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The ubiquitous nature of smartphone ownership, its broad application and usage, along with its interactive delivery of timely feedback are appealing for health-related behavior change interventions via mobile apps. However, users' perspectives about such apps are vital in better bridging the gap between their design intention and effective practical usage. In this vein, a modified technology acceptance model (mTAM) is proposed here, to explain the relationship between users' perspectives when using an AI-based smartphone app for personalized nutrition and healthy living, namely, PROTEIN, and the mTAM constructs toward behavior change in their nutrition and physical activity habits. In particular, online survey data from 85 users of the PROTEIN app within a period of 2 months were subjected to confirmatory factor analysis (CFA) and regression analysis (RA) to reveal the relationship of the mTAM constructs, i.e., perceived usefulness (PU), perceived ease of use (PEoU), perceived novelty (PN), perceived personalization (PP), usage attitude (UA), and usage intention (UI) with the users' behavior change (BC), as expressed via the acceptance/rejection of six related hypotheses (H1–H6), respectively. The resulted CFA-related parameters, i.e., factor loading (FL) with the related p-value, average variance extracted (AVE), and composite reliability (CR), along with the RA results, have shown that all hypotheses H1–H6 can be accepted (p < 0.001). In particular, it was found that, in all cases, FL > 0.5, CR > 0.7, AVE > 0.5, indicating that the items/constructs within the mTAM framework have good convergent validity. Moreover, the adjusted coefficient of determination (R2) was found within the range of 0.224–0.732, justifying the positive effect of PU, PEoU, PN, and PP on the UA, that in turn positively affects the UI, leading to the BC. Additionally, using a hierarchical RA, a significant change in the prediction of BC from UA when the UI is used as a mediating variable was identified. The explored mTAM framework provides the means for explaining the role of each construct in the functionality of the PROTEIN app as a supportive tool for the users to improve their healthy living by adopting behavior change in their dietary and physical activity habits. The findings herein offer insights and references for formulating new strategies and policies to improve the collaboration among app designers, developers, behavior scientists, nutritionists, physical activity/exercise physiology experts, and marketing experts for app design/development toward behavior change.

Abstract Current research implicates pre- and probiotic supplementation as a potential tool for improving symptomology in physical and mental ailments, which makes it an attractive concept for clinicians and consumers alike. Here we focus on the transitional period of late adolescence and early adulthood during which effective interventions, such as nutritional supplementation to influence the gut microbiota, have the potential to offset health-related costs in later life. We examined multiple indices of mood and well-being in 64 healthy females in a 4-week double blind, placebo controlled galacto-oligosaccharides (GOS) prebiotic supplement intervention and obtained stool samples at baseline and follow-up for gut microbiota sequencing and analyses. We report effects of the GOS intervention on self-reported high trait anxiety, attentional bias, and bacterial abundance, suggesting that dietary supplementation with a GOS prebiotic may improve indices of pre-clinical anxiety. Gut microbiota research has captured the imagination of the scientific and lay community alike, yet we are now at a stage where this early enthusiasm will need to be met with rigorous research in humans. Our work makes an important contribution to this effort by combining a psychobiotic intervention in a human sample with comprehensive behavioural and gut microbiota measures.

Processed foods are increasingly under the spotlight since the development of classification systems based on proxies for food processing. Published critical reviews and commentaries suggest different views among professional disciplines about the definition and classification of processed food. There is a need to further understand perspectives of professionals on the conceptualisation of processed food and the agreements and disagreements among experts, to encourage interdisciplinary dialogue and aid communication to the public. The aim of this research was to elicit views and understandings of professionals on processed food, their perceptions of lay people's perceptions of the same, and their perspectives on the challenges of communicating about processed foods to the public. The online discussion groups brought together a range of professionals (n = 27), covering the fields of nutrition, food technology, policy making, industry, and civil society, mixed in 5 heterogenous groups. Through thematic analysis the following themes relating to the conceptualisation of processed food and challenges for communication were identified: (1) Broad concepts that need differentiation; (2) Disagreements on scope and degree of processing; (3) The role of food processing within the food system: the challenges in framing risks and benefits; and (4) The challenge of different perspectives and interests for risk communication. Throughout the discussions blurred lines in the characterisation of processing, processed foods, and unhealthy foods were observed. Participants agreed that consensus is important, but difficult. Participants identified a need for further interdisciplinary dialogue, including public engagement, to break down the observed issues, and work towards a mutual understanding and develop clear communication messages.

