human
***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: Systematic review s ( SRs ) are an increasingly popular evidence -based tool and are often used to answer complex research questions across many different research domains . Early SR methodology was advanced by social scientists , and the term meta- analysis was coined by a social scientist who also conducted research in psychology . SRs have recently become popular in healthcare and are likely to be beneficial in any field . The aim of this report is to highlight issues in SR conduct with a focus on the field of nutrition and to make recommendations on improving SR conduct in this area . Development of the research question is probably the most important step in conducting an SR . The 4 main components of an answerable question are 1 ) the patient , population , or problem ; 2 ) the intervention , independent variable , or exposure ; 3 ) the comparators ; and 4 ) the dependent variables or outcomes of interest . The question will be used to determine the optimal methods for conducting the SR . SRs often include study design s beyond r and omized trials and do not always include a meta- analysis of the results . Other topics explored include underst and ing and interpreting discordant review s and the importance of reporting tools [ eg , QUality Of Reporting Of Meta-analyses ( QUOROM Statement ) or CONsoli date d St and ards Of Reporting of Trials ( CONSORT Statement ) ] . Recommendations are then provided , such as developing a capacity-building program , search ing the primary literature for research gaps , and extending reporting tools such as the QUOROM Statement to the field of nutrition PURPOSE This study addressed three questions : What is the power of the Theory of Planned Behavior ( TPB ) in predicting adolescents ' intended and self-perceived consumption of  non-milk extrinsic sugars using a non-intervention prospect i ve approach ? To what extent do the TPB constructs change across time following adolescents ' mere exposure to an oral health survey ? Do changes in self-perceived sugar consumption at follow-up associate with changes in behavioral intention as predicted by the TPB ? METHOD A survey was conducted in Kampala ( urban ) and Lira ( rural ) and 1146 secondary school students completed question naires assessing the TPB at school ( Time 1 ) . A r and om sub- sample of 415 students was selected from the original survey of which 372 students were examined clinical ly . After 3 months ( Time 2 ) , the question naire was administered a second time in the sub- sample . All analyses are based on the number of students who participated on both survey occasions , n = 372 . RESULTS Attitudes and perceived behavioral control predicted intended sugar consumption at Time 1 and Time 2 , accounting for 58 % ( DeltaR(2 ) = 0.58 ) and 19 % ( DeltaR(2 ) = 0.19 ) of the variance , respectively . Time 1 intention provided significant prediction of Time 2 self-perceived sugar consumption with DeltaR(2 ) = 0.5 . Adolescents with high-caries experience more than their counterparts with low , changed towards weaker intentions and less frequent sugar consumption across the survey period . Mean sugar consumption scores changed from 2.6 to 2.7 ( ns ) , 3.1 to 2.6 ( P < 0.001 ) and 2.3 to 3.2 ( P < 0.001 ) among adolescents who , respectively , remained stable , increased and decreased their intentions across time . CONCLUSION This study supports the validity of the TPB in predicting intended and self-perceived sugar consumption prospect ively An implicit association test ( IAT ) measures differential association of 2 target concepts with an attribute . The 2 concepts appear in a 2-choice task ( 2-choice task ( e.g. , flower vs. insect names ) , and the attribute in a 2nd task ( e.g. , pleasant vs. unpleasant words for an evaluation attribute ) . When instructions oblige highly associated categories ( e.g. , flower + pleasant ) to share a response key , performance is faster than when less associated categories ( e.g. , insect & pleasant ) share a key . This performance difference implicitly measures differential association of the 2 concepts with the attribute . In 3 experiments , the IAT was sensitive to ( a ) near-universal evaluative differences ( e.g. , flower vs. insect ) , ( b ) expected individual differences in evaluative associations ( Japanese + pleasant vs. Korean + pleasant for Japanese vs. Korean subjects ) , and ( c ) consciously disavowed evaluative differences ( Black + pleasant vs. White + pleasant for self-described unprejudiced White subjects ) Objective . This study was conducted to identify some factors ( beliefs and norms ) which are related to fast food consumption among high school students in Isfahan , Iran . We used the framework of the theory planned behavior ( TPB ) to predict this behavior . Subjects & Methods . Cross-sectional data were available from high school students ( n = 521 ) who were recruited by cluster r and omized sampling . All of the students completed a question naire assessing