Mei-Yen Chen

Adequate sleep among adolescents is positively associated with health status and health-related behaviors

BackgroundAmount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6–8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents.MethodsA cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior.ResultsA total of 656 boys (53.2%) and girls (46.8%), ranging in age from 13–18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54%) reported that they slept less than the suggested 6–8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1) life appreciation; (2) taking responsibility for health; (3) adopting healthy diet; (4) effective stress management; (5) regular exercise; and (6) total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS.ConclusionThese findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate sleep may be a screening indicator for an unhealthy lifestyle and poor health status. The results might be useful for future research into the development of intervention strategies to assist adolescents who are not receiving enough hours of sleep.

Health-promoting lifestyles of university students in Mainland China

BackgroundHealth-promoting lifestyles of adolescents are closely related to their current and subsequent health status. However, few studies in mainland China have examined health-promoting behaviors among university students, notwithstanding the dramatic development of higher education over the past two decades. Moreover, no study has applied a standardized scale to such an investigation. The adolescent health promotion (AHP) scale has been developed and is commonly used for measuring adolescent health-promoting lifestyles in Taiwan. The aim of this study is to determine the appropriateness of the AHP for use in mainland China.MethodsA cross-sectional study was performed on a total of 420 undergraduates, who were randomly selected using a two-stage stratified sampling method in a university in Guangzhou city, mainland China. The simplified Chinese version of the AHP scale, comprising six dimensions (Nutrition behavior, Social support, Life-appreciation, Exercise behavior, Health-responsibility and Stress-management), was used to measure health-promoting lifestyles among undergraduates. The reliability of the AHP scale was assessed using split-half reliability coefficients, intraclass correlation coefficients and Cronbachs α coefficient. Validity was assessed by factor analysis and correlation analysis. Factors associated with health-promoting lifestyles were identified using multiple linear regression.ResultsCronbachs coefficients were greater than 0.7 in all dimensions of the AHP scale except for Nutrition behavior (0.684). Intraclass correlation coefficients ranged from 0.689 to 0.921. Split-half reliability coefficients were higher than 0.7 in three AHP dimensions (Social support, Life-appreciation and Exercise behavior). Our results were generally in accordance with the theoretical construction of the AHP scale. The mean score for each of the six dimensions was lower than 70. Gender and grade were the factors primarily associated with health-promoting lifestyles among undergraduates.ConclusionThe AHP is a valid and reliable instrument for assessing health-promoting lifestyles of undergraduates in mainland China, which remain at a low level. Health behavior education taking account of gender and grade differences may also be applied.

Irregular breakfast eating and health status among adolescents in Taiwan

BackgroundRegular breakfast eating (RBE) is an important contributor to a healthy lifestyle and health status. The aims of the present study were to evaluate the relationships among irregular breakfast eating (IRBE), health status, and health promoting behavior (HPB) for Taiwanese adolescents.MethodsA cross-sectional, descriptive design was used to investigate a cluster sample of 1609 (7th -12th grade) adolescents located in the metropolitan Tao-Yuan area during the 2005 academic year. The main variables comprised breakfast eating pattern, body weight, and health promoting behaviors. Data were collected by a self-administered questionnaire.ResultsA total of 1609 participants were studied, 64.1% in junior high school and 35.9% in high school, boys (47.1%) and girls (52.9%) ranging in age from 12–20 years. Of the total participant population, 28.8% were overweight and nearly one quarter (23.6%) reported eating breakfast irregularly during schooldays. The findings indicated that adolescents with RBE had a lower risk of overweight (OR for IRBE vs. RBE = 1.51, 95% CI: 1.12, 2.04), and that the odds of becoming overweight were 51% greater for IRBE than for RBE even after controlling for demographical and HPB variables. IRBE also was a strong indicator for HPB. However, the profile of the high-risk IRBE group was predominantly junior high schoolchildren and/or children living without both parents.ConclusionThis study provides valuable information about irregular breakfast eating among adolescents, which is associated with being overweight and with a low frequency of health promoting behavior. School and family health promotion strategies should be used to encourage all adolescents to eat breakfast regularly.

Effectiveness of a health promotion programme for farmers and fishermen with type‐2 diabetes in Taiwan

AIMSnThis paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme.nnnBACKGROUNDnImproving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations.nnnMETHODSnA quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period.nnnRESULTSnMost of the participants were fishermen or farmers who had <6 years of education (79%) and were elders (68·9 ± 9·5 years). Most of the physiological variables and foot self-care capabilities showed statistically significant improvement after the programme. Furthermore, 37 participants with severe high risk of diabetic foot accepted additional referral treatments, and their peripheral nerve and vascular functions improved.nnnCONCLUSIONnThe research outcomes support the value of community-based health promotion programmes in rural areas, incorporating a multidisciplinary health team and culturally competent materials to help the elder rural inhabitants with diabetes enjoy better health and quality of life.