AI-based software applications for personalized nutrition have recently gained increasing attention to help users follow a healthy lifestyle. In this paper, we present a knowledge-based recommendation framework that exploits an explicit dataset of expert-validated meals to offer highly accurate diet plans spanning across ten user groups of both healthy subjects and participants with health conditions. The proposed advisor is built on a novel architecture that includes (a) a qualitative layer for verifying ingredient appropriateness, and (b) a quantitative layer for synthesizing meal plans. The first layer is implemented as an expert system for fuzzy inference relying on an ontology of rules acquired by experts in Nutrition, while the second layer as an optimization method for generating daily meal plans based on target nutrient values and ranges. The system’s effectiveness is evaluated through extensive experiments for establishing meal and meal plan appropriateness, meal variety, as well as system capacity for recommending meal plans. Evaluations involved synthetic data, including the generation of 3000 virtual user profiles and their weekly meal plans. Results reveal a high precision and recall for recommending appropriate ingredients in most user categories, while the meal plan generator achieved a total recommendation accuracy of 92% for all nutrient recommendations.

The aim was to investigate, among pregnant women, (1) the use of food supplements and (2) the awareness of food supplement recommendations and beliefs about food supplement use in four European countries: Finland, Italy, Poland, and the United Kingdom. The participants (n = 1804) completed an online questionnaire with predefined statements. Daily intakes of vitamins and minerals were calculated using uploaded pictures or weblinks of the supplement packages. Country differences were assessed. Most participants (91%) used at least one food supplement during pregnancy. A prenatal multivitamin was the most commonly used supplement type (84% of the users), and 75% of the participants thought consumption of multivitamin is recommended. Of the participants, 81% knew that folic acid is recommended during pregnancy while 58% knew the recommendation for vitamin D. In 19% of the supplement users, the daily safe upper intake limit of at least one nutrient was exceeded. Nevertheless, most participants agreed that they knew which supplements (91%) and doses of supplements (87%) needed to be used during pregnancy. To conclude, the majority of the participants used food supplements, but lower proportions knew and adhered to the recommended intakes. Between-country differences were observed in the use and knowledge of and beliefs regarding supplements. The results suggest a need for assessment and monitoring of supplement use in antenatal care to ensure appropriate use.

Recent interest in the gut-brain-axis has highlighted the potential of prebiotics to impact wellbeing, and to affect behavioral change in humans. In this clinical trial, we examined the impact of four-weeks daily supplementation of galacto-oligosaccharides (GOS) on self-reported nutrient intake and relationships on gut microbiota in a four-week two-armed parallel double-blind placebo controlled GOS supplement trial in young adult females. Food diaries and stool samples were collected prior to and following 28 days of supplement consumption. It was found that four weeks of GOS supplementation influenced macronutrient intake, as evident by reduced carbohydrate and sugars and increased fats intake. Further analysis showed that the reduction in carbohydrates was predicted by increasing abundances of Bifidobacterium in the GOS group in comparison to the placebo group. This suggests that Bifidobacterium increase via GOS supplementation may help improve the gut microbiota composition by altering the desire for specific types of carbohydrates and boosting Bifidobacterium availability when fiber intake is below recommended levels, without compromising appetite for fiber from food.

This study aimed to compare the use of the bioelectrical impedance device (BIA) seca® mBCA 515 using dual X-ray absorptiometry (DXA) as a reference method, for body composition assessment in adults across the spectrum of body mass indices. It explores the utility of simple anthropometric measures (the waist height ratio (WHtR) and waist circumference (WC)) for the assessment of obesity. In the morning after an overnight fast (10 h), 30 participants underwent a body composition DXA (GE iDXA) scan, BIA (seca 515), and anthropometric measures. Compared to the DXA reference measure, the BIA underestimated fat mass (FM) by 0.32 kg (limits of agreement −3.8 kg, 4.4 kg); overestimated fat free mass (FFM) by 0.43 kg (limits of agreement −8.2 kg, 4.3 kg). Some of the variation was explained by body mass index (BMI), as for FM, the mean difference of the normal range BMI group was smaller than for the overweight/obese group (0.25 kg and 0.35 kg, respectively) with wider limits of agreement (−4.30 kg, 4.81 kg, and −3.61 kg, 4.30 kg, respectively). There were significant differences in visceral adipose tissue (VAT) volume measurements between methods with BIA systematically overestimating VAT compared to DXA. WC was more strongly correlated with DXA FM (rho = 0.90, p < 0.001) than WHtR (rho = 0.83, p < 0.001). BIA had some agreement with DXA; however, they are not equivalent measures for the range of BMIs explored, with DXA remaining the more informative tool. WC is a useful and simple assessment tool for obesity.

