Category: 3. Business

  • These travellers are going the extra mile this holiday season to be with loved ones

    These travellers are going the extra mile this holiday season to be with loved ones

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    For some, the holiday season means packing their bags to spend time with loved ones, some of whom are half a world away.

    The St. John’s International Airport, located in the city’s east end, was busy on Christmas Eve as people were arriving at their destination and catching flights.

    Curtis Collier, who landed at the airport in the morning, said he’s looking forward to his mother’s home cooked meals and having turkey dinner on Christmas Day.

    He added his mother’s family has Polish-Ukrainian roots so she makes perogies and cabbage rolls on Christmas Eve.

    “It feels great to be home, I haven’t been here since October so I’m very much looking forward to seeing my family and friends,” Collier told CBC News.

    An older couple standing side by side in an airport.
    Marion and Dave Osborne are going to spent the holidays with their daughter’s family in Halifax. (Leila Beaudoin/CBC)

    Marion and Dave Osborne were at the airport to catch a flight to Halifax so they could join their daughter and grandchildren for the holidays.

    She said the grandchildren are “very, very excited” to see them, with Dave Osborne adding when they visited in October “the first words they asked — ‘You’re coming back for Christmas?’ So that would give you an indication.”

    She said it is a relief that the weather was clear too, so there would be no travel delays.

    “I was so upset, thinking I wasn’t going to get there. It would have ruined our Christmas.”

    WATCH | The CBC’s Leila Beaudoin takes us inside the St. John’s airport::

    Travellers in N.L. are excited to spend the holidays home and abroad

    With clear skies in St. John’s passengers are lifting off and touching down, just in time for Christmas. The CBC’s Leila Beaudoin reports.

    Rome for the holidays

    Martin O’Driscoll was at the airport to begin the first leg of his journey that will bring him to Rome, where he will be visiting his brother’s family.

    He’s looking forward to seeing his young niece and nephew, adding he saw them in Paris last year.

    “They’re so happy to see me. I’m so happy to see them. It brings joy to my life,” said O’Driscoll.

    Man in orange jacket smiling. Behind him is a decorated tree.
    Martin O’Driscoll says he expects to land in Rome early Christmas Day. (Leila Beaudoin/CBC)

    It was also “fantastic” to start the first leg of his long journey on time with no delays, he said.

    “As you know about Newfoundland weather, it’s unpredictable. So I’ve been the victim of several cancellations and postponements,” said O’Driscoll.

    “I’m very grateful to be getting out today.”

    He expects to arrive in Rome at 9 a.m. on Christmas morning.

    O’Driscoll said people travelling on the holidays tend to be in a “jolly mood” and while airport staff are still working they exude a certain joy.

    A man and woman with a small dog.
    Gabriella Walsh and Benjamen Bragg, along with their small dog Winnie, will be spending the holidays in Kingman’s Cove. (Leila Beaudoin/CBC)

    Gabriella Walsh and Benjamen Bragg, along with their small dog Winnie, started their day in Halifax before landing in St. John’s.

    Walsh said her family lives on Newfoundland’s southern shore, so they’re headed to Kingman’s Cove for the holidays.

    “We’re really excited to go do that. And we always have a big Boxing Day party, so I’ll get to see all my family,” she said.

    Bragg said he’s also looking forward to spending time with friends and family.

    Walsh said they “lucked out for sure” when it came to travel weather.

    “We were really worried. We’re always really worried, travelling around this time of year, you never know with delays,” she said.

    Bragg added he gives a “sigh of relief” when they can sit down in their plane seats.

    Download our free CBC News app to sign up for push alerts for CBC Newfoundland and Labrador. Sign up for our daily headlines newsletter here. Click here to visit our landing page.

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  • Whitehorse not at imminent risk of blackouts, says ATCO Electric Yukon

    Whitehorse not at imminent risk of blackouts, says ATCO Electric Yukon

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    The Yukon’s energy provider says Whitehorse is not at imminent risk of blackouts, but with very cold weather forecasted through the holidays, residents are still being asked to conserve power.

    “We know people need to eat their Christmas dinner, that’s not going to be deferred,” said ATCO Electric vice-president Jay Massie. “But the dishwasher, the laundry, electrical heat, if you have baseboards in multiple rooms, some can be turned down while you’re cooking.”

    On Wednesday, temperatures sank below -40 C in most Yukon communities, including Whitehorse, and fell to -50 C in Ross River and Faro, according to Environment Canada. The cold temperatures started on Dec. 9 — the result of a cold front from Siberia — and plunged most of the territory into a much colder-than-average December.

    The Yukon’s energy minister warned on Tuesday that the territory’s energy grid was experiencing peak demand, and that Whitehorse could be subject to rolling blackouts as a last resort if maximum capacity is exceeded. 

    Rolling blackouts are a measure to mitigate widespread power outages when demand exceeds supply. Specific neighbourhoods would temporarily lose power to give the whole system a break.

    ATCO Electric is the territory’s power distributor and Yukon Energy is the energy utility.

    Stephanie Cunha with Yukon Energy said on Wednesday that Yukoners are using 80 to 90 per cent of the territory’s available energy supply.

    She said industrial customers and mine remediation sites have already been asked to disconnect from the grid and switch to diesel generators. Communities have also been switched over to diesel. 

    A thick ice fog is seen in a Whitehorse park
    A thick ice fog shrouds the S.S. Klondike in downtown Whitehorse on Wednesday. (Virginie An/CBC)

    But Massie with ATCO Electric said the territory has a “good buffer” before it needs to move to rolling blackouts as a last resort.

    “We’re in a fairly decent spot,” he said. “But it’s good to have this conversation [about rolling blackouts] so that people understand what they’re about.”

    Yukon Energy has a multi-step emergency plan for managing peak demand, according to the utility’s website. There are multiple steps to alleviate pressure on the grid before rolling blackouts are necessary, including potentially sending an emergency alert to Yukoners asking them to immediately stop “all non-essential electricity use.”

