High prevalence of fatty liver and its association with metabolic syndrome among rural adults with chronic hepatitis C: Implications for primary healthcare.

BACKGROUND: Chronic hepatitis C (CHC) virus infection is a global health concern that is associated with significant liver-related morbidity and mortality. Owing to the inflammatory pathway, CHC can causefatty liver, liver cirrhosis, and liver cancer and is associated with cardiometabolic diseases, such as hypertension and diabetes. Fatty liver is associated with metabolic disorders, cardiovascular diseases, diabetes, and liver cancer. Hence, the early detection of fatty liver through noninvasive screening in adults with CHC is important in primary healthcare settings. This study aimed to explore the prevalence of fatty liver and its association with metabolic syndrome amongrural adults with CHC. METHODS: This was a series of cohort studies related to the elimination of the CHC burden around the western coastal Yunlin County, Taiwan, between August 2018 and July 2021. A cross-sectional study was conducted after hepatitis C virus RNA confirmation in a hepatitis C- endemic area. A gastrointestinal physician or radiologist assessed fatty liver by ultrasonography. Fatty liver was classified into four grades: normal, mild, moderate, and severe. Three liver enzyme biomarkers were identified. According to the Taiwan national standard, metabolic syndrome was defined based on the presence of three or more of the five abnormal biomarkers, including increased waist circumference, elevated blood pressure, elevated fasting blood glucose level, elevated triglyceride level, and low high-density lipoprotein cholesterol level. RESULTS: A total of 256 rural adults with CHC were enrolled. The mean age of the participants was 67.5 (standard deviation = 11.8) years, with a low educational level. High prevalence of fatty liver (79%), central obesity (54.3%), elevated blood pressure (55.5%),elevated fasting blood glucose (FBG) level (44.9%), and metabolic syndrome (37.9%) were observed.The results showed that adults with CHC with moderate to severe fatty liver were significantly associated with an increased risk of increased waist circumference (P < 0.001), increased blood pressure (P < 0.001), low high-density lipoprotein cholesterol level (P < 0.05), and elevated liver enzyme biomarker levels (all P < 0.05) after adjusting for age, sex, and educational level. Furthermore, adults with CHC with moderate to severe fatty liver were significantly associated with a greater risk of metabolic syndrome (odds ratio = 2.85, 95% confidence interval = 1.66 to 4.92). CONCLUSIONS: The findings demonstrate a high prevalence of fatty liver in rural adults with CHC, which is significantly associated with obesity, metabolic syndrome, and elevated liver biomarker levels. Clinicians and primary healthcare providers must encourage patients with CHC to receive antiviral therapy combined with weight loss management and lifestyle modification, allowing general improvements in their liver and cardiometabolic health.

The Causes, Counseling, and Prevention Strategies for Maladaptive and Deviant Behaviors in Schools.

Governments, organizations, and schools around the world are committed to creating a safe and friendly campus environment to ensure students' high-quality comprehensive development and to cultivate positive mental and physical health states [...].

High Prevalence of Cardiometabolic Risks and Health Needs Among Patients With Hepatocellular Carcinoma After Treatment: A Cross-sectional Study.

BACKGROUND: Many studies have indicated that inadequate health-related behavior is associated with the progression of cancer and cardiometabolic disorders. Because patients with hepatocellular carcinoma may adopt inadequate health behaviors, they are at risk for cancer recurrence, mortality, cardiometabolic disease progression, and worse quality of life. OBJECTIVE: To explore the prevalence of cardiometabolic risks and health-promoting behaviors associated with quality of life among patients with hepatocellular carcinoma after treatment. METHODS: A cross-sectional study was conducted from October 2021 to August 2022. Data were collected through face-to-face interviews using a structured questionnaire, and cardiometabolic information was recorded from medical charts. RESULTS: In total, 115 patients with liver cancer after treatment were enrolled; 73% were male. The mean age was 67.7 years, and high prevalence rates of central obesity (72.2%) and metabolic syndrome (47%) were noted. Inadequate exercise, oral hygiene, and cigarette smoking were common. The health-promoting score was significantly associated with exercise, the number of remaining teeth, and metabolic syndrome, which correlated with quality of life, including positive functional and negative symptoms dimensions. CONCLUSIONS: The findings demonstrated a high prevalence of cardiometabolic risks and inadequate health-related behaviors among patients with liver cancer after treatment. This study highlights the need for healthcare providers to help patients increase health literacy for preventing cardiometabolic risks at outpatient clinics. IMPLICATIONS FOR PRACTICE: Findings from this study can be used to advise healthcare providers to educate patients with liver cancer during and after treatment on improving their health-promoting behaviors.

