Effectiveness of behavior change interventions for smoking cessation among expectant and new fathers: findings from a systematic review

BACKGROUND

Smoking cessation during pregnancy and the postpartum period by both women and their partners offers multiple health benefits. However, compared to pregnant/postpartum women, their partners are less likely to actively seek smoking cessation services. There is an increased recognition about the importance of tailored approaches to smoking cessation for expectant and new fathers. While Behavior Change Interventions (BCIs) are a promising approach for smoking cessation interventions, evidence on effectiveness exclusively among expectant and new fathers are fragmented and does not allow for many firm conclusions to be drawn.

METHODS

We conducted a systematic review on effectiveness of BCIs on smoking cessation outcomes of expectant and new fathers both through individual and/or couple-based interventions. Peer reviewed articles were identified from eight databases without any date or language restriction.Two independent reviewers screened studies for relevance, assessed methodological quality of relevant studies, and extracted data from studies using a predeveloped data extraction sheet.

RESULTS

We retrieved 1222 studies, of which 39 were considered for full text screening after reviewing the titles and abstracts. An additional eight studies were identified from reviewing the reference list of review articles picked up by the databases search. A total of nine Randomised Control Trials were included in the study. Six studies targeted expectant/new fathers, two targeted couples and one primarily targeted women with an intervention component to men. While the follow-up measurements for men varied across studies, the majority reported biochemically verified quit rates at 6 months. Most of the interventions showed positive effects on cessation outcomes. BCI were heterogenous across studies. Findings are suggestive of gender targeted interventions being more likely to have positive cessation outcomes.

CONCLUSIONS

This systematic review found limited evidence supporting the effectiveness of BCI among expectant and new fathers, although the majority of studies show positive effects of these interventions on smoking cessation outcomes. There remains a need for more research targeted at expectant and new fathers. Further, there is a need to identify how smoking cessation service delivery can better address the needs of (all) gender(s) during pregnancy.

[Consequences of the COVID-19 pandemic: Are there risk groups for reduced subjective well-being after the first lockdown?]

BACKGROUND

Measures to contain COVID-19 have created burdens that have widened health inequalities. We examine the extent to which risk groups for reduced subjective well-being can be identified after the 2020 lockdown. In doing so, we also consider possible interactions of different social grouping characteristics as part of an intersectional approach.

METHOD

Socio-Economic Panel (SOEP) data from the years 2018-2020 were analyzed. A total of 16,000 cases with information on changes in well-being (SF-12 scores and individual indicators) were included in the analyses. We use the classification method "random forests" to identify groups with different trends in well-being. For the interpretation of the content, we also present results from a regression model with social and health aspects as predictors.

RESULTS

Demographic and social characteristics explained only a very small part of the changes in subjective well-being (R² = 0.007-0.012) and did not allow for the differentiation of homogeneous risk groups. Although some significant predictors were found in the regression models, the corresponding effects were mostly small. In addition to the initial state of well-being before the pandemic began, the presence of chronic illnesses and disabilities in particular contributed to the explanation of subjective well-being.

DISCUSSION

The currently available data do not allow a clear identification of risk groups for losses in well-being in the first year of the COVID-19 pandemic. Health status before the onset of the pandemic appears to be more important for short-term changes in subjective well-being than socio-demographic and socio-economic categorization characteristics.

Effectiveness of Behavior Change interventions for smoking cessation among expectant and new fathers

Background

The perinatal period is an optimal time to intervene for achieving smoking cessation in expectant parents and offers multiple health benefits for women and the newborn. While Behavior Change Technique (BCT) interventions are a promising approach to support pregnant smokers to quit smoking, effectiveness of these interventions among expectant and new fathers is not equally well documented. Better understanding of the potential utility of these BCT interventions for this group is important for the development of effective gender-sensitive programmes.

Methods

This systematic review examines the existing evidence on effectiveness of BCTs on smoking cessation outcomes when offered to expectant and new fathers (child < 1 year) both through individual and/or couple-based interventions. Eight databases were searched for peer-reviewed articles. Studies were subjected to systematic retrieval and quality-assessment by two independent reviewers.

Results

We identified 9 randomised control trial studies (including 4,681 men) that fulfilled the inclusion criteria. In terms of quit outcome data, 8 studies reported biochemically verified quit rates for men. While 5 BCT interventions targeted expectant/new fathers, 3 were directed to couples and 1 primarily focused on women with a component directed at men. Though most of the interventions were found to be effective, they showed small significant positive effects on cessation outcomes. Findings are suggestive of gender specific interventions being more likely to have positive outcomes. High heterogeneity across the studies made it difficult to determine the most effective BCT approach.

Conclusions

This review suggests that use of BCT interventions for smoking cessation among expectant and new fathers is effective in achieving positive quit rates; however, these studies are limited. Further research is needed to determine the most effective BCT approach associated with smoking cessation among this group.

Key messages

• BCT interventions for smoking cessation among expectant and new fathers are a promising approach to increase quit rates.

• Future research needs to develop evidence based BCT interventions for smoking cessation specifically targeting expectant and new fathers to inform policy and practice.