variables of st and ard TPB model including attitude , subjective norms , perceived behavior control ( PBC ) , and the additional variables past behavior , actual behavior control ( ABC ) . Results . The TPB variables explained 25.7 % of the variance in intentions with positive attitude as the strongest ( β = 0.31 , P < 0.001 ) and subjective norms as the weakest ( β = 0.29 , P < 0.001 ) determinant . Concurrently , intentions accounted for 6 % of the variance for fast food consumption . Past behavior and ABC accounted for an additional amount of 20.4 % of the variance in fast food consumption . Conclusion . Overall , the present study suggests that the TPB model is useful in predicting related beliefs and norms to the fast food consumption among adolescents . Subjective norms in TPB model and past behavior in TPB model with additional variables ( past behavior and actual behavior control ) were the most powerful predictors of fast food consumption . Therefore , TPB model may be a useful framework for planning intervention programs to reduce fast food consumption by students OBJECTIVE To examine the effect of communicating images of energy-dense snack foods paired with aversive images of the potential health consequences of unhealthy eating , on implicit and explicit attitudes and food choice behavior . DESIGN Participants were r and omly allocated to either an evaluative conditioning ( EC ) procedure that paired images of snack foods with images of potential adverse health consequences or a control condition that featured images of snack foods alone . MAIN OUTCOME MEASURES Implicit attitudes were assessed pre- and post-intervention . Explicit attitudes and food choice behavior were assessed post-intervention . RESULTS The conditioning intervention made implicit attitudes toward energy-dense snacks more negative , with this effect greatest in those with relatively more favorable implicit attitudes toward these snacks at baseline . Participants in the conditioning intervention were more likely to choose fruit rather than snacks in a behavioral choice task , a relationship mediated by changes in implicit attitudes . CONCLUSION Presenting aversive images of potential health consequences with those of specific foodstuffs can change implicit attitudes , which impacts on subsequent food choice behavior This prospect i ve study tested the prediction that impulsivity would contribute to the prediction of behaviour over and above key variables from an extended theory of planned behaviour ( TPB ) model . At Time 1 , participants completed a question naire including measures of TPB constructs related to the avoidance of high-calorie snacks , in addition to measures of impulsivity and dietary restraint . At Time 2 , participants ( N=315 ) completed a question naire assessing their snacking behaviour over the previous 2 weeks . Results revealed that impulsivity significantly contributed to the prediction of behaviour over and above TPB constructs , with those higher in impulsivity being more likely to snack . This relationship was not moderated by behavioural intention . It is concluded that impulsivity might profitably be included alongside TPB variables when predicting behaviours that are not adequately characterized by careful , analytic , compensatory decision-making strategies OBJECTIVE The primary purpose of the present study was to examine the utility of the Theory of Planned Behavior ( TPB ) in explaining the 5-A-Day intentions and behavior of college students . A secondary purpose was to determine whether any of the TPB relationships were moderated by gender or ethnicity . DESIGN A prospect i ve design that asked college students to complete a baseline TPB 5-A-Day question naire and a fruit and vegetable consumption measure 1 week later . SETTING Undergraduate fitness and health classes at 2 universities in the southern United States . PARTICIPANTS 511 college students with a mean age of 19.8 years ( st and ard deviation = 2.71 ) . MAIN OUTCOME MEASURES  TPB variables and fruit and vegetable consumption . ANALYSES Path analyses and invariance ( ie , to examine ethnic and gender moderated ) analyses . RESULTS Affective attitude ( beta = .16 , P < .05 ) and perceived behavioral control ( beta = .59 , P < .05 ) were significant predictors of intention , which in turn was a significant predictor of behavior ( beta = .32 , P < .05 ) . Follow-up invariance analyses showed that none of the  TPB relationships was moderated by gender or ethnicity . CONCLUSIONS AND IMPLICATION S The TPB may be a useful framework on which to base a 5-A-Day intervention for male and female college students of different ethnic background OBJECTIVE To study predictors of fruit intake in a sample of 627 adults . DESIGN Potential predictors of fruit intake were assessed at baseline , and fruit intake was assessed at two-week follow-up with self-administered question naires distributed by e-mail . SETTING The study was conducted among Dutch adult members of an Internet research panel . PARTICIPANTS A r and om sample of 627 