Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which ...Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which could lead to a tendency to avoid physical activity(PA).To better understand the association between perceived WS and PA,knowledge of the likely mediators in this association such as weight bias internalization(WBI)and psychological distress were investigated in the present study.Methods:Using a two-wave longitudinal study and convenient sampling,388 Taiwan residents participants(55%females;mean age=29.7 years[SD±6.3])completed two surveys six months apart.Body mass index(BMI),Perceived Weight Stigma Scale(PWSS),Weight Bias Internalization Scale(WBIS),Depression,Anxiety,Stress Scale(DASS-21),and Tendency to Avoid Physical Activity and Sport Scale(TAPAS)were assessed.Results:A mediation model controlling for age,gender,and BMI with 5000 bootstrapping resamples was performed.Perceived WS exerted significant direct effects on WBI(β=0.25;p<0.001),psychological distress(β=0.15;p=0.003),and tendency to avoid PA(β=0.10;p=0.027);WBI exerted a significant direct effect on tendency to avoid PA(β=0.47;p<0.001).Standardized indirect effects of WBI and psychological distress on the association between perceived WS and tendency to avoid PA were 0.12 and 0.01,respectively.Conclusion:Given the direct association of perceived WS on the tendency to avoid PA and the mediating role of WBI in this association,interventions addressing perceived WS and WBI may contribute to promoting PA.Therefore,health interventionists(both when planning and executing PA programs)need to consider weight stigmawhen encouraging physical activity.展开更多
AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life ...AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment （interferon α with ribavirin）, and measured the HRQOL before, at the 12m wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS： A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status （P〈0.01）. Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C （P〈0.05）. In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase significantly by the end of treatment, or at mo 6 after stopping the treatment when compared to the pretreatment values. CONCLUSION： HRQOL in CH-C patients is significantly impaired in most SF-36 domains. Antiviral treatment impaired HRQOL of CH-C subjects during early treatment, mainly in non-sustained virological responders, and improved at mo 6 after stopping the treatment, mainly in sustained virological responders.展开更多
Although mental health symptoms in children and adolescents are shown to predict young adult mental health outcomes, long-term prospective studies of childhood cohorts are few. The aim of the present study was to anal...Although mental health symptoms in children and adolescents are shown to predict young adult mental health outcomes, long-term prospective studies of childhood cohorts are few. The aim of the present study was to analyze the prospective importance of internalized mental health symptoms in adolescence for internalized symptoms in adulthood. Methods: A community-based prospective longitudinal cohort provided information by questionnaire about psychological status at age 16 and 43 (n=1010, representing 94.3% of those still alive). Socio-demographic variables which were indicative of possible childhood adversity (parental class, absence, illness, unemployment, relationship, crowding, number of moves) were treated as confounders and controlled for in ordinal regression. Results: For both women and men, internalizing mental health symptoms reported at 16 significantly predicted the same outcome at 43 years, after controlling for previous adverse environmental conditions (OR =1.2 for women, 1.3 for men). Conclusion: In this representative cohort studied over 27 years with excellent retention rates, the occurrence of self-reported worry, panic and sadness in mid-adolescence significantly increased the likelihood of similar states in middle adulthood.展开更多
