Umbrella review of time-restricted eating on weight loss, fasting blood glucose, and lipid profile.

CONTEXT: A growing number of systematic reviews with meta-analyses have examined the effectiveness of time-restricted eating (TRE) in reducing weight and improving fasting blood glucose and lipid profiles. However, mixed results have been found, and its effectiveness remains uncertain. OBJECTIVE: This umbrella review aimed to summarize systematic reviews that (1) examine the effects of TRE on weight loss, fasting blood glucose, total cholesterol, triglycerides, high-density-lipoprotein cholesterol (HDL-C) and low-density-lipoprotein cholesterol (LDL-C) in individuals with overweight and obesity; and (2) compare the effect sizes on these outcomes between conventional TRE and Ramadan fasting. DATA SOURCES: A total of 11 databases were searched from inception until March 11, 2022. DATA EXTRACTION: Two independent reviewers performed article selection, data extraction, and quality assessment. DATA ANALYSIS: Seven systematic reviews with 30 unique meta-analyses involving 7231 participants from 184 primary studies were included. The quality of each review was evaluated as moderate (14.3%) or critically low (85.7%) according to the Assessment of Multiple Systematic Reviews 2. The degree of overlap was rated as slight for all outcomes (corrected cover area = 1.04%-4.27%). Meta-analyses at the meta-data level suggest that TRE is beneficial for reducing weight (P = .006) and fasting blood glucose (P < .01). Meta-analyses at the primary study level suggest that the effect on LGL-C was significant (P = .03). Subgroup analyses revealed greater effects in lowering fasting blood glucose, total cholesterol, and LDL-C from Ramadan fasting than from conventional TRE. The credibility of evidence was rated as suggestive (3.3%), weak (36.7%) or nonsignificant (60%) using a classification method. CONCLUSION: TRE may complement usual care and reduce body weight and fasting blood glucose. Rigorous randomized controlled trials with long-term assessments in a wide range of populations are warranted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022325657.

Social Media Engagement in Two Governmental Schemes during the COVID-19 Pandemic in Macao.

Social media engagement is a vehicle for effective communication and engagement between governments and individuals, especially in crises such as the COVID-19 pandemic. Additionally, it can be used to communicate resilience measures and receive feedback. This research aims to investigate public social media engagement with resilience measures related to COVID-19 in Macao. We examined 1107 posts and 791 comments about the government's face mask supply and consumption voucher schemes on Facebook. Using the Crisis Lifecycle model, we partitioned the data and analyzed the content and engagement of related posts, as well as the word semantics in user comments. Our findings show that social media engagement in these resilience measures is high and positive in the early stages of the pandemic, suggesting social media's potential in mobilizing society, preserving social resilience, and serving as a two-way communication tool in public health emergencies.

The Influence of Social Capital on Youths' Anti-Epidemic Action in the Field of Epidemic-Preventative Social Distancing in China.

Social distancing restrictions for COVID-19 epidemic prevention have substantially changed the field of youths' social activities. Many studies have focused on the impact of epidemic-preventative social distancing on individual physical and mental health. However, in the field of social distancing for epidemic prevention, what are the changes in youth anti-epidemic action and states caused by their interpersonal resources and interactions? Responding to this question by studying the impact of the elements of social capital in youths' anti-epidemic actions and anti-epidemic states could help identify an effective mechanism for balancing social distancing for effective epidemic prevention and sustainable social-participation development among youth. Bourdieu's field theory holds that the elements of social capital change with a change in the field. Therefore, we introduced the specific elements of social capital as independent variables and used a multinomal logistic model to analyze and predict the levels of youth anti-epidemic action through an empirical investigation of 1043 young people in Guangdong Province, China. The results show that, first, level of social distancing for epidemic prevention shows differences by occupation status and income level and correlates with social support. Second, social support and social norms play positive roles in promoting youth participation in anti-epidemic activities when social distance is certain. Third, social capital has a significant positive effect on youth social satisfaction and core relationships; however, social trust has a significant negative effect on youth physical and mental health. This study emphasized that social distancing for epidemic prevention is a special social situational state, which is a field where social capital has an impact on the differential changes in the public-participating actions and habitus of youth.

