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Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks. Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID‐19, but there appear to be differences in health beliefs of nurses within and between countries regarding these. Methods: This qualitative descriptive study used content analysis with a framework approach. Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts. Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level. Implications for nursing policy and health policy: The COVID‐19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence‐based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide‐reaching education campaign. [ABSTRACT FROM AUTHOR]

The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

Introduction: This study presents a global research scenario in the broad domain of osteoarthritis (OA) research, using quantitative and qualitative publication and citation indicators. Methods: The study is based on 45,368 global publications, sourced from the Scopus bibliographical database, covering three decades (1994–2023). We studied the performance of the top 12 developed and top 12 developing countries. The key countries, organizations and authors at national and international levels were identified. The broad subject areas and key journals contributing to global OA research were delineated, besides identifying the broad characteristics of highly cited papers in the field. Results: The United States and China were the most productive countries, while the Netherlands and Canada made the largest citation impact. Harvard Medical School and the University of Sydney made the most contribution, while Boston University and Pfizer Inc., USA registered the highest citation impact. Hunter DJ and Guermazi A were the most productive authors, while Lohmander LS, and Hochberg MC registered the highest citation impact. Osteoarthritis and Cartilage (n = 4879) and Annals of the Rheumatic Diseases (n = 786) published the maximum papers, while Arthritis and Rheumatism and Nature Reviews Rheumatology registered the largest citation impact. The highly cited papers with 100 or more citations constituted 6.25% of the total publications. Conclusions: There has been a systematic growth of publications on OA. The research on OA was mainly done in developed countries, with the maximum publications coming from the United States of America, China and Canada. The most impactful publications on OA were from the Netherlands, Canada and the United States of America. [ABSTRACT FROM AUTHOR]

Background: Although existing studies have shown that both repetitive transcranial magnetic stimulation (rTMS) and music therapy have advantages in the treatment of non‐fluent aphasia, the efficacy of the combination of these two methods remains to be investigated. Aims: To investigate the clinical efficacy of low‐frequency rTMS combined with music therapy on language function and depression in patients with non‐fluent aphasia after stroke. Methods & Procedures: A single‐blind parallel randomised controlled trial was conducted. Sixty patients (mean duration = 93.78 days) with non‐fluent aphasia after stroke were randomly divided into a traditional therapy group (n = 20), a music therapy group (n = 20) and a combined therapy group (n = 20, 1 Hz). The language function and depression were evaluated before and 3 weeks after treatment with the Chinese version of the Western Aphasia Battery scale, Boston Diagnostic Aphasia Examination scale and Stroke Aphasic Depression Questionnaire Hospital Version scale. Outcomes & Results: The combined therapy group was significantly better in all outcomes than the traditional therapy group and was significantly better in depression than the music therapy group. The music therapy group was significantly better in repetition and depression than the traditional therapy group. Language improvement was positively correlated with depression improvement. For adverse events, only two patients in the combined therapy group showed slight dizziness during rTMS treatment and their symptoms improved after rest. Conclusions & Implications: Our preliminary randomised controlled study indicates that low‐frequency rTMS combined with music therapy is feasible and safe in improving language function and depression in non‐fluent aphasia patients after stroke. WHAT THIS PAPER ADDS: What is already known on this subject: Repetitive transcranial magnetic stimulation (rTMS) and music therapy respectively have advantages in the treatment of non‐fluent aphasia after stroke, but whether the combination of the two methods is more effective is still unknown. What this paper adds to the existing knowledge: This is one of the first randomised control trials to investigate whether the clinical efficacy of low‐frequency rTMS combined music therapy for non‐fluent aphasia is better. The findings show that low‐frequency rTMS combined music therapy is superior to traditional therapy in spontaneous speech, auditory comprehension, repetition, naming, aphasia quotient, functional language level and depression, and superior to music therapy in depression, while music therapy is superior to traditional therapy in repetition and depression. What are the potential or actual clinical implications of this work?: Low‐frequency rTMS combined music therapy may be a better method for treatment of non‐fluent aphasia. [ABSTRACT FROM AUTHOR]