The prevalence of chronic dehydration and associated with cardiometabolic risks among agriculture and aquaculture workers.

Background: Chronic dehydration is associated with complications and mortality in acute ischemic stroke patients. Prior literature indicates that farmers and fishery workers are commonly affected by cardiometabolic diseases and there is a need for early prevention of stroke. This study explores the prevalence of dehydration and the association of cardiometabolic risk profiles in agricultural and aquaculture workers. Methods: We conducted a community-based, cross-sectional study of agriculture and aquaculture workers in Yunlin County of Taiwan between August 1 and December 31, 2021. Data on demographic characteristics and health-related lifestyles were collected through one-on-one interviews using a questionnaire. The threshold for dehydration is defined as serum osmolality ≥295 mOsm/kg, and physiological biomarkers were collected from a collaborating hospital. Multivariable logistic regression analyses adjusted for demographic characteristics were performed to investigate the association between dehydration levels, cardiometabolic risks, and health-related behaviors. Results: A total of 962 Taiwanese agriculture and aquaculture workers who were predominantly women (65%) with a mean age of 64 years (SD = 13.8) were enrolled. The findings showed a high prevalence of dehydration (36%), metabolic syndrome (44.5%), abnormal waist circumference (64.4%), and abnormal blood pressure (68.5%). Multivariate logistic regression demonstrated that dehydration was significantly associated with metabolic syndrome (p < 0.001), 10-year stroke risk prediction (p < 0.001), and an unhealthy lifestyle (p < 0.001). Conclusion: The prevalence of chronic dehydration was higher in Taiwanese agriculture and aquaculture workers, which was significantly associated with cardiometabolic risks and unhealthy lifestyles.

A Novel Salivary Sensor with Integrated Au Electrodes and Conductivity Meters for Screening of Diabetes.

The rise in diabetes cases is a growing concern due to the aging of populations. This not only places a strain on healthcare systems but also creates serious public health problems. Traditional blood tests are currently used to check blood sugar levels, but they are invasive and can discourage patients from regularly monitoring their levels. We recently developed nano-sensing probes that integrate Au microelectrodes and conductivity meters, requiring only 50 µL of saliva for measurement. The usage of the co-planar design of coating-free Au electrodes makes the measurement more stable, precise, and easier. This study found a positive correlation between the participant's fasting blood sugar levels and salivary conductivity. We observed a diabetes prevalence of 11.6% among 395 adults under 65 years in this study, using the glycated hemoglobin > 6.5% definition. This study found significantly higher salivary conductivity in the diabetes group, and also a clear trend of increasing diabetes as conductivity levels rose. The prediction model, using salivary conductivity, age, and body mass index, performed well in diagnosing diabetes, with a ROC curve area of 0.75. The study participants were further divided into low and high groups based on salivary conductivity using the Youden index with a cutoff value of 5.987 ms/cm. Individuals with higher salivary conductivity had a 3.82 times greater risk of diabetes than those with lower levels, as determined by the odds ratio calculation. In conclusion, this portable sensing device for salivary conductivity has the potential to be a screening tool for detecting diabetes.

Association between serum carcinoembryonic antigen and cardiometabolic risks: Implication for cardiometabolic prevention.