adults aged 18 - 78 . VARIABLES MEASURED Attitudes , subjective norms , self-efficacy , expected pros and cons , habit strength , intention , and fruit intake . Fruit intake  was assessed with a vali date d food-frequency question naire . ANALYSIS Hierarchical linear and logistic regression analyses . Alpha < .05 was considered statistically significant . RESULTS Sex , attitudes , subjective norms , perceived pros , different self-efficacy expectations , and habit strength were significantly associated with the intention to eat two or more servings of fruit per day . Age , intentions , and habit strength were significant predictors of consumption of two or more servings of fruit per day . CONCLUSIONS AND IMPLICATION S The results confirm that Theory of Planned Behavior constructs predict fruit intake , and that habit strength and different self-efficacy expectations may be additional determinants relevant to fruit intake . Because habitual behavior is considered to be triggered by environmental cues , fruit promotion interventions should further explore environmental change strategies OBJECTIVE The theory of planned behaviour ( TPB ) has been criticized for not including interactions between major constructs thought to underlie behaviour . This study investigated the application of the TPB to the prediction of  fruit and vegetable consumption across three prospect i ve cohorts . The primary aim of the study was to investigate whether interactions between major constructs in the theory would increase the ability of the model to predict intention to consume fruit and vegetables ( i.e. , attitude × perceived behavioural control [ PBC ] , subjective norm × PBC , subjective norm × attitude ) and self-reported fruit and vegetable intake ( i.e. , PBC × intention ) . DESIGN Secondary data analysis from three cohorts : One predictive study ( cohort 1 ) and two intervention studies ( cohorts 2 and 3 ) . METHOD Participants completed a TPB measure at baseline and a measure of fruit and vegetable intake at 1 week ( cohort 1 ; n = 90 ) or 1 month ( cohorts 2 and 3 ; n = 296 ) . RESULTS Attitude moderated the impact of PBC on intention . PBC moderated the impact of intention on behaviour at 1 week but not 1 month . CONCLUSION The variance accounted for by the interactions was small . However , the presence of interactions between constructs within the TPB demonstrates a need to consider interactions between variables within the TPB in both theoretical and applied research using the model 
    Output:
    
agent
***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: Systematic review s ( SRs ) are an increasingly popular evidence -based tool and are often used to answer complex research questions across many different research domains . Early SR methodology was advanced by social scientists , and the term meta- analysis was coined by a social scientist who also conducted research in psychology . SRs have recently become popular in healthcare and are likely to be beneficial in any field . The aim of this report is to highlight issues in SR conduct with a focus on the field of nutrition and to make recommendations on improving SR conduct in this area . Development of the research question is probably the most important step in conducting an SR . The 4 main components of an answerable question are 1 ) the patient , population , or problem ; 2 ) the intervention , independent variable , or exposure ; 3 ) the comparators ; and 4 ) the dependent variables or outcomes of interest . The question will be used to determine the optimal methods for conducting the SR . SRs often include study design s beyond r and omized trials and do not always include a meta- analysis of the results . Other topics explored include underst and ing and interpreting discordant review s and the importance of reporting tools [ eg , QUality Of Reporting Of Meta-analyses ( QUOROM Statement ) or CONsoli date d St and ards Of Reporting of Trials ( CONSORT Statement ) ] . Recommendations are then provided , such as developing a capacity-building program , search ing the primary literature for research gaps , and extending reporting tools such as the QUOROM Statement to the field of nutrition PURPOSE This study addressed three questions : What is the power of the Theory of Planned Behavior ( TPB ) in predicting adolescents ' intended and self-perceived consumption of  non-milk extrinsic sugars using a non-intervention prospect i ve approach ? To what extent do the TPB constructs change across time following adolescents ' mere exposure to an oral health survey ? Do changes in self-perceived sugar consumption at follow-up associate with changes in behavioral intention as predicted by the TPB ? METHOD A survey was conducted in Kampala ( urban ) and Lira ( rural ) and 1146 secondary school students completed question naires assessing the TPB at school ( Time 1 ) . A r and om sub- sample of 415 students was selected from the original survey of which 372 students were examined clinical ly . After 3 months ( Time 2 ) , the question naire