Engagement of Government Social Media on Facebook during the COVID-19 Pandemic in Macao.

Government social media is widely used for providing updates to and engaging with the public in the COVID-19 pandemic. While Facebook is one of the popular social media used by governments, there is only a scant of research on this platform. This paper aims to understand how government social media should be used and how its engagement changes in prodromal, acute and chronic stages of the pandemic. We collected 1664 posts and 10,805 comments from the Facebook pages of the Macao government from 1 January to 31 October 2020. Using word frequency and content analysis, the results suggest that the engagement was relatively low at the beginning and then surged in the acute stage, with a decreasing trend in the chronic stage. Information about public health measures maintained their engagement in all stages, whereas the engagement of other information was dropping over time. Government social media can be used for increasing vigilance and awareness in the prodromal stage; disseminating information and increasing transparency in the acute stage; and focusing on mental health support and recovery policies in the chronic stage. Additionally, it can be a tool for controlling rumors, providing regular updates and fostering community cohesion in public health crises.

Perinatal depressive symptoms, sociodemographic correlates, and breast-feeding among Chinese women.

OBJECTIVES: The objectives of the study were to (1) investigate the relationship between breast-feeding initiation and duration and patterns of perinatal depressive symptoms and (2) identify the sociodemographic correlates of such initiation and duration. METHOD: A sample of 2365 women in their second and third trimesters and 6 weeks postdelivery was recruited via systematic sampling from 6 regional public hospitals in Hong Kong. The women were identified as having perinatal depressive symptoms, using the Edinburgh Postnatal Depression Scale. Their sociodemographic variables were investigated using the empirical evidence. RESULTS: A total of 285 (47.66%) of the participants were found to have initiated breast-feeding, of whom 222 had breast-fed for more than 3 weeks. Logistic regression analysis revealed a monthly family income less than HK$5000 to be significantly associated with breast-feeding initiation and that housewives or part-time workers with antenatal depressive symptoms at 32 weeks of gestation were significantly more likely to breast-feed for longer duration. CONCLUSIONS: These findings help explicate breast-feeding practices among Chinese women and indicate that effective breast-feeding promotion should consider sociodemographic correlates and perinatal depressive symptoms. The study's limitations and implications are discussed.

Psychometric evaluation of the Chinese version of the fear of intimacy with helping professionals scale.

OBJECTIVES: This study aimed to evaluate the internal consistency, reliability, convergent validity, known-group comparisons, and structural validity of the Chinese version of Fear of Intimacy with Helping Professionals (C-FIS-HP) scale in Macau. METHODS: A cross-sectional design was used on a sample of 593 older people in 6 health centers. We used Chinese version of Exercise of Self-Care Agency Scale (C-ESCAS) and Morisky 4-item medication adherence scale to evaluate self-care actions and medication adherence. The internal consistency and reliability of C-FIS-HP were analyzed using the Spearman-Brown split-half reliability, Cronbach's alpha, and test-retest reliability. Convergent validity was tested the construct of C-FIS-HP and self-care actions. Known-group comparisons differentiated predefined groups in an expected direction. Two separated samples were used to test the structural validity. An exploratory factor analysis (EFA) tested the factor structure of C-FISHP using the principal axis factoring. A confirmatory factor analysis (CFA) was further conducted to confirm the factor structure constructed in the prior EFA. RESULTS: The C-FIS-HP had a Spearman-Brown split-half coefficient, Cronbach's alpha, and intraclass correlation coefficient of 0.96, 0.93, and 0.96, respectively. Convergent validity was satisfactory with significantly correlations between the C-FIS-HP and C-ESCAS. C-FIS-HP to differentiate the differences between high-, moderate-, and low- medication adherence groups. EFA demonstrated a two-factor structure among 297 older people. A first-order CFA was performed to confirm the construct dimensionality of C-FIS-HP with satisfactory fit indices (NFI = 0.92; IFI = 0.95; TLI = 0.94; CFI = 0.95 and RMSEA = 0.07) among 296 older people. CONCLUSIONS: C-FIS-HP is a reliable and valid test for assessing helping relationships in older Chinese people. Health professionals can use C-FIS-HP as a clinical tool to assess the comfort level of patients in a helping relationship, and use this information to develop culturally sensitive therapeutic interventions and treatment plans. Further studies need to be conducted concerning the different psychometric properties, as well as the application of C-FIS-HP in various regions.