Examining the role of affective states in relation to exercise intentions and participation in extra-curricular exercise classes at university: A repeated measurement observational study

Background

Previous research has shown evidence on the role of affective states for physical activity behavior. However, there is a lack of research investigating the interplay between affective states, intentions, and exercise behavior, especially with respect to maintaining regular exercise over time. The study aimed to investigate whether post-exercise affective states and changes in affect during exercise (i) are related to exercise intentions; (ii) moderate the relationship between intention and subsequent exercise behavior, and (iii) directly predict future exercise.

Methods

Participants from weekly voluntary sports and gym classes at two universities were recruited. For 13 weeks, 268 individuals’ (M_age = 24.5 years, SD = 5.6, 90% students, 67.4% female) class attendance was documented on a weekly basis. Before and immediately after training, participants self-reported affective states, including affective valence (Feeling Scale) and perceived arousal (Felt Arousal Scale). Participants also reported their intention to re-attend the class the following week. Mixed-effect linear models and Cox proportional hazard models were used to examine the relationships between affective states, change in affective states, re-attendance intentions, and class re-attention.

Results

Affective valence at the end of training was significantly positively associated with the intention to re-attend the class on the within-person level (β = 0.880, p < 0.001) as well as the between-person level (β = 0.831, p < 0.001), while higher increases of valence during class were related to smaller intention. For class re-attendance, significant effects of affective states were only found on the within-person level. A one-point increase on the valence scale increased the hazard ratio to re-attend by 8.4% (p < 0.05), but this effect was no longer meaningful after adjusting for intention. No moderation of the relationship between intention and subsequent class re-attendance was found.

Conclusion

The results suggest that positive affective state immediately after exercise does not facilitate translation of intentions into subsequent exercise behavior (i.e., do not close the intention-behavior gap). Rather, affective valence was found to be an important predictor of exercise intentions but seemed indirectly related to behavior via intentions. Practitioners should plan exercise programs that allow for positive affective states especially at the end of a training.

Reducing vessel noise increases foraging in endangered killer whales

Disturbance from underwater noise is one of the primary threats to the critically endangered southern resident killer whales (SRKWs). Previous studies have demonstrated that SRKWs spend less time feeding when vessels are present. In 2018, we measured the effects of a voluntary vessel slowdown action in SRKW critical habitat to assess whether ship speed (and related source level) affects foraging behaviour. Observations of SRKWs and ships were collected from land-based sites on San Juan Island, WA, USA, overlooking the Haro Strait slow-down area. Exploratory analyses found little support for a linear relationship between ship speed and SRKW behaviour, but strong support between received noise level from ships and the probability of SRKWs engaging in foraging activity. Reducing ship speed, and therefore ship noise amplitude will help decrease the probability of ship noise disrupting SRKW foraging activity and may help to increase the proportion of accessible salmon.

What Intervention Techniques Are Effective in Changing Positive Affective Variables and Physical Activity? A Systematic Review and Meta-Analysis

A recent meta-analysis has demonstrated that positive affective variables (PAVs) partially mediate physical activity (PA) interventions. However, the effectiveness of each intervention technique on PAVs and PA is still unknown. Thus, this meta-analytic review included two primary objectives: (1) to summarize intervention effects on PA and PAVs; (2) to examine each behavior change technique's effectiveness in modifying PAVs and PA. Following PRISMA protocols, we had searched five electronic databases by April 1, 2020. The random-effect model in the Comprehensive Meta-Analysis Version 3 was adopted to perform these meta-analytic analyses. The search identified 1,742 articles, and 37 studies (49 datasets) met our inclusion criteria. Finally, inferential statistics yielded that: the utilization of "teach to use prompts/cues," "facilitate social comparison," and "provide information on consequences of behavior in general" had positive effects on PA or PAVs outcomes; the utilization of "barrier identification/problem solving" and "plan social support/social change" negatively affected on PA or PAVs outcomes. However, there was considerable heterogeneity in the findings. Nonetheless, this paper has considerable implications for guiding future comparative intervention studies to achieve more reliable outcomes.

Can Positive Affective Variables Mediate Intervention Effects on Physical Activity? A Systematic Review and Meta-Analysis

Well-developed theories are necessary to guide the public in increasing physical activity (PA) and promoting physical health. The role of positive affective variables (PAVs) in exercise is gaining more attention, but none of the literature has provided a systematic review and quantitative analysis of its mediating role. Therefore, the purposes of this study are (1) to systematically review studies of PA interventions, that use PAVs as the mediating variables, in order to evaluate and provide narrative summaries of these studies; (2) to statistically synthesize evidence for the mechanism of the effects of PAVs on PA outcomes. To conduct an extensive search, a PRISMA-compliant protocol was completed, and five electronic databases had been searched by 1 April 2020. We used a two-stage structural equation modeling (TSSEM) analysis approach to test how interventions trigger the critical PA change process to influence outcomes. The search strategy generated 1,732 papers potentially relevant to this study; forty of these studies met the data extraction criteria for meta-analytic mediation analysis. The path coefficient from intervention to PAV a = 0.26 (95% CI = 0.08 to 0.44), the path coefficient from PAV to PA b = 0.21 (95% CI = 0.13 to 0.28), and the direct effect from intervention to PA is also significant (c = 0.19, 95% CI = 0.12 to 0.26). In addition, the indirect effect of intervention on PA via PAV was statistically significant (c' = 0.05, 95% CI = 0.02 to 0.10). This reveals that PAVs partially mediate the relationship between interventions and PA. Our study is the first to systematically summarize the effects of experimental studies to increase PA through PAVs. It is highly recommended to make future interventions more innovative and to target the PAVs as mediators with higher fidelity.

