Objectives To develop and evaluate forecasting models using the Holt-Winters statistical approach and the long short-term memory (LSTM) deep learning method for weekly seasonal influenza-like illness (ILI) incidences in Saudi Arabia. The study compares model performance and assesses the predictive value added by incorporating region-specific exogenous variables within Middle Eastern epidemiological modeling.
Methods This study compared the performance of Holt-Winters and LSTM models in forecasting weekly ILI cases in Saudi Arabia, using data collected from 2017 to 2022. Time series analysis integrated exogenous variables including climatic conditions and population mobility trends. The Holt-Winters model employed both additive and multiplicative seasonal components. Model performance was evaluated using root mean squared error (RMSE), mean absolute percentage error, and R2.
Results The best-performing model, LSTM with exogenous variables, achieved an RMSE of 28.55, mean absolute error (MAE) of 0.14, R2 of 0.96, and percent bias (PBIAS) of +2.1%, indicating negligible systematic error. The LSTM model without exogenous variables demonstrated slightly lower accuracy (RMSE of 34.07, MAE of 0.18, R2 of 0.93, PBIAS of +5.8%), indicating strong predictive capability but less precision in determining peak ILI cases. The Holt-Winters model effectively captured seasonal and long-term trends, but showed a moderate performance with an RMSE of 82.57, MAE of 0.38, R2 of 0.58, and a high PBIAS of +14.2%, revealing significant unexplained variability during periods of high incidence fluctuation.
Conclusion This study highlights the respective strengths and limitations of statistical and machine learning approaches for ILI forecasting.
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Objectives This review and meta-analysis examined the effectiveness of non-pharmacological therapies delivered through school-based interventions for smoking cessation among adolescents in South and Southeast Asian countries.
Methods A systematic search was conducted across PubMed, Scopus, Science Direct, BioMed Central, the Cochrane Library, and ProQuest Dissertations & Theses Global from inception to October 2024. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared non-pharmacological smoking cessation interventions delivered in schools or other educational institutions. Data on smoking abstinence outcomes were extracted from published studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model via the Mantel-Haenszel estimator.
Results Seven studies involving 1,260 participants were included. The meta-analysis demonstrated that non-pharmacological school-based therapies significantly increased smoking abstinence compared to controls (OR, 2.83; 95% CI, 1.83–4.40; p<0.001. Subgroup analyzes revealed benefits across both randomized controlled trials and quasi-experimental studies with varying abstinence rates. Studies utilizing biochemical verification showed significant positive effects despite substantial heterogeneity, and short-term (<3 months) abstinence was significantly higher in intervention groups compared to controls. Overall, no differences were found between subgroups regarding intervention effectiveness.
Conclusion This meta-analysis indicates that non-pharmacological school-based interventions positively impact smoking abstinence rates, although effectiveness may vary based on study design, follow-up duration, and use of biochemical verification. The findings underscore the need for further research with larger sample sizes, extended follow-up periods, and improved methodological rigor in these regions.
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<sec>
<title>Objectives</title>
<p>This study was conducted to evaluate whether a “smoking cessation intervention” education program based on blended learning, was effective in improving nursing students’ perceived competence and motivation to perform a smoking cessation intervention for smokers.</p></sec>
<sec>
<title>Methods</title>
<p>A quasi-experimental, pretest–posttest design was conducted. The smoking cessation intervention education program based on blended learning, was administered to the experimental group (<italic>n</italic> = 23) in 5 sessions, consisting of 2 courses of an e-learning program and 1 course of a face-to-face learning program per session. The control group (<italic>n</italic> = 21) received the opportunity to participate in an e-learning program as well as receiving material of a face-to-face learning program, after completion of the smoking cessation intervention education program.</p></sec>
<sec>
<title>Results</title>
<p>The experimental group showed significant differences in autonomous motivation (<italic>t</italic> = −6.982, <italic>p</italic> < 0.001), controlled motivation (<italic>t</italic> = −3.729, <italic>p</italic> = 0.001), and perceived competence compared to the control group (<italic>t</italic> = −3.801, <italic>p</italic> < 0.001).</p></sec>
<sec>
<title>Conclusion</title>
<p>This study showed that a smoking cessation intervention education program adopting blended learning, was significantly effective in enhancing nursing students’ autonomous motivation and perceived competence to conduct a smoking cessation intervention. Further studies are needed to confirm longitudinal effects of this program.</p></sec>
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Objectives
Nurses have been identified as an instrumental partner in tobacco reduction. This study aimed to examine factors affecting Korean nurses' intention to implement smoking cessation intervention in Busan, Korea. Methods
The participants were a total of 215 Korean registered nurses. A self-administered questionnaire evaluated predisposing factors, motivational factors (attitude, social influence, and self-efficacy) and intention to implement smoking cessation intervention. Data were analyzed by <i>t</i> tests, Pearson's correlation, and hierarchical multiple regression. Results
The mean age of the participants was 28.12 ± 5.72 years. The majority of the participants were staff nurses (85.6%), and 64.2% of the sample had < 5 years of work experience. Significant predictors of intention to implement smoking cessation intervention included perceived barrier of smoking cessation intervention (β = −0.128, <i>p</i> = 0.023), willingness to receive smoking cessation training (β = 0.123, <i>p</i> = 0.034), more positive attitude (β = 0.203, <i>p</i> = 0.002), higher social influence (β = 0.292, <i>p</i> < 0.001), and higher self-efficacy toward smoking cessation intervention (β = 0.151, <i>p</i> = 0.021), which explained 45% of the total variance of intention to implement smoking cessation intervention. Conclusion
Attitude, social influence, and self-efficacy towards smoking cessation intervention had a significant positive influence in determining the intention to implement smoking cessation intervention. These findings can be used to develop evidence-based smoking cessation training programs for nurses in Korea. The programs should aim for positive attitude, higher social influence, and higher self-efficacy in hospital settings.
