Deciphering the In Situ Reconstruction of Metal Phosphide/Nitride Dual Heterostructures for Robust Alkaline Hydrogen Evolution Above 3 A cm-2.

Hydrogen evolution reaction (HER) in neutral or alkaline electrolytes is appealing for sustainable hydrogen production driven by water splitting, but generally suffers from unsatisfied catalytic activities at high current densities owing to extra kinetic energy barriers required to generate protons through water dissociation. In response, here, a competitive Ni3N/Co3N/CoP electrocatalyst with multifunctional interfacial sites and multilevel interfaces, in which Ni3N/CoP performs as active sites to boost initial water dissociation and Co3N/CoP accelerates subsequent hydrogen adsorption process as confirmed by density functional theory calculations and in situ X-ray photoelectron spectroscopy analysis, is reported. This hybrid catalyst possesses extraordinary HER activity in base, featured by extremely low overpotentials of 115 and 142 mV to afford 500 and 1000 mA cm-2, respectively, outperforming most ever-reported metal phosphides-based catalysts. This catalyst presents an ultrahigh current density of 3545 mA cm-2 by a factor of 4.96 relative to noble Pt/C catalysts (715 mA cm-2) at 0.2 V. Assembled with Fe(PO3)2/Ni2P anode, industrial-level current densities of 500/1000 mA cm-2 at ultralow cell voltages of 1.62/1.66 V for overall water electrolysis with outstanding long-term stability are actualized. More interestingly, this hybrid catalyst also performs well in acidic, neutral freshwater, and seawater requiring relatively low overpotentials of 140, 290, and 331 mV to reach 500 mA cm-2. Particularly, this catalyst can withstand electrochemical corrosion without obvious activity decay at the industrial-level current densities for over 100 h in base. This work provides a cornerstone for the construction of advanced catalysts operated in different pH environments.

College students' perceptions of electronic cigarette risks and benefits: a concept mapping study.

The use of electronic cigarettes (e-cigarettes) is on the rise among young adults, with higher public acceptance than traditional tobacco. A study in Taiwan employed concept mapping to explore risk and benefit perceptions of e-cigarette use among college students. The study involved 100 college students from 11 Taiwanese universities, with 50 being e-cigarette users and 50 non-users. Data collection and analysis were done with the GroupWisdom™ platform. Participants engaged in brainstorming, rating and sorting their perceptions, which were analyzed using multidimensional scaling and hierarchical cluster analyses. The participants' mean age was 19.24 years, and 55% were male. This process resulted in the identification of 10 clusters encompassing 64 statements, with 3 clusters focused on risk perceptions, 6 on benefit perceptions, and 1 dealing with e-cigarette regulations. Notably, risk perceptions were rated higher than benefit perceptions. Non-users held significantly higher risk perceptions and lower benefit perceptions across the nine clusters related to e-cigarette use. Concept mapping proved to be an effective tool for understanding college students' perceptions. These findings can assist health educators in comprehending college students' viewpoints on e-cigarette use and in developing targeted interventions. Additionally, exploring benefit perceptions may enhance students' critical thinking skills regarding e-cigarette advertising.

College Students' E-health Literacy, Social Media Use, and Perceptions of E-cigarettes in Taiwan.

This study aimed to examine the relationship between social media use, e-health literacy, and the risk and benefit perceptions of e-cigarettes among college students in Taiwan. A cross-sectional online survey was conducted with 1,571 Taiwanese college students, which included four questionnaires to assess participants' perceptions, social media use behavior, e-health literacy, and sociodemographic factors. The data were presented in terms of means, standard deviations, and percentages. Stepwise regression was used to identify factors associated with the participants' perceptions. The study found that 75.01% of the participants were exposed to e-cigarette information on social media, with 31.26% actively searching for it and 15.95% sharing it. Participants had a high e-cigarette risk perception, indicating low benefit perception, but acceptable e-health literacy. Factors such as current e-cigarette and tobacco use, e-health literacy, academic achievement, and sex significantly predicted e-cigarette risk perception, while sharing e-cigarette related information, sex, age, academic achievement, and current e-cigarette use significantly predicted its benefit perception. Thus, implementing effective e-health literacy programs to enhance college students' e-cigarette risk perception is recommended along with a proactive approach to tackle e-cigarette advertising messages on social media, minimizing their sharing behavior to decrease their perception of associated benefits.

