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Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Conclusion: Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students. [ABSTRACT FROM AUTHOR]

The current study aimed to explore the protective factors and underlying mechanisms associated with loneliness and psychological distress among older Chinese adults within the framework of a longitudinal design. This investigation specifically focused on the mediating role of attitudes toward own aging (ATOA) in the relationship between social support and the experience of loneliness and psychological distress (comprising depression, anxiety, and stress) amidst the backdrop of the COVID-19 pandemic. A cohort of 345 elderly individuals (mean age = 83.84 years, standard deviation = 8.49 years; 55.1% females) participated in this research endeavor. The participants were required to complete self-report instruments measuring their perceived levels of social support at Time 1 (T1), attitudes towards own aging, ATOA at Time 2 (T2), and their experiences of loneliness, and psychological distress (including depression, anxiety, and stress) at T1 and Time 3 (T3). The data collection timeline encompassed baseline data collection at T1 in September 2020, a subsequent six-month follow-up at T2 in March 2021, and a one-year follow up at T3 in September 2021. The findings of this investigation unveiled a negative predictive relationship between social support at T1 and psychological distress (encompassing depression, anxiety, and stress) at T3. Furthermore, it was discerned that ATOA at T2 acted as a mediating mechanism, elucidating the longitudinal association between social support at T1 and the manifestation of loneliness and psychological distress (including depression, anxiety, and stress) at T3. The discussion section of this paper delves into an exploration of the limitations and implications inherent in these conclusions, particularly concerning their relevance to potential intervention strategies. [ABSTRACT FROM AUTHOR]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time. Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time. Main outcome measures: SRH at two time points with a -two-year span. Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards. Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time. [ABSTRACT FROM AUTHOR]

With the increased popularity of mobile learning, there is a growing demand on the understanding of how the scalable technology, such as mobile devices, influences individual learning behaviours as well as their learning outcome. A theoretical model was built based on the adaptive structuration theory (AST) and the knowledge spiral theory. Using this model, we examined the relationship between structural sources, individuals' adaptive structural behaviours, and their perceived learning. A Structural Equation Modeling method was employed in our empirical study. Findings indicate that users' task adaptation had a positive influence on their perceived learning, In addition, their exploitive technology adaptation influenced the ultimate perceived learning, but the impact of users' exploratory technology adaptation on learning was mediated by their task adaptation. Contrary to expectations, the effect of computer self-efficacy on exploitive and exploratory technology adaptation was negative, and exploratory technology adaptation negatively affected exploitive task adaptation. A detailed discussion of the findings and implications are provided in this paper. [ABSTRACT FROM AUTHOR]

The study aims to investigate the association of learning participation with the quality of life (QoL) in older Chinese adults, verifying how the differing types of learning activity participation may influence their QoL. We conducted two studies to gain a better understanding of learning participation and QoL among adults over 55 years of age. In the first study, we conducted five focus groups among 43 older adults about their understanding of learning benefits and their general well-being. In a second study, we assessed the QoL using the EUROHIS-QOL 8-item index, while learning participation was measured through a questionnaire addressing the frequency of involvement in educational activities among 579 Chinese older adults. The results indicate that being engaged in learning activities in old age has the potential to increase the QoL of older adults. Moreover, in contrast to nonformal learning, the results of the hierarchical linear regression model demonstrate that both informal and formal learning have a significant positive influence on QoL. The paper concludes by discussing the implications for research and practice pertaining to the encouragement of learning participation in later life. [ABSTRACT FROM AUTHOR]

China's rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of sexually transmitted infections (STIs), having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings. [ABSTRACT FROM PUBLISHER]

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93;p< 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38;p< 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80;p< 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79;p< 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91;p< 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers. [ABSTRACT FROM AUTHOR]

Objective. Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. Design. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. Results. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Conclusions. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians. [ABSTRACT FROM AUTHOR]

This paper's design is descriptive and correlational based on retrospective self-report survey data collected in Kunming city, China. The study investigated the difference between a group of Chinese HIV positive (N=36) and negative (N=131) opioid dependent adults maintained on methadone treatment. Comparisons were based on their quality of life (QOL), methadone treatment adherence, adverse symptom occurrence related to methadone treatment, and HIV-related behavior changes. No significant differences were found between the two groups in age, methadone maintenance dose, methadone adherence, sex desire, and drug craving level. Participants who were HIV positive reported significantly lower scores on physical health and total health-related qualify of life. They also reported greater engagement in injection related risk behavior before methadone treatment than those who tested HIV negative. For both groups, sexual and injection risk behavior significantly decreased following initiation of methadone treatment. A regression model revealed that those infected with HIV, associated significantly with higher likelihood of reporting constipation and lack of appetite, and higher frequency of reporting abdominal pain and nausea than HIV negative patients. The primary implication of these findings is that HIV positive persons in methadone treatment may require more focused services to meet their special HIV care and substance treatment needs. [ABSTRACT FROM AUTHOR]