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Ching-Nung Wu,1,2 Yu-Ming Wang,3,4 Wei-Chih Chen,1 Fu-Min Fang,3,4 Shau-Hsuan Li,5 Tai-Lin Huang,5 Chung-Feng Hwang,1 Yu Lee,6 Chung-Ying Lin,2,7– 9 Sheng-Dean Luo1,10,11 1Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 2Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 4Proton and Radiation Therapy Center, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 5Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; 6Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan; 7Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 8Department of Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 9Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 10Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan; 11School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taoyuan, 33302, TaiwanCorrespondence: Chung-Ying Lin, National Cheng Kung University Tainan, 70101, Taiwan, Tel +886-7-731-7123 ext: 2533, Email cylin36933@gmail.com Sheng-Dean Luo, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosong District, Kaohsiung City, 83301, Taiwan, Email rsd0323.tw@gmail.comBackground: Few instruments are available for assessing the otorhinologic-related quality of life (QOL) in nasopharyngeal carcinoma (NPC) patients. Therefore, we evaluated whether the 22-item Sinonasal Outcome Test (SNOT-22) could be applied to these patients.Methods: Patients diagnosed with NPC, who had been treated with standard protocol and followed up in our institute between 2019 and 2022, were invited to join the cross-sectional study during their clinic visits. All participants completed the SNOT-22 and Eustachian Tube Dysfunction Questionnaire-7 once they were recruited. Confirmatory factor analysis (CFA) was performed to decide the most suitable model for the underlying SNOT-22 subdomains, along with various validity and reliability tests.Results: We identified a total of 275 patients, with 84 (30.5%) women and 191 (69.5%) men. The mean age was 54.1 years (standard deviation: 11.2). Among these patients, 171 (62.1%) were in late stages, and 260 (94.5%) received chemoradiotherapy as treatment. The median interval between primary RT treatment and questionnaire completion was 50 months (interquartile range: 29– 93). CFA supported a five-factor model for the SNOT-22 for NPC patients, including nasal, ear/facial, sleep, function, and emotion domains. The internal consistency and test-retest reliability of the SNOT-22 domain score were good. In addition, known-group validity was good for the SNOT-22 total score and domain scores according to the disease recurrence status.Conclusion: Psychometric analyses supported the reliability and validity of a five-domain SNOT-22 for assessing otorhinologic-related QOL in NPC patients.Keywords: SNOT-22, nasopharyngeal carcinoma, quality of life, psychometrics, chronic rhinosinusitis

Daniel Kwasi Ahorsu,1 Vida Imani,2 Marc N Potenza,3 Hsin-Pao Chen,4,5 Chung-Ying Lin,6 Amir H Pakpour7,8 1Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong; 2Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, 5166/15731, Iran; 3Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; 4Division of Colon and Rectal Surgery, Department of Surgery, E-DA Hospital, I-Shou University, School of Medicine, Kaohsiung, Taiwan; 5College of Medicine, I-Shou University, Kaohsiung, 824, Taiwan; 6Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 7Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; 8Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, SwedenCorrespondence: Amir H Pakpour; Hsin-Pao Chen, Email amir.pakpour@ju.se; shinpao2002@yahoo.com.twPurpose: Exercising can promote good health. However, excessive exercising may have downsides. This study examined the association between exercise addiction and eating disorders and whether the identified association was mediated by psychological distress, insomnia (including sleep quality), and body image concern.Methods: A total of 2088 adolescents (mean age of 15.3 years) participated in this cross-sectional study by questions assessing exercise addiction, eating disorders, psychological distress, insomnia, sleep quality, and body image concern.Results: There were significantly positive relationships between the variables (r=0.12– 0.54, p< 0.01) with effect sizes from small to large. The four potential mediators (ie, insomnia, sleep quality, psychological distress, and body image concern), individually and in total, significantly mediated the association between exercise addiction and eating disorders.Conclusion: The findings suggest that exercise addiction in adolescents may influence eating disorders through multiple pathways, such as insomnia, psychological distress, and body image concerns. Future research should examine these relationships longitudinally and use gathered information to inform intervention development. Clinicians and healthcare workers are encouraged to assess exercise addiction when treating individuals with eating disorders.Keywords: addictive behaviour, exercise, eating disorder, insomnia, stress, compulsive behaviour, adolescent

Additional file 1. Appendix A. Characteristics of subjects by age group for Asia standards. Appendix B. Nominal logistic regression models analyzing select subject characteristics by misperceived overweight and misperceived underweight. Appendix C. Main effects, interaction effects, and the total effect of gender and age on the misperception of overweight and underweight.

