not for the fluctuation of measurements taken from every participant. We investigated the impact of the number of participants and frequency of measurements per participant upon the confidence intervals (CIs) for the hours worked per week. METHODS: Statistical analyses of the time-use data we obtained from GPs were performed. Ninety-five percent CIs were calculated, using equations and simulation techniques, for various different numbers of GPs included in the dataset and for various frequencies of measurements per participant. RESULTS: Our results showed that the one-tailed CI, including sample and measurement fluctuation, decreased from 21 until 3 h between one and 50 GPs. As a result of the formulas to calculate CIs, the increase of the precision continued and was lower with the same additional number of GPs. Likewise, the analyses showed how the number of participants required decreased if more measurements per participant were taken. For example, one measurement per 3-h time slot during the week requires 300 GPs to achieve a CI of 1 h, while one measurement per hour requires 100 GPs to obtain the same result. CONCLUSIONS: The sample size needed for time-use research based on a time-sampling technique depends on the design and aim of the study. In this paper, we showed how the precision of the measurement of hours worked each week by GPs strongly varied according to the number of GPs included and the frequency of measurements per GP during the week measured. The best balance between both dimensions will depend upon different circumstances, such as the target group and the budget available.

Simulation Theory Applied to Direct Systematic Observation.

Observational studies entail making several decisions before data collection, such as the observational design to use, the sampling of sessions within the observational period, the need for time sampling within the observation sessions, as well as the observation recording procedures to use. The focus of the present article is on observational recording procedures different from continuous recording (i.e., momentary time sampling, partial and whole interval recording). The main aim is to develop an online software application, constructed using R and the Shiny package, on the basis of simulations using the alternating renewal process (a model implemented in the ARPobservation package). The application offers graphical representations that can be useful to both university students constructing knowledge on Observational Methodology and to applied researchers planning to use discontinuous recording in their studies, because it helps identifying the conditions (e.g., interval length, average duration of the behavior of interest) in which the prevalence of the target behavior is expected to be estimated with less bias or no bias and with more efficiency. The estimation of frequency is another topic covered.