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Objectives
The aim of this study was to examine the composition of metabolic syndrome (MetS) components among middle-aged and older Koreans. Methods
A total of 263 participants (age 40 + years) in a lifestyle modification intervention program who met the MetS definition of National Cholesterol Education Program (NCEP) – Adult Treatment Panel (ATP) III criteria were included in the study. The frequent patterns and clustering of MetS components were investigated. Clustering of changes in individual components, through a lifestyle modification intervention, was also identified. All characteristics were stratified by and compared between sexes. Results
Approximately 80% of the participants had three of five MetS risk factors at baseline. The prevalence of each risk differed by sex. MetS composition patterns that do not include low high-density lipoprotein (HDL) cholesterol were more noticeable in men because of the low prevalence of low HDL cholesterol. In women, with higher prevalence of low HDL cholesterol, more patterns that include low HDL cholesterol were observed. The most common combination was “elevated blood pressure + abdominal obesity + impaired fasting glucose” in both sexes. Clustering of MetS risks was also found with most of the frequent combinations of MetS components. Through the lifestyle intervention, the greatest change was observed in HDL cholesterol among men and blood pressure among women. Triglycerides and HDL cholesterol were likely to be improved with blood pressure in men and abdominal obesity in women. Conclusion
Differences in the prevalent patterns of MetS compositions were observed prior to and after the intervention, along with during-intervention changes. It is recommended that intervention strategies and guidelines for MetS management consider the MetS composition patterns for effectiveness.
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Objectives
Obesity is one of the most serious health problems in the world today. Asian Americans are usually less overweight and obese than African Americans and Hispanic Americans, but the rate of obesity in Asian Americans is still increasing, especially in younger generations. This research examines Asian American obesity using existing research, as a means of finding the need for greater emphasis on Asian American obesity intervention research. Methods
In this research literature review, Asian American obesity using existing research as a means of finding the need for greater emphasis on Asian American obesity intervention research is examined. A systematic review is done in order to find Asian American obesity research, due to the minimal amount of existing studies. In total, there were only nine papers which were not duplicates and which still met the criteria for inclusion, from an initial 106 papers. Results
There is very little research on obesity in Asian Americans. Although the rate of obesity among Asian Americans is increasing, there are few related articles, projects, and surveys, and there is little information. There is a need for more specific and in-depth analysis of Asian American obesity. Asian Americans are associated with a lower waist circumference (WC) and BMI, while Hawaiian/Pacific Islanders are associated with a higher WC and BMI. Typically, Asian Americans who were born in the United States (US) tend to be overweight and more obese than those born in foreign countries. Conclusion
Based on this literature review, it is concluded that there is a shortage of Asian American obesity research, even though there is an evident need for particular obesity intervention programs that target Asian Americans.
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Objectives
This study aims to examine the effectiveness of a 6-month lifestyle modification program on the improvement in metabolic syndrome (MetS) status and in stages of change for lifestyle behaviors associated with MetS among Korean older adults. Methods
A lifestyle modification program was developed based on the transtheoretical model. The program consisted of health counseling, education classes, a self-management handbook, newsletters and a health diary. Older adults aged ≥60 (<i>n</i> = 480) with MetS were randomly assigned to the intervention group (IG) or the comparison group (CG). The IG received a comprehensive 6-month lifestyle modification intervention, while the CG received minimal information on MetS and lifestyle modification. Health examination and selfadministered survey were conducted before and after the intervention to determine the effectiveness of the program. Results
After the intervention, the prevalence of MetS decreased to 38.1% in the IG and 52.4% in the CG (<i>p</i> = 0.046). The IG improved abdominal obesity (<i>p</i> = 0.016), blood pressure (<i>p</i> = 0.030), and triglyceride (<i>p</i> = 0.005) more than the CG did. The IG demonstrated significant improvements in the behavioral stages for portion control (<i>p</i> = 0.021), balanced diet (<i>p</i> < 0.001) and adequate intake of fruits and vegetables (<i>p</i> = 0.012). The IG reduced the prevalence of abdominal obesity (OR = 2.34) and improved MetS status (OR = 1.79) better than the CG. The IG were more likely to advance from preaction stages at baseline to action stage at post-intervention for portion control (OR = 3.29) and adequate intake of fruits and vegetables (OR = 2.06). Conclusion
Lifestyle modification can improve the MetS status and behavioral stages in older adults.
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