The contribution of the upper and lower face in happy and sad facial expression classification

We used a happy/sad classification task and a psychophysical model to study the tuning properties of facial expression processors across viewing conditions. Using morphed faces, in this study we measured the extent to which classification of facial expressions depends on the intensity of a particular expression on either the upper or lower face. In the fovea, the upper and lower parts of the test image were either aligned or had a lateral shift of 44 visual angle. In the periphery, the aligned test image was placed at a 6 degrees visual angle to the left of the fixation. Observers were asked to classify a test image of a facial expression as happy or sad. We discovered that the alignment of the upper and lower halves of the face had no effect on happy/sad classification in the fovea, suggesting that the classification of facial expressions is an analytic process. The model also showed no interaction between the two halves of the face in foveal facial expression classification. In addition, the poor performance of observers in recognizing happiness in the periphery manifests a computational complexity, suggesting a model in which the happy-face processor relies on both facial features and the interaction between them to recognize happiness in the periphery.

Using principal component analysis to develop a single-parameter screening tool for metabolic syndrome

BackgroundMetabolic syndrome (MS) is an important current public health problem faced worldwide. To prevent an epidemic of this syndrome, it is important to develop an easy single-parameter screening technique (such as waist circumference (WC) determination recommended by the International Diabetes Federation). Previous studies proved that age is a chief factor corresponding to central obesity. We intended to present a new index based on the linear combination of body mass index, and age, which could enhance the area under the receiver operating characteristic curves (AUCs) for assessing the risk of MS.MethodsThe labour law of the Association of Labor Standard Law, Taiwan, states that employers and employees are respectively obligated to offer and receive routine health examination periodically. Secondary data analysis and subjects biomarkers among five high-tech factories were used in this study between 2007 and 2008 in northern Taiwan. The subjects included 4712 males and 4196 females. The first principal component score (FPCS) and equal-weighted average (EWA) were determined by statistical analysis.ResultsMost of the metabolic and clinical characteristics were significantly higher in males than in females, except high-density lipoprotein cholesterol level. The older group (>45 years) had significantly lower values for height and high-density lipoprotein cholesterol level than the younger group. The AUCs of FPCS and EWA were significantly larger than those of WC and waist-to-height ratio. The low specificities of EWA and FPCS were compensated for by their substantially high sensitivities. FPCS ≥ 0.914 (15.4%) and EWA ≥ 8.8 (6.3%) were found to be the most prevalent cut off points in males and females, respectively.ConclusionsThe Bureau of Health Promotion, Department of Health, Taiwan, had recommended the use of WC ≥ 90 cm for males and ≥ 80 cm for females as singular criteria for the determination of central obesity instead of multiple parameters. The present investigation suggests that FPCS or EWA is a good predictor of MS among the Taiwanese. However, the use of FPCS is not computationally feasible in practice. Therefore, we suggest that EWA be used in clinical practice as a simple parameter for the identification of those at risk of MS.

Responses, Actions and Health-Promoting Behavior Among Rural Taiwanese Women With Abnormal Papanicolaou Test

OBJECTIVESnThe incidence and mortality rate of cervical cancer in Taiwan are higher than in other developed countries. This study aimed to explore womens responses and actions after receiving their test reports and their practice of health-promoting behaviors.nnnDESIGNnThis study employed a cross-sectional descriptive design.nnnSAMPLEnA convenient sample of 101 women living in a rural area.nnnMEASUREMENTSnDemographic characteristics, semistructured questions and Chinese Adult Health Promotion scale were used in this study.nnnRESULTSnThe mode of the duration of their marriages was 20 years. Nearly 14% were diagnosed as precancerous and underwent further treatment. 24 percent of the women took no action during the 3 months after receiving the results. As many as 96% of the participants were not aware of the 90% 5-year survival rate for localized cervical cancer. From semistructured interviews, 4 behavioral responses and 5 actions were identified. Notably, many women in this study practiced health-promoting behaviors for health responsibility, regular exercise and stress management with low frequency.nnnCONCLUSIONSnThese analytical results may prove useful in developing intervention strategies to assist women with positive Papanicolaou test results to choose treatment modalities and adopt healthy behaviors.

A facial expression image database and norm for Asian population: A preliminary report

We collected 6604 images of 30 models in eight types of facial expression: happiness, anger, sadness, disgust, fear, surprise, contempt and neutral. Among them, 406 most representative images from 12 models were rated by more than 200 human raters for perceived emotion category and intensity. Such large number of emotion categories, models and raters is sufficient for most serious expression recognition research both in psychology and in computer science. All the models and raters are of Asian background. Hence, this database can also be used when the culture background is a concern. In addition, 43 landmarks each of the 291 rated frontal view images were identified and recorded. This information should facilitate feature based research of facial expression. Overall, the diversity in images and richness in information should make our database and norm useful for a wide range of research.