Browsing by Author "Yang, Lin"
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Item Open Access Effects of Basketball and Baduanjin Exercise Interventions on Problematic Smartphone Use and Mental Health among College Students: A Randomized Controlled Trial(2021-01-29) Xiao, Tao; Jiao, Can; Yao, Jie; Yang, Lin; Zhang, Yanjie; Liu, Shijie; Grabovac, Igor; Yu, Qian; Kong, Zhaowei; Yu, Jane Jie; Zhang, JietingProblematic smartphone use (PSU) has become a prevalent issue worldwide. Previous studies suggest that physical exercising may effectively reduce smartphone users’ addiction levels. Comparisons and further evaluations on the long-term effects of different types of exercise-based interventions on treating PSU remain to be investigated. Objective. We investigated if group-based basketball and Baduanjin exercise (a type of Qigong) would reduce PSU and improve the mental health of college students and whether such effects would be sustained. A twelve-week experiment was conducted, where 96 eligible Chinese college students with PSU were randomly assigned to two intervention arms (i.e., basketball and Baduanjin exercises) and a control arm. Outcome measures, including PSU (measured by the Mobile Phone Addiction Index in Chinese (MPAI)) and mental health indices for anxiety (measured by Self-Rating Anxiety Scale (SRAS)), loneliness (measured by the short-form of the UCLA Loneliness Scale (UCLA-LS)), inadequacy (measured by the revised Janis and Field’s Feelings of Inadequacy Scale (FIS)), and stress (measured by the Chinese version of Perceived Stress Scale (CPSS)) were collected at the baseline, the end of week 12, and the two-month follow-up. A Generalized Estimating Equations (GEE) model for longitudinal data was utilized in analyses. Results. Both exercise interventions demonstrated significant effects on decreasing PSU (basketball: ; Baduanjin: ), feelings of anxiety (basketball: ; Baduanjin: ), loneliness (basketball: ; Baduanjin: ), inadequacy (basketball: ; Baduanjin: ), and perceived stress (basketball: ; Baduanjin: ), at the end of interventions. At two months after interventions, both exercise interventions demonstrated significant effects on decreasing PSU (basketball: ; Baduanjin: ), feelings of anxiety (basketball: ; Baduanjin: ), loneliness (basketball: ; Baduanjin: ), and inadequacy (basketball: ; Baduanjin: ), but not for feeling of stress. Furthermore, group-based basketball demonstrated larger improvements for all these significant results on reducing PSU and meanwhile improving their related mental health parameters among college students.Item Open Access Gender-based disparities on health indices during COVID-19 crisis: a nationwide cross-sectional study in Jordan(2021-04-06) Abufaraj, Mohammad; Eyadat, Zaid; Al-sabbagh, Mohammed Q; Nimer, Abdullah; Moonesar, Immanuel A; Yang, Lin; Al Khatib, Walid; Al-Qutob, Ra’edaAbstract Background COVID-19 has an inevitable burden on public health, potentially widening the gender gap in healthcare and the economy. We aimed to assess gender-based desparities during COVID-19 in Jordan in terms of health indices, mental well-being and economic burden. Methods A nationally representative sample of 1300 participants ≥18 years living in Jordan were selected using stratified random sampling. Data were collected via telephone interviews in this cross-sectional study. Chi-square was used to test age and gender differences according to demographics, economic burden, and health indices (access to healthcare, health insurance, antenatal and reproductive services). A multivariable logistic regression analysis was used to estimate the beta-coefficient (β) and 95% confidence interval (CI) of factors correlated with mental well-being, assessed by patients’ health questionnaire 4 (PHQ-4). Results 656 (50.5%) men and 644 (49.5%) women completed the interview. Three-fourths of the participants had health insurance during the COVID-19 crisis. There was no significant difference in healthcare coverage or access between women and men (p > 0.05). Half of pregnant women were unable to access antenatal care. Gender was a significant predictor of higher PHQ-4 scores (women vs. men: β: 0.88, 95% CI: 0.54–1.22). Among women, age ≥ 60 years and being married were associated with significantly lower PHQ-4 scores. Only 0.38% of the overall participants lost their jobs; however, 8.3% reported a reduced payment. More women (13.89%) were not paid during the crisis as compared with men (6.92%) (P = 0.01). Conclusions Our results showed no gender differences in healthcare coverage or access during the COVID-19 crisis generally. Women in Jordan are experiencing worse outcomes in terms of mental well-being and economic burden. Policymakers should give priority to women’s mental health and antenatal and reproductive