***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The objective of this study was to compare the relationship between repeated momentary reports of stress and headaches in female adolescents with varying degrees of headache frequency . BACKGROUND Headaches are the most common form of pain reported by adolescents affecting more than a third of all adolescents . High levels of stress during adolescence may predispose an adolescent to experience headaches in adulthood . R and omized , momentary data collection of stress and headaches provides the most accurate data regarding the adolescent experience of these variables . METHODS The research methodology , ecological momentary assessment , is a valid approach to better underst and the relationship between stress and headaches in adolescence . Data were obtained by each participant 's use of an electronic diary ( ED ) , which captured repeated momentary reports of perceived stress , head pain , and stress-related symptoms in female adolescents with varying degrees of recurrent headache . Seven times per day for the 21-day study period , teen girls responded to ED questions about their current stress levels , head pain , and stress-related symptoms . Based on participants ' momentary reports of headaches , Low Headache , Moderate Headache , and Chronic Headache groups were created . General estimating equation models were used to analyze the relationship between momentary variables as well as the lag effect between stress and head pain . RESULTS Thirty-one participants , aged 14 - 18 years , completed 2841 r and omized ED reports and reported 674 occurrences of headache . The Chronic Headache and Moderate Headache groups reported significantly increased levels of stress , head pain , and headaches . The relationship between momentary stress and head pain was significantly strong both within and across participants . The strength of this relationship increased with increased headache activity . A significant lag effect was found between stress and headaches ; however , the effect of depression as a moderator of the stress and headache relationship remains unclear . CONCLUSION Perceived stress and head pain was highly correlated in these female adolescents . Given the large population of teens affected by headaches , a plausible next step would be to vali date these results in other sample s and to determine methods with which to identify teens who may be at risk for a pattern of increasing stress and headaches Background Research examining  adolescent mood , stresses , and coping has tended to use retrospective question naires which are affected by recall biases . The aim of this study was to develop , pilot , and evaluate a youth-friendly mobile phone program to monitor , in real-time , young people ’s everyday experiences of mood , stress , and their coping behaviours . Method and design A momentary sampling program was design ed for mobile phones , and ran for 7 days , administering a brief question naire four r and om times each day , capturing information on current activity , mood , responses to negative mood , stresses , alcohol and cannabis use .  Eleven high school students review ed the program in focus groups , and 18 students completed 7 days of monitoring . Results Engagement with the mobiletype program was high with 76 % of 504 possible entries completed and 94 % ( 17/18 ) of the participants reporting that the program adequately captured their moods , thoughts , and activities . The mobiletype program captured meaningful and analyzable data on the way young people ’s moods , stresses , coping strategies , and alcohol and cannabis use , vary both between and within individuals . Conclusions The mobiletype program captured a range of detailed and interesting qualitative and quantitative data about young people ’s everyday mood , stresses , responses , and general functioning INTRODUCTION AND AIMS Alcohol use during adolescence is associated with the onset of alcohol use disorders , mental health disorders , substance abuse as well as socially and physically damaging behaviours , the effects of which last well into adulthood . Nevertheless , alcohol use remains prevalent in this population . Underst and ing motivations behind adolescent alcohol consumption may help in developing more appropriate and effective interventions . This study aims to increase this underst and ing by exploring the temporal relationship between mood and different levels of alcohol intake in a sample of young people . DESIGN AND METHODS Forty-one secondary school students used a purpose - design ed mobile phone application to monitor their daily mood and alcohol use for 20 r and om days within a 31 day period . Generalised estimating equations were used to examine the relationship between differing levels of alcohol consumption ( light , intermediate and heavy ) and positive and negative mood three days before and after drinking episodes . RESULTS While there was no relationship between light and heavy drinking and positive mood , there was an increase in positive mood before and after the drinking event for those that drank intermediate amounts . No statistically significant relationships were found between negative mood and any of the three drinking categories . DISCUSSION AND CONCLUSION Adolescents who drank in intermediate amounts on a single drinking occasion experienced an increase in positive mood over the three days