Background: Somatic symptoms and related factors in patients with chronic heart failure have been extensively researched. However, more insight into the complex interconnections among these constructs is needed, as most studies focus on them independently from each other. Aims: The aim of this study is to gain a comprehensive understanding of how somatic symptoms and related factors are interconnected among patients with chronic heart failure. Methods: A total of 379 patients were enrolled. Network analysis was used to explore the interconnections among the somatic symptoms and related risk factors. Results: The four core symptoms of chronic heart failure were daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping. Within the network, the edge weights of depression–anxiety, subjective social support–objective social support, and subjective social support–social support availability were more significant than others. Among physiological, psychological and environmental factors, the edge weights of NYHA–dyspnea, depression–difficulty sleeping, and social support availability–dyspnea when lying down were more significant than others. Depression and anxiety had the highest centrality, indicating stronger and closer connections with other nodes. Conclusions: Psychological and environmental factors stood out in the network, suggesting the potential value of interventions targeting these factors to improve overall health. Summary statement: What is already known about this topic? Limited studies have explored core somatic symptoms in patients with chronic heart failure using network analysis.There is a lack of a holistic perspective when studying symptoms in patients with chronic heart failure and their association with various factors. What this paper adds? This study identifies daytime dyspnea, dyspnea when lying down, fatigue and difficulty sleeping as the four core symptoms of chronic heart failure.Targeting these core symptoms in treatments and management can potentially lead to improvements in patients' overall health.The network analysis highlights the importance of psychological and environmental factors, suggesting that interventions targeting these factors may contribute to overall health improvement. The implications of this paper: It provides evidence of core symptoms of chronic heart failure.It provides evidence of the complex interconnections among symptoms and related factors in chronic heart failure.It provides implications for future interventions and strategies in managing chronic heart failure. [ABSTRACT FROM AUTHOR]

Aims: To test the psychometric properties of the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory on a sample of patients with chronic obstructive pulmonary disease in China. Background: Measuring the self‐care of patients with chronic obstructive pulmonary disease is vital to promote the performance of effective self‐care behaviours. However, few instruments have been developed to measure self‐care in chronic obstructive pulmonary disease, and the existing instruments lack theoretical support and satisfactory psychometrics properties. The Self‐Care in Chronic Obstructive Pulmonary Disease Inventory based on Middle‐Range Theory of Self‐Care of Chronic Illness has been developed and tested previously in Italian and US population. Design: A cross‐sectional instrument development study. Methods: Construct validity was tested by confirmatory factor analysis and hypothesis testing, and reliability internal consistency using factor score determinacy coefficients. Results: A convenience sample of 185 patients with chronic obstructive pulmonary disease was recruited from September 2020 to January 2022. The instrument consists of three scales: self‐care maintenance, self‐care monitoring and self‐care management. Confirmatory factor analysis performed on the three scales produced good fit indices. The internal consistency was adequate with factor score determinacy coefficients ranging from 0.891 to 0.953 in Self‐Care Maintenance Scale, 0.990 to 0.993 in Self‐Care Monitoring Scale and 0.750 to 0.976 in Self‐Care Management Scale. Conclusions: The Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has acceptable reliability and validity. Some differences from the original instrument were identified. Further validation studies should be conducted to confirm the psychometric properties of the instrument in Chinese population. Summary statement: What is already known about this topic? The Middle‐Range Theory of Self‐care of Chronic Illness has been used to direct clinical nursing practice for coronary heart disease, heart failure, hypertension, chronic obstructive pulmonary disease and other chronic illnesses and has been shown to have good guiding significance for clinical nursing practice for the self‐care of clinical chronic illness.In patients with chronic obstructive pulmonary disease, self‐care has a significant positive effect on preserving disease stability and enhancing health‐related quality of life.There is a shortage of moderate length evaluation instruments for chronic obstructive pulmonary disease self‐care with comprehensive theoretical assessment content, but the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory, based on the Middle‐Range Theory of Self‐care of Chronic Illness, has been demonstrated to have positive application effects in Italy and the United States. However, its applicability in China is unclear. What this paper adds? This paper indicates that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory has good reliability and validity and can reflect the self‐care ability of patients with chronic obstructive pulmonary disease in China. The implications of this paper: The results show that the Chinese version of the Self‐Care in Chronic Obstructive Pulmonary Disease Inventory is simple and accessible, and nurses can use it to assess patients' capacity for self‐care regularly.The Chinese version of the Self‐Care Scale has different dimensions from the original scale, indicating that different medical backgrounds and varying understanding of concept of self‐care in various nations may result in various self‐care behaviours.To ensure its wider application, the development of this scale necessitates cross‐cultural adaptation of populations in more countries. [ABSTRACT FROM AUTHOR]

