Serial mediation effect of physical activity and sleep quality between dietary behaviour and depression symptoms: A nationwide cross-sectional survey.

Background: Substantial studies have revealed the potential mechanisms underlying the link between dietary behaviour and depression symptoms. This study investigated the relationship between depression symptoms and dietary behaviour, physical activity, and sleep quality in a nationwide sample of Chinese residents. Methods: A total of 18 819 Chinese Residents completed the dietary behaviour, patient health questionnaire, international physical activity questionnaire, and Pittsburgh sleep quality index. We used the Hayes' serial mediation model to investigate the correlation between the variables. Results: Among the participants, 85.5% were aged between 18 and 59, 41.2% were male, and 73.8% were urban residents. There is a negative correlation between dietary behaviour and physical activity (r = -0.038, P < 0.001), while there is a positive correlation with depression symptoms (r = 0.238, P < 0.001) and sleep quality (r = 0.115, P < 0.001). Additionally, depression shows a positive correlation with physical activity (r = 0.024, P < 0.001) and sleep quality (r = 0.298, P < 0.001), while there is a negative correlation between physical activity and sleep quality (r = -0.035, P < 0.001). Dietary behaviour was found to be connected with depression symptoms via three mediation pathways: (1) physical activity (B = -0.003, 95% confidence interval (CI) = -0.016, -0.007), (2) sleep quality (B = 0.034, 95% CI = 0.126, 0.164), and (3) physical activity and sleep quality (B = 0.001, 95% CI = 0.001, 0.003). Conclusions: These findings highlight the significance of psychological and physical factors in exploring the mechanisms through which dietary behaviour is related to depression symptoms. Overall, this study showed the important role of lifestyle factors in depression symptoms, suggesting that appropriate dietary behaviours, appropriate physical activity, and good sleep quality are necessary for the avoidance or improvement of depression symptoms.

How is family health related to health-related quality of life among middle-aged and older adults in rural China? A cross-sectional study.

BACKGROUND: Health-related quality of life (HRQOL) is unequal between countries and regions, and the emphasis on HRQOL of populations of low-income countries and regions is unprecedented. OBJECTIVES: To examine the association between family health and HRQOL among middle-aged and older adults in rural China, and determine whether this association differs by age, gender and chronic disease subgroup. METHODS: Cross-sectional survey carried out from July to September 2021. The participants were 1059 people aged 46 and over living in rural China. We used the European Quality of Life Five Dimension Five Level (EQ-5D-5L) and Family Health Scale-Short Form (FHS-SF) to assess health-related quality of life (HRQOL) and family health, respectively. RESULTS: The mean EQ-VAS was 75.66, the mean EQ index score was 0.92, and the mean FHS was 37.90 in rural middle-aged and older adults. After Bonferroni correction, generalised linear regression models showed that FHS was significantly associated with the EQ-VAS (ß = 0.829; 95% confidence interval [CI]: 0.660 to 0.997; p < .001) and the EQ index score (ß = 0.003; 95%CI: 0.001 to 0.004; p < .001). Binary logistic regression models showed that FHS was associated with three dimensions of HRQOL (mobility, self-care and usual activities) (p < .01). Based on subgroup analyses, the effect of FHS on EQ-VAS and the EQ index score was significant in three subgroups after Bonferroni correction (p < .01), but the association between FHS and the dimensions of HRQOL differed by age, gender and chronic disease group (p > .01). CONCLUSIONS: This study is the first to explore that family health and its dimensions are significant positive predictors of HRQOL among middle-aged and older adults in rural China. Family-based measures may have more potential and value because better family health significantly improves HRQOL. IMPLICATIONS FOR PRACTICE: In the health strategy, the government and primary health care workers should include family health as an indicator and assess it before and after the implementation of the strategy.

Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study.

