The novel coronavirus disease 2019 (COVID-19) infection has rapidly grown worldwide,
and many governments have implemented policies to control the infection rate. For example, school suspension, ...self-quarantine, requirement of citizens to stay at home,
travel and border controls, and discouragement of outdoor activities
have been used. Although these actions emphasizing the importance of "spatial distancing" are based on the perspective of public health, they may result in health problems other than COVID-19 infection, such as psychological distress and fear.
Therefore, the present authors examined the potential predictors for psychological distress among schoolchildren during COVID-19 school suspension.
Background and aims. Due to the rapid spread of the novel coronavirus disease 2019 (COVID-19), policies based on the nature of “spatial distancing” have been implemented and have resulted in school ...suspensions and online learning among schoolchildren. In order to examine the impact of such policies on schoolchildren, the aims of the present study were to (i) assess changes in the level of engagement in three internet-related activities (smartphone use, social media use, and gaming) before and during the COVID-19 outbreak, including prolonged and problematic engagement in these activities; (ii) investigate the differences of psychological distress before and after COVID-19 outbreak; and (iii) to use structural equation modeling to investigate the mediating roles of problematic internet-related behaviors in the causal relationships of psychological distress and time spent on internet-related activities. Methods. Self-report measures were used to assess internet-related activities and psychological distress. Time spent on internet-related activities, problematic use of internet-related activities, and psychological distress were collected from primary school students (N = 535; 265 boys; M age = 10.32 years SD = 0.84). The data were first collected before the COVID-19 outbreak (i.e., early November 2019) and then collected again during the school suspension due to COVID-19 outbreak (i.e., end of March 2020) for comparisons of changes. Results. Schoolchildren spent significantly more time on the smartphone (increased 1.02 h daily; P < 0.001) and social media (increased 0.73 h daily; P < 0.001) but not gaming (increased 0.14 h daily; P = 0.07) during the school suspension compared to the baseline. Schoolchildren who increased by 15 or 30 min daily on internet-related activities showed an increased level of psychological distress. The association between problematic use of social media and psychological distress was stronger during the school suspension (β = 0.584) than at the baseline (β = 0.451; P < 0.001). Conclusion. Increased problematic use of internet-related activities among schoolchildren was associated with greater psychological distress. Parents should therefore monitor internet-related activities and psychological distress of their children to support their mental health.
Internet addiction has been found to be prevalent worldwide, including Asian countries, and related to several negative outcomes and other behavioral addictions. The Bergen Social Media Addiction ...Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9) have been extensively used to assess internet-related addictions. However, the three aforementioned instruments have rarely been used in Asian countries. The aim of the present study was to investigate whether the BSMAS, SABAS, and IGDS-SF9 were appropriate for use in heterogeneous subsamples from Hong Kong and Taiwan. University students from Hong Kong (n = 306) and Taiwan (n = 336) were recruited via an online survey. Multigroup confirmatory factor analysis (MGCFA) was used to assess measurement invariance of the BSMAS, SABAS, and IGDS-SF9 across the two subcultures. The original unidimensional structures of BSMAS, SABAS and IGDS-SF9 were confirmed through confirmatory factorial analysis in both subcultures. The MGCFA results showed that the unidimensional structures of the BSMAS and IGDS-SF9 were invariant across the two Chinese cultural areas (Hong Kong and Taiwan). However, the measurement invariance of the SABAS was established after some model modifications. In conclusion, the present study found that the Chinese BSMAS, SABAS, and IGDS-SF9 were all adequate instruments to validly assess internet-related addictions among university students. The three brief instruments used for assessing addictions to social media, smartphone applications, and online gaming are valid and psychometrically robust across two Chinese subcultures and can be used by healthcare professionals in these regions.
•Chinese Bergen Social Media Addiction Scale has unidimensional structure.•Chinese Smartphone Application-Based Addiction Scale has unidimensional structure.•Chinese Internet Gaming Disorder Scale-Short Form has unidimensional structure.
