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Introduction Improving adherence to nicotine replacement therapy (NRT) in pregnancy may result in higher smoking cessation rates. Informed by the Necessities and Concerns Framework, we developed an intervention targeting pregnancy NRT adherence. To evaluate this, we derived the NRT in pregnancy necessities and concerns questionnaire (NiP-NCQ), which measures perceived need for NRT and concerns about potential consequences. Aims and Methods Here we describe the development and content validation of NiP-NCQ. From qualitative work, we identified potentially modifiable determinants of pregnancy NRT adherence and classed these as necessity beliefs or concerns. We translated these into draft self-report items and piloted items on 39 pregnant women offered NRT and a prototype NRT adherence intervention, assessing distributions and sensitivity to change. After removing poorly performing items, smoking cessation experts (N = 16) completed an online discriminant content validation (DCV) task to determine whether retained items measure a necessity belief, concern, both, or neither construct. Results Draft NRT concern items encompassed safety for the baby, side effects, too much or insufficient nicotine, and addictiveness. Draft necessity belief items included perceived need for NRT for short- and longer-term abstinence, and desire to minimize or cope without NRT. Of 22 out of 29 items retained after piloting, four were removed following the DCV task: three were judged to measure neither construct and one possibly both. The final NiP-NCQ comprised nine items per construct (18 total). Conclusions The NiP-NCQ measures potentially modifiable determinants of pregnancy NRT adherence within two distinct constructs and may have research and clinical utility for evaluating interventions targeting these. Implications Poor adherence to NRT in pregnancy may result from low perceived need and concerns about consequences; interventions challenging these beliefs may yield higher smoking cess

Understanding the environmental response to the last glacial termination in regions located in transitional climate zones such as the Atlantic Iberian mountains is crucial to estimate potential changes in regions affected by current glacial melting. We present an 8.5 m-long, solid last deglaciation and Holocene chronostratigraphic record including detailed sediment analysis from Lake Peixão, a pro-glacial lake in the Serra da Estrela (Central Portugal). The age–depth model relies on a Bayesian approach that includes 16 AMS C dates and Pb–CS measurements, robustly dating the lake formation at 14.7 ± 0.32 cal. ka BP. This chronological reconstruction shows an average sedimentation rate of ca. 0.07 cm yr (15 yr cm), enabling proxy analyses at decadal timescales. The sediment sequence is composed of five lithological units: (U1) coarse and unsorted fluvioglacial lacustrine deposits; (U2) massive fluvioglacial lacustrine deposits (863–790 cm below surface [bsf]; 14.7 ± 0.32–13.8 ± 0.12 cal. ka BP); (U3) water current fluvioglacial lacustrine deposits (790–766 cm bsf; 13.8 ± 0.12–12.9 ± 0.29 cal. ka BP); (U4) laminated/banded lacustrine deposits characterized by terrigenous deposits from ice-covered lake periods and episodic events of ice and snow melting (766–752 cm bsf; 12.9 ± 0.29–11.7 ± 0.15 cal. ka BP); and (U5) massive muddy lacustrine deposits (752–0 cm bsf; 11.7 ± 0.15 cal. ka BP–present). The occurrence of U2 to U4 deposits defines the transition from glacial cold (U1) to net warm postglacial conditions (U5). These climate transitions are marked by changes in sediments and the presence of very low sedimentation rate periods, possibly related to the Intra-Allerød Cold Period and the coldest phase of the Younger Dryas. Our results support the previously proposed timing of the retreat of the Serra da Estrela glaciers ca. 13.8 ± 0.12 cal. ka BP. The robust chronology of Lake Peixão highlights the potential of Iberian pro-glacial lakes for dating deglaciation processe

