The RU_SATED as a measure of sleep health: cross-cultural adaptation and validation in Chinese healthcare students.

BACKGROUND: The RU_SATED scale is a multidimensional instrument measuring sleep health, consisting of Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration dimensions. We adapted and validated the Chinese RU_SATED (RU_SATED-C) scale. METHODS: The RU_SATED-C scale was developed through a formal linguistic validation process and was validated in an observational longitudinal survey design. Healthcare students completed the RU_SATED scale, Sleep Quality Questionnaire, and Patient Health Questionnaire-4 among two sites of Hangzhou and Ningbo, China. Psychometric assessments included structural validity, longitudinal measurement invariance, convergent and divergent validity, internal consistency, and test-retest reliability. RESULTS: A total of 911 healthcare students completed the RU_SATED-C scale at baseline (Time 1, T1) and follow-up (Time 2, T2) with an average time interval of 7 days + 5.37 h. Confirmatory factor analysis (CFA) confirmed a single-factor model and resulted in an acceptable model fit. The two-factor model previously found in the Japanese version fit better than the one-factor model, whereas the one-factor model fit had a better fit than the two-factor model found in the English version. Longitudinal CFA resulted in negligible changes in fit indices for four forms of increasingly restrictive models and supported that a single-factor model was equivalent over time. The data also endorsed longitudinal measurement invariance among the two-factor models found in the English and Japanese samples. The RU_SATED-C scale total score displayed a moderately strong negative correlation with sleep quality; however, negligible associations were observed with anxiety and depression. Ordinal Cronbach's alpha and Ordinal McDonald's omega at T1 and T2 ranged from suboptimal to acceptable. The RU_SATED-C scale and all items were significantly correlated across time intervals. CONCLUSION: The RU_SATED-C scale is an easy-to-use instrument with potentially valid data for the measurement of multidimensional sleep health. Use of the RU_SATED-C scale can help raise awareness of sleep health and could pave the way for important efforts to promote healthy sleep.

Adaptation and validation of the Chinese version of the Sleep Quality Questionnaire.

STUDY OBJECTIVES: Sleep quality is essential to health. The current study aimed to adapt and validate the Sleep Quality Questionnaire (SQQ) into Chinese language. METHODS: The Chinese version of the SQQ (SQQ-C) was created following the guidelines for cross-cultural adaptation. Compliant with the COSMIN methodology, baseline data (N = 13,325) examined three validity domains and internal consistency, including content validity using the content validity index (CVI) and the cognitive debriefing and focus group (relevance, comprehensiveness and comprehensibility), construct validity using structural validity and cross­sectional measurement invariance, and criterion validity using concurrent/convergent validity. Follow-up data (N = 3410) gathered within a mean of 168 (167-207) h interval were used to additionally assess longitudinal measurement invariance and test-retest reliability using intraclass correlation coefficient (ICC). RESULTS: Scale-level CVI/Average was equal to 0.922; Item-level CVIs ranged from 0.889 to 1.000 (excellent), except for item 2 (0.556-fair). A panel of local experts and local participants during cognitive debriefing and focus group stated that it had sufficient relevance and comprehensibility but a slight deficiency in comprehensiveness. Confirmatory factor analysis indicated a stable two-factor structure encompassing Daytime Sleepiness Subscale and Sleep Difficulty Subscale from baseline to follow-up data. The SQQ-C-9 (without item 2) outperformed the SQQ-C-10 (full form). The SQQ-C-9 provided evidence of measurement invariance (strict) across subgroups (cohorts, gender, and age) and across time. The SQQ-C was negatively correlated with the Chinese Nonrestorative Sleep Scale and the Chinese Sleep Condition Indicator. Cronbach's alpha (α), McDonald's Omega (ω), and ICC, respectively, ranged from 0.712 to 0.838, 0.723 to 0.840, and 0.738 to 0.764 for total scale and each subscale. CONCLUSION: The SQQ-C exhibits adequate psychometric properties and a stable two-factor structure, and should enable valuable assessments of sleep quality in clinical and research settings.

The effect of duration of youth/parent communication on depression and anxiety during COVID-19 isolation in China.

The current study examines the mediating roles of self-efficacy and sleep disturbance and the moderating role of gender in the association between the duration of youth/parent communication on depression and anxiety during the COVID-19 isolation period in China. We used the self-designed demographic variable questionnaire, General Self-Efficacy Scale, the Pittsburgh Sleep Quality Index, the Self-Rating Depression Scale, and the Self-Rating Anxiety Scale with 1,772 youths aged 15-24 from 26 provinces in China during the COVID-19 lockdown. We performed demographic variable analysis, correlation analysis, mediation analysis, and moderated analysis. The duration of daily communication with parents was significantly positively correlated with self-efficacy and significantly negatively correlated with sleep disturbance, depression, and anxiety. The chain mediation analysis revealed that the duration of communication with parents directly affected depression and anxiety. Self-efficacy, sleep disturbance, and self-efficacy sleep disturbance had significant mediating and chain-mediating effects on the duration of communication with parents, depression, and anxiety. The interactions between sleep disturbance and gender (B = 0.35, 95% CI 0.06 to 0.64, p = .02 < .05) were significant. The duration of parent/youth communication directly affected depression and anxiety and indirectly affected depression and anxiety via the chain-mediating effect of self-efficacy and sleep disturbance. Gender moderates the relationships between sleep disturbance and depression.