(How) Does Affect Influence the Formation of Habits in Exercise?

Objectives: Habitually instigated exercise is thought to increase health behavior maintenance. Previous research has explored several aspects of habit formation. However, there is a lack of longitudinal research investigating affective determinants, especially post-exercise affective states. Therefore, the present study aimed to investigate (a) if behavior frequency will enhance automaticity, (b) if positive affect will enhance automaticity, and (c) if positive affect will moderate the relationship between behavior frequency and automaticity. Methods: 226 participants (64% females, mean age 24 years) who attended weekly sports and gym classes at two universities were followed for 13 weeks. Class attendance was documented on a weekly basis (behavior frequency) during the semester. Before, during and immediately after each class, participants filled in the Feeling Scale (affective valence). Furthermore, at the beginning of each class, they answered a question about their automaticity in arriving at the decision to attend the class (instigation habit). We used a two-level modeling approach to predict subsequent automaticity by the different constructs at the previous attendance. Results: The cumulative frequency of prior class attendance did not significantly enhance the automaticity of the decision to re-attend the class. There were significant effects of valence on automaticity on the between-subject level, i.e., a one-point higher mean valence score was associated with a 0.62 point increase in automaticity (p = 0.001). No moderation effects of affect on the association between behavior frequency and automaticity were observed. Conclusion: Behavior repetition, albeit not significant, and positive affective states at the end of an exercise class may be beneficial in building exercise instigation habits. Practitioners and researchers alike may thus want to emphasize the importance of behavior repetition and affective response for health behavior maintenance.

Antecedents and Consequences of Outward Emotional Reactions in Table Tennis

The purpose of the present study was to shed light on the behavioral component of emotions by investigating antecedents and consequences of outward emotional reactions during table tennis competitions. With regards to the antecedents of outward emotional reactions, in line with appraisal theories, we considered the importance and the controllability of the situation as two important constructs. Fifteen table tennis matches, involving in total 21 players (7 females) with a mean age of 16.71 (SD = 0.70), were video recorded during the finals of the youth National Championship in Greece. Based on the footage, outward emotional reactions after every point were classified as neutral, positive, or negative. Situational factors in relation to the scoring system, bearing the importance and the controllability of the situation, were formed to assess antecedents of outward emotional reactions. To measure the consequences of outward emotional reactions, the impact on the outcome of the next point was assessed. Generalized linear models with a logit link were computed separately for positive outward emotional reactions after having won a point and negative outward emotional reactions after having lost a point. In general, the results show that while situational factors bearing the importance of the situation could predict positive and negative outward emotional reactions, the effects of situational factors bearing the controllability of the situation were less conclusive. In addition, the results also showed interactive effects between the two constructs for both positive and negative outward emotional reactions. With regard to the consequences of outward emotional reactions, negative and positive outward emotional reactions could not predict the outcome of the next point. To conclude, this study highlights the behavioral component of emotions as a viable alternative to enhance our understanding of the role of emotions in sport.

The 2017/18 Health Behaviour in School-aged Children (HBSC) study - Methodology of the World Health Organization's child and adolescent health study

The Health Behaviour in School-aged Children (HBSC) study is an international research project in collaboration with the World Health Organization (WHO) for over 35 years. HBSC is the largest study on child and adolescent health and one of the most important sources of data for the WHO's international comparative health monitoring. Every four years, data on the health and health behaviour of students aged 11, 13 and 15, as well as the social contexts and conditions for growing up healthy, are collected. A total of 50 countries belong to the HBSC network, with 45 countries taking part in the 2017/18 survey. Germany has contributed to the HBSC surveys since 1993/94. For the most recent 2017/18 cycle, students at 146 schools in Germany were interviewed (response rate of schools: 15.6%). A net sample of n = 4,347 girls and boys was achieved for Germany (response rate: 52.7%). Participation was voluntary and the survey was conducted in German school years five, seven and nine (corresponding to ages 11, 13 and 15). A weighting procedure was applied to allow for representative findings on the health of children and adolescents in Germany. HBSC offers a valuable contribution to health monitoring and provides numerous starting points to identify needs, risk groups and fields of action to initiate targeted and actual needs-based measures of prevention and health promotion in the school setting.

Physical activity and dietary habits of older children and adolescents in Germany - Cross-sectional results of the 2017/18 HBSC study and trends

Numerous findings are known to exist between dietary habits, physical activity, and child and adolescent health. Here, we will use data from the most recent Health Behaviour in School-aged Children (HBSC) study to describe dietary habits and patterns of physical activity. Using the survey data for 11-, 13- and 15-year-old students from across Germany, we report findings for key indicators of diet and physical activity for the 2017/18 cycle. By comparing these findings with data from the 2009/10 and 2013/14 survey cycles, we also consider current trends. Results from the most recent cycle show that 10.0% of girls and 16.9% of boys meet the World Health Organization's (WHO) physical activity recommendations. Across all HBSC cycles, this is the lowest figure so far. Concerning dietary habits, 50.6% of girls and 59.0% of boys reported having breakfast every morning. Data for daily fruit, vegetable and soft drink consumption emphasises the need to promote a healthy diet among adolescents. For all indicators of physical activity and diet, differences between girls and boys are apparent. Girls' intake of fruit and vegetables is higher and they consume fewer soft drinks, yet boys are more physically active and have breakfast more regularly. For the majority of indicators of dietary habits and physical activity, considerable inequalities relating to family affluence are observed. An important implication of the study results for dietary habits and physical activity of older children and adolescents is the need to foster settings-based approaches to promote physical activity and a healthy diet that integrate a gender-sensitive perspective.