This study was aimed at comparing different formats of illustrations for children's books created by modern Chinese and Ukrainian artists. At the same time, it was not focused just on determining the leading format, but on identifying the attractiveness factors of each format. To this end, the study investigated children's illustration preferences drawing from the following three age groups: 5–6 years old (preschoolers), 7–8 years old (second‐graders), and 9–10 years old (fourth‐graders). According to the survey, children were most concerned with illustration colourfulness (this is true for paper and pop‐up books) and viewing convenience. There were no statistically significant differences found between Chinese and Ukrainian books in terms of these parameters. At the same time, Chinese e‐books appeared to outperform the Ukrainian texts in terms of feature management and illustration colourfulness. Publishers and artists of children's books can use these data for effective creative activity and making constructive decisions. At the same time, these findings may be of interest to parents, informing or guiding book selection for children. [ABSTRACT FROM AUTHOR]

There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

Aims: This study aims to examine the prevalence of anxiety symptoms and identify predictors of anxiety among pregnant women with gestational diabetes mellitus and their partners and explore the mediating role of marital satisfaction between maternal and paternal anxiety. Design: A cross‐sectional study was conducted in Guangzhou, China, from July 2021 to May 2022. Methods: A total of 306 dyads of pregnant women with gestational diabetes mellitus and their partners completed the State–Trait Anxiety Inventory, Locke–Wallace Marital Adjustment Test and the socio‐demographic and clinical data sheet. Results: The prevalence of anxiety symptoms was 32.4% and 36.6% in pregnant women with gestational diabetes mellitus and their partners, respectively. The predictors of maternal anxiety were paternal anxiety, maternal marital satisfaction, maternal monthly salary, fasting glucose value and 1‐h glucose value. By contrast, the predictors of paternal anxiety were maternal anxiety, paternal marital satisfaction and paternal monthly salary. Moreover, the relationship between maternal and paternal anxiety was mediated by marital satisfaction. Conclusions: The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other, and this relationship was mediated by marital satisfaction. Every couple should be screened for anxiety symptoms and treated as a team rather than focusing solely on the pregnant woman. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with various short‐ and long‐term adverse maternal and neonatal outcomes.The diagnosis of gestational diabetes mellitus is stressful for pregnant women and their partners.No studies have been conducted to examine and compare the anxiety symptoms among pregnant women with GDM and their partners in mainland China. What this paper adds? The anxiety symptoms of pregnant women with gestational diabetes mellitus and their partners influence each other.The prevalence of anxiety symptoms was high in both pregnant women with gestational diabetes mellitus and their partners.Marital satisfaction played a mediating role between maternal and paternal anxiety. The implications of this paper: Study findings provide important information to guide future practice for nurses and other health‐care professionals.For the future, routine screening for anxiety symptoms is necessary for both pregnant women with gestational diabetes mellitus and their partners; mental health support should be delivered in a timely fashion for couples.Pregnant women with gestational diabetes mellitus and their partners should be treated as a team rather than focusing solely on pregnant women, with couples given training on enhancing marital satisfaction skills to prevent and reduce their anxiety symptoms. [ABSTRACT FROM AUTHOR]

