Sleep hygiene behaviours in Iranian adolescents: an application of the Theory of Planned Behavior

Poor sleep quality and inadequate sleep in adolescents are a rising trend globally. The Theory of Planned Behaviour (TPB)—which centres on an individual’s attitude toward performing the behaviour, subjective norms and perceived behavioural control—has been applied to examine sleep hygiene behaviours in young adults. We expanded on prior works by using a longitudinal design to examine the effects of TPB factors, together with sleep hygiene knowledge and planning constructs, on sleep hygiene behaviours and on sleep quality and health in a group of Iranian adolescents. A total of 1822 healthy adolescents (mean age = 13.97) from 25 high schools in Qazvin, Iran, completed a selfreported survey at baseline and 6 months later. Structural equation modelling (SEM) was used to delineate the pathway from adolescents’ sleep hygiene knowledge, TPB constructs of their behavioural intentions and sleep hygiene behaviours and their sleep quality and self-reported health. The SEM model demonstrated that although behavioural intention, coping planning and action planning predicted the sleep hygiene behaviours positively 6 months later with acceptable model fit [comparative fit index (CFI) = 0.936; Tucker–Lewis index (TLI) = 0.902; root mean square error of approximation (RMSEA) = 0.080; standardized root mean square residual (SRMR) = 0.044], sleep hygiene knowledge did not predict behavioural intentions significantly. Sleep hygiene behaviours were associated with sleep quality and psychiatric wellbeing. Thus, the TPB, combined with coping and action planning, is useful in understanding the sleep hygiene behaviours of adolescents. Health-care providers may want to emphasize TPB constructs and coping and action planning to improve adolescents’ sleep hygiene behaviours, rather than rely solely upon increasing adolescents’ sleep hygiene knowledge

Effect of a liver cancer education program on hepatitis B screening among Asian Americans in the Baltimore-Washington metropolitan area, 2009-2010

IntroductionAsian Americans have the highest incidence of hepatocellular carcinoma (HCC), the major form of primary liver cancer, of all ethnic groups in the United States. Chronic hepatitis B virus (HBV) infection is the most common cause of HCC, and as many as 1 in 10 foreign-born Asian Americans are chronically infected with HBV. We tested the effectiveness of a culturally tailored liver cancer education program for increasing screening for HBV among Chinese, Korean, and Vietnamese Americans residing in the Baltimore–Washington metropolitan area, from November 2009 through June 2010. MethodsWe used a cluster randomized controlled trial to recruit volunteer participants from community-based organizations (CBOs) in the Baltimore–Washington metropolitan area. We selected 877 participants by using a pretest survey. People were eligible to participate if they had not attended a hepatitis B–related education program in the past 5 years. The intervention group (n = 441) received a 30-minute educational program, and the control group (n = 436) received an educational brochure. After attending the educational program, the intervention group completed a post-education survey. Six months later, participants in both groups were followed up by telephone. Receipt of HBV screening was the outcome measure. ResultsApproximately 79% (n = 688) of participants completed the 6-month follow-up telephone survey. Among those who had not had HBV screening at baseline (n = 446), the adjusted odds of self-reported receipt of HBV screening at the 6-month follow-up to the educational program were significantly higher for the intervention group than for the control group (odds ratio = 5.13; 95% confidence interval, 3.14–8.39; P \u3c .001). Chinese Americans and Vietnamese Americans had significantly higher odds of having HBV screening in the 6-month period than Korean Americans. ConclusionCulturally tailored education programs that increase liver cancer awareness can be effective in increasing HBV screening among underserved Asian American populations

Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan

The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from March to July in 2018. Adolescents were asked questions regarding depressive symptoms, obesity-related perceived stigma, and internalized stigma. Structural equation modeling was used to fit the pathway model. The pathway was first analyzed with the full sample and then stratified by actual and perceived weight status. Our final analytic sample consisted of 464 adolescents. The pathway model suggested an acceptable model fit. Perceived weight stigma (PWS) was significantly associated with internalized stigma regardless of actual or self-perceived weight status. Internalized stigma was significantly associated with anxiety for both actual (β = 0.186) and self-perceived nonoverweight (non-OW) participants (β = 0.170) but not for overweight (OW) participants (neither actual nor self-perceived). For OW adolescents, perceived weight stigma was associated with anxiety. However, the internalization process did not exist. It may be that the influence of perceived weight stigma is larger than internalized stigma on anxiety. It may also be that the level of internalization was not yet high enough to result in anxiet

Healthcare IT Adoption under Different Government Models: Debating the HITECH Impacts

Governments around the world are investing in healthcare as they attempt to increase access to care and the quality of care, while simultaneously lowering the costs of providing care. Many of these investments are in healthcare IT (HIT). The IT software industry is preparing for intensive competition for their HIT packages and workers in response to government and private industry investments. Yet different national healthcare models have produced widely differing healthcare outcomes and HIT adoption rates, with the U.S. performing poorly on both. The objective of this panel is to provide insights based on HIT research conducted in multiple healthcare contexts under different national government models, and then to engage the panel audience in debating the prospects for success of three IT-enabled healthcare delivery reforms being government-funded in the U.S. over the next 5 years. Our larger goal is to provide a forum for information sharing that will motivate other IS researchers across the global IS research community to contribute to the design of solutions and the capturing of best practices that will address some of the key goals of IT-enabled healthcare reform: improved access and quality, and decreased costs

Design of the PACIFIC study: A randomized controlled trial evaluating a novel treatment for adults with overweight and obesity.