Abstract The COVID-19 pandemic represented a rise in ‘people power’ globally, expressed through manifold acts of kindness, solidarity and mutualism as communities organised and came together where governments could or would not. In this study we were interested in the mechanisms through which communities and agencies extended existing practices and structures to respond to the pandemic or adopted new ways of organising. We undertook a rapid realist systematic review, following established steps and drawing on the Volunteer Process Model as our core theory. We worked with 59 studies to identify the mechanisms through which individuals, agencies and organisations, and communities mobilised and we identified six mechanisms. Gaining experience and developing role identity were key in mobilising volunteers to undertake activities and also resulted in positive outcomes for the volunteers themselves. Adaptability ensured that individuals, groups and local agencies and organisations were able to respond to the changing needs of beneficiary groups. Co-ordination helped communities, agencies and mutual aid groups to work together rather than in competition. Emotional support, support in the form of social and material recognition, and support through training were important in sustaining a volunteer workforce and protecting the wellbeing of the volunteer workforce. Altruism was a key motivator for stepping up during the pandemic and becoming a volunteer while greater trust was linked with the extent to which groups and communities were able to scale up efforts to respond to higher demands during the pandemic. While the COVID-19 pandemic represented a period of great social upheaval, it illuminated the ‘power of people’ working together. Our findings identify six key mechanisms that supported this mobilisation, which may be critical to activate in future health emergencies, but are also largely reflective of investments made before the pandemic to support the development of social capital and the development of volunteering infrastructure.

Updated UF/IFAS Extension Florida 4-H Youth Protection Policy

Background: Models of academic public and global health programmes that are culturally situated and that provide training to meet the needs of communities affected by health disparities can provide inspiration for the development of such programmes throughout the world. In the USA, for example, more American Indian health professionals and researchers are needed to develop culturally relevant health education. Native Nations should exercise their sovereignty by designing programmes and passing policy to achieve health equity while recognising the role that culture plays in our understanding of health. Here, we describe a programme at Diné College (Navajo Nation Tribal College) that aims to build and institutionalise the social and institutional infrastructure needed to enhance the Navajo Nation's professional public health capacity by training Navajo students, practitioners, and researchers. Methods: Public health faculty at Diné College have developed a BSc degree that meets the specific health needs of the Navajo Nation. The programme is grounded in the Diné educational philosophy, Są'áh Naagháí Bik'eh Hózhóo (SNBH). SNBH provides a philosophy for healthy living through balance with the universe and protection from life's deficiencies. SNBH is composed of four equal and interdependent components: thinking, planning, living, and assurance. In addition, the BSc in Public Health programme is guided by core competencies that reflect both Western public health practice and traditional Diné ideas about health, healing, and the research process. Through a culturally-informed curriculum, this programme aims to produce Diné scholars who are uniquely qualified to conduct health research and to practise public health in their communities. Findings: We evaluated the project through tracking student enrolment, completed courses, and student experiences; we also documented factors associated with academic success and application of learned skill sets. Students report that the indigenous focus of the programme reinforces their commitment to a career in health or public health service and research. The new BSc in Public Health programme had 60 enrolled majors in 2018. Students have completed up to 100 credit hours of coursework, and a student advisory committee has reported self-confidence in their progress towards public health competencies. Interpretation: Academic programmes that use a culturally-situated curriculum to successfully target aspiring global health practitioners from rural communities with health disparities can serve as models to increase the diversity of global health researchers and the global health workforce. Funding: Navajo NARCH Partnership National Institutes' of Health National Institute of General Medical Sciences (NIH-NIGMS), S06GM123550. Diné College Title III Funding.

Trauma disclosure in interpersonal relationships has received limited attention in both clinical and empirical literature. In the current study, using a mixed method research design, participants’ disclosure levels were coded based on their interview descriptions of their disclosure of trauma experiences to their spouse. Participants were classified into one of two groups: low trauma disclosure (n=16) or high trauma disclosure (n=55). The low disclosure group reported significantly lower relationship adjustment than the high disclosure group. In addition, using qualitative methods, the high disclosure group participants reported primarily positive functioning themes, while the low disclosure group participants reported more negative effects.