    In the meantime, Massie said, every little bit helps when it comes to saving energy.

    Residents can conserve energy by using large appliances, like dishwashers and washing machines, outside of peak hours; turning off unused lights; unplugging unused electronics, like laptops; and using smaller appliances, like microwaves and toaster ovens, for cooking. Peak hours are between 7 a.m. and 10 a.m., and between 4 p.m. and 8 p.m.

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  • Journal of Medical Internet Research

    Journal of Medical Internet Research

    Sleep is a fundamental physiological process essential for maintaining physical health, mental well-being, and overall quality of life. However, it remains an underrecognized priority in public health agendas, particularly in low- and middle-income countries []. According to the 2025 China National Health Sleep White Paper, sleep quality among residents remains suboptimal, with approximately 64% experiencing sleep disturbances once or twice per week. []. The prevalence and severity of sleep disturbances vary across age groups. Young and middle-aged adults, as a core segment of the workforce, are particularly vulnerable to sleep disturbances due to occupational stress, long working hours, and irregular schedules [-]. Chronic sleep disturbance impairs stress management and exacerbates emotional distress while also being associated with poorer health outcomes, placing a burden on health care systems and reducing workplace productivity [,].

    Sleep quality is influenced by multiple factors, including socioeconomic, physiological, psychological, and behavioral elements [,]. While these factors contribute to variations in sleep quality, increasing attention has been directed toward the role of eHealth literacy in health management. Defined as an individual’s ability to access, understand, evaluate, and apply health information from digital sources to make informed health decisions [], eHealth literacy has been shown to facilitate changes in health-related behaviors by bridging the gap between health information acquisition and actionable practices []. A systematic review further confirmed that eHealth literacy is associated with positive outcomes, including improved health behaviors, better psychological well-being, and increased use of health services []. These findings suggest that individuals with higher eHealth literacy are better equipped to adopt and maintain health-promoting behaviors that improve sleep outcomes.

    While the significance of eHealth literacy in facilitating health-related behavior changes is recognized, its specific impact on sleep quality remains inadequately investigated. Some studies have suggested potential pathways through which eHealth literacy may influence sleep quality. For example, higher eHealth literacy has been associated with greater adherence to sleep hygiene practices [], potentially by enhancing individuals’ ability to identify and apply credible health information, thereby promoting better sleep quality. Another study indicated that higher eHealth literacy could reduce the risk of cyberchondria, which is subsequently associated with improved sleep quality []. However, evidence regarding the direct relationship between eHealth literacy and sleep quality is limited.

    The association between eHealth literacy and sleep quality may vary by age. Previous research indicates that eHealth literacy is typically higher among younger populations [,]. Younger adults tend to engage more with digital health resources and may benefit significantly from them in managing sleep-related issues []. In contrast, middle-aged adults often face barriers in accessing and using such tools effectively despite a growing need for sleep management as sleep quality tends to decline with age [,]. This age-related disparity, coupled with unequal engagement with digital health resources, could contribute to widening gaps in sleep health—reflecting a digital health divide []. Therefore, understanding how eHealth literacy influences sleep quality across age groups is critical in addressing this divide.

    This study aimed to examine the association between eHealth literacy and sleep quality across age groups among adults aged 18 to 59 years in Shanghai, China. By providing empirical evidence on age-specific associations, this study sought to inform tailored sleep interventions that incorporate eHealth literacy enhancement and address disparities arising from the digital health divide.

    Participants and Procedure

    This study was conducted between October and December 2022 in Shanghai. Three districts representing urban, periurban, and rural areas were randomly selected. Seven community health service centers from these districts that agreed to participate in the study were included. At each center, community residents were recruited using a convenience sampling approach. Before completing the survey, trained staff provided a detailed explanation of the study’s purpose and requirements, emphasizing the anonymity of responses. Participants were required to sign an informed consent form before proceeding with the questionnaire.

    The inclusion criteria were (1) residence in Shanghai, (2) age 18 to 59 years, and (3) provision of informed consent and agreement to participate in the survey. The exclusion criteria were (1) severe hearing or speech impairments and (2) inability to comprehend the survey due to mental or cognitive conditions. Anonymous questionnaires were completed through the online survey platform Wenjuanxing.

    The sample size was calculated using the prevalence of poor sleep quality as the primary outcome. On the basis of previous literature, the prevalence of poor sleep quality was estimated to be approximately 35%, with an allowable error of 3.5%. Using the PASS software for cross-sectional survey sample size calculation (NCSS, LLC), the minimum required sample size was determined to be 740. Considering the design effect of 2 due to convenience sampling and an anticipated nonresponse rate of 15%, the adjusted minimum required sample size was 1742.

    A total of 1872 eligible participants were invited, and 1810 valid questionnaires were collected, yielding an effective response rate of 96.7%. The final sample size met the minimum requirement for analysis.

    Measurements

    eHealth Literacy

    The Chinese version of the eHealth Literacy Scale (eHEALS), a translation of the original scale developed by Norman and Skinner [], was used to assess participants’ eHealth literacy []. This scale consists of 8 items, each rated on a 5-point Likert scale ranging from 1 (“strongly disagree”) to 5 (“strongly agree”), yielding a total score between 8 and 40. Higher average scores indicate better self-perceived skills, knowledge, and comfort regarding online health information. The eHEALS has good reliability and validity among Chinese adults [,]. In this study, the scale showed good internal consistency, with a Cronbach α of 0.98.

    Sleep Quality

    The Pittsburgh Sleep Quality Index (PSQI) was used to measure participants’ sleep quality over the previous month []. The scale consists of 19 items evaluating 7 components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. The sum of the component scores yields a total score ranging from 0 to 21, with higher scores indicating poorer sleep quality. According to the recommended cutoff in the original study describing the PSQI, a total score of 5 or lower indicates good sleep quality, whereas a score above 5 indicates poor sleep quality []. The PSQI has demonstrated good psychometric robustness and factorial structure among Chinese adults [,].

