Search Results (183)

Sedentary behavior is conventionally defined as waking time spent sitting, reclining, or lying at very low energy expenditure (≤1.5 METs), a definition that supports surveillance and guideline translation. For cognitive and mental-health outcomes in later life, however, total sedentary minutes may be too coarse: seated episodes differ in cognitive demand, social context, autonomy over pacing, and stopping cues. This perspective advances a falsifiable thesis: distinguishing cognitively active from cognitively passive sedentary domains should yield more coherent and interpretable associations with cognition and mental health than total sedentary time alone. Existing evidence suggests that passive, media-dominant patterns and cognitively engaging seated practices relate differently to cognitive decline, dementia risk, and depression-related outcomes, although confounding and reverse causality remain central concerns. We propose a minimal measurement agenda: domain reporting, key modifiers, reliability flags for mixed episodes, episode-linked ecological momentary assessment, and time-reallocation contrasts. If domain resolution does not improve stability, coherence, or substitution-based interpretability, the thesis should be rejected or revised. Full article

LGBTQ+ individuals experience disparities in cardiovascular health, but little is known about how daily minority and general stress affect physiological and psychological responses in real-world settings. Twenty LGBTQ+ young adults aged 18–27 completed a 14-day exploratory pilot study using ecological momentary assessment (EMA) with four daily smartphone surveys and continuous smartwatch-based sensor monitoring. This study is among the first to combine EMA with wearable sensor data to capture autonomic stress responses to minority stressors in naturalistic settings. Outcomes included a physiological stress score derived from heart rate variability during the 60 min before each EMA completion, as well as positive and negative affect (PA and NA). Four stress measures, Everyday Discrimination Scale (EDS), Sexual Orientation Microaggression Inventory Short Form (SOMI-SF), EMA of stressful events (EMA-SE), and current perceived stress (CPS), and a combined variable (COMB) were examined. In mixed-effects within-person models, all stress measures showed trends in the expected direction, with higher physiological stress scores, lower PA, and higher NA, though these varied in magnitude and statistical significance. SOMI-SF showed the strongest association with physiological stress, while general stress measures showed stronger associations with affect. These preliminary findings suggest that LGBTQ+-specific and general stressors may differentially engage physiological and psychological response systems; however, caution is warranted given the small sample size. Full article

Physical activity is a key lifestyle factor for mental health prevention, yet the influence of accelerometer placement on mood prediction remains unclear. We merged high-resolution acceleration data and Ecological Momentary Assessment (EMA) mood reports from 259 healthy participants across three ambulatory studies (SedMood, 24 hrCog, HO). Additionally, 15 min pre-assessment movement windows consisting of raw triaxial acceleration (64 Hz) from hip, thigh, chest, and wrist sensors were paired with six-item mood EMA queries. Features (e.g., mean, entropy, spectral power) were extracted and fed into gradient-boosted decision tree models (XGBoost), trained separately for energetic arousal, valence, and calmness. Performance was measured using the metrics MAE, RMSE and R². Within individual studies, chest and hip sensors achieved the highest performance, followed by wrist and thigh. In the combined dataset, hip sensors again outperformed thigh (R² 0.38 vs. 0.20). Multi-sensor models rarely surpassed the best single-sensor configuration and sometimes reduced accuracy. These results suggest that sensor location modestly impacts mood-prediction performance, with hip and chest offering the most reliable signals, while adding sensors does not reliably enhance predictive power. Future work should explore larger, homogenous datasets and location-specific feature engineering to refine wearable-based mental health monitoring. Full article

Emotional eating under negative affect refers to eating responses that occur in brief unpleasant emotional states and are not explained by hunger alone. This narrative review synthesizes representative evidence from experimental, ecological, and neurocognitive studies on emotional eating under negative affect, with emphasis on two interrelated pathways. (1) Emotion regulation: emotional eating may function as a rapid and accessible regulatory strategy through which food, especially highly palatable food, is used to attenuate negative affect. The immediate soothing effects of eating may reinforce later motivation and habitual responses to regulate emotions through food, whereas more adaptive strategies, such as cognitive reappraisal, may reduce the likelihood and intensity of emotion-related eating. (2) Reward processing and biased decision making: negative affect and affective stress contexts may diminish cognitive control and bias food choice toward immediate rewards. This pathway is reflected in increased attentional bias to food cues, stronger weighting of taste and palatability during value weighing, heightened responsivity to highly rewarding foods, and reduced regulatory influence of health and nutrition attributes. These processes may shift food choice toward energy-dense, nutrient-poor, and ultra-processed foods. The nutritional manifestations of emotional eating are not limited to total intake. Changes in intake quantity are heterogeneous, whereas changes in food choice, diet quality, degree of processing, and eating patterns appear more consistent. Repeated emotional eating may therefore contribute to less stable eating patterns and potential nutritional implications, although links with long-term physiological outcomes remain indirect. Future longitudinal and ecological momentary assessment studies are needed to clarify when emotional eating becomes a stable dietary pattern and which individual or contextual factors increase vulnerability. Full article