Background: Serum carcinoembryonic antigen (CEA) is a biomarker commonly used to detect colorectal cancer. CEA levels are affected by many factors, including cardiometabolic diseases, such as cardiovascular diseases (CVDs) and diabetes. Cardiometabolic diseases and cancer share a similar pathological inflammatory pathway, which correlates with an unhealthy lifestyle. Hence, establishing an adequate CEA cut-off value might be a valuable reference for developing precision healthcare programs for cardiometabolic disease prevention. This study aimed to investigate the association between cardiometabolic risks and serum CEA and the underlying factors. Methods: A community-based, cross-sectional study was conducted between March and December 2021 on the western coast of Taiwan. Lifestyle data were assessed using a structured questionnaire. The cardiometabolic biomarkers, serum CEA, urine malondialdehyde, and 1-hydroxypyrene were quantified by the central laboratory of the collaborating hospital. Chi-square and binary multivariable logistic regression implemented in R version 4.0.2 were used to identify factors defining the risk of high serum CEA levels. Results: A total of 6,295 adult residents without cancer-related diseases completed the study. The mean age was 48.6 (SD = 16.4) years, 56% were female, 32% had metabolic syndrome, and 23% and 10% had CVDs and diabetes, respectively. Multivariate logistic regression showed that age ≥ 65 years, male sex, alcohol consumption, smoking, infrequent use of dental floss, fewer remaining teeth, CVDs, diabetes, and oxidative stress were significantly associated with serum CEA ≥ 3 ng/mL. The discriminatory performance of the area under the receiver operating characteristic curve was 0.75 (0.73-0.76), showing that this model was suitable for distinguishing high CEA levels. Conclusion: Our findings highlight the importance of understanding cardiometabolic diseases, unhealthy lifestyles, and oxidative stress, which contribute to high serum CEA. This study demonstrates that CEA, a well-known tumor marker, can help the early detection and prevention of cardiometabolic diseases via personalized lifestyle modification.

Effects of far-infrared radiation lamp therapy on recovery from muscle damage induced by eccentric exercise.

The present study investigated the effects of a far-infrared radiation (FIR) lamp therapy on changes in muscle damage and proprioception markers after maximal eccentric exercise of the elbow flexors (EF: Study 1) and the knee flexors (KF: Study 2) in comparison to a sham treatment condition. In each study, 24 healthy sedentary women were assigned to a FIR or a sham treatment group (n = 12/group). They performed 72 maximal EF eccentric contractions (Study 1) or 100 maximal KF eccentric contractions (Study 2) with their non-dominant limbs. They received a 30-min FIR (wavelength: 8-14 µm) or sham treatment at 1, 25, 49, 73 and 97 h post-exercise to the exercised muscles. Maximum voluntary isometric contraction (MVC) torque, muscle soreness, plasma creatine kinase activity, and proprioception assessed by position sense, joint reaction angle, and force match were measured before, and 0.5, 24, 48, 72, 96 and 120 h post-exercise. The outcome measures showed significant changes (P < 0.05) at 0.5-hour post-exercise (before treatment) similarly (P > 0.05) between the conditions in both studies. However, changes in all measures at 24-120 h post-exercise were smaller (P < 0.05) for the FIR than sham condition in both studies. For example, MVC torque returned to the baseline by 72 h post-exercise for the FIR condition in both studies, but was still 19 ± 6% (Study 1) or 17 ± 12% (Study 2) lower than the baseline at 120 h post-exercise for the sham condition. These results suggested that the FIR lamp therapy was effective for accelerating recovery from muscle damage.

FIR lamp therapy was effective for recovering muscle strength and proprioception 1­3 days faster to the baseline.FIR lamp therapy was effective for attenuating muscle soreness by 55­60%, and reducing peak plasma CK activity by 45­89%.The effects of the FIR lamp therapy appear to be greater than other therapeutic interventions for eccentric exercise-induced muscle damage that have been investigated previously.

From self-care behaviours to cardiometabolic risks prevention for the health of farmers: Nursing implications.

AIMS: The study aimed to explore farmers' self-care behaviours including oral hygiene, remaining natural teeth, cardiometabolic risks, hepatitis, risk of stroke and their determinant factors. METHODS: This cross-sectional study was conducted between June 2020 and March 2021 in the south-western remote areas of Taiwan. We recruited current farmers who participated in an annual community health screening conducted by a collaborated local hospital. Data were collected through face-to-face interviews using a semi-structured questionnaire. Blood samples were drawn and stored in the central laboratory of the cooperating hospital. The study outcomes included cardiometabolic risks, the remaining natural teeth, and farmers' self-care behaviours including oral hygiene, adopting a healthy diet and substance use. RESULTS: Overall, 183 current farmers (55.2% women, aged 66.9 ± 11.7 years) were enrolled. Abnormal blood pressure, high risk of stroke, metabolic syndrome and hepatitis C virus infection were found among the participants. The average remaining teeth were 12.1, 73.2% of participants had <20 teeth; 90.2% and 71% did not undergo regular dental check-ups and scaling or use dental floss, respectively. The determinant factors associated with the remaining teeth included a high risk of stroke, teeth scaling and dental floss use. Although only 3.8% felt mentally distressed, many farmers were unaware of having potential cardiometabolic diseases and curable viral hepatitis, and only two had received antiviral treatment. CONCLUSION: The farmers in this study had a high prevalence of cardiometabolic risks, a high probability of stroke, inadequate number of remaining teeth and poor oral hygiene behaviours. These findings can provide evidence to develop health promotion programmes for farmers. IMPACT: This study demonstrates the health needs of farmers. We strongly recommend that community nurses empower farmers to engage in self-care behaviours through tailored health promotion programmes. For instance, by discussing cardiometabolic risk prevention from the farmers' perspectives to improve their health literacy.