services. Financial security should be addressed in all Jordanian COVID-19 national plans because the crisis appears widening the gender gap in the economy.Item Open Access Identifying personalized barriers for hypertension self-management from TASKS framework(2024-08-14) Yang, Jiami; Zeng, Yong; Yang, Lin; Khan, Nadia; Singh, Shaminder; Walker, Robin L.; Eastwood, Rachel; Quan, HudeAbstract Objective Effective management of hypertension requires not only medical intervention but also significant patient self-management. The challenge, however, lies in the diversity of patients' personal barriers to managing their condition. The objective of this research is to identify and categorize personalized barriers to hypertension self-management using the TASKS framework (Task, Affect, Skills, Knowledge, Stress). This study aims to enhance patient-centered strategies by aligning support with each patient's specific needs, recognizing the diversity in their unique circumstances, beliefs, emotional states, knowledge levels, and access to resources. This research is based on observations from a single study focused on eight patients, which may have been a part of a larger project. Results The analysis of transcripts from eight patients and the Global Hypertension Practice Guidelines revealed 69 personalized barriers. These barriers were distributed as follows: emotional barriers (49%), knowledge barriers (24%), logical barriers (17%), and resource barriers (10%). The findings highlight the significant impact of emotional and knowledge-related challenges on hypertension self-management, including difficulties in home blood pressure monitoring and the use of monitoring tools. This study emphasizes the need for tailored interventions to address these prevalent barriers and improve hypertension management outcomes.Item Open Access Long-Term Opioid Prescribing among Patients Living with Metastatic Cancer as a Chronic Disease(2024-10-28) Harsanyi, Hannah; Cuthbert, Colleen; Yang, Lin; Lau, Jenny; Cheung, Winson Y.Patients living with metastatic cancer often experience pain which requires involvement of palliative care and symptom management teams. Opioids are a commonly used tool for the treatment of this cancer-related pain. While opioids serve an important purpose in symptom management and end-of-life care, harms related to their use are increasingly recognized as having a significant impact on patients with cancer. This changing perception has resulted from a growing body of literature investigating opioid-related harms, such as long-term prescribing, opioid-related healthcare utilization, and nonmedical use within cancer populations. However, many of these studies exclude patients with metastatic disease, and very few specifically investigate this population. The work reported in this thesis aims to address this knowledge gap by reviewing perceptions of opioid use among patients with metastatic disease, investigating the incidence of opioid-related hospitalizations and emergency department visits among recipients of long-term opioid prescribing, and determining the contribution of nonmedical opioid use to these encounters. Based on a review of previously published literature, stigmatization of opioid use was identified as a significant barrier to effective cancer pain management. Patients reported fears of addiction, tolerance, and side-effects which led to opioid-restricting behaviours. Despite these reported concerns, a large proportion of patients in Alberta received long-term opioid prescribing, with 23% of opioid-naïve patients with chronic metastatic disease being affected. Among these patients, the incidence of opioid-related healthcare encounters was higher than that reported in other cancer populations and was significantly associated with higher dosage and concurrent prescribing of psychoactive medications. Increased implementation of harm-reduction measures may be useful to mitigate this risk. From reviewing medical records of patients who experienced opioid-related healthcare encounters, nonmedical opioid use was identified as a possible contributing factor for 35% of patients. However, a majority of encounters were not primarily attributable to nonmedical opioid use and many patients experienced poorly controlled pain and displayed possible manifestations of opioid stigma. While risk assessment for nonmedical opioid use is important for patients receiving long-term opioid prescribing, it should be conducted in a non-stigmatizing manner which encourages patients to prioritize effective management of their pain.Item Open Access Neighbourhood walkability associated with initiation of, and adherence to, a pedometer-based physical activity intervention among inactive Canadian adults(2019-08-12) Consoli, Anna; McCormack, Gavin R.; Nettel-Aguirre, Alberto; Spence, John