Background: For adults with inflammatory bowel disease (IBD), they experience many challenges in dietary decision‐making. Thus, this study examined the perspective and experiences of adults with IBD in dietary decision‐making. Objective: This study aimed to explore the perception and consideration of people with IBD in their daily dietary decisions through monitoring, interpretation and action during the decision‐making process. Design: A qualitative study of individuals affected by IBD was conducted through semistructured interviews. Results: Twenty patients were recruited from four tertiary hospitals in Nanjing, China, and each participant completed a semistructured interview. The majority of participants reported on the process and experience of dietary decision‐making. Key themes were categorised into three stages: (1) assessing needs, preferences and food cues (monitor); (2) moving from experience to expertise (interpret) and (3) balancing expectations amidst limitations (act). The majority of participants reported that their decisions were shaped by assessing current disease status and food cues. Those interviewed with IBD were willing to make tradeoffs for bowel stability, but their decisions were also influenced by past dietary experiences and traditional Chinese beliefs. The lack of awareness of dietary guidelines was a significant barrier to healthy eating decisions. Positive or negative feelings accompanied dietary decisions. Conclusion: Although most people with IBD change their diet after diagnosis, the changes made are often inconsistent with existing dietary recommendations. Several factors can influence the dietary decision‐making process. This study will help assess the experiences of people with IBD in dietary decision‐making to encourage the formation of targeted dietary health and well‐being interventions. Knowledge of nutrition and diet should be provided in education and training programmes for IBD management. Patient or Public Contribution: The first three authors of this paper were the lead researchers in this study's design. These authors were mentored by patient researchers who also contributed to the manuscript, and the research process was co‐lead and directed by other patient participants and consultants. The results of this paper were directly obtained from patient participants. [ABSTRACT FROM AUTHOR]

Background: With potential of deep learning in musculoskeletal image interpretation being explored, this paper focuses on the common site of rotator cuff tears, the supraspinatus. It aims to propose and validate a deep learning model to automatically extract the supraspinatus, verifying its superiority through comparison with several classical image segmentation models. Method: Imaging data were retrospectively collected from 60 patients who underwent inpatient treatment for rotator cuff tears at a hospital between March 2021 and May 2023. A dataset of the supraspinatus from MRI was constructed after collecting, filtering, and manually annotating at the pixel level. This paper proposes a novel A-DAsppUnet network that can automatically extract the supraspinatus after training and optimization. The analysis of model performance is based on three evaluation metrics: precision, intersection over union, and Dice coefficient. Results: The experimental results demonstrate that the precision, intersection over union, and Dice coefficients of the proposed model are 99.20%, 83.38%, and 90.94%, respectively. Furthermore, the proposed model exhibited significant advantages over the compared models. Conclusion: The designed model in this paper accurately extracts the supraspinatus from MRI, and the extraction results are complete and continuous with clear boundaries. The feasibility of using deep learning methods for musculoskeletal extraction and assisting in clinical decision-making was verified. This research holds practical significance and application value in the field of utilizing artificial intelligence for assisting medical decision-making. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self‐efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. Design: A cross‐sectional study. Methods: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self‐efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. Results: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self‐efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. Conclusion: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self‐efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. Impact: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self‐efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. Patient or Public Contribution: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. Summary Statement: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self‐regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self‐efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses. [ABSTRACT FROM AUTHOR]