leading up to and three days following a drinking event . These findings contribute to an underst and ing of the motivations that underpin adolescent alcohol use , which may help inform future interventions The objective of this study was to identify physical , social , and intrapersonal cues that were associated with the consumption of sweetened beverages and sweet and salty snacks among adolescents from lower SES neighborhoods . Students were recruited from high schools with a minimum level of 25 % free or reduced cost lunches . Using ecological momentary assessment , participants ( N=158 ) were trained to answer brief question naires on h and held PDA devices : ( a ) each time they ate or drank , ( b ) when prompted r and omly , and ( c ) once each evening . Data were collected over 7days for each participant . Participants reported their location ( e.g. , school grounds , home ) , mood , social environment , activities ( e.g. , watching TV , texting ) , cravings , food cues ( e.g. , saw a snack ) , and food choices . Results showed that having unhealthy snacks or sweet drinks among adolescents was associated with being at school , being with friends , feeling lonely or bored , craving a drink or snack , and being exposed to food cues . Surprisingly , sweet drink consumption was associated with exercising . Watching TV was associated with consuming sweet snacks but not with salty snacks or sweet drinks . These findings identify important environmental and intrapersonal cues to poor snacking choices that may be applied to interventions design ed to disrupt these food-related , cue-behavior linked habits Computerized ecological momentary assessment ( EMA ) is widely accepted as a “ gold st and ard ” method for capturing momentary symptoms repeatedly experienced in daily life . Although many studies have addressed the within-individual temporal variations in momentary symptoms compared with simultaneously measured external criteria , their concurrent associations , specifically with continuous physiological measures , have not been rigorously examined . Therefore , in the present study , we first examined the variations in momentary symptoms by validating the associations among self-reported symptoms measured simultaneously ( depressive mood , anxious mood , and fatigue ) and then investigated covariant properties between the symptoms ( especially , depressive mood ) and local statistics of locomotor activity as the external objective criteria obtained continuously . Healthy subjects ( N = 85 ) from three different population s ( adolescents , undergraduates , and office workers ) wore a watch-type computer device equipped with EMA software for recording the momentary symptoms experienced by the subjects .  Locomotor activity data were also continuously obtained by using an actigraph built into the device . Multilevel modeling analysis confirmed convergent associations by showing positive correlations among momentary symptoms . The increased intermittency of locomotor activity , characterized by a combination of reduced activity with occasional bursts , appeared concurrently with the worsening of depressive mood . Further , this association remained statistically unchanged across groups regardless of group differences in age , lifestyle , and occupation . These results indicate that the temporal variations in the momentary symptoms are not r and om but reflect the underlying changes in psychophysiological variables in daily life . In addition , our findings on the concurrent changes in depressive mood and locomotor activity may contribute to the continuous estimation of changes in depressive mood and early detection of depressive disorders BACKGROUND Variables that are thought to precipitate migraine or tension-type headache episodes in children hitherto have only been studied using retrospective reports . As such , there is little empirical evidence to support the actual predictive association between presumed headache triggers and actual headache occurrence in children . OBJECTIVE The present study sought to determine if fluctuations in weather , a commonly reported headache trigger in children , predict increased likelihood of headache occurrence when evaluated using rigorous prospect i ve methodology ( " electronic momentary assessment ") . METHODS Twenty-five children ( 21 girls , 4 boys ) between the ages of 8 - 17 years attending a new patient neurology clinic appointment and having a diagnosis of chronic migraine , chronic tension-type , or episodic migraine headache ( with or without aura ) participated in the study . Children completed baseline measures on headache characteristics , presumed headache triggers , and mood and subsequently were trained in the use of electronic diaries to record information on headaches . Children then completed thrice daily diaries on h and held computers for a 2-week time period ( 42 assessment s per child ) while data on weather variables ( temperature , dew point temperature , barometric pressure , humidity , precipitation , and sunlight )  in the child 's geographic location were recorded each time a diary was completed . Data were analyzed using multilevel models . RESULTS Of the weather variables , relative humidity and presence of precipitation were significantly predictive of new headache onset , with nearly a 3-fold increase in probability of headache occurrence during times of precipitation or elevated humidity in