    Covariates

    The selection of covariates was guided by the biopsychosocial theoretical framework [], which conceptualizes sleep quality as an outcome shaped by biological, psychological, and social determinants. Therefore, covariates were categorized into 3 domains as follows.

    Biological Factors

    Biological factors included sex (male or female), age, and weight status. Weight status was derived from self-reported height and weight, with BMI calculated as weight (kg) divided by height squared (m2). Overweight or obesity was defined based on the BMI classification criteria recommended by the Working Group on Obesity in China [].

    Psychological Factors

    Psychological factors included depressive and anxiety symptoms. Depressive symptoms were assessed using the Patient Health Questionnaire–9, with total scores ranging from 0 to 27. Scores of ≥5, 10, and 15 represent mild, moderate, and severe depressive symptoms, respectively []. In this study, the Patient Health Questionnaire–9 demonstrated good internal consistency (Cronbach α=0.964).

    Anxiety symptoms were measured using the Generalized Anxiety Disorder–7 scale, with total scores ranging from 0 to 21. Scores of ≥5, 10, and 15 represent mild, moderate, and severe anxiety symptoms, respectively []. In this study, the Generalized Anxiety Disorder–7 exhibited good internal consistency (Cronbach α=0.978).

    Social Factors

    Social factors included educational attainment (junior high school or lower, senior high school, or college or higher), employment status (employed or unemployed), family monthly income (<¥5000 [US $707.30], ¥5001-¥9999 [US $707.44-$1414.45], ¥10,000-¥19,999 [US $1414.59-$2829.04], or ≥¥20,000 [US $2829.18]), marital status (either married or single, divorced, or widowed), and residential area (urban, periurban, or rural).

    Statistical Analysis

    Participants were first categorized into 3 age groups: emerging adults (18‐29 years) [], established adults (30‐45 years) [], and middle-aged adults (46‐59 years). Descriptive statistics were used to summarize their background variables, eHealth literacy, and sleep quality by age group. Given the skewed distribution of eHEALS scores, eHealth literacy was categorized into 3 groups based on IQRs: 25th percentile or below (lowest quartile), 25th to 75th percentile (middle quartiles), and 75th percentile or above (highest quartile). Differences in eHealth literacy and sleep quality among the 3 age groups were examined using chi-square tests.

    To examine the association between eHealth literacy and sleep quality, multivariable logistic regression analyses were conducted in a stepwise manner. Model 1 adjusted for biological factors, including sex, age, and BMI. Model 2 incorporated additional adjustments for psychological factors, including depressive and anxiety symptoms. Model 3 further adjusted for social factors, including educational attainment, household monthly income, employment status, marital status, and residential area, to evaluate whether these factors influenced the association between eHealth literacy and sleep quality.

    Finally, age-stratified analyses were performed to explore whether the association between eHealth literacy and sleep quality varied across age groups. In sensitivity analyses, we further included potential confounding variables, including chronic disease status and health behaviors (smoking and alcohol consumption), to assess the robustness of the findings.

    Ethical Considerations

    The study protocol was approved by the ethics committee of the Xuhui District Center for Disease Control and Prevention (XHLL202205). Written informed consent was obtained from all participants. Participant privacy and confidentiality were strictly protected. All data were anonymized and securely stored, with access limited to the research team.

    Descriptive Characteristics of the Sample

    presents the sample characteristics. Of the 1810 participants, 673 (37.2%) were male, and 1137 (62.8%) were female, with a mean age of 40.0 (SD 10.1) years. Of these, 15.7% (285/1810) were emerging adults (18‐29 years), 53.3% (965/1810) were established adults (30-45 years), and 30.9% (560/1810) were middle-aged adults (45‐59 years). Most had a college degree or higher (n=1351, 74.6%), were employed (n=1533, 84.7%), and were married (n=1429, 79%). Approximately half (n=927, 51.2%) reported a monthly household income of ≥¥10,000 (US $1414.59). Regarding residence, 20.7% (375/1810) lived in urban areas, 30.4% (550/1810) lived in periurban areas, and 48.9% (885/1810) lived in rural areas. A total of 21.2% (384/1810) had moderate to severe depressive symptoms, and 15% (271/1810) had moderate to severe anxiety symptoms.