Background and aims Despite its inclusion in the 11th revision of the International Classification of Diseases, there is a virtual paucity of high-quality scientific evidence about compulsive sexual behavior disorder (CSBD), especially in underrepresented and underserved populations. Therefore, we comprehensively examined CSBD across 42 countries, genders, and sexual orientations, and validated the original (CSBD-19) and short (CSBD-7) versions of the Compulsive Sexual Behavior Disorder Scale to provide standardized, state-of-the-art screening tools for research and clinical practice. Method Using data from the International Sex Survey (N = 82,243; Mage = 32.39 years, SD = 12.52), we evaluated the psychometric properties of the CSBD-19 and CSBD-7 and compared CSBD across 42 countries, three genders, eight sexual orientations, and individuals with low vs. high risk of experiencing CSBD. Results A total of 4.8% of the participants were at high risk of experiencing CSBD. Country- and gender-based differences were observed, while no sexual-orientation-based differences were present in CSBD levels. Only 14% of individuals with CSBD have ever sought treatment for this disorder, with an additional 33% not having sought treatment because of various reasons. Both versions of the scale demonstrated excellent validity and reliability. Discussion and conclusions This study contributes to a better understanding of CSBD in underrepresented and underserved populations and facilitates its identification in diverse populations by providing freely accessible ICD-11-based screening tools in 26 languages. The findings may also serve as a crucial building block to stimulate research into evidence-based, culturally sensitive prevention and intervention strategies for CSBD that are currently missing from the literature.

Supplementary Material 1

Supplemental Material for Problematic Gaming in Malaysian University Students: Translation and Psychometric Evaluation of the Malay Language Versions of Gaming Disorder Test and Gaming Disorder Scale for Young Adults by Farah Raihana Ghazi, Wan Ying Gan, Serene En Hui Tung, I-Hua Chen, Wai Chuen Poon, Yan-Li Siaw, Ruckwongpatr Kamolthip, Jung-Sheng Chen, Shih-Wei Huang, Mark D. Griffiths, and Chung-Ying Lin in Evaluation & the Health Professions

This systematic review summarized and reviewed evidence from various populations regarding instruments with regard to intrinsic capacity's structural validity, internal consistency, cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, convergent validity, and discriminative or known-group validity.

This systematic review summarized and reviewed evidence from various populations regarding instruments with regard to ageism structural validity, internal consistency, cross-cultural validity/measurement invariance, reliability, measurement error, criterion validity, convergent validity, and discriminative or known-group validity.

The rapid spread of the coronavirus disease 2019 (COVID-19) has led to high levels of fear worldwide. Given that fear is an important factor in causing psychological distress and facilitating preventive behaviors, assessing the fear of COVID-19 is important. The seven-item Fear of COVID-19 Scale (FCV-19S) is a widely used psychometric instrument to assess this fear. However, the factor structure of the FCV-19S remains unclear according to the current evidence. Therefore, the present study used a network analysis to provide further empirical evidence for the factor structure of FCV-19S. A total of 24,429 participants from Iran (n = 10,843), Bangladesh (n = 9906), and Norway (n = 3680) completed the FCV-19S in their local language. A network analysis (via regularized partial correlation networks) was applied to investigate the seven FCV-19S items. Moreover, relationships between the FCV-19S items were compared across gender (males vs. females), age groups (18–30 years, 31–50 years, and >50 years), and countries (Iran, Bangladesh, and Norway). A two-factor structure pattern was observed (three items concerning physical factors, including clammy hands, insomnia, and heart palpitations; four items concerning psychosocial factors, including being afraid, uncomfortable, afraid of dying, and anxious about COVID-19 news). Moreover, this pattern was found to be the same among men and women, across age groups and countries. The network analysis used in the present study verified the two-factor structure for the FCV-19S. Future studies may consider using the two-factor structure of FCV-19S to assess the fear of COVID-19 during the COVID-19 era., publishedVersion