Background Obesity is a multifactorial chronic disease with a high,increasing worldwide prevalence.Genetic causes account for 7%of the cases in children with extreme obesity.Data sources This narrative review was cond...Background Obesity is a multifactorial chronic disease with a high,increasing worldwide prevalence.Genetic causes account for 7%of the cases in children with extreme obesity.Data sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE,Embase and SciELO databases and included 161 articles.The search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case reports.Results The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body weight.However,several important aspects of the pathophysiology of obesity remain unknown.Genetic causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this purpose.There are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric surgery.Conclusions Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.展开更多
BACKGROUND In women worldwide, breast cancer is the most common cancer. Breast cancer accounted for 26.6% of all new cancers in females diagnosed in 2015 in Hong Kong.AIM To examine women's awareness, perception, ...BACKGROUND In women worldwide, breast cancer is the most common cancer. Breast cancer accounted for 26.6% of all new cancers in females diagnosed in 2015 in Hong Kong.AIM To examine women's awareness, perception, knowledge, and screening practice of breast cancer in Hong Kong.METHODS We carried out a population-based survey using random telephone interviews to women aged 18 or above using the United Kingdom Cancer Research Breast Cancer Awareness Measure(United Kingdom CAM). The data was analysed using proportions, chi-square test(χ~2-test) and adjusted odds ratios(ORs).RESULTS A total of 1000 participants completed the CAM questionnaire from 1,731 responses(response rate = 57.8%) from September to October 2017. One in five and one in four respondents recalled ≥ 3 early warning signs and ≥ 2 risk factors of breast cancer respectively. The majority(62.6%) reported they were not confident that they would notice a change in their breasts. Among the respondents, 16.8% would have regular mammography at least every two years.In general, 4 in 10 women had tried practices on preventing breast cancer.Respondents with better result in recalling breast cancer signs and symptoms were more likely to seek immediate medical help when noticed a change in their breasts(χ2-test P = 0.038), and more likely had tried prevention practice(χ~2-test P< 0.001). Respondents received higher education(secondary school or above) had higher breast cancer awareness(OR = 2.83, CI: 1.61-4.97), more frequent screening(OR = 2.64, CI: 1.63-4.26) and more had tried prevention practices(OR = 2.80, CI:1.96-4.02) when compared to those with lower education. Those in age groups 31-45 and 46-60 had higher percentages in performing breast self-exam and mammography when compared to the 18-30 and 61 or above age groups.CONCLUSION Population-wide public health initiatives should emphasize on prevention and early detection of breast cancer in women, with targeted strategy for those with low education level and advance in age.展开更多
Purpose:Comparison of effective road safety approaches with those of relatively similar countries can be used to identify possibilities for safety improvement.Since there is no clear and comprehensive study of countri...Purpose:Comparison of effective road safety approaches with those of relatively similar countries can be used to identify possibilities for safety improvement.Since there is no clear and comprehensive study of countries'current and successful approaches to road safety in the world,the aim of this study was to identifying common road safety approaches in the world.Methods:This study was performed using scoping review and thematic analysis.The study followed the approach proposed by Arksey and O'Malley.In this study all articles were selected without time limit by searching in the following databases:Web of Science,PubMed,Scopus,ProQuest,and Embase.An initial search of 5612 papers was found and finally,20 papers met the inclusion criteria and were analyzed.Results:There were different road safety approaches in different countries around the world,which were classified in three themes:traditional approach,systemic approach,and vision zero.The traditional approach includes the sub-theme of the road-user approach,and the causal approach.The systemic approach also includes sub-themes of sustainable safety,safety system,and the United Nations plan for decade of action,Conclusion:A systemic approach to road safety seems to be welcomed by most developed and developing countries,and a paradigm shift towards a safe system has taken place.Also,given the successful results of implementing vision zero in leading countries,most countries are trying to design and implement this approach.Finally,the choice and implementation of road safety approaches varies according to the principles,priorities and infrastructure of each country.展开更多