Background: Limited research on the effectiveness of additional online and face‐to‐face practise opportunities for promoting active learning among Chinese EFL learners in higher education. Current understanding of self‐regulated and collaborative learning theories in educational contexts. Objectives: To establish the efficacy of interactive online and face‐to‐face practise opportunities for enhancing active learning among Chinese EFL learners. Methods: Employed mixed methods research to assess the impact of different types of practise opportunities on 116 EFL learners. Utilised methodological triangulation of QUAN + QUAL data and one‐way ANOVA for interpretation. Results and conclusions: The study demonstrated the effectiveness of integrating online and face‐to‐face practise opportunities to enhance active learning. Empirical evidence supports the pedagogical and theoretical benefits of these opportunities for promoting active learning among EFL learners. Lay Summary: What is currently known about this topic: Limited scholarly exploration of supplementary practise opportunities for active learning among Chinese EFL learnersExisting understanding of self‐regulated and collaborative learning theories in educational contexts What does this paper add: Establishes the effectiveness of interactive online and face‐to‐face practise opportunities for promoting active learningProvides empirical evidence supporting the integration of these opportunities to enhance active learning Implications for practise/or policy: Advocates for the combined use of online and face‐to‐face practise opportunities to enrich engagement, problem‐solving, feedback, and motivation among EFL learnersSuggests the development of instructional frameworks based on self‐regulated and collaborative learning theories for enhanced CALL courses [ABSTRACT FROM AUTHOR]

Background: Deep discussions play an important role in students' online learning. However, researchers have largely focused on engaging students in deep discussions in online asynchronous forums. Few studies have investigated how to promote deep discussion via mobile instant messaging (MIM). Objectives: In this study, we applied learning analytical tools (i.e., KBdeX and word clouds) to enhance students' shared epistemic agency and thereby support their deep discussions in MIM. Methods: Forty Chinese college students participated in this study and reflected on their MIM engagement by participating in the learning analytics (LA)‐augmented meta‐discourse sessions. The study used multiple data analysis methods, including content analysis, statistical analysis, epistemic network analysis and lag sequential analysis. Results: We found that LA engaged students in deep discussions and shared epistemic agency‐related discourse, such as creating shared understanding, creating knowledge objects, and projective and regulative processes. In particular, word clouds engaged students in more complete shared epistemic agency discourse trajectory which started from creating awareness of unknowns, then progressed to setting projective plans and sharing information, and ultimately, creating shared understanding. Moreover, our analysis indicated that epistemic agency discourse moves of creating shared understanding led students to a high level of deep discussion. Implications: This study contributes to research by extending the 'comparison paradigm', which focuses on comparing (a)synchronous forums with MIM, to a 'design paradigm', which mobilises design features from (a)synchronous forums to MIM and using learning analytical tools to engage students in deep online discussions by promoting their epistemic agency. Lay Description: What is known in this subject matter: Supporting students' online deep discussions is important.Prior studies have shown multiple technological and pedagogical strategies to support deep discussions in (a)synchronous discussion forums, but few studies in mobile instant messaging (MIM).MIM is a quasi‐synchronous tool. It is difficult to transform the traditional external scaffolds (i.e., scripts or teachers' facilitation) which promote deep discussions from (a)synchronous forums to MIM. What this paper adds to this: We constructed a design framework which used learning analytical tools‐augmented meta‐discourse to engage students in shared epistemic agency discourse moves to promote their deep discussion in MIM.We conducted multiple types of analyses (content analysis, statistical analysis, epistemic network analysis and lag sequential analysis) on students' WeChat message (a major MIM in China).Results indicated both learning analytical tools helped engage students in shared epistemic agency discourse moves, such as creating shared understanding, creating knowledge objects, projective and regulative, thus, to promote students' deep discussions. Word cloud especially engaged students in more complete shared epistemic agency discourse trajectory. Moreover, analysis results indicated that shared epistemic agency discourse moves of creating shared understanding would lead students to a high level of deep discussions. Implications of study findings for practitioners: Our study provides a feasible way to educational practitioners who want to promote students' deep discussions in their online learning course (both fully online and flipped classroom mode).Knowledge Building Discourse Explorer (KBDeX presents the original analysis results of students' written messages in discussion forums as socio‐cognitive networks.) could be implemented in the classroom. The objective is to encourage students to understand the importance of connecting with peers' ideas in a one‐session implementation period.If time allows, teachers could use word cloud and meta‐discourse to engage students in socio‐metacognitive conversations in class to promote their shared epistemic agency discourse in online discussions. [ABSTRACT FROM AUTHOR]