Zainab Alimoradi,1,&ast; Chung-Ying Lin,2– 5,&ast; Irfan Ullah,6 Mark D Griffiths,7 Amir H Pakpour8 1Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; 2Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 3Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 5Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 6Kabir Medical College, Gandhara University, Peshawar, Pakistan; 7International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK; 8Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden&ast;These authors contributed equally to this workCorrespondence: Irfan Ullah, Kabir Medical College, Gandhara University, Peshawar, Pakistan, Email irfanullahecp2@gmail.com Amir H Pakpour, Department of Nursing, School of Health and Welfare, Jönköping University, Barnarpsgatan 39, Jönköping, 55111, Sweden, Email amir.pakpour@ju.seBackground: The COVID-19 pandemic is still ongoing and is not yet under control. Evidence regarding the impacts of COVID-19 on psychological distress has been widely reported worldwide, and one of the primary concerns regarding psychological distress is fear (ie, fear of COVID-19). Therefore, having a robust instrument for assessing fear of COVID-19 is important. The present systematic review aimed to synthesize the psychometric evidence evaluated using item response theory (IRT) on the Fear of COVID-19 Scale (FCV-19S).Methods: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four academic databases (Scopus, PubMed Central, ProQuest, and ISI Web of Knowledge) were used to search target papers. Keywords used for search were “Fear of COVID-19 Scale” and its abbreviation (ie, “FCV-19S”) and IRT-related terms. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist was then applied to evaluate the methodological quality of the reviewed papers. Moreover, psychometric properties using IRT methods were synthesized using a qualitative method.Results: The initial search resulted in 552 papers (73 duplicates) and 479 were screened based on their titles and abstracts. Finally, 16 papers were included for review regarding their methodological quality (via COSMIN) to synthesize the psychometric evidence for FCV-19S. The 16 papers included 21 countries with 16 language versions of FCV-19S.Conclusion: All the psychometric evidence indicated that the seven items in the FCV-19S fit with the concept of fear. The FCV-19S is a strong and valid instrument for assessing fear across different languages. The seven items in the FCV-19S appear to be unidimensional in assessing fear, which indicates that all items are necessary in the FCV-19S.Keywords: COVID-19, fear, item response theory, psychometrics, Rasch, review

BackgroundSelf-image reflects overall self-acceptance in developing adolescents. Using a representative cohort of Taiwanese youth, this study aims to explore the relationship between weight status, pubertal timing, athletic competence, and adolescent self-image.MethodsData come from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2690, 51% males, Mage = 13.3 ± 0.5 years) surveyed annually from seventh grade. Self-image was measured by perceived satisfaction with appearance and physique. Weight status was proxied by self-reported body mass index (BMI; kg/m2). Pubertal timing was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Athletic competence was assessed by experiences with participation in competitive sports and self-perceived talent for sports. Linear regression analysis was applied to test for an association between BMI and self-image. In order to test for mediating roles of pubertal timing and athletic competence, Hayes' PROCESS macro on SPSS was conducted applying 5,000 bootstrap resamples with 95% confidence intervals of the indirect effect.ResultsBMI was inversely associated with self-image in both males (β = −0.074, [−0.095, −0.053]) and females (β = −0.095, [−0.122, −0.069]). The boot-strapped 95% confidence intervals indicated statistically significant mediating effects of pubertal timing (β = −0.008, [−0.015, −0.001]) and athletic competence (β = −0.006, [−0.011, −0.002]) in the link between BMI and self–image in females, whilst only athletic competence mediated this association (β = −0.006, [−0.009, −0.002]) in males. Moreover, BMI at baseline were also associated with long-term self-image in males (β = −0.037, [−0.057, −0.017]) and females (β = 0.132, [0.073, 0.190]).ConclusionsUnderstanding the mediating factors may help enhance adolescents' self-image by providing guidance on healthy weight and physical activity behaviors according to different stages of pubertal progression.