Background/Objectives: First responders frequently encounter high-stress environments that challenge physiological resilience and autonomic regulation. Heart rate variability (HRV) complexity is a critical marker of adaptive capacity and stress regulation. This study assessed the impact of a wearable-based mindfulness intervention on HRV complexity among first responders using a smartwatch. Methods: A total of 87 first responders participated in a one-month wearable-based intervention. Participants wore Garmin Vivosmart 5 devices to continuously collect PPG data (photoplethysmogram), focusing on beat-to-beat intervals (BBIs). The intervention involved daily Ecological Momentary Assessments (EMAs) and individual randomization to either a mindfulness message, a prompt to access an audio exercise, or no-treatment/control; interventions were delivered via the MYAPT.MIND mobile application. HRV metrics, including Sample Entropy, Multiscale Entropy (MSE), Recurrence Rate (RR), and Determinism (Det), were analyzed pre- and post-intervention/control using paired-samples t-tests. Results: Significant improvements were observed in HRV complexity metrics post-intervention. Sample Entropy increased (M = 1.42, SD = 0.11) compared to pre-intervention (M = 1.39, SD = 0.10; p = 0.007). MSE also showed significant gains (p = 0.038), particularly at lower scales, indicating enhanced short-term autonomic flexibility. Reductions were noted in RR (p = 0.025) and Det (p = 0.018), suggesting improved cardiovascular adaptability and reduced physiological rigidity. Other traditional time-domain metrics, such as Mean HR, SDNN, and RMSSD, did not exhibit significant changes. Conclusions: The wearable-based intervention significantly enhanced HRV complexity, reflecting improved autonomic regulation and adaptive capacity in first responders. These findings support the integration of digital mindfulness strategies for stress management in high-risk occupations. Future research should explore the longitudinal effects and mechanisms mediating these autonomic adaptations. Full article

Web-based repeated-measures cohorts enable remote, scalable, and temporally structured monitoring of health-related outcomes in naturalistic settings. This paper presents the DiCoBENE study, a web-based cohort of healthcare-track university students, and reports evidence-informed instrument selection together with protocol features and pilot baseline findings. A structured review was used to inform the web-based administration of patient-reported outcome measures (PROMs) covering sleep quality, perceived stress, anxiety symptoms, depressive symptoms, and quality of life. In the pilot baseline sample, 442 students constituted the analytic dataset and 370–372 completed the core PROM battery, depending on the instrument. Poor sleep quality, anxiety symptoms, depressive symptoms, and perceived stress were common. Internal consistency was good to excellent for the Generalized Anxiety Disorder 7-item scale (GAD-7), the Patient Health Questionnaire 9-item depression module (PHQ-9), and the 10-item Perceived Stress Scale (PSS-10), and moderate for the Pittsburgh Sleep Quality Index (PSQI). Exploratory multivariate analyses, including latent profile analysis, principal component analysis, and partial-correlation network analysis, suggested that baseline heterogeneity was more parsimoniously summarized as a graded multidimensional burden continuum than as sharply separated phenotypes. Taken together, these findings position DiCoBENE as a methodologically explicit framework for web-based repeated outcome assessment in student well-being research. Full article