    Table 1. Sample characteristics by age group (N=1810).
    Total, n (%) Emerging adults (n=285), n (%) Established adults (n=965), n (%) Middle-aged adults (n=560), n (%)
    Sex
    Male 673 (37.2) 132 (46.3) 345 (35.8) 196 (35.0)
    Female 1137 (62.8) 153 (53.7) 620 (64.2) 364 (65.0)
    Weight status
    Normal weight or underweight 1159 (64.0) 191 (67.0) 637 (66.0) 331 (59.1)
    Overweight 514 (28.4) 65 (22.8) 254 (26.3) 195 (34.8)
    Obesity 137 (7.6) 29 (10.2) 74 (7.7) 34 (6.1)
    Depressive symptoms
    None 776 (42.9) 113 (39.6) 399 (41.3) 264 (47.1)
    Mild 650 (35.9) 91 (31.9) 349 (36.2) 210 (37.5)
    Moderate 135 (7.5) 18 (6.3) 79 (8.2) 38 (6.8)
    Severe 249 (13.8) 63 (22.1) 138 (14.3) 48 (8.6)
    Anxiety symptoms
    None 971 (53.6) 133 (46.7) 500 (51.8) 338 (60.4)
    Mild 568 (31.4) 91 (31.9) 310 (32.1) 167 (29.8)
    Moderate 190 (10.5) 43 (15.1) 110 (11.4) 37 (6.6)
    Severe 81 (4.5) 18 (6.3) 45 (4.7) 18 (3.2)
    Educational attainment
    Junior high school or lower 176 (9.7) 11 (3.9) 39 (4.0) 126 (22.5)
    Senior high school 283 (15.6) 17 (6.0) 105 (10.9) 161 (28.8)
    College or higher 1351 (74.6) 257 (90.2) 821 (85.1) 273 (48.8)
    Employment status
    Employed 1533 (84.7) 248 (87.0) 924 (95.8) 361 (64.5)
    Unemployed 277 (15.3) 37 (13.0) 41 (4.2) 199 (35.5)
    Family monthly income
    <¥5000 (US $707.30) 349 (19.3) 53 (18.6) 152 (15.8) 144 (25.7)
    5001-¥9999 (US $707.44-$1414.45) 534 (29.5) 96 (33.7) 285 (29.5) 153 (27.3)
    10,000-¥19,999 (US $1414.59-$2829.04) 543 (30.0) 85 (29.8) 302 (31.3) 156 (27.9)
    ≥20,000 (US $2829.18) 384 (21.2) 51 (17.9) 226 (23.4) 107 (19.1)
    Marital status
    Married 1429 (79.0) 82 (28.8) 834 (86.4) 513 (91.6)
    Single, divorced, or widowed 381 (21.0) 203 (71.2) 131 (13.6) 47 (8.4)
    Residential area
    Urban 375 (20.7) 43 (15.1) 197 (20.4) 135 (24.1)
    Periurban 550 (30.4) 96 (33.7) 289 (29.9) 165 (29.5)
    Rural 885 (48.9) 146 (51.2) 479 (49.6) 260 (46.4)
    eHealth literacy score
    Below the 25th percentile 440 (24.3) 79 (27.7) 221 (22.9) 140 (25.0)
    Between the 25th and 75th percentiles 909 (50.2) 117 (41.1) 472 (48.9) 320 (57.1)
    Above the 75th percentile 461 (25.5) 89 (31.2) 272 (28.2) 100 (17.9)
    Sleep quality
    Good 1124 (62.1) 190 (66.7) 617 (63.9) 317 (56.6)
    Poor 686 (37.9) 95 (33.3) 348 (36.1) 243 (43.4)

    The median score on the eHEALS was 32 (IQR 28-40). The prevalence of poor sleep quality was 37.9% (686/1810). Chi-square analysis revealed significant associations between age group and both eHealth literacy (χ24=32.0; P<.001) and sleep quality (χ22=11.1; P=.004). Compared to younger adults, a lower proportion of middle-aged adults had eHealth literacy scores above the 75th percentile. Additionally, the proportion of middle-aged adults reporting poor sleep quality was higher than that of younger adults.

    Association Between eHealth Literacy and Poor Sleep Quality: Multimodel Regression

    The association between eHealth literacy and poor sleep quality was examined using multimodel logistic regression (). In model 1, after adjusting for biological factors, participants with eHealth literacy scores between the 25th and 75th percentiles (odds ratio [OR] 1.876, 95% CI 1.463-2.406, P<.001) and those with scores below the 25th percentile (OR 2.289, 95% CI 1.726-3.037, P<.001) had a significantly higher likelihood of reporting poor sleep quality compared to those with scores above the 75th percentile. After further adjusting for psychological factors in model 2, this association remained statistically significant (OR 1.574, 95% CI 1.204-2.058, P<.001 for scores between the 25th and 75th percentiles; OR 1.526, 95% CI 1.115-2.088, P=.008 for scores below the 25th percentile). The association persisted even after additional adjustment for social factors in model 3 (OR 1.594, 95% CI 1.216-2.089, P<.001 for scores between the 25th and 75th percentiles; OR 1.584, 95% CI 1.149-2.182, P=.005 for scores below the 25th percentile).

    Table 2. Association between eHealth literacy and poor sleep quality using multivariable logistic regression (N=1810).
    Model 1 Model 2 Model 3
    OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value
    eHealth literacy
    Below the 25th percentile Reference Reference Reference
    Between the 25th and 75th percentiles 1.876 (1.463-2.406) <.001 1.574 (1.204-2.058) <.001 1.594 (1.216-2.089) <.001
    Above the 75th percentile 2.289 (1.726-3.037) <.001 1.526 (1.115-2.088) .008 1.584 (1.149-2.182) .005
    Sex
    Male Reference Reference Reference
    Female 1.050 (0.852-1.294) .65 1.089 (0.878-1.351) .44 1.068 (0.856-1.332) .56
    Age 1.012 (1.002-1.022) .02 1.020 (1.010-1.031) <.001 1.030 (1.016-1.044) <.001
    Weight status
    Normal weight or underweight Reference Reference Reference
    Overweight 0.875 (0.698-1.097) .25 0.848 (0.671-1.071) .17 0.852 (0.673-1.079) .18
    Obesity 0.998 (0.684-1.454) .99 1.061 (0.718-1.567) .77 1.099 (0.740-1.632) .64
    Depressive symptoms
    None Reference Reference
    Mild 2.276 (1.699-3.050) <.001 2.297 (1.711-3.085) <.001
    Moderate 3.499 (2.199-5.566) <.001 3.402 (2.132-5.429) <.001
    Severe 2.082 (1.156-3.749) .02 2.092 (1.156-3.784) .02
    Anxiety symptoms
    None Reference Reference
    Mild 1.236 (0.923-1.654) .16 1.243 (0.927-1.667) .15
    Moderate 1.620 (0.912-2.876) .10 1.641 (0.920-2.924) .09
    Severe 1.632 (0.795-3.348) .18 1.741 (0.844-3.594) .13
    Educational attainment
    Junior high school or lower Reference
    Senior high school 0.654 (0.432-0.990) .045
    College or higher 1.104 (0.742-1.642) .63
    Employment status
    Employed Reference
    Unemployed 1.211 (0.892-1.645) .22
    Family monthly income
    <¥5000 (US $707.30) Reference
    5001-¥9999 (US $707.44-$1414.45) 1.010 (0.741-1.375) .95
    10,000-19,999 (US $1414.59-$2829.04) 1.004 (0.728-1.386) .98
    ≥¥20,000 (US $2829.18) 1.132 (0.794-1.614) .49
    Marital status
    Married Reference
    Single, divorced, or widowed 1.423 (1.073-1.889) .01
    Residential area
    Urban Reference
    Periurban 0.824 (0.620-1.097) .19
    Rural 0.871 (0.664-1.143) .32

    aAdjusting for sex and age.

    bAdjusting for sex, age, depressive symptoms, and anxiety symptoms.

    cAdjusting for sex, age, depressive symptoms, anxiety symptoms, educational attainment, employment status, family monthly income, marital status, and residential area.

    dOR: odds ratio.

    eNot applicable.