The majority of adults in the United States have overweight or obesity which is associated with significant health and psychological consequences. Behavioral Weight Loss (BWL) is the current gold-standard weight-loss program for adults but recidivism rates continue to be disturbingly high. Given the health consequences of excess weight and the lack of long-term effectiveness of BWL, it is important to identify novel weight-loss programs. We developed the ROC (Regulation of Cues) program to reduce overeating through improvement in sensitivity to appetitive cues and decreased responsivity to external food cues. This study is a 4-arm randomized control trial designed to evaluate the efficacy of ROC, ROC combined with BWL, BWL alone and an active comparator over 24 months. Study recruitment completed in November 2017. Two hundred and seventy-one participants were randomized (mean age = 46.97 years; 82% female, mean BMI = 34.59; 20% Hispanic) and assessments were conducted at baseline, mid-treatment (6 months) and post-treatment (12 months). At this time, participants are completing 6- (18 months) and 12-month (24 months) follow-ups. Targeting novel mechanisms is critically important to improve weight-loss programs. Through this trial, we hope to identify treatments for adults with overweight and obesity to facilitate long-term weight loss and improved health

Effects of Childhood Adversity and Resilience on Taiwanese Youth Health Behaviors

Adverse childhood experiences (ACEs) can leave negative impacts on one\u27s health behaviors or social functioning later in life. Resilient characteristics have been shown to mitigate effects against risk behaviors in developing adolescents. However, clinical and research attention has rarely been given to jointly consider the effects of ACEs and resilient characteristics on health behaviors in Taiwanese youth. Method: A total of 200 individuals aged 15–22 years were recruited from primary care settings, communities, and schools. Participants completed questionnaires assessing their ACEs, resilient characteristics, and health behaviors. Univariate analysis was firstly used to describe the correlates of ACEs and resilient characteristics. Further multivariate logistic regression analysis was used to examine the association of both factors with health behaviors. Results: More than half (61.5%) of those surveyed had been exposed to at least one category of ACE. Verbal (37%) and physical (21%) abuses were the most common types of ACEs. The counts in the ACE categories were associated with being involved in physical fights (odds ratio 1.28 [confidence interval 1.01–1.63]), property damage (1.29 [1.03–1.61]), running away from home (1.30 [1.05–1.60]), bullying victimization (1.37 [1.16–1.61]), and sleep problems/tiredness (1.25 [1.03–1.52]). Meanwhile, resilience scores were associated with decreased odds of infrequent seatbelt use (0.47 [0.23–0.97]), low fruit and vegetable intake (0.42 [0.21–0.86]) unsatisfied body image (0.46 [0.22–0.97]), and sleep problems/tiredness (0.37 [0.18–0.79]). Conclusions: ACEs and resilience characteristics play a significant role in shaping youth health behaviors. Further research should be undertaken to identify ways to build resilience against health risks in youth with prior ACE exposure

Gender-Differential Associations between Attention Deficit and Hyperactivity Symptoms and Youth Health Risk Behaviors

Attention deficit and hyperactivity disorder (ADHD) is one of the common developmental disorders that generally receives clinical attention at learning ages, and some symptoms may persist in young adulthood.1 Past research has demonstrated a consistent association between ADHD and youth health risk behaviors (e.g., cigarette smoking), which often develop during adolescence and contribute to early morbidity and mortality among young adults.2 However, ADHD symptoms are not routinely screened in adolescents and emerging adults during their visits to healthcare providers.3 The six-item Adult Self-Report Scale (ASRS-6) for ADHD has been validated in the young population for screening purposes.4 This short form is time-saving and also provides a comparable predictivity of ADHD diagnosis as that of the original long version.5 Although accumulating evidence has demonstrated the association between ADHD symptoms and youth health risk behaviors, this issue has scarcely been explored in the Taiwanese youth population.6 Therefore, this study was conducted to validate the psychometric property of the Chinese version of ASRS-6 and examine the gender-stratified association between ADHD symptoms and youth health risk behaviors

Young Adults View Smartphone Tracking Technologies for COVID-19 as Acceptable:The Case of Taiwan

Taiwan has been successful in controlling the spread of SARS-CoV-2 during the COVID-19 pandemic; however, without a vaccine the threat of a second outbreak remains. Young adults who show few to no symptoms when infected have been identified in many countries as driving the virus' spread through unidentifiable community transmission. Mobile tracking technologies register nearby contacts of a user and notifies them if one later tests positive to the virus, potentially solving this issue; however, the effectiveness of these technologies depends on their acceptance by the public. The current study assessed attitudes towards three tracking technologies (telecommunication network tracking, a government app, and Apple and Google's Bluetooth exposure notification system) among four samples of young Taiwanese adults (aged 25 years or younger). Using Bayesian methods, we find high acceptance for all three tracking technologies (>75%), with acceptance for each technology surpassing 90% if additional privacy measures were included. We consider the policy implications of these results for Taiwan and similar cultures

The Shortest Telomere, Not Average Telomere Length, Is Critical for Cell Viability and Chromosome Stability

Loss of telomere function can induce cell cycle arrest and apoptosis. To investigate the processes that trig- ger cellular responses to telomere dysfunction, we crossed mTR/ G6 mice that have short telomeres with mice heterozygous for telomerase (mTR/) that have long telomeres. The phenotype of the telomerase null offspring was similar to that of the late generation parent, although only half of the chromosomes were short. Strikingly, spectral karyotyping (SKY) analysis revealed that loss of telomere function occurred pref- erentially on chromosomes with critically short telo- meres. Our data indicate that, while average telomere length is measured in most studies, it is not the aver- age but rather the shortest telomeres that constitute telomere dysfunction and limit cellular survival in the absence of telomerase