the child 's area , b = 0.38 , t(821 ) = 2.10 , P = .04 , and b = 0.02 , t(821 ) = 2.81 , P = .01 , respectively . These associations remained after accounting for fluctuations in mood , and associations were not significantly stronger in children who at baseline thought that weather was a headache trigger for them . Changes in temperature , dew point temperature , barometric pressure , and sunlight were not significantly predictive of new headache episode occurrence in this sample . CONCLUSIONS Results of the present study lend some support to the belief commonly held by children with recurrent headaches that weather changes may contribute to headache onset . Although electronic momentary assessment methodology was found to be feasible in this population and to have the potential to identify specific headache triggers for children , it remains to be determined how best ( or even whether ) to incorporate this information into treatment recommendations This study uses ecological momentary assessment ( EMA ) to simultaneously capture youths ' perceptions of peer affiliates and social context s to determine their association with youths ' current and future mood states . A sample of 82 seventh grade students ( 36 at risk for developing or escalating rule breaking and substance use and 46 r and omly selected ) from 4 schools participated . Using EMA methodology , we had students report their peer affiliations , perceptions of peer affiliates , moods , activities , location , and behaviors during their free time . Data from 3 assessment waves were collected ; each wave consisted of 27 r and omly prompted assessment s during a week . Youths spent a large portion of their free time watching television , on the computer , or playing video games . Being " out and about " increased over the school year , whereas adult supervision decreased , showing an increase in potentially risky situations . Happiness was associated with affiliating with peers who were perceived to be popular . Negative moods were associated with affiliating with peers by whom they were teased or treated meanly . Multilevel models found that both levels and lability of negative moods ( i.e. , sadness , anxiety ) were predicted by risk status and affiliation with peers who tease them . Compared with boys , girls who affiliated more with peers who teased them and were classified as at risk had more extreme negative moods and negative mood lability .  EMA methodology has demonstrated the ways in which salient intrapersonal and peer processes are associated over time , which can inform efforts to prevent the development and escalation of behavior problems , substance use , and mood disorders in adolescence Paper diaries are commonly used in health care and clinical research to assess patient experiences . There is concern that patients do not comply with diary protocol s , possibly invalidating the benefit of diary data . Compliance with paper diaries was examined with a paper diary and with an electronic diary that incorporated compliance-enhancing features .  Participants were chronic pain patients and they were assigned to use either a paper diary instrumented to track diary use or an electronic diary that time-stamped entries . Participants were instructed to make three pain entries per day at predetermined times for 21 consecutive days . Primary outcome measures were reported vs actual compliance with paper diaries and actual compliance with paper diaries ( defined by comparing the written times and the electronically-recorded times of diary use ) . Actual compliance was recorded by the electronic diary . Participants su bmi tted diary cards corresponding to 90 % of assigned times ( + /-15 min ) . However , electronic records indicated that actual compliance was only 11 % , indicating a high level of faked compliance . On 32 % of all study days the paper diary binder was not opened , yet reported compliance for these days exceeded 90 % . For the electronic diary , the actual compliance rate was 94 % . In summary , participants with chronic pain enrolled in a study for research were not compliant with paper diaries but were compliant with an electronic diary with enhanced compliance features . The findings call into question the use of paper diaries and suggest that electronic diaries with compliance-enhancing features are a more effective way of collecting diary information BACKGROUND Smartphone applications can potentially provide recovery monitoring and support in real-time , real-life context s. Study aims included determining feasibility of ( a ) adolescents completing ecological momentary assessment s ( EMAs )  and utilizing phone-based ecological momentary interventions ( EMIs ) ; and ( b ) using EMA and EMI data to predict substance use in the subsequent week . METHODS Twenty-nine adolescents were recruited at discharge from residential treatment , regardless of their discharge status or length of stay . During the 6-week pilot , youth were prompted to complete an EMA at 6 
    Output:
    
The reported compliance rates did not differ by duration of EMA period among studies from either clinical or non clinical setting s. CONCLUSIONS The compliance rate among mobile-EMA studies in youth is moderate but suboptimal .
Study design may affect protocol compliance differently between clinical and non clinical participants ; including additional wearable devices did not affect participant compliance .