Iberian lacustrine sediments are a valuable archive to document environmental changes since the last glacial termination, seen as key for anticipating future climate/environmental changes and their far-reaching implications for generations to come. Herein, multi-proxy-based indicators of a mountain lake record from Serra da Estrela were used to reconstruct atmospheric (in)fluxes and associated climatic/environmental changes over the last ∼13.5 ka. Depositions of long-range transported dust (likely from the Sahara) and halogens (primarily derived from seawater) were higher for the pre-Holocene, particularly in the late Bølling-Allerød–Younger Dryas period, compared to the Holocene. This synchronous increase could be related to a recognized dust-laden atmosphere, along with the combined effect of (i) an earlier proposed effective transport of Sahara dust for higher latitudes during cold periods and (ii) the progressive Polar Front expansion southwards, with the amplification of halogen activation reactions in lower latitudes due to greater closeness to snow/sea ice (halide-laden) surfaces. Additionally, the orographic blocking of Serra da Estrela may have played a critical role in increasing precipitation of Atlantic origin at higher altitudes, with the presence of snow prompting physical and chemical processes involving halogen species. In the Late Holocene, the dust proxy records highlighted two periods of enhanced input to Lake Peixão, the first (∼3.5–2.7 ka BP) after the end of the last African Humid Period and the second, from the 19th century onwards, agreeing with the advent of commercial agriculture, and human contribution to land degradation and dust emission in the Sahara/Sahel region. The oceanic imprints throughout the Holocene matched well with North Atlantic rapid climatic changes that, in turn, coincided with ice-rafted debris or Bond events and other records of increased storminess for the European coasts. Positive parallel peaks in halogens were found

Ecological Momentary Assessment (EMA) involves repeated, real-time sampling of health behaviours in context. We present the state-of-knowledge in EMA research focused on five key health behaviours (physical activity and sedentary behaviour, dietary behaviour, alcohol consumption, tobacco smoking, sexual health), summarising theoretical (e.g., psychological and contextual predictors) and methodological aspects (e.g., study characteristics, EMA adherence). We searched Ovid MEDLINE, Embase, PsycINFO and Web of Science until February 2021. We included studies focused on any of the aforementioned health behaviours in adult, non-clinical populations that assessed ≥1 psychological/contextual predictor and reported a predictor-behaviour association. A narrative synthesis and random-effects meta-analyses of EMA adherence were conducted. We included 633 studies. The median study duration was 14 days. The most frequently assessed predictors were 'negative feeling states' (21%) and 'motivation and goals' (16.5%). The pooled percentage of EMA adherence was high at 81.4% (95% CI = 80.0%, 82.8%, k = 348) and did not differ by target behaviour but was somewhat higher in student (vs. general population) samples, when EMAs were delivered via mobile phones/smartphones (vs. handheld devices), and when event contingent (vs. fixed) sampling was used. This review showcases how the EMA method has been applied to improve understanding and prediction of health behaviours in context.

BACKGROUND: In Australia, tobacco smoking rates have declined but inequalities remain with significantly higher smoking prevalence among low-socioeconomic populations. Clinical trial data suggest vaporized nicotine products (VNPs) aid smoking cessation. Most VNP trials have used refillable tank systems, but newer generation (pod) devices now comprise the largest market share yet have limited clinical trial evidence on safety and effectiveness. This study evaluates the effectiveness, safety and cost-effectiveness of VNPs (pod and tank device) compared with nicotine replacement therapy ([NRT]-gum or lozenge) for smoking cessation. METHODS: This is a two-arm, open-label, superiority, parallel group, randomized controlled trial (RCT) with allocation concealment and blinded outcome assessment. The RCT is conducted at the National Drug and Alcohol Research Centre at the University of New South Wales, Sydney, Australia. Participants are people who smoke daily, are interested in quitting and receive a government pension or allowance (N = 1058). Participants will be randomized (1:1 ratio) to receive 8 weeks of free: VNPs, with pod (40 mg/mL nicotine salt) and tank device (18 mg/mL freebase nicotine) in mixed flavours; or NRT (gum or lozenge; 4 mg). All participants will receive daily text message behavioural support for 5 weeks. Assessments will be undertaken by telephone at baseline, with three follow-up calls (two check-in calls within the first month and final follow-up at 7 months post randomization) to ascertain smoking status, treatment adherence and adverse events. The primary outcome is 6-month continuous abstinence verified by carbon monoxide breath test of ≤5ppm at 7-month follow-up. Safety and cost-effectiveness of VNPs versus NRT will also be evaluated. DISCUSSION: Further data are required to strengthen certainty of evidence for VNPs aiding smoking cessation, particularly for newer generation pod devices. To our knowledge, this trial is the first to offer choice