Psychosocial risk factors associated with falls among Chinese community-dwelling older adults in Hong Kong.

This study examined the relationship between psychosocial factors and falls among community-dwelling older adults in the Hong Kong Special Administrative Region of China. The study included 1573 adults aged 60 or above who lived at home and who were applying for long-term care services. These participants were part of a large cross-sectional survey carried out between 2003 and 2004 in which they completed the Hong Kong Chinese version of the Resident Assessment Instrument-Home Care (RAI-HC) assessment. Of those persons who were surveyed, 516 (32.8%, 95% CI 30.5% to 35.2%) had fallen in the previous 90 days. Bivariate analyses showed that five psychosocial factors (depressive symptoms, fear of falling, a decline in social activities, the number of hours of informal care support during weekdays and living alone) were significantly associated with falls (P < 0.05). Logistic regression analysis showed living alone (odds ratio (OR) = 0.62; 95% CI 0.44 to 0.86) was the only psychosocial factor significantly associated with falls, after adjusting for the known significant factors related to falls. It was also found that more elders who lived with others had environmental hazards than those who lived alone (71.0% vs 29.0%, chi2 = 4.80, P = 0.028). These findings suggested that living with others may not be as safe as we assume. Interventions to increase awareness of home safety and to seek co-operation with family members in falls prevention are recommended. Fall preventive strategies should be educated to family members who are living with frail older adults. On the other hand, Chinese older adults who live alone often receive support from relatives or friends. Social support seems to be crucial to prevent them from falls and this measure is recommended to be continued in the community.

Validation of the Mainland Chinese version of the Edinburgh Postnatal Depression Scale in Chengdu mothers.

BACKGROUND: The Mainland Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) has been validated among antenatal women, subsequent validation among postnatal women is necessary. OBJECTIVES: This study investigated the prevalence of postnatal depression and the psychometric characteristics of the Mainland Chinese version of the EPDS among postnatal women. DESIGN: Two studies were used for validating the EPDS with specific aims. Study I established the psychometric properties of the EPDS by examining the convergent, discriminant and construct validity, internal consistency and stability of the scale. Study II established its sensitivity, specificity and the optimal cut-off score of the EPDS according the DSM-IV-TR criteria using the Structured Clinical Interview. SETTING: : Four regional public hospitals in Chengdu. PARTICIPANTS: : A convenience sample was composed of 300 and 342 postnatal women in study I and II, respectively. METHOD: A receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. The Beck Depression Inventory (BDI), Dyadic Adjustment Scale (DAS) and standard SF-12 Health Survey (SF-12) were used to investigate the convergent, discriminant and construct validity. An exploratory factor analysis was used to investigate the structural validity of the scale. Confirmatory factor analysis (CFA) was tested the proposed factor module by Linear Structural Relations (LISREL). The Cronbach's alpha reliability coefficient, split-half reliability and test-retest reliability were used to examine the internal consistency and stability of the scale. RESULTS: The prevalence of postnatal depression was 4.7%. Structural validity revealed a three-factor structure for the EPDS and the CFA showed a good overall fit of this three-factor model. Convergent and construct validity was supported and discriminant validity suggested that the EPDS successfully discriminated among the nondepressed, mildly and clinically depressed groups. The area under curve (AUC) was 89.6% and the logistic estimate for the threshold score was 10.5 (sensitivity, 81.25%; specificity, 80.67%) for clinical depression. The split-half reliability of the EPDS was 0.74, Cronbach's alpha was 0.78 and test-retest reliability was 0.90. CONCLUSIONS: Our data confirm the validity of the Mainland Chinese version of EPDS in identifying postnatal depression among postnatal women in Chengdu by using >10 cut-off point. Because of its brevity and acceptability, it is recommended that the EPDS be used in routine postnatal screening.