Background Study: Technology‐supported learning environments, act as significant observational and enabling indicators for evaluating and encouraging the digital revolution of education, are of vital importance in current educational research. Keeping track of the dynamics of technology‐supported learning environment research allows for the enrichment of theoretical studies and a prompt innovation of talent‐training environments. Objectives: The present study carried out a bibliometric analysis of the core collection of WoS database over the last two decades. Method: This study is a bibliometric research. We applied CiteSpace and VOSviewer for co‐occurrence and evolution analysis. In addition, we extracted the fundamental ideas and thoughts through reading and analysis. Results: First, the study found that technology‐supported learning environment research is in a growth phase, with core journals such as Interactive Learning Environments or Computers & Education. The findings show that a core research team comprised of such scholars as Hwang Gwo‐Jen, Lester James C. and Wong Lung‐Hsiang. Key nations of publishing and research strength are from China, the United States, the United Kingdom and the Netherlands. Second, the hot topics in research on technology‐supported learning environments were virtual learning environments, technology‐enabled learning environments and interactive learning environments. Nine study specifics were derived from these three topics such as moulding function, generating scenario, stimulating sensation, effect verification, design idea, research reflection, inquiry and research, virtual community, and mixed environment. Lastly, the frontier evolution offers a pattern of development from enhancing performance to changing mode to incorporating experience. Conclusion: Looking ahead, our research recommendations for the field of technology‐supported learning environments include a multifaceted approach. We should aim to enhance research designs and methodologies, develop contemporary guiding theories and strive for a balanced representation across various educational domains, expanding our scope to encompass all academic disciplines. In terms of practical application, it is imperative to focus on the design and implementation of technology‐supported learning environments from three critical perspectives: "change‐demand," "student‐learning" and "online‐offline." These approaches will collectively ensure that technology‐supported learning environments are both innovative and responsive to the diverse needs of the educational landscape. Lay Description: What is already known about this topic: Technology‐supported learning environments are currently a focal and hot research topic in the field of education.Although numerous studies have been conducted on the learning environment of technical support, there has yet to be a systematic and comprehensive review of the related research. What this paper adds: This study provides a comprehensive review of research on the technology‐supported learning environments over the past two decades.This study primarily presents an overview of research on the technology‐supported learning environments over the past two decades, focusing on main literature, research strength, hot topics and frontier evolution. Implications for practice and/or policy: Researchers need to further advance research on technology‐supported learning environments by enriching research designs and methods, constructing up‐to‐date guiding theories and achieving a balance across different educational domains while extending the reach to all disciplines.Educational practitioners need to pay attention to the design and implementation of technology‐supported learning environments from the three viewpoints of "change‐demand," "student‐learning" and "online‐offline." [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: SDM improves clinical outcomes by increasing attendance and treatment adherence in adolescents diagnosed with depression.SDM could reduce treatment disagreements and enhance consumers' and their families' satisfaction with mental healthcare services.Healthcare professionals are a critical part of SDM. However, MHPs' practices of SDM in the daily management of adolescents diagnosed with depression need to be clarified. What the paper adds to existing knowledge?: From the viewpoints of MHPs, SDM was not extensively applied in the daily management of adolescents diagnosed with depression.MHPs who trust their consumers and have received training related to SDM are more likely to practice SDM in the daily management of adolescents diagnosed with depression.The positive preferences for providing information and family involvement in treatment decision‐making are facilitators; working in closed inpatient mental health wards and