INTRODUCTION: Ecological momentary assessment (EMA) involves repeated, real-time assessments of phenomena (eg, cognitions, emotions, behaviours) over a period of time in naturalistic settings. EMA is increasingly used to study both within-person and between-person processes. We will review EMA studies investigating key health behaviours and synthesise: (1) study characteristics (eg, frequency of assessments, adherence, incentives), (2) associations between psychological predictors and behaviours and (3) moderators of adherence to EMA protocols. METHODS AND ANALYSIS: This review will focus on EMA studies conducted across five public health behaviours in adult, non-clinical populations: movement behaviour (including physical activity and sedentary behaviour), dietary behaviour, alcohol consumption, tobacco smoking and preventive sexual health behaviours. Studies need to have assessed at least one psychological or contextual predictor of these behaviours. Studies reporting exclusively on physiological outcomes (eg, cortisol) or those not conducted under free-living conditions will be excluded. We will search OVID MEDLINE, Embase, PsycINFO and Web of Science using terms relevant to EMA and the selected health behaviours. Reference lists of existing systematic reviews of EMA studies will be hand searched. Identified articles will be screened by two reviewers. This review is expected to provide a comprehensive summary of EMA studies assessing psychological or contextual predictors of five public health behaviours. ETHICS AND DISSEMINATION: The results will be disseminated through peer-reviewed publications and presentations. Data from included studies will be made available to other researchers. No ethics are required. PROSPERO REGISTRATION NUMBER: CRD42020168314.

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INTRODUCTION: Digital behavioural weight loss interventions have the potential to improve public health; however, these interventions are often not adequately tailored to the needs of the participants. This is the protocol for a trial that aims to determine the effectiveness and cost-effectiveness of the Choosing Health programme as a means to promote weight loss and weight loss maintenance among overweight/obese adults. METHODS AND ANALYSIS: The proposed study is a two-group randomised controlled trial with a nested interrupted time series (ITS) within-person design. Participants (n=285) will be randomly assigned to either the Choosing Health digital intervention or a control group. For intervention participants, ecological momentary assessment will be used to identify behavioural determinants for each individual in order to tailor evidence-based behaviour change techniques and intervention content.Control group participants will receive non-tailored weight loss advice via e-book and generic emails. The primary outcome is the mean difference in weight loss between groups at 6 months controlled for baseline. Secondary outcomes include blood pressure and percentage of body fat; self-reported measures of physical activity, sitting time, quality of life, cost and theory-derived correlates of weight loss. Secondary outcomes will be measured at baseline, 3, 6 and 12 months. The primary outcome for ITS will be daily weight loss plan adherence. Data will be analysed using regression and time series analyses. ETHICS AND DISSEMINATION: Ethics approval was granted by Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland, approval number 03/P/12/2019. The project results will be disseminated through structured strategy implemented in collaboration with the Ministry of Health. TRIAL REGISTRATION DETAILS: This trial was registered with www.clinicaltrials.gov; registration number NCT04291482.

Rapid changes in ocean circulation and climate have been observed in marine-sediment and ice cores over the last glacial period and deglaciation, highlighting the non-linear character of the climate system and underlining the possibility of rapid climate shifts in response to anthropogenic greenhouse gas forcing. To date, these rapid changes in climate and ocean circulation are still not fully explained. One obstacle hindering progress in our understanding of the interactions between past ocean circulation and climate changes is the difficulty of accurately dating marine cores. Here, we present a set of 92 marine sediment cores from the Atlantic Ocean for which we have established age-depth models that are consistent with the Greenland GICC05 ice core chronology, and computed the associated dating uncertainties, using a new deposition modeling technique. This is the first set of consistently dated marine sediment cores enabling paleoclimate scientists to evaluate leads/lags between circulation and climate changes over vast regions of the Atlantic Ocean. Moreover, this data set is of direct use in paleoclimate modeling studies.