Clinical characteristics of 68 children with atypical hand, foot, and mouth disease caused by coxsackievirus A6: a single-center retrospective analysis.

Background: Hand, foot, and mouth disease (HFMD) caused by coxsackievirus A6 (CV-A6) has become prevalent in many parts of the world. It is commonly referred to as atypical HFMD which more likely to present as bullous lesions. Compared with traditional HFMD, its misdiagnosis rate is relatively high, which brings difficulties to clinical diagnosis. We retrospectively analyze the clinical characteristics of children with HFMD with bullous lesions caused by CV-A6. Methods: The study included 68 children with atypical HFMD caused by CV-A6 who were hospitalized from 2018 to 2020. Data of the children including age, sex, month of HFMD onset, the morphologies and distribution of rashes, the details of fever, the presence or absence of onychomadesis, and laboratory test results were analyzed and compared between an infant group (<1 year), a toddler group (1-<3 years), and a preschool group (3-<6 years). Results: Of the 68 children, 67 were younger than 5 years old, with a male to female ratio of 1.62:1. The disease peaked in the period from June to September. With 75.0% of the infant group had more than three kinds of rashes; 95.0% of the preschool group had rashes in more than five locations. These differences were statistically significant (P<0.05). All children had fever. The peak fever in the toddler group was lower (P=0.033). No critical cases were observed in any of the groups. Of the 61 children who were successfully followed up, 68.9% developed onychomadesis within 2-3 weeks. The proportion of cases with abnormal liver function was 83.3%, 41.7%, and 10.0% in the infant, toddler, and preschool groups (P<0.001). The proportion of cases with increased serum creatine kinase MB isoenzyme (CK-MB) were significantly higher in the toddler group (P<0.05). Conclusions: Atypical HFMD caused by CV-A6 infection usually occurred in children under 5 years old. The morphologies of the rashes in the infant group changed more, while the rashes in the preschool group was more widely distributed. The incidence of critical cases was low. More than half of the cases can develop onychomadesis in the recovery period. Organ damage was relatively mild in the preschool group.

Development of pedestrian- and vehicle-related safety performance functions using Bayesian bivariate hierarchical models with mode-specific covariates.

INTRODUCTION: Pedestrian safety is a major concern as traffic crashes are the leading cause of fatalities and injuries for commuters. Traffic safety research in the past has developed various strategies to counteract traffic crashes, including the safety performance function (SPF). However, there is still a need for research dedicated to enhancing the SPF for pedestrians from perspectives of methodological framework and data input. To fill this gap, this study aims to add to the current SPF development practice literature by focusing on pedestrian-involved collisions, while considering the typical vehicle ones as well. METHODS: First, bivariate models are used to account for the common unobserved heterogeneity shared by the pedestrian- and vehicle-related crashes at the same intersections. Second, variable importance ranking technique is used, along with correlation analysis, to determine mode-specific feature input. Third, the exposure information for both modes, annual pedestrian count, and annual daily vehicles traveled are used for model development. Fourth, a recent Bayesian inference approach (integrated nested Laplace approximation (INLA)) was adopted for bivariate setting. Finally, different evaluation criteria are used to facilitate comprehensive model assessment. RESULTS: The results reveal different statistically significant factors contributing to each of the modes. The offset intersection provides better safety performance for both pedestrians and drivers as compared to other intersection designs. The model findings also corroborate the sensibility of using the bivariate models, rather than the separate univariate ones. Practical Applications: The study shows that pedestrians are more vulnerable to various intersection features such as left-turn channelization, intersection control, urban and rural population group, presence of signal mastarm on the cross-street, and mainline average daily traffic. Greater focus should be directed toward such intersection features to improve pedestrian safety.

Exploring temporal interactions of crash counts in California using distinct log-linear contingency table models.

Temporal trait of crashes has huge impact on road crash occurrence and a large proportion of research have considered different time periods to determine the causes and features of crash occurrence or frequency. Compared with other safety studies based on a single time interval, considerably less research has relied on the use of multiple time units, especially for the time intervals of less than one year. The research aims to fill the gap by investigating the temporal distribution of crash counts using multiple time spans including hour, weekday and month. To illustrate the most accurate results possible, both the Chi-square test and Cochran-Mantel-Haenzel tests were employed to explore the independence of various time units based on two-way and three-way contingency tables. Eight contingency table models were developed which can be classified into four groups including Complete Independence, Joint Independence, Conditional Independence and Homogeneous Association. Finally, a set of evaluation criteria were utilized for evaluation of the model performance. The results revealed the significant association existence in all time variables (hour, weekday, month) and the model with both main and all interactive effects of time variables provides best prediction performance. Also, the findings showed that Hour 18, weekdays 1, 6, 7 (Friday and Weekends), and month 8 (August) have the largest number of crash occurrences. It is suggested that both main and interactive effects of time variables should be included for model development, which otherwise might yield misleading information. It is anticipated that research results will benefit the safety professionals with better understanding of the temporal patterns of crashes with different time periods and allow the safety administrators to allocate the safety resources.