Association between viral hepatitis and metabolic syndrome in lung function impairment: A Taiwan community-based study.

OBJECTIVES: Metabolic syndrome (MetS) and hepatitis C virus (HCV) are associated with a higher risk of impaired pulmonary function (iPF). This study aimed to investigate the relationships among MetS, iPF, and viral hepatitis. METHODS: This community-based study enrolled participants undergoing annual health check-ups in southern Taiwan between March and December 2019. We performed multivariable logistic regression analyses adjusted for demographics and characteristics to identify the factors associated with iPF. RESULTS: A total of 2337 participants completed examinations, of whom 928 (39.7%) had iPF. The participants with iPF were elderly (68.8 ± 12.8 years old) and predominately female (63%). MetS increased the risk of iPF (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.27-1.81, p < 0.001). Beyond age (OR 1.03, 95% CI 1.02-1.04) and smoking (OR 1.309, 95% CI 1.004-1.705), female sex (OR 0.74, 95% CI 0.59-0.93) and high education level (OR 0.96, 95% CI 0.94-0.98, p < 0.001) protected against iPF. HCV was not significantly associated with iPF (OR 1.17, 95% CI 0.90-1.52, p = 0.235) in multivariable analysis. MetS was associated with a higher risk of iPF in the non-HBV/HCV group (OR 1.86, 95% CI 1.54-2.26) and HBV alone group (OR 3.44, 95% CI 1.89-6.28), but not in the HCV alone group (OR 1.02, 95% CI 0.64-1.62). DISCUSSION: MetS was an independent predictor of iPF, especially the restrictive type, and had different effects in the HBV/non-viral hepatitis and HCV groups. Female sex and education were inversely associated with iPF.

A novel nomogram for predicting cardiometabolic diseases from modifiable risks in middle-aged adults-implication for health education.

Background: Middle-aged adults often overlook critical modifiable risk factors that contribute to the emergence of cardiometabolic diseases (CMDs), including hypertension and diabetes. Many CMDs can be alleviated by addressing these modifiable risks. However, there has been insufficient research focused on rural adults with lower levels of health literacy in this regard. The aim of this study was to explore and develop an intuitive assessment tool for predicting cardiometabolic diseases (CMDs), which can be used for health education with adults of low health literacy. Methods: This was a community-based, cross-sectional study. A structured questionnaire on health-promoting habits, smoking, sleep, and physiological biomarkers was obtained via community health screening in the coastal region of Yunlin County, Taiwan. Multivariate logistic regression was used to screen for significant variables in the nomogram construction. Analysis with nonlinear restricted cubic spline was performed. Results: A total of 712 participants (60.9% females) aged 40-64 years, with middle school level or lower education, were included. The average age was 55.6 years (SD=7.3), and 220 individuals (31%) had CMDs. Multivariate logistic regression analysis revealed that age, lower scores of vegetables, fruit, water, and exercise (VFWE), smoking history, sleep deprivation, and being overweight were significantly associated with CMDs. The model incorporating these modifiable risk factors demonstrated good discriminatory ability, as indicated by an area under the receiver operating characteristic curve of 0.75 (0.73-0.76). A predictive nomogram was developed that presented modifiable risk factors in a simple graphical format to facilitate the prediction of CMDs. Conclusions: This study highlights a high prevalence of CMDs among middle-aged adults, along with the disregard for important risk factors that could be modified. The developed nomogram could be a practical and effective tool for community health education to enhance health literacy and prevent the progression of CMDs.

Effectiveness of Smoking Prevention Programs on the Knowledge, Attitudes, and Anti-Smoking Exposure Self-Efficacy among Non-Smoking Rural Seventh-Grade Students in Taiwan.