Gender role orientation and body satisfaction during adolescence - Cross-sectional results of the 2017/18 HBSC study

During adolescence both sexes experience a loss of body satisfaction, whereby the effect is greater among girls. Coming to terms with gender roles is an important step in the development of a person's identity. Traditional gender roles tend to emphasise certain physical attributes: attractiveness in women, and strength and dominance in men. This article analyses associations between a traditional gender role orientation and body satisfaction during adolescence based on logistic regression models and using data taken from the 2017/18 Health Behaviour in School-aged Children (HBSC) study (n=1,912 girls, n=1,689 boys). The results show an overall high degree of body satisfaction, with girls scoring lower than boys. Role preconceptions were mostly not traditional, with boys being slightly more traditional than girls. In both sexes, a more traditional role orientation was accompanied by lower levels of body satisfaction; in boys, this effect was seen to decrease with age. The stereotypical features of role preconceptions are examined as a possible explanation for these differences. An alternative explanation posits that an egalitarian role orientation (i.e. one based on the principle of equality) creates a more tolerant environment with greater social support, which could foster a greater sense of self-acceptance. These results indicate that questioning traditional preconceptions of gender roles during adolescence may help prevent problems related to body image in both sexes.

Weight Reduction Behaviors Among European Adolescents-Changes From 2001/2002 to 2017/2018

PURPOSE

The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors (WRBs) among European adolescents from 26 countries between 2001/2002 and 2017/2018. The impact of the perception of body weight on WLB was also analyzed, with particular attention being paid to overestimation.

METHODS

The data of 639,194 European adolescents aged 11, 13, and 15 years who participated in the Health Behaviour in School-aged Children survey were analyzed. Age-standardized prevalence rates of WRB were estimated separately by survey round and gender for each country, using the overall 2017/2018 Health Behaviour in School-aged Children study population as the standard. Multivariate logistic regression analyses were used to assess WRB trends over time, adjusted for survey year, body mass index, body weight misperception, and family affluence and stratified by gender and age.

RESULTS

In the 26 countries examined, the overall age-adjusted prevalence rates of WRB were 10.2% among boys and 18.0% among girls. The prevalence of WRB was higher for girls, but in the more recent surveys, gender differences in WRB decreased. There was a significant increase in the percentage of WRB among boys in most countries. Among girls, most countries did not experience significant changes. Increases in body mass index and overestimation of body weight were significant factors increasing the risk of WRB in both genders.

CONCLUSIONS

The change in the prevalence of WRB by gender warrants greater attention from researchers and practitioners alike.

[Gender equality and the gender gap in life expectancy in Germany]

BACKGROUND

The gender gap in life expectancy is documented worldwide with lower life expectancy in male new-borns. International studies have shown that the gender gap in life expectancy varies markedly with gender inequality.

OBJECTIVES

The paper addresses the questions: (1) whether there are life-expectancy differences between the federal states and whether the extent of gender equality at federal level is associated with (2) gender differences in life expectancy and (3) the life expectancy of women and men.

MATERIALS AND METHODS

The Gender Inequality Index (GII) developed by the United Nations Development Project was calculated using data from the federal states. Using linear regressions, GII was associated with the gender gap in life expectancy as well as with life expectancy in males and females.

RESULTS

The GII varies between 0.065 (Bavaria) and 0.117 (Mecklenburg-Vorpommern) and the gender gap in life expectancy differs by almost two years within Germany. We found a correlation between the gender difference in life expectancy and GII (R² linear = 0.848) as well as between GII and life expectancy of male (R² linear = 0.700), but not female newborns (R² linear = 0.102). The association remains if GDP is taken into account as an indicator of economic power.

CONCLUSIONS

Gender equality seems to be positively related to the life expectancy of men. This can be explained by the reduced importance of male gender stereotypes and associated risk behaviors. The requirements for gender-differentiated interventions formulated in the Prevention Act (Präventionsgesetz) are highly significant.

Effectiveness of a school-based intervention to prevent child sexual abuse-Evaluation of the German IGEL program

BACKGROUND

Child sexual abuse (CSA) is a problem with severe consequences for victimized children. A variety of interventions have been developed and implemented over the last decades to prevent CSA. However, most of them have not been systematically evaluated to determine their effectiveness. The IGEL program is a school-based intervention to prevent CSA in third-grade primary school children in Germany.

METHODS

This study was conducted using a quasi-experimental design, in which almost 300 children and their parents from eight intervention and four control schools were surveyed three times (pretest, posttest, 3 months later). In order to measure outcomes, a questionnaire was developed based on validated instruments to assess the knowledge, courses of action and self-protective skills of the children. Furthermore, increased anxiety and generalized touch aversion were examined as potentially harmful side effects of the program.