PURPOSE: This study aimed to explore the effects of self-efficacy on adherence to self-management and medication among patients with chronic diseases in China. METHODS: A cross-sectional survey of 2047 patients with chronic diseases in 120 cities across China was conducted between May and September 2021 using a multi-stage sampling method. Self-efficacy was measured using the New General Self-Efficacy Scale. The adherence to self-management was measured using the item response theory based self-management adherence scale, and the medication adherence was assessed using the Medication Adherence Scale for the Chronically Ill. The adherence to self-management and medication were evaluated by linear regression and logistic regression models, respectively. RESULTS: After adjusting for all covariates, self-efficacy was significantly associated with adherence to self-management (ß =0.207, 95% CI =0.064-0.350, P = 0.005), but not with medication adherence (for[middle/low]: OR = 1.119, 95% CI =0.828-1.511, P = 0.47; for[high/low]: OR = 1.281, 95% CI =0.935-1.754, P = 0.12). In subgroup analysis, self-efficacy positively correlated with adherence to self-management in patients with multiple chronic diseases (ß =0.286, 95% CI =0.037-0.535, P = 0.03), but not in those with only one chronic disease (P = 0.12). Self-efficacy was not significantly associated with medication adherence in any of the subgroups. CONCLUSION: Self-efficacy was positively associated with adherence to self-management in patients with chronic diseases, but not with medication adherence. Enhanced health education in patients with one chronic disease alone may have an association with better adherence to self-management and medication in daily life.

Chinese adult segmentation according to health skills and analysis of their use for smart home: a cross-sectional national survey.

BACKGROUND: Digital health has become a heated topic today and smart homes have received much attention as an important area of digital health. Smart home is a device that enables automation and remote control in a home environment via the internet. However, most of the existing studies have focused on discussing the impact of smart home on people. Only few studies have focused on relationship between health skills and use of smart home. AIMS: To analyze the health skills of Chinese adults and segment them to compare and analyze the use of smart home for each group. METHODS: We used data from 11,031 participants aged 18 and above. The population was clustered based on five health skills factors: perceived social support, family health, health literacy, media use, and chronic diseases self-behavioral management. A total of 23 smart homes were categorized into three sub-categories based on their functions: entertainment smart home, functional smart home, and health smart home. We analyzed demographic characteristics and utilization rate of smart home across different cluster. Each groups' features and the differences in their needs for smart home functions were compared and analyzed. RESULTS: As a result of the survey on health skills, three groups with different characteristics were clustered: good health skills, middle health skills, and poor health skills. The utilization rate of smart home was the highest was good health skills group (total smart home: 92.7%; entertainment smart home: 61.1%, functional smart home: 77.4%, and health smart home: 75.3%; P < 0.001). For entertainment smart home, smart TV had the highest utilization rate (good health skills: 45.7%; middle health skills: 43.5%, poor health skills: 33.4%, P < 0.001). For functional smart home, smart washing machine (good health skills: 37.7%, middle health skills: 35.11%, poor health skills: 26.5%; P < 0.001) and smart air conditioner (good health skills: 36.0%, middle health skills: 29.1%, poor health skills: 24.6%) were higher than other of this category. For health smart home, sports bracelet has the highest utilization rate (good health skills: 37.3%, middle health skills: 24.5%, poor health skills: 22.8%). CONCLUSION: People can be divided into different categories based on health skill profiles, those with good health skills had a better utilization rate of smart home. The government and smart home companies need to focus on people with poor smart home use in various ways to promote their use of smart homes for personal health management.

Embracing the Future Internet of Things.

All of the objects in the real world are envisioned to be connected and/or represented, through an infrastructure layer, in the virtual world of the Internet, becoming Things with status information. Services are then using the available data from this Internet-of-Things (IoT) for various social and economical benefits which explain its extreme broad usage in very heterogeneous fields. Domain administrations of diverse areas of application developed and deployed their own IoT systems and services following disparate standards and architecture approaches that created a fragmentation of things, infrastructures and services in vertical IoT silos. Coordination and cooperation among IoT systems are the keys to build "smarter" IoT services boosting the benefits magnitude. This article analyses the technical trends of the future IoT world based on the current limitations of the IoT systems and the capability requirements. We propose a hyper-connected IoT framework in which "things" are connected to multiple interdependent services and describe how this framework enables the development of future applications. Moreover, we discuss the major limitations in today's IoT and highlight the required capabilities in the future. We illustrate this global vision with the help of two concrete instances of the hyper-connected IoT in smart cities and autonomous driving scenarios. Finally, we analyse the trends in the number of connected "things" and point out open issues and future challenges. The proposed hyper-connected IoT framework is meant to scale the benefits of IoT from local to global.