The disproportionate smoking prevalence among adolescents in rural Taiwan may be attributed to insufficient anti-smoking education. Increasing access to such education may help reduce initiation and promote smoking cessation in adolescents, particularly in rural areas. However, effects of these programs require verification. This study determined the effectiveness of a school-based prevention program in enhancing knowledge, attitudes, and anti-smoking exposure self-efficacy among seventh-grade non-smoking students. A quasi-experimental design with convenience sampling was employed, where participants included seventh graders from two junior high schools who completed a questionnaire 1−2 weeks before and after the intervention. Furthermore, the intervention group received four smoking and secondhand smoke (SHS) prevention classes, whereas the control group engaged in scheduled school activities. Knowledge on smoking (B = 4.38, p < 0.001) and SHS (B = 2.35, p < 0.001) were significantly greater in the intervention group. Moreover, the groups differed significantly in avoiding SHS exposure (B = 3.03, p = 0.031). Intervention modifications may be necessary to enhance the program's effect on smoking exposure-related attitudes and self-efficacy. Additionally, cultural and other aspects (or "urban-rural gap") might influence these results. Future randomized controlled trials should compare urban to rural adolescents, use longitudinal designs, and assess smoking initiation or cessation.

Health Inequality among Fishery Workers during Climate Change: A National Population-Based and Retrospective Longitudinal Cohort Study.

Background: Owing to specific working environments, it is important to attain sustainable development goals for the health of fishery workers during climate change. Fishery workers have a hazardous working environment, leading to specific injuries and fatal events. However, limited studies have investigated the health status of fishery workers through long-term longitudinal follow-up and compared it with that of farmers and employed workers with similar socioeconomic status. Methods: The Longitudinal Health Insurance Database 2000, a subset of the Taiwan National Health Insurance Research Database was used for this retrospective cohort study. Only fishery workers, farmers, and employed workers were included. Based on the majority of causes of death and related diseases, participants newly diagnosed with 18 diseases, classified into cardiometabolic diseases, mental illness, chronic kidney disease, infection, and malignancy, were included. Participants with an old diagnosis of these diseases were excluded. All included participants were followed up from 1 July 2000 to the diagnosis and withdrawal date, or 31 December 2012, whichever occurred first. Due to the substantial difference in the baseline demographics, we executed a cohort study with propensity score-matched and applied the Cox model to explore the participants' health status. Results: After matching, there were negligible differences in the baseline demographics of fishery workers, farmers, and employed workers. Compared to farmers and employed workers, fishery workers were more frequently diagnosed with 11 and 14 diseases, respectively, such as hypertension (hazard ratio [HR]: 1.11, p < 0.01), diabetes (HR: 1.21, p < 0.001), dyslipidemia (HR: 1.18, p < 0.001), depression (HR: 1.38, p < 0.001), peptic ulcer (HR: 1.17, p < 0.001), chronic viral hepatitis (HR: 2.06, p < 0.001), hepatocellular carcinoma (HR: 1.67, p < 0.001), and total malignancy (HR: 1.26, p < 0.001). Conclusions: Compared to farmers and employed workers, fishery workers were more impacted by cardiometabolic diseases, mental illness, infection, and malignancy. Therefore, it is imperative to specifically focus on health policies for fishery workers, such as providing curable antiviral treatment and initiating culture-tailored health promotion programs, to mitigate health inequality.

Alanine aminotransferase to aspartate aminotransferase ratio and hepatitis B virus on metabolic syndrome: a community-based study.

Background: The serum aminotransferase elevation in metabolic syndrome (MetS) reflected hepatosteatosis, but there is a conflict with the coexistence of viral hepatitis, especially for the hepatitis B virus (HBV). Thus, this study aimed to investigate the relationship between the alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio, MetS, and HBV infection in a rural Taiwanese population. Methods: We conducted a cross-sectional analysis in southern Taiwan between March and December 2019. Multivariable logistic regression analyses adjusted for demographics, education, dietary behaviors, irregular exercise, substance use, and viral markers were performed to investigate the association between the ALT/AST ratio and MetS. Results: Altogether, 2,416 participants (891 men and 1,525 women; mean age, 64.1 ± 14.9 years) were enrolled. Of the participants, 22.7% (n = 519) were seropositive for viral hepatitis. In the multivariable analysis, age [odds ratio (OR) 1.02, 95% CI 1.01-1.03, p < 0.001], ALT/AST ratio >1 (OR 2.63, 95% CI 2.15-3.21, p < 0.001), education (OR 0.96, 95% CI 0.94-0.98, p < 0.001), and HBV seropositivity (OR 0.70, 95% CI 0.52-0.95, p = 0.021) were associated with the risk of MetS. The area under the curve of the ALT/AST ratio was 0.62 (95% CI 0.60-0.64, p < 0.001), and the cutoff value was >0.852 for the Youden index. Conclusion: An ALT/AST ratio >1 could be a simple index for MetS prediction during community checkups. In contrast to age and betel nut chewing, HBV seropositivity and higher education might be inversely associated with MetS. Aggressive health promotion for MetS prevention has emerged as essential in participants without HBV and with lower education levels. Further large-scale, longitudinal studies are needed to unlink these correlations.

