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1.  The association between internet addiction and psychiatric co-morbidity: a meta-analysis 
BMC Psychiatry  2014;14:183.
Background
This study evaluates the association between Internal Addiction (IA) and psychiatric co-morbidity in the literature.
Methods
Meta-analyses were conducted on cross-sectional, case–control and cohort studies which examined the relationship between IA and psychiatric co-morbidity. Selected studies were extracted from major online databases. The inclusion criteria are as follows: 1) studies conducted on human subjects; 2) IA and psychiatric co-morbidity were assessed by standardised questionnaires; and 3) availability of adequate information to calculate the effect size. Random-effects models were used to calculate the aggregate prevalence and the pooled odds ratios (OR).
Results
Eight studies comprising 1641 patients suffering from IA and 11210 controls were included. Our analyses demonstrated a significant and positive association between IA and alcohol abuse (OR = 3.05, 95% CI = 2.14-4.37, z = 6.12, P < 0.001), attention deficit and hyperactivity (OR = 2.85, 95% CI = 2.15-3.77, z = 7.27, P < 0.001), depression (OR = 2.77, 95% CI = 2.04-3.75, z = 6.55, P < 0.001) and anxiety (OR = 2.70, 95% CI = 1.46-4.97, z = 3.18, P = 0.001).
Conclusions
IA is significantly associated with alcohol abuse, attention deficit and hyperactivity, depression and anxiety.
doi:10.1186/1471-244X-14-183
PMCID: PMC4082374  PMID: 24947851
Internet addiction; Depression; Anxiety; Alcohol abuse; Attention deficit; Hyperactivity
2.  Is low health literacy associated with overweight and obesity in adolescents: an epidemiology study in a 12–16 years old population, Nanning, China, 2012 
Archives of Public Health  2014;72(1):11.
Background
The problem of overweight and obesity in children and adolescents is considered an epidemic in both developed and developing world by the WHO. There has been little study on the relationship between health literacy and body weight among adolescents.
This epidemiological study aims to investigate the association between low health literacy and overweight and obesity among a population of Chinese adolescents aged 12–16 years in the city of Nanning, China in 2012.
Methods
This study was a population-based cross-sectional health survey utilising a two-stage random cluster sampling design. The sample consisted of high school students aged between 12–16 years with the total student population attending high schools in a large city as the sample frame. Health literacy was measured by the Chinese version of the short form of the Test of Functional Health Literacy translated for and validated among Taiwanese adolescents. Overweight and obesity were assessed in accordance to the recommendation of the World Health Organization (WHO) Global Database of Body Mass Index classification methods. Data were analysed using logistic regression modelling techniques with adjustment to the cluster sampling effect.
Results
A total of 1035 students responded to the survey providing usable information with 628 (48.1%) respondents classified as high, 558 (42.8%) moderate, and 119 (9.1%) low levels of health literacy. After adjusting for potential confounding factors and the cluster sampling effect, low health literacy was significantly associated with overweight and obesity (OR = 1.84, 95% C.I. = 1.13-2.99).
Conclusion
Results suggested that low health literacy level was associated with many aspects of adolescence health including their body weight. These results have public health implications on an important global problem of adolescence body weight. Enhancing the health literacy should be considered as part of the strategies in combating adolescence weight problem.
doi:10.1186/2049-3258-72-11
PMCID: PMC3994214  PMID: 24685203
Health literacy; Overweight; Obesity; Adolescents; Epidemiology study
3.  Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial 
BMC Surgery  2012;12:14.
Background
Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time.
Method/Design
The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution.
Discussion
This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes.
Australian New Zealand Clinical Trials Registry number
ACTRN12610000591055
doi:10.1186/1471-2482-12-14
PMCID: PMC3411492  PMID: 22817672
4.  Self-harm and risk of motor vehicle crashes among young drivers: findings from the DRIVE Study 
Background
Some motor vehicle crashes, particularly single-vehicle crashes, may result from intentional self-harm. We conducted a prospective cohort study to assess the risk that intentional self-harm poses for motor vehicle crashes among young drivers.
Methods
We prospectively linked survey data from newly licensed drivers aged 17–24 years to data on licensing attempts and police-reported motor vehicle crashes during the follow-up period. We investigated the role of recent engagement in self-harm on the risk of a crash. We took into account potential confounders, including number of hours of driving per week, psychological symptoms and substance abuse.
Results
We included 18 871 drivers who participated in the DRIVE Study for whom data on self-harm and motor vehicle crashes were available. The mean follow-up was 2 years. Overall, 1495 drivers had 1 or more crashes during the follow-up period. A total of 871 drivers (4.6%) reported that they had engaged in self-harm in the year before the survey. These drivers were at significantly increased risk of a motor vehicle crash compared with drivers who reported no self-harm (relative risk [RR] 1.42, 95% confidence interval [CI] 1.15–1.76). The risk remained significant, even after adjustment for age, sex, average hours of driving per week, previous crash, psychological distress, duration of sleep, risky driving behaviour, substance use, remoteness of residence and socio-economic status (RR 1.37, 95% CI 1.09–1.72). Most of the drivers who reported self-harm and had a subsequent crash were involved in a multiple-vehicle crash (84.1% [74/88]).
Interpretation
Engagement in self-harm behaviour was an independent risk factor for subsequent motor vehicle crash among young drivers, with most crashes involving multiple vehicles.
doi:10.1503/cmaj.090459
PMCID: PMC2780486  PMID: 19917659
5.  Cross-boundary Substance Uses Among Hong Kong Chinese Young Adults 
The study documents the characteristics of Hong Kong residents who used substances in mainland China. Characteristics of such users were compared with those using substances elsewhere. A cross-sectional survey was used. Data analyses were stratified by gender, and multivariate analyses were performed. Respondents, Hong Kong adults aged 18–30 (n = 6,528), were interviewed using a mixed interviewer and computerized mobile phone method, at the Hong Kong-mainland China boundary. Cross-border substance users and other types of substance users had characteristics that were quite different (e.g., education level, perceived harmfulness of substance use in general, having friends who frequently used substances in mainland China). Cross-boundary substance users also found it easier to obtain substances in mainland China than in Hong Kong (males: 60.5%, females: 39.6%) and perceived no chance of being arrested in mainland China because of substance use (men: 28.8%, women: 24.5%). They tended to use substances in discos/rave parties together with friends (men: 77%, women: 81%), and substances were often obtained for free (men: 63.2%, women: 78%). Ecstasy and ketamine were often used (men: 86.5% & 79.4%, women: 81% & 70.2%), and multiple uses of different substances were common (men: 81.3%, women: 68.6%). Lower price, peer influence, and better availability were reasons behind cross-boundary substance use behaviors. Cross-boundary substance users have specific characteristics. Prevention policies should take these characteristics into account. Regional collaborations are highly warranted.
doi:10.1007/s11524-007-9206-2
PMCID: PMC2231849  PMID: 17610070
Chinese; Cross-boundary; Substance use; Young adults.

Results 1-5 (5)