Relationships Between the Usage of Televisions, Computers, and Mobile Phones and the Quality of Sleep in a Chinese Population: Community-Based Cross-Sectional Study.

BACKGROUND: No study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages. OBJECTIVE: This study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality. METHODS: This cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, "Healthy Living, Longer Lives." Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. RESULTS: The prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends<.001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively; P<.001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P<.001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years; P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72% (95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of having poor sleep quality (PSQI score>5), respectively. CONCLUSIONS: The mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. "J" shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.

Dementia Literacy in the Greater Bay Area, China: Identifying the At-Risk Population and the Preferred Types of Mass Media for Receiving Dementia Information.

Background: The aim of this cross-sectional study was to assess the dementia literacy of community-dwelling adults in four cities (Hong Kong, Guangzhou, Macau, and Zhuhai) of the Greater Bay Area of China, and to determine their mass media preferences for receiving dementia information. Methods: The survey was completed by 787 community-dwelling adults. Dementia literacy was indirectly measured using two validated scales-the 30-item Alzheimer's Disease Knowledge Scale and the 20-item Dementia Attitude Scale (DAS). Participants were also asked to indicate whether they wanted to receive dementia information via digital or traditional media. Chi-square tests, logistic regressions, and MANOVA analyses were conducted. Results: Unemployed or retired people had poor attitudes towards dementia and lower levels of knowledge about dementia. Single, cohabiting, or divorced people in Hong Kong and Macau had lower DAS scores than married people. Young people and those with a secondary education preferred to get their dementia information from social media. People with a tertiary education and employed people enjoyed searching government or hospital websites for information. Middle-aged, unemployed, or retired people tended to learn about dementia from television or radio. Conclusion: It is worth educating the public about dementia and developing strategies consistent with their preferences for types of mass media.

Characteristics of influential peers in the eyes of secondary school students: a mixed method study.

Aim It is the aim of this study to explore the characteristics of influential peers identified by schoolmates, and the mechanism by which they exert their influence on their peers. BACKGROUND: Adolescent crowds are a salient influence on the health-risk behaviors of peers, contributing to adolescent substance use such as drinking alcohol, smoking cigarettes, and taking drugs. METHODS: A mixed method study. Three schools granted us access to students and those who had been nominated as influential by their peers. The students were asked to nominate and indicated the characteristics of peers whom they considered influential in a quantitative study. Those peers whom they considered influential were invited to take part in focus group interviews. A total of six focus group interviews were conducted, comprised of two groups from each school, with an average of seven participants in each group. Findings Students considered caring and friendliness (91.0%), being a buddy (88.5%), and entertaining/humor (86.8%) as the top three characteristics of influential peers. The interviews revealed that the students believed that they are influential because of their cheerfulness and humor, considerateness, ability to communicate, popularity and sociability, sincerity and trustworthiness, and because they possess the characteristics of a leader. They also believed that their power to influence came about through their helpfulness, accommodation, and the closeness of their relationships. Their influence was manifested in both positive and negative ways on the academic pursuits and health-risk behaviors of their peers. In order to engage at-risk students in health promotion programs, it is important to identify their influential peers, and to understand how adolescent friends may help one another to resist behaviors that pose a risk to their health.

Methicillin-resistant Staphylococcus aureus (MRSA) contamination in bedside surfaces of a hospital ward and the potential effectiveness of enhanced disinfection with an antimicrobial polymer surfactant.