The Relationship of Social Media Addiction With Internet Use and Perceived Health: The Moderating Effects of Regular Exercise Intervention.

The popularity of online social media in recent years has not only brought information and social convenience to people's lives, but has also given rise to many problems, among which social media addiction (SMA) has become a concern of many scholars and experts. Past research has shown that regular exercise (REx) can have many health benefits for the body, so numerous scholars and experts believe that this may be one possible strategy for reducing the health effects of online community addiction and Internet use (IU). Therefore, this study adopted a secondary data research approach to explore and predict the effect of age on social media use and personal health, and therefore included age as a control variable to investigate whether the intervention of REx, excluding the effect of age, moderates the effect of SMA on IU and on perceived health (PH). The participants of this study were adults aged 18 years or older in Taiwan, using the 2019 "Survey Research Data Archive," Vol. 7, No. 5 data. A total of 1,933 questionnaires were retrieved, and after elimination of invalid responses, 1,163 data were analyzed using Partial Least Squares Structural Equation Modeling, PLS-SEM. The results were as follows: (1) SMA positively affected IU, (2) SMA could negatively affect PH, (3) there was no statistical effect of IU on PH, (4) SMA did not indirectly affect PH through IU, (5) REx had a moderating effect on SMA and IU, and (6) REx did not regulate the effect of SMA on PH. First, from these results, it is clear that the negative health effects of SMA may not be simply due to prolonged IU. Secondly, while it is true that the moderating effect for people with low levels of SMA can reduce IU, for people with high levels of SMA, the moderating effect of REx becomes a catalyst for increased Internet usage behavior. Finally, we draw conclusions based on the results of the study and propose directions and recommendations for follow-up research.

The Relationship of Breathing and COVID-19 Anxiety When Using Smart Watches for Guided Respiration Practice: A Cross-Sectional Study.

COVID-19 mortality rates are increasing worldwide, which has led to many highly restrictive precautionary measures and a strong sense of anxiety about the outbreak for many people around the world. There is thus an increasing concern about COVID-19 anxiety, resulting in recommending approaches for effective self-care. From a positive psychology perspective, it is also important for people to have positive affect when dealing with this pandemic. According to previous literature, respiration is considered to be an effective way to enhance people's mental health. Among all the wearable devices, Apple Watch has the largest market share, so this study recruited Chinese users that use respiration exercise function on Apple Watch; a total of 316 valid data were retrieved. Meanwhile, to understand one approach related to using Apple Watch to practice respiration to reduce COVID-19 anxiety about being infected during the COVID-19 outbreak, this study used a web-based cross-sectional survey to examine anxiety about being infected by COVID-19 among Chinese people who had been using the Apple Watch to practice respiration during the period of the COVID-19 outbreak. The study was based on the Health Theoretical Model, and the model was developed with four dimensions and was validated with structural equation modeling. The results of this study showed that practicing few minutes had a positive relationship on positive attitude, and positive attitude had a negative relationship on pandemic anxiety and a positive relationship on continuance use intention. Anxiety about the pandemic had a negative relationship on the intention to continue using the function. This showed that respiration practice can help to suppress the increase in anxiety levels regarding this pandemic.

Effects of Short Video Addiction on the Motivation and Well-Being of Chinese Vocational College Students.