Purpose:Various organizations and institutions are involved in road traffic injury(RTI)and crash registration such as police,forensic medicine organization,hospitals and emergency medical services.But there is a subst...Purpose:Various organizations and institutions are involved in road traffic injury(RTI)and crash registration such as police,forensic medicine organization,hospitals and emergency medical services.But there is a substantial uncertainty in interpreting the data,duplicated data collection and missing data in relation to RTI in most systems.This study aims to identify data sources for RTI surveillance in Iran and to explore traffic safety data source domains,data elements and detailed information by each data source.Methods:This is a qualitative study which was conducted in 2017 in Iran.Data were collected employing semi-structured interviews with informants in road safety organizations in relation to traffic safety including Police,Ministry of Health and Medical Education as well as Forensic Medicine Organization and other authorities-in-charge.For completing the preliminary extraction information,the minimum data set was used and compared in each system.Results:Eight different organizations relevant to road traffic safety were identified.The main domain of data provided by each one consists of Emergency Medical System form,Police KAM114 form,Ministry of Transport and Road Administration,Red Crescent Organization/Disaster Management Information System,Ministry of Health and Medical Education,Forensic Medicine Organization,Insurance Company and Ministry of Justice.Each system has its own database,based upon its scope and mainly at crash and postcrash status and little on pre-crash circumstance.Conclusion:All current registry systems are not surveillance systems for RTI prevention.Huge data have been collected in various registry systems in Iran,but most of the collected variables are duplicated in each system.On the other hand,some variables like alcohol and substance abuse,child seat belt,helmet use in relation to RTI prevention are missed in all systems.Accordingly,it is a critical need to integrate and establish a comprehensive surveillance system,with focus on the goal of each system and collection of minimum data in each organization,which currently is underway.展开更多
基金funded by the Ministry of Science and Technology,Taiwan(MOST 110-2410-H-006-115,MOST 111-2410-H-006-100,NSTC 112-2410-H-006-089-SS2)E-Da Hospital(EDAHS112032,EDAHS113021 and EDAHS113036)the Higher Education Sprout Project,Ministry of Education to the Headquarters of University Advancement at National Cheng Kung University(NCKU).
文摘Background:Physical inactivity is a major public health problem worldwide that results in physical and mental health problems.One major issue for physical inactivity is weight stigma(WS),especially perceived WS,which could lead to a tendency to avoid physical activity(PA).To better understand the association between perceived WS and PA,knowledge of the likely mediators in this association such as weight bias internalization(WBI)and psychological distress were investigated in the present study.Methods:Using a two-wave longitudinal study and convenient sampling,388 Taiwan residents participants(55%females;mean age=29.7 years[SD±6.3])completed two surveys six months apart.Body mass index(BMI),Perceived Weight Stigma Scale(PWSS),Weight Bias Internalization Scale(WBIS),Depression,Anxiety,Stress Scale(DASS-21),and Tendency to Avoid Physical Activity and Sport Scale(TAPAS)were assessed.Results:A mediation model controlling for age,gender,and BMI with 5000 bootstrapping resamples was performed.Perceived WS exerted significant direct effects on WBI(β=0.25;p<0.001),psychological distress(β=0.15;p=0.003),and tendency to avoid PA(β=0.10;p=0.027);WBI exerted a significant direct effect on tendency to avoid PA(β=0.47;p<0.001).Standardized indirect effects of WBI and psychological distress on the association between perceived WS and tendency to avoid PA were 0.12 and 0.01,respectively.Conclusion:Given the direct association of perceived WS on the tendency to avoid PA and the mediating role of WBI in this association,interventions addressing perceived WS and WBI may contribute to promoting PA.Therefore,health interventionists(both when planning and executing PA programs)need to consider weight stigmawhen encouraging physical activity.