RESULTS

The results clearly demonstrate increased CSA-related knowledge and courses of action in children from the intervention group compared to the control children. These effects were medium-sized and sustained for at least three months after the last session. No meaningful negative side effects were detected in the evaluation for either the children or parents.

CONCLUSION

The outcome evaluation indicates that the IGEL program is an effective intervention in terms of knowledge about CSA and known courses of action, and may therefore contribute to the prevention of CSA in primary schools. Despite this positive core finding of the intermediate outcomes, some adaptations of the program to children with different cultural backgrounds were made prior to further dissemination.

Behavior change techniques for increasing physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials

Purpose

The purpose of this systematic review and meta-analysis is to investigate how physical activity (PA) can be effectively promoted in cancer survivors. The effect of PA-promoting interventions in general, behavior change techniques (BCTs), and further variables as moderators in particular are evaluated.

Methods

This study included randomized controlled trials of lifestyle interventions aiming at an increase in PA that can be carried out independently at home, published by December 2016, for adults diagnosed with cancer after completion of the main treatment. Primary outcomes were subjective and objective measures of PA prior to and immediately after the intervention. Meta-analysis and meta-regression were used to estimate effect sizes (ES) in terms of standardized mean differences, variation between ES in terms of heterogeneity indices (I²), and moderator effects in terms of regression coefficients.

Results

This study included 30 studies containing 45 ES with an overall significant small positive effect size of 0.28 (95% confidence interval=0.18–0.37) on PA, and I²=54.29%. The BCTs Prompts, Reduce prompts, Graded tasks, Non-specific reward, and Social reward were significantly related to larger effects, while Information about health consequences and Information about emotional consequences, as well as Social comparison were related to smaller ES. The number of BCTs per intervention did not predict PA effects. Interventions based on the Theory of Planned Behavior were associated with smaller ES, and interventions with a home-based setting component were associated with larger ES. Neither the duration of the intervention nor the methodological quality explained differences in ES.

Conclusion

Certain BCTs were associated with an increase of PA in cancer survivors. Interventions relying on BCTs congruent with (social) learning theory such as using prompts and rewards could be especially successful in this target group. However, large parts of between-study heterogeneity in ES remained unexplained. Further primary studies should directly compare specific BCTs and their combinations.

Individual and school level correlates of moderate to vigorous physical activity among school-children in Germany--a multi-level analysis

Background

Young people spend half of their days in school, but evidence concerning the influence of school environment on the physical activity (PA) of pupils is still inconsistent. A better understanding of potential correlates of PA on the school-level and their possible interaction with individual aspects is needed to improve the development of more effective interventions.

Methods

We used data from the 2009/10 German Health Behaviour in School-aged Children study (HBSC)-sample (n=5,005 students aged 11–15 years) including self-reported moderate to vigorous intensity PA as well as a variety of biological, demographic and behavioral correlates and matched them with school-level data from the national school principals’ HBSC questionnaire. We analyzed the associations of individual- and school-level correlates with MVPA by gender-specific multi-level regression.

Results

Only a small share of the overall variation in student’s PA was attributable to the school-level. Consequently, the associations of individual-level correlates with PA were stronger than those of the school-level. Our analysis revealed significant associations of individual-level (i.e. age, consumption of softdrinks, overweight) as well as school-level correlates (i.e. the availability of a football ground and a swimming pool) with MVPA. We also observed some gender-specific findings especially for the school level correlates. Cross-level interactions between individual- and school-level were not apparent.

Conclusions

Our findings indicate the usefulness of applying an ecological framework to understand and explain complex health behaviors like PA. As we found gender-specific association it might be important to acknowledge that boys and girls have specific needs to be more physically active. Further research should also take other features/elements of the school environment and neighborhood as well as socio-cognitive correlates into account to advance the field.

Supportive communication with parents moderates the negative effects of electronic media use on life satisfaction during adolescence

OBJECTIVES

To examine the impact of electronic media (EM) use on teenagers' life satisfaction (LS) and to assess the potential moderating effect of supportive communication with parents (SCP).

METHODS

Data were drawn from the cross-national Health Behaviour in School-aged Children (HBSC) study (2009/2010) in Canada, England, Germany, Hungary, Italy, Israel, The Netherlands, Poland and Scotland. Sample size: 53,973 students aged 11-15 years.

RESULTS

More hours per day spent on the computer were associated with lower LS; more EM communication with friends with higher LS. This relationship became negative if EM use reached and exceeded a certain threshold. SCP moderated the effect of EM communication with friends, but not computer use for the total sample. SCP seems to be more important than computer use or EM communication with friends for LS and it seems to buffer negative effects of EM use.

CONCLUSIONS

Communication with parents seems to buffer the negative effects of EM use on LS during adolescence. Higher computer use was related to lower LS, but "optimal" frequency of EM communication with friends was country specific.

Frequent electronic media communication with friends is associated with higher adolescent substance use

OBJECTIVES

This study investigated the unique associations between electronic media communication (EMC) with friends and adolescent substance use (tobacco, alcohol, and cannabis), over and beyond the associations of face-to-face (FTF) interactions with friends and the average level of classroom substance use.

METHODS

Drawn from the cross-national 2009/2010 Health Behaviour in School-aged Children (HBSC) study in The Netherlands, 5,642 Dutch adolescents (Mage = 14.29) reported on their substance use, EMC, and FTF interactions. Two-level multilevel analyses (participants nested within classrooms) were run.