Additional file 3. Standardized direct and indirect effects of knowledge, Those who have intention to take up HPV vaccine if the price is below NT$8000 vs. the referencea, Those who have intention to take up HPV vaccine no matter what the price is vs. the referencea and Vaccine uptake in the 6th month follow-up.

Supplemental material, sj-doc-3-dhj-10.1177_20552076221136372 for Effect of health literacy and shared decision-making on choice of weight-loss plan among overweight or obese participants receiving a prototype artificial intelligence robot intervention facilitating weight-loss management decisions by Yi-Tang Chu, Ru-Yi Huang, Tara Tai-Wen Chen, Wei-Hsuan Lin, James TaoQian Tang, Chi-Wei Lin, Chi-Hsien Huang, Chung-Ying Lin, Jung-Sheng Chen, Sabrina Kurtz-Rossi and Kristine Sørensen in Digital Health

Supplemental material, sj-doc-1-dhj-10.1177_20552076221136372 for Effect of health literacy and shared decision-making on choice of weight-loss plan among overweight or obese participants receiving a prototype artificial intelligence robot intervention facilitating weight-loss management decisions by Yi-Tang Chu, Ru-Yi Huang, Tara Tai-Wen Chen, Wei-Hsuan Lin, James TaoQian Tang, Chi-Wei Lin, Chi-Hsien Huang, Chung-Ying Lin, Jung-Sheng Chen, Sabrina Kurtz-Rossi and Kristine Sørensen in Digital Health

Additional file 1.

Supplemental material, sj-doc-2-dhj-10.1177_20552076221136372 for Effect of health literacy and shared decision-making on choice of weight-loss plan among overweight or obese participants receiving a prototype artificial intelligence robot intervention facilitating weight-loss management decisions by Yi-Tang Chu, Ru-Yi Huang, Tara Tai-Wen Chen, Wei-Hsuan Lin, James TaoQian Tang, Chi-Wei Lin, Chi-Hsien Huang, Chung-Ying Lin, Jung-Sheng Chen, Sabrina Kurtz-Rossi and Kristine Sørensen in Digital Health

Additional file 2. Regression analysis to determine what percent of the variance of the outcome variable (vaccine uptake) is determined by the different independent variables.

Supplemental material, sj-doc-1-taj-10.1177_20406223221080646 for Effectiveness of using calligraphic activity to treat people with schizophrenia: a randomized controlled trial in Southern Taiwan by Wen-Yi Huang, Hector W.H. Tsang, Shu-Mei Wang, Yu-Chen Huang, Yi-Chun Chen, Chih-Heng Cheng, Chih-Yin Chen, Jung-Sheng Chen, Yen-Ling Chang, Ru-Yi Huang, Chung-Ying Lin, Marc N. Potenza and Amir H. Pakpour in Therapeutic Advances in Chronic Disease

Additional file 3. Standardized direct and indirect effects of knowledge, Those who have intention to take up HPV vaccine if the price is below NT$8000 vs. the referencea, Those who have intention to take up HPV vaccine no matter what the price is vs. the referencea and Vaccine uptake in the 6th month follow-up.

Additional file 2. Regression analysis to determine what percent of the variance of the outcome variable (vaccine uptake) is determined by the different independent variables.

Supplementary_Appendix_A for Validating the Persian Intuitive Eating Scale-2 Among Breast Cancer Survivors Who Are Overweight/Obese by Babak Nejati, Chia-Wei Fan, William J. Boone, Mark D. Griffiths, Chung-Ying Lin and Amir H. Pakpour in Evaluation & the Health Professions