Attitude and utilization of ChatGPT among registered nurses: A cross-sectional study.

AIM: This study explores the influencing factors of attitudes and behaviors toward use of ChatGPT based on the Technology Acceptance Model among registered nurses in Taiwan. BACKGROUND: The complexity of medical services and nursing shortages increases workloads. ChatGPT swiftly answers medical questions, provides clinical guidelines, and assists with patient information management, thereby improving nursing efficiency. INTRODUCTION: To facilitate the development of effective ChatGPT training programs, it is essential to examine registered nurses' attitudes toward and utilization of ChatGPT across diverse workplace settings. METHODS: An anonymous online survey was used to collect data from over 1000 registered nurses recruited through social media platforms between November 2023 and January 2024. Descriptive statistics and multiple linear regression analyses were conducted for data analysis. RESULTS: Among respondents, some were unfamiliar with ChatGPT, while others had used it before, with higher usage among males, higher-educated individuals, experienced nurses, and supervisors. Gender and work settings influenced perceived risks, and those familiar with ChatGPT recognized its social impact. Perceived risk and usefulness significantly influenced its adoption. DISCUSSION: Nurse attitudes to ChatGPT vary based on gender, education, experience, and role. Positive perceptions emphasize its usefulness, while risk concerns affect adoption. The insignificant role of perceived ease of use highlights ChatGPT's user-friendly nature. CONCLUSION: Over half of the surveyed nurses had used or were familiar with ChatGPT and showed positive attitudes toward its use. Establishing rigorous guidelines to enhance their interaction with ChatGPT is crucial for future training. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers should understand registered nurses' attitudes toward ChatGPT and integrate it into in-service education with tailored support and training, including appropriate prompt formulation and advanced decision-making, to prevent misuse.

High-Performance Bifunctional Porous Iron-Rich Phosphide/Nickel Nitride Heterostructures for Alkaline Seawater Splitting.

Seawater is the most abundant natural water resource in the world, which is an inexhaustible and low-cost feedstock for hydrogen production by alkaline water electrolysis. It is appearling to develop robust and stable electrocatalysts for alkaline seawater electrolysis. However, the development of seawater electrolysis is seriously impeded by anodic chloride corrosion and chlorine evolution reaction, and few non-noble electrocatalysts show prominent catalytic performance and excellent durability. Here, a heterogeneous electrocatalyst constructed by in situ growing highly dispersed iron-rich bimetallic phosphide nanoparticles on metallic Ni3 N (Fe2-2 x Co2 x P/Ni3 N), which exhibits outstanding bifunctional catalytic activities for alkaline seawater splitting, is reported. The optimal (Fe0.74 Co0.26 )2 P/Ni3 N and Fe2 P/Ni3 N electrocatalysts demand only 113 and 212 mV to afford 100 mA cm-2 for hydrogen and oxygen evolution reactions (HER and OER) in 1 m KOH, respectively, thus substantially expediting overall water/seawater electrolysis at 100 mA cm-2 with 1.592/1.645 V. Particularly, Fe2 P/Ni3 N displays an unprecedented overpotential of 302 mV at 500 mA cm-2 , which represents the best alkaline seawater oxygen evolution activity among the ever-reported non-noble electrocatalysts; and thus substantially expedites overall water/seawater splitting at 500 mA cm-2 with 1.701/1.768 V, surpassing most of the reported non-noble lectrocatalysts. This work provides a new approach for developing high-performance electrocatalysts for seawater splitting.

Preliminary evaluation of a scenario-based nutrition literacy online programme for college students: a pilot study.