RESULTS

Electronic media communication was positively associated with adolescent substance use, though significantly more strongly with alcohol (β = 0.15, SEβ = 0.02) than with tobacco (β = 0.05, SEβ = 0.02, t (5,180) = 3.33, p < 0.001) or cannabis use (β = 0.06, SEβ = 0.02, t (5,160) = 2.79, p < 0.01). Further, EMC strengthened several positive associations of FTF interactions and average classroom substance use with adolescent substance use.

CONCLUSIONS

Electronic media communication was uniquely associated with substance use, predominantly with alcohol use. Thus, adolescents' EMC and other online behaviors should not be left unnoticed in substance use research and prevention programs.

Trends in television time, non-gaming PC use and moderate-to-vigorous physical activity among German adolescents 2002-2010

Background

Studies in youth highlight that moderate-to-vigorous physical activity (MVPA) and screen-time behaviours such as television viewing and PC use are associated with a range of health outcomes. However, little is known about recent trends in these behaviours in adolescents. This paper presents time trends in German adolescents’ television time, non-gaming PC use as well as MVPA from 2002 to 2010.

Methods

Data were derived from the cross-sectional German Health Behaviour in School-aged Children (HBSC) study in 2002, 2006 and 2010. Analyses were based on 16,918 11-to 15-year olds boys (49.1%) and girls. Outcome variables were time spent in TV viewing and using a PC (weekday and weekend day) as well as the number of days achieving 60 minutes of MVPA. Changes in both screen-time behaviours and MVPA over time were analysed using sex-specific linear regression, controlling for age and family affluence.

Results

TV viewing on weekdays, but not at weekends, declined steadily over time with a difference between 2002 and 2010 of 12.4 min/day in girls and 18.3 min/day in boys (p for trend < .01). We found a strong increase in PC use for non-gaming purposes over time for girls only, with a difference between 2002 and 2010 of 54.1 min/weekday and 68.8 min/weekend day (p < .001). For MVPA we found a slight statistically significant increase in terms of meeting PA guidelines as well as days/week in MVPA for boys and girls (p < .001). In 2010 14.0% of girls and 19.9% of boys met PA guideline.

Conclusion

Although MVPA increased from 2002 to 2010 in German adolescents, the time spent in MVPA was still low. Despite the observed decrease in TV viewing, there was no overall decline in the observed screen-based behaviours, especially for girls. This is mainly due to a marked increase in use of a PC for chatting on-line, internet, emailing, homework etc. among girls during the last ten years which outweighs the corresponding decrease in TV viewing. The findings highlight a need for strategies and interventions aimed at reducing screen-time behaviours and promoting MVPA.

Physical activity and screen-based media use: cross-sectional associations with health-related quality of life and the role of body satisfaction in a representative sample of German adolescents

Purpose: Although it is widely accepted that physical activity (PA) positively, and screen-based media use (SBM) negatively, affects well-being, there is a lack of studies relating PA and SBM to health-related quality of life (HRQoL) in adolescents. We examined these associations in German adolescents for different HRQoL subdomains and explored the role of body satisfaction as a possible mediator. Methods: The 11–17-year-old subsample of the German Health Interview and Examination Survey (2003–2006) was analysed (N = 6813; 51.3% male). Cross-sectional associations of self-reported PA frequency and amount of daily SBM with HRQoL subscale scores (according to KINDL-R) were examined by hierarchical linear regression models, adjusting for the clustering of the sample and for a variety of possible confounders. The size and significance of indirect effects via body (dis)satisfaction (BDS) were examined by mediation analyses. Results: Higher PA frequency was significantly associated with higher HRQoL on nearly all subscales and dose–response-relationships were observable. Variations were greatest in terms of social well-being in boys (effect size d = 0.59) and physical well-being in girls (d = 0.43). Higher SBM was related to lower HRQoL on all subscales in girls and on some subscales in boys, with the largest effects for school functioning in both genders (d = 0.31 and 0.37, respectively). The mediated effects for PA and SBM were significant in both genders, but the sizes and the proportions of total effects mediated by body satisfaction were rather small. Conclusions: Higher PA frequency was associated with higher self-reported HRQoL, and higher SBM was associated with lower self-reported HRQoL in both genders, even after adjusting for relevant covariates. The results support the assumption of independent health impacts of both behaviours, although no causal relationship can be confirmed with these cross-sectional data. Mechanisms other than body satisfaction must largely account for the effects of PA and SBM on well-being.

Health-related quality of life in overweight German children and adolescents: do treatment-seeking youth have lower quality of life levels? Comparison of a clinical sample with the general population using a multilevel model approach

Background

Health-related quality of life (HRQoL) is reduced in obese children and adolescents, especially in clinical samples. However, little is known regarding the HRQoL of moderately overweight youth. Moreover, several studies have indicated perceived overweight as a critical factor associated with lower HRQoL. Our main objective was to compare HRQoL between treatment-seeking overweight youth and the general adolescent population, whilst separating the effects of treatment-seeking status and perceived weight from those of objective weight status.