R.; Yang, LinConsistent evidence suggests that the built environment can influence physical activity. However, the extent to which the neighbourhood built environment constrains or amplifies the effectiveness of physical activity interventions is understudied. The aim of this thesis was to investigate the role of the neighbourhood built environment in constraining or facilitating the effectiveness of a 12-week internet-facilitated pedometer-based physical activity intervention (UWALK) among inactive adults. Specifically, this thesis examined the effects of the objectively-measured neighbourhood built environment (i.e., walkability estimated via Walk Score®) and the self-reported (perceived) neighbourhood built environment on adoption of, adherence to the UWALK intervention, and levels of pedometer-measured physical activity. A quasi-experiment was undertaken in Calgary between May 2016 and August 2017 which included 573 inactive adults. Self-reported walkability was positively associated with pedometer-measured physical activity. Walk Score® was not significantly associated with pedometer-measured physical activity. Neither objectively-measured walkability or perceived walkability were significantly associated with UWALK adoption or adherence outcomes. Strategies for targeting neighbourhood perceptions may improve the effectiveness of physical activity interventions.Item Open Access One-year urinary and sexual outcome trajectories among prostate cancer patients treated by radical prostatectomy: a prospective study(2021-05-17) Yang, Lin; Lee, Jung A.; Heer, Emily; Pernar, Claire; Colditz, Graham A.; Pakpahan, Ratna; Imm, Kellie R.; Kim, Eric H.; Grubb, Robert L.; Wolin, Kathleen Y.; Kibel, Adam S.; Sutcliffe, SiobhanAbstract Background To examine one-year trajectories of urinary and sexual outcomes, and correlates of these trajectories, among prostate cancer patients treated by radical prostatectomy (RP). Methods Study participants were recruited from 2011 to 2014 at two US institutions. Self-reported urinary and sexual outcomes were measured at baseline before surgery, and 5 weeks, 6 months and 12 months after surgery, using the modified Expanded Prostate Cancer Index Composite-50 (EPIC-50). Changes in EPIC-50 scores from baseline were categorized as improved (beyond baseline), maintained, or impaired (below baseline), using previously-reported minimum clinically important differences. Results Of the 426 eligible participants who completed the baseline survey, 395 provided data on at least one EPIC-50 sub-scale at 5 weeks and 12 months, and were analyzed. Although all mean EPIC-50 scores declined markedly 5 weeks after surgery and then recovered to near (incontinence-related outcomes) or below (sexual outcomes) baseline levels by 12 months post-surgery, some men experienced improvement beyond their baseline levels on each sub-scale (3.3–51% depending on the sub-scale). Having benign prostatic hyperplasia (BPH) at baseline (prostate size ≥ 40 g; an International Prostate Symptom Index Score ≥ 8; or using BPH medications) was associated with post-surgical improvements in voiding dysfunction-related bother at 5 weeks (OR = 3.9, 95% CI: 2.1–7.2) and 12 months (OR = 3.3, 95% CI: 2.0–5.7); and in sexual bother at 5 weeks (OR = 5.7, 95% CI:1.7–19.3) and 12 months (OR = 3.0, 95% CI: 1.2–7.1). Conclusions Our findings provide additional support for considering baseline BPH symptoms when selecting the best therapy for early-stage prostate cancer.Item Open Access The association of carotid artery atherosclerosis with the estimated excretion levels of urinary sodium and potassium and their ratio in Chinese adults(2021-06-06) Peng, Shuang; Wang, Jiangang; Xiao, Yuanming; Yin, Lu; Peng, Yaguang; Yang, Lin; Yang, Pingting; Wang, Yaqin; Cao, Xia; Li, Xiaohui; Li, YingAbstract Background Arterial stiffness is an independent cardiovascular risk factor. However, the association between sodium/potassium intake and vascular stiffness was inconsistent. Therefore, a large community-based cross-sectional study was performed to try and achieve more definitive conclusion. Methods Urinary sodium, potassium, and creatinine levels were tested in spot urine samples during physical examinations of each recruited participant. The 24-h estimated urinary sodium excretion (eUNaE) and estimated urinary potassium excretion (eUKE) levels were determined using the Kawasaki formula (used as a surrogate for intake). Carotid intima-media thickness (IMT) and plaques were measured using ultrasound. Results In 13,523 subjects aged 18–80 years, the relationships between carotid plaques and IMT with eUNaE, eUKE and their ratios were analyzed. Overall, 30.2% of participants were diagnosed with carotid artery plaques. The ratio of estimated sodium vs. potassium excretion (Na/K ratio) of