Background: Substance Use Disorder (SUD) is characterized by recurrent craving episodes frequently associated with emotional dysregulation and altered reward processing. This study aimed to evaluate whether emotional states associated with craving episodes can be detected through automated facial emotion recognition during controlled emotional induction. Methods: Forty-one participants completed a 14-day ecological momentary assessment (EMA) monitoring anxiety and craving levels, followed by an emotional induction task using standardized stimuli from the EmoMadrid database and addiction-related images. Facial expressions were recorded and analyzed in real time using a computational facial emotion recognition model trained on the FER-2013 dataset. Results: Participants with SUD exhibited significantly reduced positive emotional valence and emotional activation in response to positive stimuli compared with healthy controls (HC), with large effect sizes observed for emotional valence (Hedges’ g = 1.76) and emotional activation (Hedges’ g = 1.33). Item-level analyses revealed that most between-group differences occurred in stimuli depicting social interactions. Individuals with SUD also showed higher frequencies of fear-related facial expressions and lower frequencies of disgust-related expressions compared with HC, with moderate effect sizes observed for both emotional dimensions (Hedges’ g = 0.72; p = 0.02). Conclusions: These results suggest that people with SUD have changes in how they process emotions, showing less response to positive things and unique facial expressions related to craving. However, given the relatively modest and clinically heterogeneous sample, the findings should be interpreted cautiously and require replication in larger and more homogeneous populations. Full article

Breathing exercises are a low-cost strategy for mitigating daily stress, yet their enhancement via haptic biofeedback devices remains under-explored. These devices may facilitate adaptive breathing by personalizing rhythms via providing haptic cues based on heart rate, blood oxygenation and heart rate variability. We conducted a 2-month longitudinal trial with 62 healthy participants ($M_{\mathrm{age}}=26.9\pm 8.1$ years; 81% female) to test whether a haptic breath pacer (“Moonbird”) augments the stress-reducing effects of breathing exercises. Participants were randomized to: (1) haptic feedback + app, (2) app-only, or (3) a no-exercise control. Ecological Momentary Assessment tracked daily affect (valence/arousal) and weekly stress. Students ($n=45$) also reported pre-examination stress. Between-subjects analyses revealed no condition effects on measured outcomes. However, within-subjects analyses showed that participants who felt higher arousal and valence but performed their breathing exercises felt a significant reduction in arousal and increase of valence on the following day. In the haptic group, these effects were moderated by user experience, indicating that benefits are contingent on device usability. Finally, highly stressed students who performed more exercises reported lower examination stress at the end of the semester, irrespective of their assigned condition. Full article

Background/Objectives: Fatigue is a common symptom in adults with cerebral palsy (CP), characterized by fluctuations across the day. This pilot study aimed to evaluate the feasibility, reliability, and validity of ecological momentary assessment (EMA) for capturing these temporal dynamics in adults with CP. Methods: Ten adults with CP (60% female, mean age = 44 years, Gross Motor Function Classification System levels I–III) and eight typically developed controls (62% female, mean age = 39 years) completed a 20-item EMA survey ten times daily for seven days using the SEMA³ smartphone application. Feasibility was evaluated through retention rates, response rates, and qualitative interviews. Intraindividual variability, within-person reliability, measurement reactivity, and convergent validity with the Fatigue Severity Scale (FSS) were examined using mixed-effects regression and multilevel measurement error autoregressive (MEAR) models. Results: No participants dropped out. Average response rates were 76% (CP) and 75% (control). The protocol was perceived as acceptable overall, though demanding by some participants. In the CP group, 61% of total variability in momentary fatigue was attributable to within-person fluctuations, and within-person reliability was 0.73 (SEM = 1.13). No evidence of reactivity to self-monitoring was found in fatigue ratings or qualitative interviews. FSS scores were positively associated with person-level average momentary fatigue, β = 0.51, p = 0.048. Conclusions: EMA is feasible in adults with CP and reveals substantial within-person fluctuations in fatigue. These findings provide initial proof-of-concept and inform methodological amendments for a future large-scale study of fatigue dynamics aiming to advance symptom management in this population. Full article