OBJECTIVE: This study aimed to develop and evaluate a scenario-based nutrition literacy (NL) online programme for Taiwanese college students. DESIGN: A randomised pilot trial design was used in this study. SETTING: The study was conducted at a university in Taiwan. The intervention consisted of a five-unit web-based NL programme including videos of real-life scenario-based stories, situational analysis teaching and after-unit quizzes. Theme-related website information and smartphone apps (both iOS and Android systems) were offered for reference in every unit. The NL measure consisted of a self-rated scale, a scenario-based test and a healthy eating behaviour survey. Paired sample t-tests and ANCOVA were performed to test the effects on NL and healthy eating behaviour. PARTICIPANTS: Participants were ninety-eight students, with a retention rate of 98 %. The ratio of men to women was 0·2:1. Most students were freshmen (48 %). RESULTS: Compared with the control group, the experimental group showed significant post-intervention improvements in the NL and healthy eating behaviours after controlling for pretest scores. CONCLUSIONS: This pilot study offers preliminary evidence of the potential positive effects of implementing a scenario-based NL online programme for college students. It offers a possibly novel strategy to enhance health-promoting behaviours in Taiwanese universities. Further research with larger sample sizes and more rigorous designs is warranted to confirm and build upon these initial findings.

Burnout and Mental Health and Well-Being of School Nurses After the First Wave of the COVID-19 Pandemic: A National Cross-Sectional Survey.

The aim of this study was to examine the associations between job stressors, COVID-19-related concerns, burnout, and mental health and well-being among school nurses, and whether any of these associations are mediated by burnout. Based on stratified proportional sampling, data collection was conducted by an online questionnaire distributed to 600 school nurses in Taiwan. A total of 256 participants aged between 27 and 62 years (mean = 47.08; standard deviation = 7.28) returned questionnaires. Results showed that burnout was the main mediating variable that fully mediated the relationship between COVID-19-related concerns and mental health and well-being. The effects of job stressors on mental health and well-being included direct negative effects (ß = -.29) and indirect negative effects (ß = -.67) through mediating factors. School health managers should be more aware of burnout and mental health and well-being among school nurses under the impact of COVID-19.

Competence and Stress of Medication Administration Practices for School Nurses in K-12 Taiwan Schools.

We investigated school nurses' experiences, perceived government support, school nurses' acceptance of responsibility for medication administration, perceived stress, and perceived competence of medication administration and analyzed factors associated with perceived competence. In this cross-sectional study, from February to April 2023, we conducted an online survey of 269 school nurses serving at K-12 schools in Taiwan. The results revealed that although 71% of the participants had prior experience with medication administration, they reported low competence and high stress in areas such as drug interactions, adverse drug effects, and referrals. The school nurses' disagreement with responsibilities for medication administration emerged as the only factor to be significantly associated with perceived medication administration competence, accounting for 22.8% of the variance. We recommend implementing continuing training programs to provide school nurses with up-to-date medication information. Additionally, the development of practice guidelines is suggested as a means of enhancing nurses' competence and reducing their stress levels for the administration of medications.

Boosting Alkaline Hydrogen and Oxygen Evolution Kinetic Process of Tungsten Disulfide-Based Heterostructures by Multi-Site Engineering.

Alkaline water electrolysis is an advanced technology for scalable H2 production using surplus electricity from intermittent energy sources, but it remains challenging for non-noble electrocatalysts to split water into hydrogen and oxygen efficiently, especially for tungsten disulfide (WS2 )-based catalysts. Density functional theory calculations in combination with experimental study are used to establish a multi-site engineering strategy for developing robust WS2 -based hybrid electrocatalyst on mesoporous bimetallic nitride (Ni3 FeN) nanoarrays for bifunctional water splitting. This ingenious design endows the catalyst with numerous edge sites chemically bonded with the conductive scaffold, which are favorable for water dissociation and hydrogen adsorption. Benefiting from the synergistic advantages, the N-WS2 /Ni3 FeN hybrid exhibits exceptional bifunctional properties for hydrogen and oxygen evolution reactions (HER and OER) in base with excellent large-current durability, requiring 84 mV to afford 10 mA cm-2 for HER, and 240 mV at 100 mA cm-2 for OER, respectively. Assembling the catalytic materials as both the anode and cathode to construct an electrolyzer, it is actualized very good activities for overall water splitting with only 1.5 V to deliver 10 mA cm-2 , outperforming the IrO2 (+) //Pt(-) coupled electrodes and many non-noble bifunctional electrocatalysts thus far. This work provides a promising avenue for designing WS2 -based heterogeneous electrocatalysts for water electrolysis.

Engineering In-Plane Nickel Phosphide Heterointerfaces with Interfacial sp HP Hybridization for Highly Efficient and Durable Hydrogen Evolution at 2 A cm-2.