the individuals with carotid artery plaques was significantly higher than that of participants without plaque (2.14 ± 0.73 vs. 2.09 ± 0.61, P < 0.01). After adjusting for age, gender, and other lifestyle covariates, a significant positive relation was found between carotid plaque and Na/K ratios (OR = 1.06, P < 0.05). In participants without plaque, a similar positive association was observed between Na/K ratios and increased bifurcation carotid IMT (β = 0.008, P < 0.01), especially in the females (Pinteraction < 0.01). Conclusions In this study, in which sodium intake was estimated on the basis of measured urinary excretion, high estimated excretion levels of urinary sodium and/or low estimated excretion levels of urinary potassium might be associated with an increased presence of carotid atherosclerosis in Chinese individuals.Item Open Access The Intersection of Scientific Misinformation on Social Media and the COVID-19 Pandemic and 2022 Monkeypox Outbreak(2023-04-28) Dalton, Maria Elizabeth; Peters, Cheryl; Brenner, Darren; Yang, Lin; Rainham, DanielThe propagation, and rapid increase of misinformation online, resulted in the World Health Organization declaring an “infodemic” in 2020. The 2022 monkeypox outbreak, alongside the ongoing COVID-19 pandemic, resulted in new discussions surrounding the current misinformation outbreak online – primarily on social media. The COVID-19 pandemic has highlighted the presence of misinformation online, and the direct impacts misinformation can have on action, for example, racially motivated attacks and profiling, and the burning of 5G towers in Europe. Beginning in May of 2022, the monkeypox outbreak was initially reported as a cluster of cases in the United Kingdom following travel to the African continent whereby the spread of misinformation surrounding the disease followed, with dialogues focused on men who have sex with men. A thematic analysis of Instagram posts under #monkeypox and #justsayno was conducted to critically evaluate the dominant themes present on social media related to both the COVID-19 pandemic, and 2022 Monkeypox outbreak. While posts related to COVID-19 were more likely to be flagged as misinformation, posts related to the monkeypox outbreak were typically classified as anti-misinformation or factual, perhaps signifying a shift, and algorithmic changes, in the way Instagram flags information shared on the platform. By increasing our awareness of misinformation spread, we can work to develop strategies to curb its spread and quantify areas for improvement related to social media algorithms.Item Open Access Understanding Exercise Preferences, Barriers, and Facilitators for LGBTQIA2S+ Individuals Living with and Beyond Cancer(2023-07-21) Rana, Benny; Culos-Reed, S. Nicole; Bridel, William; Yang, Lin; MacRae, J Helen; Marshall, ZackPurpose: The purpose of this study was to understand overall physical activity (PA) experiences and to identify the preferences, barriers, and facilitators for exercise among LGBTQIA2S+ individuals living with and beyond cancer. Methods: A qualitative descriptive design was employed for this study. Efforts were made to recruit individuals representing a diverse range across the target population in terms of sexual orientation and gender identity, as well as cancer diagnosis. Convenience and snowball sampling methods were used for recruitment, including outreach to cancer and LGBTQIA2S+ support groups, social media posts, and participants in current exercise oncology studies. Inclusion criteria encompassed individuals who identify as LGBTQIA2S+, have been diagnosed with any form of cancer, are on or off treatment or any stage of cancer survivorship, are over 18 years old, and have proficiency in English. Data collection involved the use of a questionnaire and semi-structured interviews. Data analysis was grounded in an Interpretive Description (ID) approach, wherein the interview data was analyzed and conceptualized using thematic description. Results: Through outreach to 49 organizations, 11 participants were recruited. The interviews with the participants yielded three main themes: 1) value of exercise in the cancer care journey, 2) perceptions of discrimination and prejudice, and perceptions of body image, and 3) LGBTQIA2S+ exercise oncology programming. These themes shed light on the participants’ experiences with exercise oncology programming and PA preferences, barriers, and facilitators. Conclusion: This study contributed to our understanding of PA and exercise oncology experiences of LGBTQIA2S+ individuals living with and beyond cancer. The findings can inform the development of future PA and exercise oncology resources, such as educational materials and programming, to address current participation barriers and foster inclusivity within this population.