was administered a second time in the sub- sample . All analyses are based on the number of students who participated on both survey occasions , n = 372 . RESULTS Attitudes and perceived behavioral control predicted intended sugar consumption at Time 1 and Time 2 , accounting for 58 % ( DeltaR(2 ) = 0.58 ) and 19 % ( DeltaR(2 ) = 0.19 ) of the variance , respectively . Time 1 intention provided significant prediction of Time 2 self-perceived sugar consumption with DeltaR(2 ) = 0.5 . Adolescents with high-caries experience more than their counterparts with low , changed towards weaker intentions and less frequent sugar consumption across the survey period . Mean sugar consumption scores changed from 2.6 to 2.7 ( ns ) , 3.1 to 2.6 ( P < 0.001 ) and 2.3 to 3.2 ( P < 0.001 ) among adolescents who , respectively , remained stable , increased and decreased their intentions across time . CONCLUSION This study supports the validity of the TPB in predicting intended and self-perceived sugar consumption prospect ively An implicit association test ( IAT ) measures differential association of 2 target concepts with an attribute . The 2 concepts appear in a 2-choice task ( 2-choice task ( e.g. , flower vs. insect names ) , and the attribute in a 2nd task ( e.g. , pleasant vs. unpleasant words for an evaluation attribute ) . When instructions oblige highly associated categories ( e.g. , flower + pleasant ) to share a response key , performance is faster than when less associated categories ( e.g. , insect & pleasant ) share a key . This performance difference implicitly measures differential association of the 2 concepts with the attribute . In 3 experiments , the IAT was sensitive to ( a ) near-universal evaluative differences ( e.g. , flower vs. insect ) , ( b ) expected individual differences in evaluative associations ( Japanese + pleasant vs. Korean + pleasant for Japanese vs. Korean subjects ) , and ( c ) consciously disavowed evaluative differences ( Black + pleasant vs. White + pleasant for self-described unprejudiced White subjects ) Objective . This study was conducted to identify some factors ( beliefs and norms ) which are related to fast food consumption among high school students in Isfahan , Iran . We used the framework of the theory planned behavior ( TPB ) to predict this behavior . Subjects & Methods . Cross-sectional data were available from high school students ( n = 521 ) who were recruited by cluster r and omized sampling . All of the students completed a question naire assessing variables of st and ard TPB model including attitude , subjective norms , perceived behavior control ( PBC ) , and the additional variables past behavior , actual behavior control ( ABC ) . Results . The TPB variables explained 25.7 % of the variance in intentions with positive attitude as the strongest ( β = 0.31 , P < 0.001 ) and subjective norms as the weakest ( β = 0.29 , P < 0.001 ) determinant . Concurrently , intentions accounted for 6 % of the variance for fast food consumption . Past behavior and ABC accounted for an additional amount of 20.4 % of the variance in fast food consumption . Conclusion . Overall , the present study suggests that the TPB model is useful in predicting related beliefs and norms to the fast food consumption among adolescents . Subjective norms in TPB model and past behavior in TPB model with additional variables ( past behavior and actual behavior control ) were the most powerful predictors of fast food consumption . Therefore , TPB model may be a useful framework for planning intervention programs to reduce fast food consumption by students OBJECTIVE To examine the effect of communicating images of energy-dense snack foods paired with aversive images of the potential health consequences of unhealthy eating , on implicit and explicit attitudes and food choice behavior . DESIGN Participants were r and omly allocated to either an evaluative conditioning ( EC ) procedure that paired images of snack foods with images of potential adverse health consequences or a control condition that featured images of snack foods alone . MAIN OUTCOME MEASURES Implicit attitudes were assessed pre- and post-intervention . Explicit attitudes and food choice behavior were assessed post-intervention . RESULTS The conditioning intervention made implicit attitudes toward energy-dense snacks more negative , with this effect greatest in those with relatively more favorable implicit attitudes toward these snacks at baseline . Participants in the conditioning intervention were more likely to choose fruit rather than snacks in a behavioral choice task , a relationship mediated by changes in implicit attitudes . CONCLUSION Presenting aversive images of potential health consequences with those of specific foodstuffs can change implicit attitudes , which impacts on subsequent food choice behavior This prospect i ve study tested the prediction that impulsivity would contribute to the prediction of behaviour over and above key variables from an extended theory of planned behaviour ( TPB ) model . At