The catalytic hydrogen-evolving activities of transition-metal phosphides are greatly related to the phosphorus content, but the physical origin of performance enhancement remains ambiguous, and tuning the catalytic activity of nickel phosphides (NiP2 /Ni5 P4 ) remains challenging due to unfavorable H* adsorption. Here, a strategy is introduced to integrate P-rich NiP2 and P-poor Ni5 P4 into in-plane heterostructures by anion substitution, in which P atoms at the in-plane interfaces perform as active sites to adsorb H* and thus facilitate the hydrogen evolution reaction (HER) process via modulating the electronic structure between NiP2 and Ni5 P4 . Consequently, the NiP2 /Ni5 P4 hybrid exhibits an outstanding hydrogen-evolving activity, requiring only 30 and 76 mV to afford 10 and 100 mA cm-2 in acid, respectively. It surpasses most of the earth-abundant electrocatalysts thus far, and is comparable to Pt catalysts (30/72 mV at 10/100 mA cm-2 ). Particularly, it can run smoothly at large current density and only requires 247 mV to reach 2000 mA cm-2 . Detailed theoretical calculations reveal that its exceptional activity stems from the moderate overlap of density states between P 2p and H 1s orbitals, thus optimizing the H*-adsorption strength. This work highlights a new avenue toward the fabrication of robust non-noble electrocatalysts by constructing in-plane heterojunctions.

Edge-oriented N-Doped WS2 Nanoparticles on Porous Co3 N Nanosheets for Efficient Alkaline Hydrogen Evolution and Nitrogenous Nucleophile Electrooxidation.

Earth-abundant layered tungsten disulfide (WS2 ) is a well-known electrocatalyst for acidic hydrogen evolution, but it becomes rather sluggish for alkaline hydrogen or oxygen evolution due to the low-density edge sites, poor conductivity, and unfavorable water dissociation behavior. Here, an interfacial engineering strategy to construct an efficient bifunctional electrocatalyst by in situ growing N-doped WS2 nanoparticles on highly conductive cobalt nitride (N-WS2 /Co3 N) for concurrent hydrogen evolution reaction (HER) and urea oxidation reaction (UOR) is demonstrated. Benefiting from the good conductivity of Co3 N, rich well-oriented edge sites and water-dissociation sites at the nanoscale interfaces between N-WS2 and Co3 N, the resultant N-WS2 /Co3 N exhibits remarkable HER activity in 1 m potasium hydroxide (KOH) requiring a small overpotential of 67 mV at 10 mA cm-2 with outstanding long-term durability at 500 mA cm-2 , representing the best alkaline hydrogen-evolving activity among reported WS2 catalysts. In particular, this hybrid catalyst also shows exceptional catalytic activities toward theurea oxidation reaction featured by very low potentials of 1.378 and 1.41 V to deliver 100 and 500 mA cm-2 along with superb large-current stability in 1 m KOH + 0.5 m urea. Moreover, the assembled two-electrode cell delivers the industrially practical current density of 500 mA cm-2 at a low cell voltage of 1.72 V with excellent durability in alkaline urea-containing solutions, outperforming most MoS2 -like bifunctional electrocatalysts for overall water splitting reported hitherto. This work provides a promising avenue for the development of high-performance WS2 -based electrocatalysts for alkaline water splitting.

Delay discounting, time perspective, and self-schemas in adolescent alcohol drinking and disordered eating behaviors.

Delay discounting, time perspective, and self-schemas are well-known predictors of health risk behaviors among adolescents. However, the associations between these constructs and their influence on such behaviors are yet to be examined. This study aimed to determine the relationships among three cognitive constructs, namely, delay discounting, time perspective, and self-schemas, and determine the associations of these constructs with alcohol drinking (alcohol use and alcohol problems) and disordered eating behaviors in adolescents. Participants were 436 eighth-graders from three public junior high schools in southern Taiwan, who answered an anonymous questionnaire assessing self-schema, delay discounting, time perspective, and health risk behaviors. Generalized linear models with robust estimation were performed to estimate the effects; gender was the covariate. Delay discounting was associated with alcohol use (OR = 1.15), but not alcohol problems and disordered eating behaviors. Present-Hedonistic time perspective was associated with alcohol use (OR = 2.01), alcohol problems (IRR = 2.23), and disordered eating behaviors (Exp(b) = 1.38); while Future time perspective was associated with alcohol problems (IRR = 2.18). Drinker self-schema was associated with alcohol use (OR = 1.62) and alcohol problems (IRR = 1.71). Fat/overweight self-schema was associated with overall disordered eating (Exp(b) = 1.03). Thus, the findings suggest that each of the three constructs is independently associated with drinking and disordered eating behaviors, and these associations vary according to the specific type of behavior. Future research identifying the underlying mechanisms linking these constructs to the abovementioned behaviors can be useful for developing targeted intervention strategies.