The novel coronavirus disease 2019 (COVID-19) pandemic, and its resulting social policy changes may result in psychological distress among schoolchildren with overweight. This study thus aimed to (1) ...compare psychological distress (including fear of COVID-19 infection, stress, anxiety, and depression), perceived weight stigma, and problematic internet-related behaviors between schoolchildren with and without overweight; (2) assess whether perceived weight stigma and problematic internet-related behaviors explained psychological distress.
Schoolchildren (n = 1357; mean age = 10.7 years) with overweight (n = 236) and without overweight (n = 1121) completed an online survey assessing their fear of COVID-19 infection, stress, anxiety, depression, perceived weight stigma, problematic smartphone application use, problematic social media use, and problematic gaming.
Schoolchildren with overweight had significantly higher levels of COVID-19 infection fear, stress, depression, perceived weight stigma, and problematic social media use than those without overweight. Regression models showed that perceived weight stigma and problematic internet-related behaviors were significant predictors of psychological distress among schoolchildren with overweight.
Strategies to manage perceived weight stigma and problematic internet-related behaviors may have a positive influence on mental health among schoolchildren with overweight under health-threatening circumstances, such as the current COVID-19 pandemic.
Given the many technological advances over the past two decades, a small minority of young people are at risk of problematic use or becoming addicted to these technologies (including activities on ...the internet and smartphones). Many brief psychometric scales have been developed to assess those at risk of problematic use or addiction including the six-item Smartphone Application-Based Addiction Scale SABAS, the six-item Bergen Social Media Addiction Scale BSMAS, and the nine-item Internet Gaming Disorder Scale-Short Form IGDS-SF9). However, to date, the reproducibility of these three scales has only been examined over a short period of time (e.g., two weeks), and it is unclear whether they are time invariant across a longer period (e.g., three months). Given the emergence of internet and smartphone addiction in Chinese population, the present study translated the three instruments into Chinese and recruited 640 university students (304 from Hong Kong 99 males and 336 from Taiwan 167 males) to complete the three scales twice (baseline and three months after baseline). Multigroup confirmatory factor analysis (MGCFA) was applied to examine the time invariance. The intraclass correlation coefficient (ICC) was used to assess the relative reliability, and the percentage of smallest real difference (SRD%) was utilized to explore the absolute reliability for the three scales. MGCFA showed that all three scales were time invariant across three months. ICC demonstrated that all the scales were satisfactory in reproducibility (0.82 to 0.94), and SRD% indicated that all the scales had acceptable measurement noise (23.8 to 29.4). In conclusion, the short, valid, reliable, and easy-to-use Chinese SABAS, BSMAS, and IGDS-SF9 show good properties across periods of three months.
•Smartphone addiction, social media addiction, and internet gaming disorder are specific internet-related disorders.•Psychometrically robust instruments have been developed for these specific disorders.•The reproducibility of these scales has only been examined over a short period of time.•Time invariance of three scales were tested over a 3-month period.•The three scales had satisfactory reproducibility with little measurement noise.
Several anaplastic lymphoma kinase inhibitors (ALKIs) have demonstrated excellent efficacy on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and also better ...adverse effect (AE) profiles compared to cytotoxic chemotherapy in advanced stage anaplastic lymphoma kinase (ALK) rearrangement-positive non-small cell lung cancer (NSCLC) in phase III randomized clinical trials (RCTs). We conducted this systematic review and network meta-analysis to provide a ranking of ALKIs for treatment-naïve ALK-positive patients in terms of PFS, ORR, and AEs. In addition, a sub-group analysis of treatment benefits in patients with baseline brain metastasis was also conducted. Contrast-based analysis was performed for multiple treatment comparisons with the restricted maximum likelihood approach. Treatment rank was estimated using the surface under the cumulative ranking curve (SUCRA), as well as the probability of being the best (Prbest) reference. All next-generation ALKIs were superior to crizotinib in PFS but lorlatinib and brigatinib had increased AEs. The probability of lorlatinib being ranked first among all treatment arms was highest (SUCRA = 93.3%, Prbest = 71.8%), although there were no significant differences in pairwise comparisons with high- (600 mg twice daily) and low- (300 mg twice daily) dose alectinib. In subgroup analysis of patients with baseline brain metastasis, low-dose alectinib had the best PFS (SUCRA = 87.3%, Prbest = 74.9%). Lorlatinib was associated with the best ranking for ORR (SUCRA = 90.3%, Prbest = 71.3%), although there were no significant differences in pairwise comparisons with the other ALKIs. In addition, low-dose alectinib had the best safety performance (SUCRA = 99.4%, Prbest = 97.9%). Lorlatinib and low-dose alectinib had the best PFS and ORR in the overall population and baseline brain metastasis subgroup, respectively. Low-dose alectinib had the lowest AE risk among the available ALKIs. Further head-to-head large-scale phase III RCTs are needed to verify our conclusions.