基金Supported by the National Science Council, Taiwan, China, NSC 89-2314-B-010-475
文摘AIM. To evaluate health-related quality of life （HRQOL） in Chinese patients with chronic hepatitis C （CH-C）, and the impact of antiviral treatment. METHODS： Short Form 36 （SF-36） Health-related Quality of Life Questionnaires to interview CH-C patients, and age- and sex-matched control subjects at outpatient clinics of a medical center in Taiwan were used. Data were transformed to scores for comparisons of eight major SF-36 domains. We also enrolled consecutive CH-C patients who completed one course of antiviral treatment （interferon α with ribavirin）, and measured the HRQOL before, at the 12m wk of treatment, at the end of treatment, and at mo 6, after stopping the treatment to evaluate the impact of antiviral treatment. RESULTS： A total of 371 outpatients were enrolled, including 182 with CH-C and 189 age- and sex-matched subjects without CH-C. CH-C subjects had obviously lower educational status （P〈0.01）. Mean scores of domains in general health, physical functioning, role-physical, role-emotional, vitality, and mental health of the SF-36 were significantly lower in subjects with CH-C than those without CH-C （P〈0.05）. In an analysis of 47 CH-C patients who received and completed the whole course of antiviral treatment, mean scores of all domains were significantly lower at wk 12 of treatment compared to baseline. The scores returned to pretreatment values by the end of treatment, but were significantly increased at mo 6 after stopping the treatment. Among the 47 CH-C patients, 21 had sustained responses and 26 had nonsustained responses to antiviral treatment. Compared to pretreatment values, subjects with sustained responses had significantly lower social functioning scores at wk 12 of treatment, and scores for all SF-36 domains returned to pretreatment values, and increased significantly at mo 6 after stopping the treatment. For non-sustained virological responders, scores of all SF-36 domains significantly decreased at wk 12 of treatment, and did not increase significantly by the end of treatment, or at mo 6 after stopping the treatment when compared to the pretreatment values. CONCLUSION： HRQOL in CH-C patients is significantly impaired in most SF-36 domains. Antiviral treatment impaired HRQOL of CH-C subjects during early treatment, mainly in non-sustained virological responders, and improved at mo 6 after stopping the treatment, mainly in sustained virological responders.
文摘Although mental health symptoms in children and adolescents are shown to predict young adult mental health outcomes, long-term prospective studies of childhood cohorts are few. The aim of the present study was to analyze the prospective importance of internalized mental health symptoms in adolescence for internalized symptoms in adulthood. Methods: A community-based prospective longitudinal cohort provided information by questionnaire about psychological status at age 16 and 43 (n=1010, representing 94.3% of those still alive). Socio-demographic variables which were indicative of possible childhood adversity (parental class, absence, illness, unemployment, relationship, crowding, number of moves) were treated as confounders and controlled for in ordinal regression. Results: For both women and men, internalizing mental health symptoms reported at 16 significantly predicted the same outcome at 43 years, after controlling for previous adverse environmental conditions (OR =1.2 for women, 1.3 for men). Conclusion: In this representative cohort studied over 27 years with excellent retention rates, the occurrence of self-reported worry, panic and sadness in mid-adolescence significantly increased the likelihood of similar states in middle adulthood.
文摘Background Obesity is a multifactorial chronic disease with a high,increasing worldwide prevalence.Genetic causes account for 7%of the cases in children with extreme obesity.Data sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE,Embase and SciELO databases and included 161 articles.The search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case reports.Results The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body weight.However,several important aspects of the pathophysiology of obesity remain unknown.Genetic causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this purpose.There are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric surgery.Conclusions Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.
基金the Centre for Health Behaviours Research,Jockey Club School of Public Health and Primary Care,The Chinese University of Hong Kongthe Hong Kong Breast Cancer Foundation
文摘BACKGROUND In women worldwide, breast cancer is the most common cancer. Breast cancer accounted for 26.6% of all new cancers in females diagnosed in 2015 in Hong Kong.AIM To examine women's awareness, perception, knowledge, and screening practice of breast cancer in Hong Kong.METHODS We carried out a population-based survey using random telephone interviews to women aged 18 or above using the United Kingdom Cancer Research Breast Cancer Awareness Measure(United Kingdom CAM). The data was analysed using proportions, chi-square test(χ~2-test) and adjusted odds ratios(ORs).RESULTS A total of 1000 participants completed the CAM questionnaire from 1,731 responses(response rate = 57.8%) from September to October 2017. One in five and one in four respondents recalled ≥ 3 early warning signs and ≥ 2 risk factors of breast cancer respectively. The majority(62.6%) reported they were not confident that they would notice a change in their breasts. Among the respondents, 16.8% would have regular mammography at least every two years.In general, 4 in 10 women had tried practices on preventing breast cancer.Respondents with better result in recalling breast cancer signs and symptoms were more likely to seek immediate medical help when noticed a change in their breasts(χ2-test P = 0.038), and more likely had tried prevention practice(χ~2-test P< 0.001). Respondents received higher education(secondary school or above) had higher breast cancer awareness(OR = 2.83, CI: 1.61-4.97), more frequent screening(OR = 2.64, CI: 1.63-4.26) and more had tried prevention practices(OR = 2.80, CI:1.96-4.02) when compared to those with lower education. Those in age groups 31-45 and 46-60 had higher percentages in performing breast self-exam and mammography when compared to the 18-30 and 61 or above age groups.CONCLUSION Population-wide public health initiatives should emphasize on prevention and early detection of breast cancer in women, with targeted strategy for those with low education level and advance in age.
