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

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

Selective and Low Overpotential Electrochemical CO2 Reduction to Formate on CuS Decorated CuO Heterostructure

Cu2O/CuO/CuS electrocatalyst was prepared by thermal oxidation of cleaned copper mesh in the air into Cu2O/CuO and CuS was deposited on oxide surface using facile successive ionic layer adsorption and reaction method. The successive fabrication of the electrocatalyst was confirmed using XRD, SEM, Raman and XPS. The catalytic enhancement is believed to be associated with the reduction of copper sulfide. Together with copper oxides, they offer favorable adsorption sites for electrochemical CO2 reduction. The synthesized catalyst offered significantly enhanced activity and selectivity performance for CO2 reduction at lower overpotential. Remarkably, the faradaic efficiency for formate generation reaches 84% at the potential of − 0.7 V versus RHE. It has also provided a high partial current density of − 20 mA cm− 2

Copper and Copper-Based Bimetallic Catalysts for Carbon Dioxide Electroreduction

Among many alternatives, CO2 electroreduction (CO2ER) is an emerging technology to alleviate its level in the atmosphere and simultaneously to produce essential products containing high energy density using various electrocatalysts. Cu-based mono- and bimetallics are electrocatalysts of concerns in this work due to the material's abundance and versatility. Intrinsic factors affecting the CO2ER are first analyzed, whereby understanding and characterizing the surface features of electrocatalysts are addressed. An X-ray absorption spectroscopy-based methodology is discussed to determine electronic and structural properties of electrocatalyst surface which allows the prediction of reaction mechanism and establishing the correlation with reduction products. The selectivity and faradaic efficiency of products highly depend on the quality of surface modification. Preparation and modification of electrocatalyst surfaces through various techniques are critical to increase the number of activity sites and the corresponding site activity. Mechanisms of CO2ER are complicate and thus are discussed in accordance with main products of interests. The authors try to concisely compile the most interesting, recent, and reasonable ideas that are agreeable to experimental results. Finally, this review provides an outlook for designing better Cu and Cu-based bimetallic catalysts to obtain selective products through CO2ER

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy

Background: The use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder. Objective: Our objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy. Methods: A total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy. Results: A total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed. Conclusions: The use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.Peer reviewe