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Theories of behaviour change and health behaviour change interventions are most often evaluated in between-person designs. However, behaviour change theories apply to individuals not groups and behavioural interventions ultimately aim to achieve within-person rather than between-group change. Within-person methodology, such as N-of-1 (also known as single case design), can circumvent this issue, though has multiple design-specific challenges. This paper provides a conceptual review of the challenges and potential solutions for undertaking N-of-1 studies in health psychology. Key challenges identified include participant adherence to within-person protocols, carry-over and slow onset effects, suitability of behaviour change techniques for evaluation in N-of-1 experimental studies, optimal allocation sequencing and blinding, calculating power/sample size, and choosing the most suitable analysis approach. Key solutions include involving users in study design, employing recent technologies for unobtrusive data collection and problem solving by design. Within-person designs share common methodological requirements with conventional between-person designs but require specific methodological considerations. N-of-1 evaluation designs are appropriate for many though not all types of interventions. A greater understanding of patterns of behaviours and factors influencing behaviour change at the within-person level is required to progress health psychology into a precision science. Video abstract: Supplementary Material 1.

The suitability of MIS 11c and MIS 19c as analogues of our present interglacial and its natural evolution is still debated. Here we examine the regional expression of the Holocene and its orbital analogues over SW Iberia using a model–data comparison approach. Regional tree fraction and climate based on snapshot and transient experiments using the LOVECLIM model are evaluated against the terrestrial–marine profiles from Site U1385 documenting the regional vegetation and climatic changes. The pollen-based reconstructions show a larger forest optimum during the Holocene compared to MIS 11c and MIS 19c, putting into question their analogy in SW Europe. Pollen-based and model results indicate reduced MIS 11c forest cover compared to the Holocene primarily driven by lower winter precipitation, which is critical for Mediterranean forest development. Decreased precipitation was possibly induced by the amplified MIS 11c latitudinal insolation and temperature gradient that shifted the westerlies northwards. In contrast, the reconstructed lower forest optimum at MIS 19c is not reproduced by the simulations probably due to the lack of Eurasian ice sheets and its related feedbacks in the model. Transient experiments with time-varying insolation and CO2 reveal that the SW Iberian forest dynamics over the interglacials are mostly coupled to changes in winter precipitation mainly controlled by precession, CO2 playing a negligible role. Model simulations reproduce the observed persistent vegetation changes at millennial time scales in SW Iberia and the strong forest reductions marking the end of the interglacial “optimum”.

Past sea surface water conditions of the western Iberian Margin were reconstructed based on biomarker analyses of a marine deep sea core MD03-2699 from the Estremadura Spur north off Lisbon, providing new insights into orbital and suborbital-scale climate variability between marine isotope stage (MIS) 15 to MIS 9 (580 to 300 ka). We use biomarker-based proxy records such as the alkenone unsaturated index to estimate sea surface temperature (SST), the total alkenone concentration to reconstruct phytoplankton productivity, and terrestrial biomarkers to evaluate the continental input. The results extend the existing biomarker record, namely the SST for the Iberian Margin, back to the sixth climatic cycle (580 ka). A general trend of stable interglacials contrasts with glacial periods and glacial inceptions which are marked by high-frequency variability. Thus, several short-lived climatic coolings were identified by large SST decreases, the occurrence of ice-rafted detritus and high percentages of the tetraunsaturated alkenone C-37:4. Some of these events were extremely cold and similar in their general trends to the well-known Heinrich events of the last glaciation. We identified eight Heinrich-type events between 580 and 300 ka. The general deglaciation pattern detected between MIS 15 and MIS 9 is similar in their general trends to that characterizing the more recent climatic cycles, i.e., marked by two coolings separated by a short warming episode which may reflect the southward, northward, and southward migration of the Polar Front.