基金This study funded by Shahid Beheshti University of Medical Sciences,Tehran,Iran.
文摘Purpose:Comparison of effective road safety approaches with those of relatively similar countries can be used to identify possibilities for safety improvement.Since there is no clear and comprehensive study of countries'current and successful approaches to road safety in the world,the aim of this study was to identifying common road safety approaches in the world.Methods:This study was performed using scoping review and thematic analysis.The study followed the approach proposed by Arksey and O'Malley.In this study all articles were selected without time limit by searching in the following databases:Web of Science,PubMed,Scopus,ProQuest,and Embase.An initial search of 5612 papers was found and finally,20 papers met the inclusion criteria and were analyzed.Results:There were different road safety approaches in different countries around the world,which were classified in three themes:traditional approach,systemic approach,and vision zero.The traditional approach includes the sub-theme of the road-user approach,and the causal approach.The systemic approach also includes sub-themes of sustainable safety,safety system,and the United Nations plan for decade of action,Conclusion:A systemic approach to road safety seems to be welcomed by most developed and developing countries,and a paradigm shift towards a safe system has taken place.Also,given the successful results of implementing vision zero in leading countries,most countries are trying to design and implement this approach.Finally,the choice and implementation of road safety approaches varies according to the principles,priorities and infrastructure of each country.
基金supported by the Iranian Ministry of Health and Medical Education through the contract number 700/1482.
文摘Purpose:Various organizations and institutions are involved in road traffic injury(RTI)and crash registration such as police,forensic medicine organization,hospitals and emergency medical services.But there is a substantial uncertainty in interpreting the data,duplicated data collection and missing data in relation to RTI in most systems.This study aims to identify data sources for RTI surveillance in Iran and to explore traffic safety data source domains,data elements and detailed information by each data source.Methods:This is a qualitative study which was conducted in 2017 in Iran.Data were collected employing semi-structured interviews with informants in road safety organizations in relation to traffic safety including Police,Ministry of Health and Medical Education as well as Forensic Medicine Organization and other authorities-in-charge.For completing the preliminary extraction information,the minimum data set was used and compared in each system.Results:Eight different organizations relevant to road traffic safety were identified.The main domain of data provided by each one consists of Emergency Medical System form,Police KAM114 form,Ministry of Transport and Road Administration,Red Crescent Organization/Disaster Management Information System,Ministry of Health and Medical Education,Forensic Medicine Organization,Insurance Company and Ministry of Justice.Each system has its own database,based upon its scope and mainly at crash and postcrash status and little on pre-crash circumstance.Conclusion:All current registry systems are not surveillance systems for RTI prevention.Huge data have been collected in various registry systems in Iran,but most of the collected variables are duplicated in each system.On the other hand,some variables like alcohol and substance abuse,child seat belt,helmet use in relation to RTI prevention are missed in all systems.Accordingly,it is a critical need to integrate and establish a comprehensive surveillance system,with focus on the goal of each system and collection of minimum data in each organization,which currently is underway.