While media use can be beneficial in some ways, excessive use of media has led to growing concerns about its potential negative consequences. With the popularity of Chinese video applications (apps) such as DouYin, TikTok, Kwai, and other short video apps sweeping through schools around the world. Due to the diversity and immersion principle of short videos, their popularity continues to grow, and the phenomenon of students being addicted to short videos also brings many hidden dangers to the learning effect. Among other things, the problem of excessive use of the Internet among Chinese youth has led the government to propose a series of control policies to strengthen the monitoring of harmful habits of youth in the use of online applications. In addition, the problem of youth addiction to short videos has become a major concern for education experts and the general public, thus demonstrating that short video addiction is indeed an ongoing research issue. Therefore, this study aimed to understand the causes of short-form video addiction and its impact on the psychology of learning, and to investigate the relationship between short-form video flow experience, short-form video addiction, intrinsic and extrinsic learning motivation, and learning well-being from the perspectives of flow experience theory and micro ecological systems. The questionnaire was sent via instant messaging software such as QQ and WeChat, and university students from vocational colleges in China were invited to complete the questionnaire. A total of 517 valid data were collected, including 222 (42.9%) were male students and 295 (57.1%) were female students. The collected questionnaires were analyzed for reliability and validity after removing incomplete data, followed by structural equation modeling for model verification. The findings showed that: (1) short video flow experience had a positive effect on short video addiction; (2) short video addiction had a negative effect on intrinsic and extrinsic learning motivation; (3) intrinsic and extrinsic learning motivation had a positive effect on learning well-being; (4) short video flow experience had an indirect negative effect on intrinsic and extrinsic learning motivation; (5) short video flow and short video addiction had indirect negative effects on learning well-being. According to the results, it is clear that addiction to short videos has a negative impact on learners' learning motivation and positive psychology of learning, so parents and teachers should effectively guide students to use short video apps in a self-controlled way.

A parsimonious and comprehensive screening tool for adult health behaviors.

BACKGROUND: A practical screening tool for early detection of unhealthy behaviors among adults to provide tailored care can have an important role in public health nursing. PURPOSE: To develop a screening tool with valid psychometric properties for adult health behaviors (AHBs). METHODS: A cross-sectional study was conducted between March 2018 and September 2019 in central-southern Taiwan. The AHBs development included qualitative and quantitative measurement of items based on literature reviews and expert opinion and exploration and confirmatory factor analysis. RESULTS: A total of 765 community adult participants: 377 women and 388 men, with a mean age of 39.3 (SD = 10.6), ranging from 20 to 64 years completed the AHBs screening tool. Analysis of the 23-items AHBs scale identified six dimensions - stress management, physical activity, health responsibility, life appreciation, healthy eating, and oral hygiene accounting for 67.3% of the variance. Total scale scores were significantly associated with a criterion variable of life satisfaction. CONCLUSION: The AHBs scale is a suitable screening tool that can be used to identify adults' unhealthy behaviors early, which is useful for public health nurses to conduct a regular assessment and initiate individualized health programs.

The Impact of Hepatitis C Virus, Metabolic Disturbance, and Unhealthy Behavior on Chronic Kidney Disease: A Secondary Cross-Sectional Analysis.

BACKGROUND: Hepatitis C virus (HCV) infection is associated with a higher risk of chronic kidney disease (CKD). This study investigates the relationship among HCV, CKD, and understudied confounders, such as unhealthy behaviors and metabolic disturbances. METHODS: This cross-sectional study was conducted as part of a community health promotion program in an HCV endemic area of Taiwan from June to December 2019. Multivariable logistic regression analyses adjusted for demographic and clinical characteristics were performed to investigate the association between CKD and HCV seropositivity. RESULTS: Of 2387 participants who underwent health check-ups, the mean age was 64.1 years old; females predominated (63.2%), and 306 (12.8%) subjects were seropositive for HCV. CKD, defined as a lower estimated glomerular filtration rate (eGFR) was associated with unhealthy dietary habits, metabolic syndrome, and HCV. Less frequent exercise, higher waist circumference (WC) and HbA1c all affected risk of CKD; HCV increased risk of CKD by 44% compared to non-HCV (OR 1.44, 95% confidence interval (CI) 1.05-1.98) in the multivariable analysis. In the HCV group, lower eGFR was also significantly associated with the severity of metabolic syndrome (MetS) (median eGFR was 86.4, 77.1, and 64.5 mL/min/1.73 m2 for individuals with three and five MetS components, respectively). CONCLUSIONS: Beyond metabolic disturbance and irregular exercise, HCV seropositivity is independently associated with CKD in a community survey. Healthy lifestyle promotion might protect against renal function decline in HCV; however, the mechanisms underlying the association need further large-scale investigation.