    In the fully adjusted model (model 3), several covariates were also associated with poor sleep quality. Specifically, age (OR 1.030, 95% CI 1.016-1.044), depressive symptoms (OR 2.297, 95% CI 1.711-3.085 for mild; OR 3.402, 95% CI 2.132-5.429 for moderate; OR 2.092, 95% CI 1.156-3.784 for severe), educational attainment (OR 0.654, 95% CI 0.432-0.990 for senior high school), and marital status (OR 1.423, 95% CI 1.073-1.889 for single, divorced, or widowed) were associated with poor sleep quality.

    Age-Stratified Analysis of the Association Between eHealth Literacy and Poor Sleep Quality

    presents the age-stratified analysis of the association between eHealth literacy and sleep quality across the 3 age groups. Among emerging adults, participants with eHealth literacy scores between the 25th and 75th percentiles (OR 2.491, 95% CI 1.133‐5.479, P=.02) and those with scores below the 25th percentile (OR 2.975, 95% CI 1.230‐7.195, P=.02) had significantly higher odds of reporting poor sleep quality compared with those with scores above the 75th percentile.

    Table 3. Association between eHealth literacy and poor sleep quality using multivariable logistic regression stratified by age.
    Emerging adults (n=285) Established adults (n=965) Middle-aged adults (n=560)
    OR (95% CI) P value OR (95% CI) P value OR (95% CI) P value
    eHealth literacy
    Above the 75th percentile Reference Reference Reference
    Between the 25th and 75th percentiles 2.491 (1.133-5.479) .02 1.439 (1.001-2.067) .049 1.651 (0.985-2.770) .06
    Below the 25th percentile 2.975 (1.230-7.195) .02 1.303 (0.834-2.036) .24 1.639 (0.901-2.980) .11
    Sex
    Male Reference Reference Reference
    Female 0.565 (0.303-1.053) .07 1.150 (0.844-1.569) .38 1.198 (0.793-1.810) .39
    Age 1.087 (0.970-1.218) .15 1.011 (0.979-1.045) .51 1.021 (0.968-1.080) .45
    Weight status
    Normal weight or underweight Reference Reference Reference
    Overweight 1.047 (0.500-2.193) .90 0.760 (0.541-1.069) .12 0.924 (0.629-1.360) .69
    Obesity 1.354 (0.482-3.801) .57 1.040 (0.604-1.789) .89 1.186 (0.551-2.550) .66
    Depressive symptoms
    None Reference Reference Reference
    Mild 4.148 (1.501-11.467) .006 2.386 (1.570-3.627) <.001 1.933 (1.202-3.110) .007
    Moderate 6.356 (1.573-25.685) .009 3.407 (1.796-6.463) <.001 3.102 (1.324-7.270) .009
    Severe 4.389 (1.019-18.904) .047 1.594 (0.690-3.681) .28 2.773 (0.834-9.210) .10
    Anxiety symptoms
    None Reference Reference Reference
    Mild 1.361 (0.539-3.438) .51 1.219 (0.807-1.842) .35 1.263 (0.774-2.060) .35
    Moderate 1.023 (0.235-4.447) .98 2.361 (1.058-5.271) .04 0.996 (0.323-3.070) .99
    Severe 3.747 (0.674-20.832) .13 2.408 (0.874-6.637) .09 0.567 (0.122-2.630) .47
    Educational attainment
    Junior high school or lower Reference Reference Reference
    Senior high school 0.095 (0.007-1.282) .08 0.730 (0.307-1.736) .48 0.696 (0.420-1.150) .16
    College or higher 1.277 (0.279-5.848) .75 1.580 (0.715-3.491) .26 0.801 (0.468-1.370) .42
    Employment status
    Employed Reference Reference Reference
    Unemployed 1.605 (0.600-4.294) .35 1.152 (0.578-2.299) .69 1.081 (0.679-1.720) .74
    Family monthly income
    <¥5000 (US $707.30) Reference Reference Reference
    5001-¥9999 (US $707.44-$1414.45) 0.557 (0.240-1.289) .17 0.997 (0.627-1.584) .99 1.101 (0.660-1.840) .71
    10,000-¥19,999 (US $1414.59-$2829.04) 0.530 (0.216-1.299) .17 0.904 (0.560-1.460) .68 1.296 (0.762-2.200) .34
    ≥¥20,000 (US $2829.18) 0.729 (0.266-1.998) .54 1.100 (0.657-1.841) .72 1.336 (0.729-2.450) .35
    Marital status
    Married Reference Reference Reference
    Single, divorced, or widowed 0.964 (0.469-1.978) .92 1.736 (1.150-2.621) .009 1.354 (0.711-2.580) .36
    Residential area
    Urban Reference Reference Reference
    Periurban 0.682 (0.294-1.584) .37 0.816 (0.546-1.219) .32 0.856 (0.527-1.390) .53
    Rural 0.547 (0.242-1.235) .15 0.868 (0.588-1.281) .48 0.897 (0.564-1.430) .65

    aOR: odds ratio.

    bNot applicable.

    Among established adults, participants with scores below the 25th percentile showed no statistically significant association (OR 1.303, 95% CI 0.834‐2.036, P=.24), whereas the group between the 25th and 75th percentiles showed a positive association (OR 1.439, 95% CI 1.001‐2.067, P=.049). However, this association was not statistically significant among middle-aged adults (OR 1.651, 95% CI 0.985‐2.770, P=.06 for scores between the 25th and 75th percentiles; OR 1.639, 95% CI 0.901‐2.980, P=.11 for scores below the 25th percentile).