Students' perceptions of school sugar-free, food and exercise environments enhance healthy eating and physical activity.

OBJECTIVE: The objective of this study was to examine the relationships between students' perceptions of their school policies and environments (i.e. sugar-sweetened beverages (SSB) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 programme (exercise 150 min/week at school)) and their dietary behaviours and physical activity. DESIGN: Cross-sectional study. SETTING: Primary, middle and high schools in Taiwan. PARTICIPANTS: A nationally representative sample of 2433 primary school (5th-6th grade) students, 3212 middle school students and 2829 high school students completed the online survey in 2018. RESULTS: Multivariate analysis results showed that after controlling for school level, gender and age, the students' perceptions of school sugar-free policies were negatively associated with the consumption of SSB and positively associated with consumption of plain water. Schools' campaigns promoting the eating of vegetables and fruit were positively associated with students' consumption of vegetables. In addition, schools' initiatives promoting outdoor physical activity and the SH150 programme were positively associated with students' engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. CONCLUSIONS: Students' perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.

Feasibility of Intervention Program to Prevent Adolescent Health-Compromising Behaviors.

Most people start experimenting with and/or initiating health-compromising behaviors and establishing behavioral patterns during adolescence. Possible selves and episodic future thinking have been used to foster behavioral changes. In this study, we aimed to (1) develop a program incorporating possible selves and episodic future thinking to decrease the risks associated with health-compromising behaviors, and (2) examine the feasibility and fidelity of implementing this intervention among Taiwanese adolescents. A novel combination of existing intervention approaches tailored for the Taiwanese context was applied to develop a school-based intervention, which we named the Future Mapping Master program. This program contains four core units: exploring the self, setting goals, developing strategies and problem solving, and understanding the threats of health-compromising behaviors. It includes daily episodic future thinking visualization exercises. The feasibility evaluation was conducted with 88 adolescents aged 12-14 years. Feedback from teachers and students supported the proposed program's feasibility and revealed favorable reactions to the intervention. The Future Mapping Master program is feasible and offers promising strategies for implementation in Taiwanese school settings.

Highly Robust Non-Noble Alkaline Hydrogen-Evolving Electrocatalyst from Se-Doped Molybdenum Disulfide Particles on Interwoven CoSe2 Nanowire Arrays.

Developing efficient non-noble and earth-abundant hydrogen-evolving electrocatalysts is highly desirable for improving the energy efficiency of water splitting in base. Molybdenum disulfide (MoS2 ) is a promising candidate, but its catalytic activity is kinetically retarded in alkaline media due to the unfavorable water adsorption and dissociation feature. A heterogeneous electrocatalyst is reported that is constructed by selenium-doped MoS2 (Se-MoS2 ) particles on 3D interwoven cobalt diselenide (CoSe2 ) nanowire arrays that drives the hydrogen evolution reaction (HER) with fast reaction kinetics in base. The resultant Se-MoS2 /CoSe2 hybrid exhibits an outstanding catalytic HER performance with extremely low overpotentials of 30 and 93 mV at 10 and 100 mA cm-2 in base, respectively, which outperforms most of the inexpensive alkaline HER catalysts, and is among the best alkaline catalytic activity reported so far. Moreover, this hybrid catalyst shows exceptional catalytic performance with very low overpotentials of 84 and 95 mV at 10 mA cm-2 in acidic and neutral electrolytes, respectively, implying robust pH universality of this hybrid catalyst. This work may provide new inspirations for the development of high-performance MoS2 -based HER electrocatalysts in unfavorable basic media for promising catalytic applications.