Time 1 , participants completed a question naire including measures of TPB constructs related to the avoidance of high-calorie snacks , in addition to measures of impulsivity and dietary restraint . At Time 2 , participants ( N=315 ) completed a question naire assessing their snacking behaviour over the previous 2 weeks . Results revealed that impulsivity significantly contributed to the prediction of behaviour over and above TPB constructs , with those higher in impulsivity being more likely to snack . This relationship was not moderated by behavioural intention . It is concluded that impulsivity might profitably be included alongside TPB variables when predicting behaviours that are not adequately characterized by careful , analytic , compensatory decision-making strategies OBJECTIVE The primary purpose of the present study was to examine the utility of the Theory of Planned Behavior ( TPB ) in explaining the 5-A-Day intentions and behavior of college students . A secondary purpose was to determine whether any of the TPB relationships were moderated by gender or ethnicity . DESIGN A prospect i ve design that asked college students to complete a baseline TPB 5-A-Day question naire and a fruit and vegetable consumption measure 1 week later . SETTING Undergraduate fitness and health classes at 2 universities in the southern United States . PARTICIPANTS 511 college students with a mean age of 19.8 years ( st and ard deviation = 2.71 ) . MAIN OUTCOME MEASURES  TPB variables and fruit and vegetable consumption . ANALYSES Path analyses and invariance ( ie , to examine ethnic and gender moderated ) analyses . RESULTS Affective attitude ( beta = .16 , P < .05 ) and perceived behavioral control ( beta = .59 , P < .05 ) were significant predictors of intention , which in turn was a significant predictor of behavior ( beta = .32 , P < .05 ) . Follow-up invariance analyses showed that none of the  TPB relationships was moderated by gender or ethnicity . CONCLUSIONS AND IMPLICATION S The TPB may be a useful framework on which to base a 5-A-Day intervention for male and female college students of different ethnic background OBJECTIVE To study predictors of fruit intake in a sample of 627 adults . DESIGN Potential predictors of fruit intake were assessed at baseline , and fruit intake was assessed at two-week follow-up with self-administered question naires distributed by e-mail . SETTING The study was conducted among Dutch adult members of an Internet research panel . PARTICIPANTS A r and om sample of 627 adults aged 18 - 78 . VARIABLES MEASURED Attitudes , subjective norms , self-efficacy , expected pros and cons , habit strength , intention , and fruit intake . Fruit intake  was assessed with a vali date d food-frequency question naire . ANALYSIS Hierarchical linear and logistic regression analyses . Alpha < .05 was considered statistically significant . RESULTS Sex , attitudes , subjective norms , perceived pros , different self-efficacy expectations , and habit strength were significantly associated with the intention to eat two or more servings of fruit per day . Age , intentions , and habit strength were significant predictors of consumption of two or more servings of fruit per day . CONCLUSIONS AND IMPLICATION S The results confirm that Theory of Planned Behavior constructs predict fruit intake , and that habit strength and different self-efficacy expectations may be additional determinants relevant to fruit intake . Because habitual behavior is considered to be triggered by environmental cues , fruit promotion interventions should further explore environmental change strategies OBJECTIVE The theory of planned behaviour ( TPB ) has been criticized for not including interactions between major constructs thought to underlie behaviour . This study investigated the application of the TPB to the prediction of  fruit and vegetable consumption across three prospect i ve cohorts . The primary aim of the study was to investigate whether interactions between major constructs in the theory would increase the ability of the model to predict intention to consume fruit and vegetables ( i.e. , attitude × perceived behavioural control [ PBC ] , subjective norm × PBC , subjective norm × attitude ) and self-reported fruit and vegetable intake ( i.e. , PBC × intention ) . DESIGN Secondary data analysis from three cohorts : One predictive study ( cohort 1 ) and two intervention studies ( cohorts 2 and 3 ) . METHOD Participants completed a TPB measure at baseline and a measure of fruit and vegetable intake at 1 week ( cohort 1 ; n = 90 ) or 1 month ( cohorts 2 and 3 ; n = 296 ) . RESULTS Attitude moderated the impact of PBC on intention . PBC moderated the impact of intention on behaviour at 1 week but not 1 month . CONCLUSION The variance accounted for by the interactions was small . However , the presence of interactions between constructs within the TPB demonstrates a need to consider interactions between variables within the TPB in both theoretical and applied research using the model 
    Output:
    