    Sensitivity Analysis

    Sensitivity analyses adjusting additionally for smoking, alcohol consumption, and chronic disease status are presented in . Among emerging adults, lower eHealth literacy remained significantly associated with higher odds of poor sleep quality (OR 2.330, 95% CI 1.045‐5.197, P=.04 for scores between the 25th and 75th percentiles; OR 2.564, 95% CI 1.017‐6.464, P=.046 for scores below the 25th percentile). Among established adults, lower eHealth literacy did not show a statistically significant association after additional adjustment (OR 1.377, 95% CI 0.953‐1.991, P=.09 for scores between the 25th and 75th percentiles; OR 0.776, 95% CI 0.776‐1.930, P=.39 for scores below the 25th percentile). Among middle-aged adults, results also remained nonsignificant (OR 1.539, 95% CI 0.910‐2.600, P=.11 for scores between the 25th and 75th percentiles; OR 1.476, 95% CI 0.802‐2.710, P=.21 for scores below the 25th percentile).

    Principal Findings

    This study investigated the association between eHealth literacy and sleep quality among adults aged 18 to 59 years in Shanghai, China. Overall, lower eHealth literacy scores were associated with a higher likelihood of poor sleep quality even after adjusting for biological, psychological, and social factors. The stratified analysis revealed that this association was significant among younger adults but not among middle-aged adults. These findings provide empirical evidence supporting the role of eHealth literacy as a potential determinant of sleep quality, particularly among younger populations.

    The significant association observed in this study is consistent with prior research linking limited health literacy to poorer sleep outcomes and increased sleep disturbances [,]. While existing studies have largely focused on traditional health literacy, emerging research suggests that eHealth literacy may play a comparable role in health management in digital contexts []. Extending previous findings that link eHealth literacy to better adherence to sleep hygiene practices [], our results suggest a more direct association between eHealth literacy and overall sleep quality. Individuals with higher eHealth literacy are better equipped to critically evaluate online health information and adopt evidence-based sleep practices. In contrast, limited eHealth literacy may increase vulnerability to online misinformation and suboptimal sleep practices, ultimately leading to poorer sleep outcomes.

    Beyond eHealth literacy, several other factors, including age, educational level, marital status, and depressive symptoms, were also associated with sleep quality in the overall model, consistent with findings from previous research [,]. Among these factors, depressive symptoms emerged as a well-established and particularly strong predictor of sleep disturbances []. Individuals with mild to severe depressive symptoms had approximately 2 to 3 times higher odds of reporting poor sleep quality compared with those without depressive symptoms. This strong psychological effect may have attenuated the independent contributions of other covariates when adjusting simultaneously. In addition, prior studies have shown that individuals with lower eHealth literacy tend to experience greater psychological distress [], partly due to the misuse of misleading or low-quality information encountered online. These patterns suggest that mental health may play an important role in the pathway through which eHealth literacy relates to sleep quality.

    In the age-stratified analysis, lower eHealth literacy was associated with poorer sleep quality only among emerging and established adults. This finding aligns with those of prior research indicating that younger adults typically engage more actively with digital health information [,] and rely more on online resources for health-related decisions. In contrast, middle-aged and older adults tend to depend more on traditional health care resources [], making their sleep quality less influenced by online health information use. Furthermore, this age-specific association may also reflect distinct underlying mechanisms of sleep disturbances. Among middle-aged adults, sleep disturbance is more frequently attributed to age-related neurophysiological and neurochemical changes (eg, reduced sleep duration and increased fragmentation) []. Such physiologically driven sleep disturbances are only minimally related to eHealth literacy. Conversely, younger adults often experience irregular sleep patterns driven by external demands (eg, academic or occupational stress) [,], which may be more amenable to modification through improved eHealth literacy.

    The age-specific association between eHealth literacy and sleep quality aligns with broader concerns about the digital health divide []. Although digital health technologies offer scalable and cost-effective solutions for health management, their benefits are not equitably distributed across age groups. Structural barriers such as limited access, lower digital confidence, and affordability disproportionately affect marginalized and older populations []. As sleep disturbances tend to increase with age, middle-aged adults may face a dual challenge: increased physiological susceptibility to poor sleep and reduced capacity to engage with digital resources. However, existing eHealth interventions aimed at improving sleep outcomes have predominantly targeted younger populations [-]. Without targeted support, the expansion of digital health tools may unintentionally widen existing age-related disparities in sleep health.

    Our findings highlight the importance of improving eHealth literacy to promote better sleep outcomes. For example, a 6-week online intervention during the COVID-19 pandemic integrated health education and digital skill training to improve university students’ eHealth literacy and related health behaviors []. Although short-term sleep improvements were limited, the study highlighted the potential of eHealth literacy–based interventions and the importance of long-term evaluation []. Given the age-stratified association observed in our study, tailoring interventions to address age-specific barriers is essential. Middle-aged adults, who have lower digital engagement, may require additional support to effectively benefit from digital tools—such as affordable internet access, community-based digital skill training, and user-friendly interface design []. By accounting for the unique needs of different age groups, eHealth literacy can be leveraged to improve health outcomes for all, ultimately advancing digital health equity.

    Strengths and Limitations

    This study has several strengths, including adjustment for multiple confounders at different levels and an age-stratified analysis, offering a more nuanced understanding of the association between eHealth literacy and sleep quality. However, several limitations should be acknowledged. First, the cross-sectional design precludes causal inferences between eHealth literacy and sleep quality. Future studies should use longitudinal or experimental designs to clarify temporal relationships and causal pathways between eHealth literacy and sleep outcomes. Second, the study was conducted exclusively among adults in Shanghai, limiting generalizability to other regions with different levels of health literacy. Third, reliance on self-reported measures for eHealth literacy and sleep quality may introduce recall and social desirability biases, potentially affecting the accuracy of the results. Fourth, due to the need to minimize respondent burden, alcohol use and smoking were assessed using frequency-based measures rather than consumption volume. This may not fully capture the potentially nonlinear associations between these behaviors and sleep quality. Fifth, the overall sample size was relatively limited, particularly within certain age groups, which may have affected the statistical precision of the findings. Finally, we did not include key determinants of sleep such as work or study pressure, exercise habits, and online behaviors, which may introduce residual confounding. Future studies should incorporate these psychosocial and behavioral factors to more fully disentangle the association between eHealth literacy and sleep quality.