The aim in this study was to assess the effectiveness of a quaternary ammonium chloride (QAC) surfactant in reducing surface staphylococcal contamination in a routinely operating medical ward occupied by patients who had tested positive for methicillin-resistant Staphylococcus aureus (MRSA). The QAC being tested is an antibacterial film that is sprayed onto a surface and can remain active for up to 8 h. A field experimental study was designed with the QAC plus daily hypochlorite cleaning as the experimental group and hypochlorite cleaning alone as the control group. The method of swabbing on moistened surfaces was used for sampling. It was found that 83% and 77% of the bedside surfaces of MRSA-positive and MRSA-negative patients respectively were contaminated with staphylococci at 08:00 hours, and that the staphylococcal concentrations increased by 80% at 1200 h over a 4-hour period with routine ward and clinical activities. Irrespective of the MRSA status of the patients, high-touch surfaces around the bed-units within the studied medical ward were heavily contaminated (ranged 1 to 276 cfu/cm2 amongst the sites with positive culture) with staphylococcal bacteria including MRSA, despite the implementation of daily hypochlorite wiping. However, the contamination rate dropped significantly from 78% to 11% after the application of the QAC polymer. In the experimental group, the mean staphylococcal concentration of bedside surfaces was significantly (p<0.0001) reduced from 4.4±8.7 cfu/cm2 at 08:00 hours to 0.07±0.26 cfu/cm2 at 12:00 hours by the QAC polymer. The results of this study support the view that, in addition to hypochlorite wiping, the tested QAC surfactant is a potential environmental decontamination strategy for preventing the transmission of clinically important pathogens in medical wards.

A preliminary conceptual framework for cancer couple dyads: live with love.

BACKGROUND: With the research focus on family caregiving shifting from the individual to the dyadic level, there is a need to develop a conceptual framework that focused on caregiver-patient dyads. OBJECTIVE: The aim of this study was to develop a preliminary conceptual framework for cancer couple dyads, to "Live With Love." METHODS: A literature search was conducted among 4 electronic databases to identify couple-based intervention studies related to couples coping with cancer. This report differs from a traditional literature review in that we synthesized the models or frameworks used in these studies rather than the outcomes of the studies. A preliminary Live With Love Conceptual Framework (P-LLCF) for cancer couple dyads was developed based on the conceptual frameworks adopted in related literature on spousal caregiving for patients with cancer. RESULTS: This P-LLCF contains 3 domains: event situation, dyadic mediators, and caregiver-patient dyads (appraisal, coping, and adjustment/outcomes). The various components in this P-LLCF will work together to benefit the positive dyadic adjustment/outcomes of the spousal caregiver-patient dyads in the cancer dyads' journey of coping with cancer. CONCLUSIONS: This P-LLCF sheds new light on the study of cancer couple dyads. It will be potentially valuable for guiding the related research and development of interventions on cancer couple dyads. IMPLICATIONS FOR PRACTICE: Future research is needed to assess the outcome of interventions that focus on different components. It is also needed to develop measurements to assess dyadic adjustment/outcomes in nursing practice.

Experiences of sub-fertility among Chinese couples in Hong Kong: a qualitative study.

AIM: This study aimed to explore the lived experience of sub-fertility among Chinese couples in Hong Kong. BACKGROUND: In Chinese culture, the duty of young married couples is to bear children to carry on the family line. Married couples who are unable to bear children often experience personal psychological stress and social pressure. DESIGN: Qualitative, exploratory study. METHODS: Seven women and four men in Hong Kong were interviewed to explore their lived experiences of being involuntarily childless. Collaizi's phenomenological methods guided data collection and analysis. RESULTS: Sub-fertile couples reported feelings of incompleteness, guilt, shame and isolation from the 'fertile' world. These couples acknowledged that sub-fertility had implications on their marital relationship and regretted not having treatment earlier. Some found ways to replace their 'loss' and to cope with their situation, and some rationalised by finding reasons that favoured being childless. DISCUSSION: It is recommended that family planning should be incorporated into premarital screening and to provide timely support and counselling. RELEVANCE TO CLINICAL PRACTICE: Family planning and fertility should be incorporated into premarital counselling. Sub-fertile couples should be encouraged to seek medical help, being provided with early referral for investigation and treatment and with support and counselling. Health care professionals should respect the decisions of sub-fertile couples with regard to investigations or assisted reproductive services. They should also assess how each partner interprets the situation if they encountered difficulty in dealing with the situation.

Risk factors for cervical abnormalities among Hong Kong Chinese women: a large-scale community-based cervical screening program.