Background/Objectives: Excess consumption of energy-dense foods (EDF; ultra-processed snacks, sweets, and sugar-sweetened beverages) among preschool-aged children is a public health concern, particularly in low-income families. Caregiver parenting style, psychological stress, and food-parenting practices (FPP) may shape children’s EDF consumption, yet little is known about how these factors operate in real time. This exploratory pilot study examined (1) associations between baseline characteristics and EDF feeding episodes across 1 week and (2) whether caregivers’ momentary stress during EDF episodes related to FPP used. Methods: In total, 22 caregivers of Head Start children (ages 3–5) completed baseline measures and 7 days of ecological momentary assessment (up to seven prompts/day). At each prompt, caregivers reported child EDF consumption in the past hour; if confirmed, they reported FPP used and rated momentary stress. Aim 1 used Poisson regression to model caregiver-level EDF episode counts. Aim 2 tested momentary stress–practice associations during EDF episodes using GEE, with within-person and between-person stress modeled separately. Results: Authoritarian parenting was associated with a higher weekly rate of EDF episodes (RR = 1.43, 95% CI 1.23–1.66, p < 0.001); authoritative parenting trended lower (RR = 0.90, p = 0.065). Higher baseline stress was associated with more EDF episodes (RR = 1.25, p = 0.001). Momentarily, elevated stress above a caregiver’s own average increased odds of using food as a reward (OR = 1.08 per +10 points, p = 0.011), while higher average momentary stress was associated with co-eating (OR = 1.59, p = 0.042). Domain-level FPP composites showed no association with momentary stress. Conclusions: Authoritarian parenting and higher caregiver stress were associated with increased EDF feeding, and momentary stress was linked to reward-based feeding during those episodes. These hypothesis-generating findings suggest potential behavioral targets for just-in-time adaptive intervention, pending replication in adequately powered studies. Full article

Background and Objectives: Metacognition-related processes (e.g., confidence calibration, self-evaluation and the use of feedback) have been linked to cognitive insight, self-evaluation, and daily functioning in psychosis. However, clinic-based assessments only provide limited information. Digital methods may capture state-like variations and contextual factors, but it is unclear to what extent they operationalise core metacognitive monitoring constructs versus adjacent self-evaluative/insight-related constructs. We mapped digital approaches used to assess metacognition-related constructs across the psychosis spectrum, summarising the associated feasibility and validity. Materials and Methods: We conducted a scoping review (PRISMA-ScR) of psychosis-spectrum studies that used digital tools to assess metacognition-related targets. These included ecological momentary assessment/experience sampling (EMA/ESM), task-based paradigms with confidence ratings, and hybrid approaches. Searches covered MEDLINE (via PubMed), Scopus, and IEEE Xplore, with the final search run on 15 December 2025. We charted constructs, operationalisations, feasibility/engagement indices and reported links with clinical or functional measures. Results: The empirical evidence map comprised 13 studies directly assessing metacognition-related constructs; eight additional implementation/methodological sources were synthesised separately to contextualise feasibility, reporting, ethics, and governance. EMA studies more often assessed adjacent self-evaluative constructs, including context-linked self-appraisal bias, conviction, and self-report–context mismatch in daily life, whereas task-based studies more directly assessed confidence–accuracy calibration and feedback updating. Across EMA studies, greater momentary symptom severity and more restricted contexts were often associated with inflated self-evaluations and divergence from observer-rated functioning. Task-based studies indicated that confidence calibration and feedback utilisation may diverge from objective performance; in performance-controlled paradigms, some studies reported comparable metacognitive sensitivity/efficiency, but the overall evidence remains uncertain. Passive sensing was common in psychosis research but was rarely explicitly tied to metacognitive constructs. Conclusions: Current digital work spans both core metacognitive monitoring constructs and adjacent self-evaluative/insight-related constructs, rather than a single unitary construct. Clinical translation remains hypothesis-generating: interpretability may be improved by combining clinical anchors, low-burden EMA, and optional contextual streams, but thresholds, workflows, and signal-action rules require prospective validation. Full article

Combined oral contraceptive pills (COCPs) are commonly used by reproductive-aged women with overweight or obesity, but their metabolic effects remain understudied. This pilot study examined the feasibility of recruiting and retaining women with overweight or obesity initiating COCPs and evaluated changes in body weight, body composition, energy intake (EI), eating behaviors, and cardiometabolic markers. Premenopausal women aged 18–40 years with a body mass index between 25 and 45 kg/m² initiating COCPs (n = 10) or using nonhormonal contraception (NHC; n = 10) were followed for six months. Outcome measures included body weight, body composition, EI, eating behavior questionnaires, ecological momentary assessment of appetite and satiety, and fasting laboratory measures. There were no between-group differences in changes in weight, EI, or appetite. Binge-eating severity decreased in COCP users and increased in NHC users, though the within-group change in COCP users was not statistically significant. Exploratory analyses demonstrated increases in hemoglobin A1c and triglycerides among COCP users compared to NHC users, while bioavailable testosterone decreased in COCP users only. This study demonstrates high retention and feasibility among women with overweight/obesity undergoing intensive dietary and metabolic monitoring. Although weight outcomes were similar between groups, these preliminary findings identify potential metabolic signals warranting confirmation in adequately powered studies. Full article