    Conclusions

    This study examined the association between eHealth literacy and sleep quality among adults aged 18 to 59 years in Shanghai, China. Findings showed that lower eHealth literacy was significantly associated with a higher likelihood of reporting poor sleep quality. Age-stratified analysis further revealed that this relationship was significant among younger adults but not among middle-aged adults. These findings underscore the potential of enhancing eHealth literacy as an effective strategy for improving sleep health, particularly when tailored to age-specific needs and digital access levels. Targeted measures to reduce the digital health divide will be essential in promoting more equitable health outcomes across age groups.

    This study was funded by the key discipline projects of the Shanghai Three-Year Action Plan for Public Health (grant GWVI-11.1-29).

    The datasets generated or analyzed during this study are not publicly available due to privacy protections or ethical restrictions but are available from the corresponding author on reasonable request.

    All authors have read and agreed to the published version of the manuscript.

    None declared.

    Edited by Amy Schwartz, Matthew Balcarras; submitted 11.Apr.2025; peer-reviewed by Li Li, Vivian Yawei Guo; final revised version received 26.Nov.2025; accepted 26.Nov.2025; published 24.Dec.2025.

    © Yujie Liu, Wenjie Xue, Yuhui Sheng, Suping Wang, Ruijie Gong, Shangbin Liu, Chen Xu, Yong Cai. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.Dec.2025.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

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  • Valkyries Offseason Tracker | Beyond the Bay: Dec. 24, 2025

    Valkyries Offseason Tracker | Beyond the Bay: Dec. 24, 2025

    Although the Valkyries’ season has concluded, the action continues for the team’s athletes. Currently, 13 Valkyries players are competing overseas, with more scheduled to participate in the Unrivaled league which has begun training camp. For a complete guide and all the latest updates on the Valkyries “Beyond the Bay,” click here.

    Team: Uni Girona CB | Spain
    Valkyries Teammates: Justė Jocytė

    Team: Reyer Venezia | Italy
    Valkyries Teammates: N/A

    Team: USK Praha | Czech Republic
    Valkyries Teammates: Janelle Salaün

    Team: PF Schio | Italy
    Valkyries Teammates: Cecilia Zandalasini

    Team: Uni Girona CB | Spain
    Valkyries Teammates: Laeticia Amihere

    Team: Fenerbahçe | Turkey
    Valkyries Teammates: Monique Billings

    Team: USK Praha | Czech Republic
    Valkyries Teammates: Kaitlyn Chen

    Team: PF Schio | Italy
    Valkyries Teammates: María Conde

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  • Northeast Ohio may see blood supply shortfall over the holidays

    Northeast Ohio may see blood supply shortfall over the holidays

    Northeast Ohio is facing a potential shortfall in blood donations this holiday season.

    The American Red Cross is holding blood drives across the region in anticipation of winter weather that could cancel future blood drives.

    Each day, the region’s 70 hospitals require about 500 pints of blood, Ryan Lang, of the American Red Cross’ Northern Ohio Region, said — and having an adequate supply can save lives.

    “We could have people that need dozens of units of blood at one time,” Lang said. “We had a Northeast Ohio woman who went in to give birth, there were complications and she required 56 units of blood.”

    Places like Holmes County with large Amish populations may be at particular risk of shortages, he said.

    “They experience more trauma with accidents in those areas involving farm equipment and on the roads,” Lang said. “A lot of it has to do with mothers birthing at home and complications with childbirth.”

    Lang said universal donors — those with Type O blood — are especially welcome.

    This past January, the Red Cross announced it had to cancel hundreds of blood drives across the U.S. due to weather and wildfires in California.

    Blood shortages can mean patients receive delayed treatment for conditions such as severe anemia, according to the Red Cross.

    “It can be tempting to wonder if we truly need blood transfusions as much as we did in the past, or to question whether there may be alternatives to blood transfusion that could be pursued,” Dr. Eric Gehrie, executive medical director for the American Red Cross, wrote in 2024. “Yet the only feasible source of blood for transfusion is the arm of a generous blood donor.”

    People can schedule donations at locations in Cleveland, Akron and Parma, or search for local drives online.


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  • Trabuco Canyon Post Office Temporarily Closed – California newsroom

    Trabuco Canyon Post Office Temporarily Closed – California newsroom

    Dec. 24, 2025

    Limited road access due to winter weather necessitates temporary Post Office closure of retail services

    Trabuco Canyon, CA — Limited road access due to inclement weather has necessitated the temporary closure of retail services at the Trabuco Canyon Post Office, located at 30595 Trabuco Canyon Rd, Trabuco Canyon, CA 92678.

    PO Box customers normally served by the Trabuco Canyon Post Office may pick up their mail at the Trabuco Canyon Carrier Annex station located at 29862 Avenida de las Banderas, Rancho Santa Margarita, CA 92688 until 3:00 p.m. today.

    Customers are reminded to please bring Photo I.D. for any mail pick-ups.

    Regular retail and delivery services will resume as soon as access is safely restored.

    Many retail services, including temporary forwards, stamps and more are also available anytime, online at USPS.com.

    This is a rapidly changing situation, and the USPS is proud to serve our local communities.

    We ask for patience as we hold our solemn duties to provide the safest, fastest, and most efficient method of providing mail service to our residents.