BACKGROUND: We sought to identify the prevalence of and risk factors associated with cervical abnormalities among Chinese women in Hong Kong. METHODS: A community-based cervical screening program was offered free of charge in Hong Kong. Information on the demographics, sexual experience, and obstetrical history of women who attended the Cervical Screening Clinic were collected and tabulated with their Pap smear results to establish the risk factors associated with cervical abnormalities among Hong Kong Chinese women. RESULTS: A total of 44,219 women attended the Cervical Screening Clinic for their first Pap smear tests over an 8-year period, with the prevalence of cervical abnormality at 4.51%. Adjusted for all associating factors, the significant risk factors of cervical abnormalities identified among Hong Kong Chinese women are being aged 40-49 (odds ratio [OR] 1.53), being single (OR 1.52) or cohabiting (OR 1.52), having received primary school education only (OR 1.53), having had three or more sexual partners (OR 1.52), onset of sexual activity at age ≤18 (OR 1.53), having reported bleeding after intercourse (OR 1.44), and having had more than three pregnancies (OR 1.47). Condom use was identified as the single most significant protective factor reducing the risk of cervical abnormalities among these women (OR 0.76). CONCLUSIONS: This first population study in Hong Kong provides a better understanding of the risk factors associated with cervical abnormalities among Hong Kong Chinese women. A primary preventive strategy to reduce cervical cancer incidence should focus on modifying these preventable risk factors, complemented by population-based cervical screening programs to increase the coverage rate to 80% in the long term, together with human papillomavirus (HPV) vaccination.

Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors.

BACKGROUND: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors. METHODS: A literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included. RESULTS: A total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English. CONCLUSION: Selection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in China or other non-English speaking countries should choose or develop instruments relevant to their own cultural context. There is a need to develop a comprehensive quality of life instrument for Chinese cervical cancer survivors across the whole survivorship, including immediately after diagnosis and for short- (less than 5 years) and long-term (more than 5 years) survivorship.

Smoking cessation intervention in parents of young children: a randomised controlled trial.

OBJECTIVE: To examine whether telephone counselling based on the stages of change component of Transtheoretical model of behaviour change together with educational materials could help non-motivated smoking parents of young children to cease. DESIGN: Randomised controlled trial. SETTING: Hong Kong Special Administrative Region, PR China. PARTICIPANTS: 952 smoker fathers and mothers of Chinese children aged 5 years. INTERVENTION: Participants were randomly allocated into two groups: the intervention group received printed self-help materials and three-session telephone-based smoking cessation counselling delivered by trained counsellors; the control group received printed self-help materials only. A structured questionnaire was used for data collection at baseline and at 1, 3 and 6 month follow up. MAIN OUTCOME MEASURES: The main outcome is 7 day point prevalence quit rate at 6 months (defined as not smoking during the 7 days preceding the 6 month follow up) determined by self reports. Other secondary outcomes were self reported 24 h point prevalence quit rate and self-reported continuous quit rate and bio-chemically validated quit rate at 6 months. RESULTS: A total of 952 smoker fathers and mothers were randomized to the intervention (n = 467) and control (n = 485) groups. Most were daily smokers (92.4%) and the mean number of cigarettes smoked per day was 14.5 (SD = 8.9). By using intention-to-treat analysis, the 7 day point prevalence quit rate at 6 month follow up was significantly greater in the intervention group (15.3%; 68/444) than the control group (7.4%; 34/459) (P < 0.001). The absolute risk reduction was 7.9% (95% confidence interval: 3.78% to 12.01%). The number needed to treat to get one additional smoker to quit was 13 (95% CI: 8-26). The crude odds ratio of quitting was 2.3(95% CI: 1.5-3.5). The adjusted odds ratio was 2.1 (95% CI: 1.4-3.4) (adjusted for age, number of years smoked, and alcohol dependency). CONCLUSION: Proactive telephone counselling is an effective aid to promote smoking cessation among parents of young children.

Comparing the effectiveness of two types of cooling blankets for febrile patients.

A randomized controlled trial was conducted to compare the effectiveness of airflow- and waterflow-cooling blankets for febrile patients in intensive care unit. More patients in the airflow than in the waterflow-cooling blanket group reached the desired temperature of <38 degrees C at the end of 8h (94.1 versus 60.0%, chi2=2.86, P=0.047). Patients in the airflow blanket group also took less time than those in the waterflow blanket group to achieve the desired temperature (3.1 and 5.7h, respectively, U=2.00, P<0.001). These findings suggest that the airflow blanket is the cooling blanket of choice for febrile patients when external cooling is needed.