Increased Time Outdoors Is Followed by Reversal of the Long-Term Trend to Reduced Visual Acuity in Taiwan Primary School Students.

PURPOSE: To investigate the change in the prevalence of reduced visual acuity (VA) in Taiwanese school children after a policy intervention promoting increased time outdoors. DESIGN: Prospective cohort study based on the Taiwan School Student Visual Acuity Screen (TSVAS) by the Ministry of Education in Taiwan. PARTICIPANTS: All school children from grades 1 through 6 were enrolled in the TSVAS from 2001 through 2015. METHODS: The TSVAS requires each school in Taiwan to perform measurements of uncorrected VA (UCVA) on all students in grades 1 through 6 every half year using a Tumbling E chart. Reduced VA was defined as UCVA of 20/25 or less. Data from 1.2 to 1.9 million primary school children each year were collected from 2001 through 2015. A policy program named Tian-Tian 120 encouraged schools to take students outdoors for 120 minutes every day for myopia prevention. It was instituted in September 2010. To investigate the impact of the intervention, a segmented regression analysis of interrupted time series was performed. MAIN OUTCOME MEASURES: Prevalence of reduced VA. RESULTS: From 2001 to 2011, the prevalence of reduced VA of school children from grades 1 through 6 increased from 34.8% (95% confidence interval [CI], 34.7%-34.9%) to 50.0% (95% CI, 49.9%-50.1%). After the implementation of the Tian-Tian 120 outdoor program, the prevalence decreased continuously from 49.4% (95% CI, 49.3%-49.5%) in 2012 to 46.1% (95% CI, 46.0%-46.2%) in 2015, reversing the previous long-term trend. For the segmented regression analysis controlling for gender and grade, a significant constant upward trend before the intervention in the mean annual change of prevalence was found (+1.58%; standard error [SE], 0.08; P < 0.001). After the intervention, the trend changed significantly, with a constant decrease by -2.34% annually (SE, 0.23; P < 0.001). CONCLUSIONS: Policy intervention to promote increased time outdoors in schools was followed by a reversal of the long-term trend toward increased low VA in school children in Taiwan. Because randomized trials have demonstrated outdoor exposure slowing myopia onset, interventions to promote increased time outdoors may be useful in other areas affected by an epidemic of myopia.

Effects of a healthy-eater self-schema and nutrition literacy on healthy-eating behaviors among Taiwanese college students.

Unhealthy eating behaviors contribute to obesity and chronic illness. This study examined the relative contributions of a healthy-eater self-schema (a self-conception as a healthy eater) and nutrition literacy on healthy-eating behaviors and whether nutrition literacy was a mediator among Taiwanese college students. A total of 1216 undergraduate students from six universities in Taiwan participated in the study from April to June 2016. Healthy-eating behaviors, nutrition literacy, healthy-eater self-schema and known determinants of eating behaviors (e.g. nutrition-related information, health status, nutrition knowledge needs, sex, year in college and residence) were measured by a self-report questionnaire. A hierarchical multiple regression and mediation analysis were conducted with the known determinants of eating behaviors as covariates. Results showed that a healthy-eater self-schema and nutrition literacy explained 9% and 12% of the variance in healthy-eating behaviors, respectively, and both had unique effects on healthy-eating behaviors. The effect of a healthy-eater self-schema on healthy-eating behaviors was partially mediated through nutrition literacy. Findings suggest that both a healthy-eater self-schema and nutrition literacy should be considered when promoting healthy-eating behaviors. Additionally, nutrition literacy interventions should be tailored to the healthy-eater self-schema status and emphasize the personal relevance of being a healthy-eater to improve the intervention's effectiveness.

Vision Improvement and Compliance With the Use of Orthokeratology Lenses in School Children: A Sample From Five Primary Schools in Northern Taiwan.

PURPOSE: To assess the visual acuity and compliance with the use of orthokeratology lenses (OrthoK) in school children. METHODS: A retrospective study was conducted to determine the education-related factors influencing the improvement in visual acuity in myopic students using OrthoK in five primary schools in Taiwan. RESULTS: Of the 5,173 eligible students from five primary schools, 1906 (36.8%) students were diagnosed with myopia. Among 201 (10.6%) students wearing OrthoK, 69.7% had used them for at least 1 year, 53.2% achieved visual acuity greater than 0.8 (6/7.5, log of minimal angle of resolution 0.1) in school, and 49.8% had received health education related to OrthoK care. Multiple logistic regression analysis showed that a higher possibility to achieve visual acuity greater than 0.8 was associated with more than 1-year use of OrthoK, good compliance, and receiving health education from an ophthalmologist. CONCLUSION: It is important that children wearing OrthoK receive education and comply with the use of OrthoK for visual acuity improvement.