Musculoskeletal symptoms (MSS) and sleep problems are prevalent in nurses. Evidence exploring associations between sleep and MSS in nurses is limited by self-reported sleep measures and recalling MSS over a long period. The purpose of this study was to examine the relationship between MSS and sleep in nurses using objective sleep measures and real-time MSS assessment. This 7-day observational study included 31 nurses who work day shifts. Sleep duration and efficiency were measured using accelerometers, and MSS were reported using ecological momentary assessment. Sleep metrics and MSS were compared between workdays and days off, and a regression model analyzed the effect of sleep duration on MSS while controlling for age and body mass index (BMI). On average, nurses did not sleep the minimum recommended duration of 7 h (6.28, SD = 1.31), and they slept significantly less prior to a workday (5.98 h, SD = 1.12) than a day off work (6.69 h, SD = 1.43) (t(185) = −5.92, p < 0.0001). Short sleep duration was associated with 18% higher MSS when controlling for age and BMI (t(822) = 2.63, p = 0.009). Understanding the association between sleep and MSS is important to healthcare organizations and policy makers because sleep is essential for health and recovery, and occupational characteristics, such as shift length and consecutive shifts, influence sleep. Nurse fatigue is detrimental to patient safety and the health of the nursing workforce, and musculoskeletal problems contribute to nurse attrition. This study may inform future research on organizational policies related to nurse fatigue and musculoskeletal symptoms. Full article

Fibromyalgia is a complex chronic pain condition characterized by pervasive pain, persistent fatigue, and cognitive disturbances. Despite advances in understanding its neurobiological mechanisms, diagnosis largely relies on subjective symptom assessment and exclusion criteria, contributing to underdiagnosis and treatment delays. Recent research has increasingly focused on identifying objective biomarkers and leveraging digital phenotyping to improve diagnostic precision. Promising biomarkers include neuroimaging indicators of altered pain processing, neuroinflammatory signatures in cerebrospinal fluid and blood, and dysregulated neuroendocrine and autonomic patterns. In addition, metabolomics and transcriptomics have revealed molecular profiles associated with fibromyalgia pathophysiology. Concurrently, digital health tools (e.g., wearable sensors, ecological momentary assessment, and machine learning-based symptom clustering) offer opportunities for continuous, real-world data collection and individualized disease characterization. This body of work suggests that integrating biological and digital metrics could enable a transition from subjective to objective data-driven fibromyalgia classification, facilitating earlier diagnosis and improved therapeutic outcomes. Full article

Background: Chronic pain, which affects over 50 million adults in the United States, has stimulated growing interest in natural and nutrition-based remedies as adjuncts to pharmacologic therapies. Evidence suggests that turmeric and related extracts (i.e., curcuminoids) may provide pain relief, albeit often at levels above dietary ranges, while piperine from black pepper exhibits bioenhancer characteristics of relevance with dietary exposures. Objective: To test the effectiveness of dietarily relevant amounts of turmeric with and without black pepper on self-reported pain ratings among adults with chronic pain. Methods: A randomized, crossover clinical trial tested the effectiveness of turmeric only (one of three amounts within culinary ranges) or turmeric with black pepper to influence pain in adults ≥ 40 years of age. Participants (n = 30, with moderate pain: 4–7 on 0–10-point scale) were enrolled in a 21-day trial, and an experience sampling methodology approach was used. Participants were prompted to report current pain using the numeric pain rating scale (NPRS; 0–10) via text message three times per day for the full study period. Data were averaged and analyzed via linear mixed effects models for repeated measurements. Results: Pain ratings from baseline to week 3 were reduced and statistically significant (p < 0.001) but not statistically different between groups. The provided turmeric, both with and without black pepper, and varying amounts of turmeric (300 mg, 1 g, and 3 g, n = 10 participants/amount) did not show statistically significant differences in pain ratings (p = 0.157 and p = 0.338, respectively). Conclusions: Consuming dietarily relevant amounts of turmeric, either alone or with black pepper, appears to improve average pain ratings. This result suggests a feasible dietary option for further study of nutritional interventions for chronic pain management. Full article