Objective: The Theory of Planned Behavior (TPB) is one of the most robust models in explaining health-related behavior. In this study, we tested the extended TPB to predict university students' ...intentions to uptake COVID-19 vaccination.
Methods: An online cross-sectional survey was developed to investigate students' intention to uptake the COVID-19 vaccine based on the components of the TPB (i.e., attitude, subjective norms, and perceived behavioral control) and extended components (i.e., knowledge about COVID-19, risk perception of COVID-19, and past influenza vaccination behavior). Non-probability sampling was used to collect data from 3145 students from 43 universities in mainland China in January 2021. Structural equation modeling (SEM) was applied to examine the proposed model. Enrolled students were relatively young (mean age = 20.80 years; SD = 2.09), half of them are female (50.2%), and most of them were studying in undergraduate programs (n = 3026; 96.2%).
Results: The results showed that students' knowledge of the COVID-19 vaccine and risk perception of COVID-19 positively influenced their attitude toward the uptake of a COVID-19 vaccine. Also, students' attitude toward COVID-19 vaccination uptake and their past influenza vaccination uptake behaviors were positively associated with the intention to uptake COVID-19 vaccination. Subjective norm and perceived behavioral control were not significant predictors for the intention to uptake COVID-19 vaccination (R
2
= 0.49).
Conclusions: The present study demonstrated that the extended TPB appears to be an efficient model with the focus on attitude, knowledge, risk perception, and past influenza vaccination uptake behaviors in explaining students' intention for COVID-19 vaccination.
•COVID-19 vaccine uptake is crucial in the attempt to inhibit the spread of COVID-19.•The Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) was developed.•9-item and 12-item versions ...of the MoVac-COVID19S were psychometrically tested.•MoVac-COVID19S can effectively assess the acceptance of COVID-19 vaccination.•MoVac-COVID19S factor structure corresponds well with the cognitive model of empowerment.
COVID-19 continues to ravage the world with economies and life significantly and negatively affected. Fortunately, there has been significant progress in the production of vaccines to stem the infection. However, with controversies and myths surrounding vaccinations, it is timely to examine individuals’ willingness to vaccinate. The present study adapted the Motors of Influenza Vaccination Acceptance Scale (MoVac-Flu Scale) into the Motors of COVID-19 Vaccination Acceptance Scale (MoVac-COVID19S) for validation and assessed the acceptance of COVID-19 vaccination utilizing the cognitive model of empowerment (CME).
A total of 3145 university students (mean age = 20.80 years; SD = 2.09) were recruited for the present study between January 5 and 16, 2021. Two MoVac-COVID19S scales (9-item and 12-item) were adapted from the MoVac-Flu Scale, an instrument developed using CME. Psychometric tests were conducted to ascertain reliability and validity properties.
The findings indicated that the MoVac-COVID19S had high internal consistency in both the 9-item version (ω = 0.921) and 12-item version (ω = 0.898). The factor structure of the MoVac-COVID19S (9-item and 12-item versions) corresponded well with CME theory. All the fit indices were satisfactory (comparative fit index = 0.984, Tucker-Lewis index = 0.971, root mean square error of approximation = 0.088, standardized root mean square residual = 0.058) but the 9-item MoVac-COVID had better fit indices than the 12-item MoVac-COVID due to the negative wording effects existing in the 12-item MoVac-COVID19S. The scale had satisfactory known-group validity in both 9-item and 12-item versions.
The MoVac-COVID19S has promising psychometric properties based on internal consistency, factor structure, and known-group validity.
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