Methods

We compared the HRQoL of a clinical sample of overweight youth (N=137 patients, mean age±s.e.=11.24±0.15 years) with that of a representative population sample (N=6354, mean age=12.75±0.03 years). The population sample was subdivided into groups based on measured and perceived weight status. We used hierarchical linear models to compare HRQoL subscale scores (self- and parent-reported) between patients and population groups, adjusted for sociodemographic characteristics and taking into account clustering of the population sample.

Results

The parent-reported HRQoL of the treatment sample was significantly lower than that of other overweight youth perceived as ‘too fat’ on two subscales: ‘self-esteem’ and ‘friends’ (effect sizes: d=0.31 and 0.34, respectively). On other subscales, patients scored lower than adolescents perceived as having a ‘proper weight’ by their parents. The patterns for self-reported HRQoL in adolescents were different: patients reported higher self-esteem than other overweight youth feeling ‘too fat’ (d=-0.39). Female patients also reported higher physical well-being (d=-0.48), whereas males scored lowest among all compared groups (d=0.42-0.95). Patients did not differ from other overweight youth who felt ‘too fat’ with respect to other HRQoL dimensions. In general, lower HRQoL was primarily associated with a perceived, rather than actual, overweight status.

Conclusions

The treatment-seeking status of overweight youth was notably associated with low social well-being, which may therefore be the main motive for seeking treatment. Other HRQoL domains were not consistently reduced in treatment-seekers. Our results further indicate that perceived overweight rather than actual overweight impacts HRQoL in youth with a modest excess weight. These results have implications for interventions in overweight youth and in individuals who are dissatisfied with their weight.

Trial registration

‘Obeldicks light’ is registered at clinicaltrials.gov (NCT00422916).

Changes in self-reported and parent-reported health-related quality of life in overweight children and adolescents participating in an outpatient training: findings from a 12-month follow-up study

BACKGROUND

Health-related quality of life (HRQoL) was found to improve in participants of weight management interventions. However, information on moderately overweight youth as well as on maintaining HRQoL improvements following treatment is sparse. We studied the HRQoL of 74 overweight, but not obese participants (32.4% male, mean age = 11.61 ± 1.70 SD) of a comprehensive and effective six-month outpatient training at four time-points up to 12 months after end of treatment.

METHODS

HRQoL was measured by self-report and proxy-report versions of the generic German KINDL-R, including six sub domains, and an obesity-specific additional module. Changes in original and z-standardized scores were analyzed by (2×4) doubly multivariate analysis of variance. This was done separately for self- and proxy-reported HRQoL, taking into account further socio-demographic background variables and social desirability. Additionally, correlations between changes in HRQoL scores and changes in zBMI were examined.

RESULTS

There were significant multivariate time effects for self-reported and proxy-reported HRQoL and a significant time-gender interaction in self-reports revealed (p < .05). Improvements in weight-specific HRQoL were evident during treatment (partial η² = 0.14-0.19). Generic HRQoL further increased after end of treatment. The largest effects were found on the dimension self-esteem (partial η² = 0.08-0.09 for proxy- and self-reported z-scores, respectively). Correlations with changes in weight were gender-specific, and weight reduction was only associated with HRQoL improvements in girls.

CONCLUSIONS

Positive effects of outpatient training on generic and weight-specific HRQoL of moderately overweight (not obese) children and adolescents could be demonstrated. Improvements in HRQoL were not consistently bound to weight reduction. While changes in weight-specific HRQoL were more immediate, generic HRQoL further increased after treatment ended. An extended follow-up may therefore be needed to scrutinize HRQoL improvements due to weight management.

TRIAL REGISTRATION

clinicaltrials.gov NCT00422916.

Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS)

Background

Physical activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS).

Methods

The 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS) was used (n = 6 813; 51.3% male, response rate = 66.6%). Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA.

Results

Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls.

Conclusions

Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies.

An effective lifestyle intervention in overweight children: findings from a randomized controlled trial on "Obeldicks light"

BACKGROUND & AIMS

Randomized controlled trials (RCT) have demonstrated the effectiveness of lifestyle interventions in obese children. However, the effectiveness of interventions for overweight, but no obese children has not been demonstrated yet by RCTs.

METHODS

A total of 66 overweight (BMI>90th< or =97th percentile) children (mean age 11.5+/-1.6 years, 58% females, mean BMI 23.4+/-1.5kg/m(2)) were randomized into a control group (CG) (n=32; no intervention for a duration of 6 months) or intervention group (IG) (n=34; 6 months intervention "Obeldicks light" based on physical activity, nutrition education, and behaviour counselling). BMI, waist circumference, skinfold thickness, bioimpedance analyses, blood pressure, physical activity based on questionnaires, and three-day-weighed dietary records were determined at baseline (T0) and 6 months (T1) later. Degree of overweight was calculated as BMI-SDS. Comparisons were performed on an intention-to-treat approach.

RESULTS

The drop-out rate was 3% in IG and 16% in CG. At T1, 94% of the children in IG decreased their BMI-SDS and 24% of them were normal weight. The changes between T0 and T1 in BMI-SDS differed significantly (p<0.001) between IG and CG (CG: +0.05+/-0.19 BMI-SDS; IG: -0.26+/-0.22 BMI-SDS). Similar findings were observed for blood pressure, waist circumference, skinfold thickness, and fat mass based on bioimpedance analyses. In the IG, energy, fat and sugar intake decreased significantly between T0 and T1, while no significant changes were observed in the CG.