The prevalence of self-reported premenstrual symptoms and evaluation of regular exercise with premenstrual symptoms among female employees in Taiwan.

Few studies have focused on premenstrual symptoms in employees. This study explored the prevalence of premenstrual symptoms in 7,193 female employees aged 18-55 years in a large electronics manufacturer in Taiwan from August 2014 to December 2014 and examined whether regular exercise was associated with premenstrual symptoms. Information was collected on demographics, lifestyle, menstrual history, menstrual pain, and premenstrual symptoms. Half of the participants reported irregular menstruation; 79.4% reported a moderate menstruation amount, and half reported little impact of menstrual pain at work. In order of prevalence, symptoms were "easy to fatigue" (24%), "backache" (21.2%), and "abdominal bloating" (17.4%). Participants who engaged in regular exercise reported fewer backaches (adjusted odds ratio [aOR] = 0.79, 95% confidence interval [CI] = 0.68-0.91), somatic discomfort (aOR = 0.78, 95% CI = 0.63-0.96), headache (OR = 0.82, 95% CI = 0.69-0.98), diarrhea (aOR = 0.76, 95% CI = 0.60-0.96), constipation (aaOR = 0.59, 95% CI = 0.44-0.78), less irritability (aOR = 0.78, 95% CI = 0.65-0.94), feeling morose and depressed (aOR = 0.75, 95% CI = 0.58-0.95), crying (aOR = 0.51, 95% CI = 0.27-0.87), and emotional lability (aOR = 0.73, 95% CI = 0.58-0.91). Regular exercise was associated with decreased menstrual pain (aOR = 0.85, 95% CI = 0.76-0.96). Our findings provide a better understanding of premenstrual symptoms in female workers, allowing for the development of premenstrual health programs to improve their health and quality of life.

Health literacy and the determinants of obesity: a population-based survey of sixth grade school children in Taiwan.

BACKGROUND: Health literacy has become an important health policy and health promotion agenda item in recent years. It had been seen as a means to reduce health disparities and a critical empowerment strategy to increase people's control over their health. So far, most of health literacy studies mainly focus on adults with few studies investigating associations between child health literacy and health status. This study aimed to investigate the association between health literacy and body weight in Taiwan's sixth grade school children. METHODS: Using a population-based survey, 162,209 sixth grade (11-12 years old) school children were assessed. The response rate at school level was 83%, with 70% of all students completing the survey. The Taiwan child health literacy assessment tool was applied and information on sex, ethnicity, self-reported health, and health behaviors were also collected. BMI was used to classify the children as underweight, normal, overweight, or obese. A multinomial logit model with robust estimation was used to explore associations between health literacy and the body weight with an adjustment for covariates. RESULTS: The sample consisted of 48.9% girls, 3.8% were indigenous and the mean BMI was 19.55 (SD = 3.93). About 6% of children self-reported bad or very bad health. The mean child health literacy score was 24.03 (SD = 6.12, scale range from 0 to 32). The overall proportion of obese children was 15.2%. Children in the highest health literacy quartile were less likely to be obese (12.4%) compared with the lowest quartile (17.4%). After controlling for gender, ethnicity, self-rated health, and health behaviors, children with higher health literacy were less likely to be obese (Relative Risk Ratio (RRR) = 0.94, p < 0.001) and underweight (RRR = 0.83, p < 0.001). Those who did not have regular physical activity, or had sugar-sweetened beverage intake (RRR > 1.10, p < 0.0001) were more likely to report being overweight or obese. CONCLUSIONS: This study demonstrates strong links between health literacy and obesity, even after adjusting for key potential confounders, and provides new insights into potential intervention points in school education for obesity prevention. Systematic approaches to integrating a health literacy curriculum into schools may mitigate the growing burden of disease due to obesity.