High-resolution sedimentological and micropaleontological studies of several deep-sea cores retrieved from the levees of the Celtic and Armorican turbidite systems (Bay of Biscay - North Atlantic Ocean) allow the detection of the major oscillations of the British-Irish Ice Sheet (BIIS) and 'Fleuve Manche' palaeoriver discharges over the last 30,000 years, which were mainly triggered by climate changes. Between 30 and 20 cal ka, the turbiditic activity on the Celtic-Annorican margin was weak, contrasting with previous stratigraphic models which predicted a substantial increase of sediment supply during low sea-level stands. This low turbidite deposit frequency was most likely the result of a weak activity of the 'Fleuve Manche' palaeoriver and/or of a reduced seaward transfer of sediments from the shelf to the margin. However, two episodes of turbiditic activity increase were detected in the Celtic-Armorican margin, during Heinrich events (HE) 3 and 2. This strengthening of the turbiditic activity was triggered by the meltwater releases from European ice sheets and glaciers favouring the seaward transfer of subglacial material, at least via 'Fleuve Manche' palaeoriver. At around 20 cal ka, a significant increase of turbidite deposit frequency occurred as a response to the onset of the last deglaciation. The retreat of the European ice sheets and glaciers induced a substantial increase of the 'Fleuve Manche' palaeoriver discharges and seaward transfer of continentally-derived material into the Armorican turbidite system. The intensification of the turbiditic activity on the Celtic system was directly sustained by the widespread transport of subglacial sediments from the British-Irish Ice Sheet (BIIS) to the Celtic Sea via the Irish Sea Basin. A sudden reduction of turbiditic activity in the Armorican system, between ca. 19 and 18.3 cal ka, could have been triggered by the first well known abrupt sea-level rise ('meltwater pulse', at around 19 cal ka) favouring the tra

Vegetation and quantitative climate reconstructions from a northwestern France shelf core (VK0358Bis) show orbital and suborbital climate variability for the last 8850 years in this region. A long-term cooling trend in summer temperatures, marked by gradual temperate and humid forest decline, parallels cooling in Greenland and the decrease of mid-latitude summer insolation reduction until at least 2000 cal. yr BP. At the long-term scale, the lowering in seasonal contrast revealed by vegetation changes follows the increase of precession. Corylus woodlands spread at the expense of deciduous Quercus forest, between 8740 and 8390 cal. yr BP, linked with the high seasonality conditions that, counterbalancing the long-term astronomical forcing trend, were amplified by the north Atlantic high-latitudes winter sea-ice expansion. High seasonality conditions resulted from the Agassiz and Ojibway final outburst episodes and consequent gradual reduction of the Meridional Overturning Circulation (MOC). Between 8390-8060 cal. yr BP, a sudden Corylus woodland decline marks the 8.2 kyr cold event in northwestern France probably triggered by the severe MOC reduction leading to the additional drop in winter temperature over Europe and Greenland. Nonetheless, seasonality remains high during this interval. The high seasonality conditions detected in 'VK03-58Bis' between 8740 and 8060 cal. yr BP reflects the multicentennial-scale climate cooling 8.6-8.0 kyr episode of the North Atlantic. Following the Agassiz and Ojibway final outburst episodes, climate became more stable. However, millennial-scale climate cooling episodes are recorded in 'VK03-Bis' and are characterized by weak winter cooling and increases in precipitation. Furthermore, dinocyst analysis and benthic gastropod Turritella communis occurrences indicate regional changes such as the southward migration of the Boreal biogeographical zone between 8740 and 8480 cal. yr BP and the subsequent opening of the English Channel at ar

The Quaternary sequence of the Armorican continental shelf in the Bay of Biscay is setting down above one regional erosion surface, which has been produced by successive transgressions that occurred during the last deglaciations. The few meters of the sequence covers the Holocene period and it is composed by two clean and sandy units at the base followed by thin (few decimetres) clayed sand unit and mud (few millimetres) unit in the top. The two upper units form the improperly called "La Grande Vasière" area over 8,000 km2. The settlement of these sedimentary units occurred since 8,000 C14 years BP, previously to other coastal mud fields setting of the shelf. Historical grain size data show that the mud field has lost part of the fine content during the last 30 years. "La Grande Vasière" evolves at the rhythm of the cycles of deposition and remobilization. Fluvial supplies and tide currents are the major control factors of the deposition. Bioturbation enhances the homogenization of the surficial sediments. Waves and anthropogenic actions are the main factors for the remobilization of the fine particles. The action of both the storms and the bottom trawls are tentatively quantified.