CONCLUSIONS

The lifestyle intervention was associated with an improvement of dietary patterns and was effective in reducing degree of overweight, fat mass, waist circumference, and blood pressure.

A new approach to template purification for sequencing applications using paramagnetic particles

A new method using traditional hybridization methodology, coupled with the new magnetic particle technology, has been developed for DNA purification, specifically for sequencing applications. The method is similar to the reverse hybridization blot system; however, a specific oligonucleotide probe was attached to the paramagnetic particle instead of a sheet membrane. The target DNA containing the complementary sequence of the probe hybridizes to the probe that is attached to the bead and is then magnetically removed from solution, washed and collected. This system eliminates the need of organic extractions and precipitation/concentration steps. The entire hybridization-purification system can be done in a 1.5-ml microcentrifuge tube making the method ideal for automation. M13 phage clones were purified with this method, both by manual means and by using the CATALYST 800 Molecular Biology LabStation fitted with a prototype magnetic station, and then sequenced. DNA sequencing results obtained with this system were reproducible and gave excellent length of read with low background.

Hypotensive and regional haemodynamic effects of fenoldopam and quinpirole in the anaesthetized rat

The effects of systemic administration of the selective dopamine1 receptor agonist fenoldopam and the selective dopamine2 receptor agonist quinpirole on blood pressure and regional haemodynamics were investigated in anaesthetized normotensive Wistar rats. Both compounds produced dose-dependent reductions in blood pressure. Mesenteric and renal blood flow were enhanced by fenoldopam, but reduced by quinpirole. Hindquarter blood flow was not modified by fenoldopam, but was increased by quinpirole. The calculated vascular resistances were reduced by both compounds in the three vascular beds. The effects of fenoldopam were antagonized by SCH 23390 but SCH 23390 did not affect those of quinpirole. The effects of quinpirole, but not those of fenoldopam, were antagonized by domperidone. Hexamethonium abolished the effects of quinpirole without affecting those of fenoldopam. These results indicate that the hypotensive effects of fenoldopam and quinpirole are due to stimulation of postsynaptic dopamine1 and neuronal dopamine2 receptors, respectively, resulting in differential regional haemodynamic effects.

Thyroid hormone reserve in asymptomatic autoimmune thyroiditis

Basal (B) and peak (P) serum levels of thyroxine (T4), free thyroxine (FT4), triiodothyronine (T3), free triiodothyronine (FT3), and TSH were measured before and after oral TRH (40 mg) administration in 79 subjects affected with asymptomatic autoimmune thyroiditis (AAT) and in 69 normal subjects. The area under the curve (AUC) and peak values of T4, FT4, T3 and FT3 were considered as parameters of thyroid hormone reserve. Intrathyroidal iodine (ITI) was measured by the X-ray fluorescence method. The AAT subjects were divided into three groups on the basis of their basal and peak TSH values. In group I, these parameters were similar to those in the normal controls; in group II, basal TSH remained normal but peak TSH was significantly increased, and in group III both values were significantly increased. Group I differed from the controls by a decrease in P FT4 and AUC FT4, whereas in groups II and III B FT4 was also significantly lowered. T3 levels were similar in all groups except in group III, in whom they dropped. ITI was already lower in group I than in the controls. Its decline went further in groups II and III. An inverse correlation with significant r values was evidenced between log B and P TSH on one hand and log B FT4, P FT4 and AUC FT4 on the other. When group III was excluded, log P TSH was positively correlated with log B T3, P T3, AUC T3, and AUC F T3.(ABSTRACT TRUNCATED AT 250 WORDS)

Postnatal development of growth hormone and prolactin cells in male and female rat pituitary. An immunocytochemical light and electron microscopic study

Localization and ultrastructural maturation of prolactin (PRL) and growth hormone (GH) cells were studied in pituitaries from neonatal, immature (4-6 weeks old), and adult rats (2-3 months old) by light and electron microscopic immunocytochemistry. The distribution pattern of these cells did not change with age. Both cell types were concentrated laterodorsally, with PRL cells adjacent to the intermediate lobe and GH cells nearer the center of the pars distalis. Labeling density of the immunogold reaction was highest for both hormones in immature rats. In neonatal and immature rats, one PRL cell type with granules 200 nm in diameter was present. In adult rats, two types of PRL cells were present: one containing polymorphous granules measuring about 500 nm (prevalent in female rats), the other with spherical granules about 200 nm (prevalent in male rats). No changes were detected in GH cells during maturation.

Noninvasive ambulatory monitoring of blood pressure in essential hypertension. Effect of age on variability and disparity

Noninvasive daytime ambulatory blood pressure monitoring using the Remler M 2000 Portometer was performed on 84 hypertensive patients to study the effects of age on blood pressure variability and on disparity between office and ambulatory blood pressure. Disparity was higher in younger (less than 30 years) and in older (greater than 60 years) subgroups, as compared with middle-aged (30-60 years) patients. Disparity correlated with age in those greater than 30 years and increased with increasing office blood pressure. Systolic blood pressure, but not diastolic blood pressure, correlated with its variability. In patients greater than 30 years old, diastolic, but not systolic, variability correlated with age. Both, the younger and the older patients showed a higher blood pressure variability as compared with middle-aged patients. Variability and disparity were unrelated to sex.