    # # #

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  • Trump administration orders 2 Indiana power plants to keep burning coal – Indiana Capital Chronicle

    1. Trump administration orders 2 Indiana power plants to keep burning coal  Indiana Capital Chronicle
    2. Indiana says it’s retiring two coal plants, but is it making other plans?  Canary Media
    3. Federal Court Order delays retirement of Jasper County coal-fired generating station.  WLFI News 18
    4. NIPSCO Receives Federal Order to Keep Indiana Coal Plant Running  EnergyNow.com
    5. DOE orders Indiana coal units totaling more than 950 MW to run past retirement dates  Utility Dive

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  • 5th person hospitalized in E. coli outbreak linked to Pillsbury brand Pizza Pops

    5th person hospitalized in E. coli outbreak linked to Pillsbury brand Pizza Pops

    Listen to this article

    Estimated 2 minutes

    The audio version of this article is generated by AI-based technology. Mispronunciations can occur. We are working with our partners to continually review and improve the results.

    The Public Health Agency of Canada is reporting a fifth hospitalization in an E. coli outbreak linked to recalled Pillsbury brand Pizza Pops.

    The federal agency says 23 people in seven provinces got sick with the bacterial illness after eating or handling certain flavours of the frozen snack between early October and late November.

    The Canadian Food Inspection Agency recalled several pepperoni and bacon Pizza Pops on Sunday due to an E. coli contamination that is under investigation.

    The outbreak has now reached Alberta, Ontario, British Columbia, New Brunswick, Manitoba, Saskatchewan and Newfoundland and Labrador.

    The health agency says that for every case that is confirmed in a lab, there are an estimated 32 more undetected in the community.

    E. coli symptoms can include nausea, vomiting, headache, mild fever, severe stomach cramps and watery or bloody diarrhea.

    Most people will fully recover after a few days without treatment, but those who are pregnant, under the age of five, over the age of 60 or have weakened immune systems are at a higher risk of severe illness.

    The affected products are Pizza Pops Pepperoni + Bacon, Pizza Pops Supremo Extreme Pepperoni + Bacon and Pizza Pops FRANK’s RedHot Pepperoni + Bacon, all with best before dates in June 2026.

    Freezers, microwaves aren’t enough to kill bacteria

    Lawrence Goodridge, a professor and Canada Research Chair in foodborne pathogen dynamics at the University of Guelph, said freezers stop the growth of bacteria, but they don’t kill it.

    That means if the product got cross-contaminated or there was a sanitation failure when it was made, the freezer would actually preserve the bacteria.

    Goodridge said the reason heat didn’t kill E. coli in this case is because microwaves don’t heat food equally and leave patches of cold spots where the bacteria can survive.

    Microwaves vary and their power weakens over time, which means heating a Pizza Pop on high for one minute is different for each person.

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  • Live Christmas Tree Recycling Program opens December 26 | News Releases | City Of Yuma, AZ – City Of Yuma, AZ (.gov)

    1. Live Christmas Tree Recycling Program opens December 26 | News Releases | City Of Yuma, AZ  City Of Yuma, AZ (.gov)
    2. Travis County residents can recycle Christmas trees at 5 drop-off locations  FOX 7 Austin
    3. Want to recycle your Christmas tree? The city of Austin makes it easy for you  KXAN Austin
    4. Maricopa Offers Convenient Christmas Tree Disposal Options Until January 12  Hoodline
    5. 7 tips for reducing waste during the holiday season in Austin  CultureMap Austin

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  • VicBre Berry Picker with Metal Comb Plastic Blueberry Scoop Rake Red, SGC-RED

    Anita






    Reviewed in Canada on March 7, 2025


    It doesn’t work

    Marie Prout






    Reviewed in Canada on March 27, 2025


    Slots a little wide for the application I wanted but a good product

    Saskia Reyer






    Reviewed in Germany on September 28, 2024


    Das was ich im Urlaub gebraucht habe. Klasse

    Marie C.






    Reviewed in the United States on September 16, 2024


    I always picked by hand until a friend told me of this so I ordered one. I picked WAY more berrues than if by hand. I thought a good value, arrived on time, works well and fun to use!

    martine






    Reviewed in Canada on August 9, 2024


    parfait

    V. Margarethe






    Reviewed in Germany on August 31, 2024


    Produkt entspricht der Beschreibung.

    Lyle






    Reviewed in Canada on August 23, 2024


    Tines are spaced just right to allow for different berries. We picked Saskatoons and choke cherries and both were easy.It is a bit wide, so getting between branches is a little tricky.

    ROBERT MORRELL






    Reviewed in Canada on August 15, 2024


    It’s rugged

    Susan






    Reviewed in the United States on July 31, 2024


    I use it to pick chamomile blossoms because I couldn’t find anything else reasonably priced. It works fine but I wish the tines were closer together as the blossoms are smaller than blueberries and I could catch more if the tines were narrower. However, I’m harvesting chamomile reasonably well. And my chamomile tea is so much better than anything store bought!

    Ines Stumpf






    Reviewed in Germany on July 28, 2024


    Ich bin begeistert, das pflücken ist sehr einfach , ich habe noch nie so schnell mein Eimer voll gehabt;)

    Lucie Picard






    Reviewed in Canada on September 22, 2023


    Très bon outil ergonomique pour accélérer la cueillette de petits fruits . Je le conseille à tous!

    Customer






    Reviewed in Canada on July 1, 2023


    Looks like picking berries will be quicker. Cleaning the stems off later may be in order but I’ll be able to do that at home in the A/C

    Barry






    Reviewed in Canada on October 27, 2023


    The berry picker is a replacement for my last one. It is identical and does an excellent job. What happens after 10 years or so, some prongs get bent and after bending them back into place they eventually break off. The picker that I just received has a detachable prong section. However, I would think if you could track down the manufacturer, the replacement part would most likely cost as much as a whole new unit? I do have one complaint. The unit was shipped in a plastic bag. Obviously Canada Post threw a heavy box onto it, and several prongs were bent. It should be shipped in a box to protct the prongs! A box cannot cost more than 50 cents? Add it onto the cost.

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