Care management service and falls prevention: a case-control study in a Chinese population.

OBJECTIVE: This study evaluates the effect of a care management service (CMS) on falls in older adults. METHOD: This is a retrospective case-control study with 78 CMS recipients as the case group who received CMS and another 312 community-dwelling frail elders as the control group.The groups were matched by age, gender, activity of daily living, cognitive impairment, and unsteady gait. Thus they were comparable in characteristics and frailty. RESULTS: Among the 390 participants, 89 older adults (23.0%) had falls in the 90 days prior to the survey. After controlling for the identified risk factors for falls, the odds ratio of CMS was 0.27 (95% confidence interval = 0.110-0.663, p < .01). DISCUSSION: These findings indicate that CMS recipients have a lower chance for falls compared to their counterparts. The two features of CMS (comprehensive assessment and multidisciplinary actions to reduce fall risks) are discussed.

The reliability and validity of the Chinese version of the Dysfunctional Attitudes Scale Form A (DAS-A) in a community sample.

OBJECTIVE: This study investigated the reliability and validity of the DAS-A in a sample of 308 Chinese adults in Hong Kong. METHOD: The reliability of the DAS-A and its relevant sub-scales was measured using internal consistency (Cronbach's alpha) and Guttman split-half reliability. Principal components analysis was performed to assess construct validity. Discriminant validity of the DAS-A was performed by examining whether the DAS-A could discriminate between the depressed and the non-depressed subjects in this study. RESULTS: The split-half reliability of the DAS-A was found to be r = 0.87; Cronbach's alpha was 0.945; and item-total correlations ranged between 0.36 and 0.75. Factor analysis revealed three factors that were similar to those that were found in other studies: Performance Evaluation, Need for Approval, and Anaclitic Self-Esteem. Discriminant validity suggested that the DAS-A discriminated successfully between the non-depressed and the depressed groups. Nevertheless, some differences were noticed in the relative strength of the factors and in the distribution of the scale items into the three factors. CONCLUSION: It was hoped that with this type of cross-cultural information, the universality of the constructs of the DAS-A could be reliably demonstrated.

Searching health information via the web: Hong Kong chinese older adults' experience.

UNLABELLED: OBJECTIVE AND SAMPLE: This paper reports on the learning experience of 88 Chinese older adults who attended a health Web-navigating workshop. DESIGN: Through a 3-hr training workshop, participants were guided to browse through seven health Web sites that provide authoritative health information by the Hong Kong government, academic institutions, or professional bodies. METHODS: Upon completion of the workshop, an evaluation was made of the participants' confidence in navigating health Web sites by themselves at home and in utilizing the health information sources. RESULTS: The findings indicated that participants' confidence in seeking health information via the Internet was not associated with their age, educational level, or experience of using computers before the workshop but was significantly associated with their satisfaction with the workshop (p<.05). Significant change of source of health information was noted at follow-up, suggesting that the workshop was successful. CONCLUSIONS: Implications of the results for running health Web-navigating programs among Chinese older adults are discussed.

Prevalence of depression and its correlates in Hong Kong's Chinese older adults.

OBJECTIVE: Because of the rapid aging of the population and inconsistent findings of previous epidemiological studies in Hong Kong, a prevalence study of depression among older adults was timely. The authors assessed the prevalence of depression among older adults and identified factors associated with it. METHODS: The authors interviewed a random representative sample of 917 community-dwelling Chinese adults age 60 and over. The 15-item Chinese Geriatric Depression Scale with a cutoff of > or = 8 was used to identify clinically significant depression in the older adults. RESULTS: The authors found that 11.0% and 14.5% of older Chinese men and women, respectively, scored above the cutoff, a prevalence rate similar to those found in other countries, including the United States, England, and Finland. Factors that were associated with an increased likelihood of depression among older adults included poor self-rated health, long-term pain, vision problems, higher level of impairment in activities of daily living, residing in Hong Kong less than 20 years, financial strain, and having less social support. CONCLUSIONS: The prevalence rate of depression among older Chinese adults in Hong Kong is more or less similar to rates found in Western countries. The data suggest that older adults who receive less social support are more likely to be depressed.