open inpatient mental health wards are hindering factors for MHPs' practices of SDM. What are the implications for practice?: MHPs should encourage information sharing with consumers and their family members to help them participate in treatment decision‐making actively.A trusting and friendly therapeutic relationship with consumers should be maintained in the daily management of adolescents diagnosed with depression.SDM‐related training should be encouraged for MHPs to promote widespread SDM. Introduction: Shared decision‐making (SDM) is an ideal model for a therapeutic relationship that can improve health outcomes. Healthcare professionals are a critical part of SDM, and they play an important role in the practices of SDM in the clinical setting. Evidence suggests that adolescents diagnosed with depression can benefit substantially from SDM. However, mental health professionals' (MHPs) practices of SDM for adolescents diagnosed with depression in China are not well‐documented. Aim: This study aimed to investigate the practices of SDM for adolescents diagnosed with depression from the viewpoints of MHPs in China. Method: In this cross‐sectional study, we recruited a total of 581 MHPs by convenience sampling. The Shared Decision‐Making Questionnaire—Physician Version (SDM‐Q‐Doc) was used to evaluate the MHPs' practices of SDM for adolescents diagnosed with depression. Results: The mean SDM‐Q‐Doc was 80.47 (±16.31). Within the six specific decision‐making situations, most MHPs selected non‐SDM (52.7%–71.6%). Substantial numbers of respondents believed that MHPs made the final decision, especially with regard to the development (37%) and adjustment of medication regimens (42%). The practice of SDM was predicted by MHPs' preference for providing information, their trust in consumers, preference for family involvement in treatment decision‐making, working in an outpatient clinic and receiving SDM training (F = 23.582; p =.000; R2 =.198; adjusted R2 =.189). Discussion: Although the MHPs' self‐rated score of SDM‐Q‐Doc was high, SDM was not extensively applied in the daily management of adolescents diagnosed with depression. Thus, SDM needs to be further promoted by enhancing SDM‐related training for MHPs, thereby actively promoting the involvement of families, facilitating the information sharing for consumers and families, and building an active, trusting consumer‐practitioner relationship. Implications for Practice: MHPs should prioritise information sharing with consumers and families, as well as build trusting and friendly therapeutic relationships. Family involvement in treatment decisions should be encouraged when adolescents diagnosed with depression are in need. Actively participating in training related to SDM is also important. Future high‐quality evidence is still needed to explore the facilitators and barriers to SDM practices from a tripartite perspective of MHPs, adolescents diagnosed with depression and their families. [ABSTRACT FROM AUTHOR]

Considering data from the fourth wave of the China Family Panel Studies (CFPS2016), this paper examines the impact of mobile Internet usage on the relationship between adult children and elderly parents. Results drawn from ordered Probit and mediation models show that mobile Internet use, rather than the usage of the fixed Internet, enhances the parent–child relationship. Secondly, older parents, having two or more children, cannot benefit well from using the mobile Internet, and they may rely more on phone calls to uphold intergenerational contact. Thirdly, the mobile Internet enhances the non-face-to-face contact between the two generations. Also, it reduces face-to-face contact in child–parent relationships and improves face-to-face contact in the parent–child relationship. Therefore, related to increasing in the population aging, relevant departments should continue to enhance the use of mobile Internet by reducing the usage costs, improving the usage capabilities, and innovating mobile phone functions, and remain cautious due to the reduction in face-to-face communication caused by the mobile Internet use. [ABSTRACT FROM AUTHOR]

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach‐supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi‐experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non‐flipped mode. Results and Conclusions: The independent t‐test results showed that the experimental MTFL group outperformed the control group in post‐test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post‐test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open‐ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety. Lay Description: What is currently known about this topicFlipped language learning is mostly reported to be effective in improving EFL learning.Peer learning is mostly reported to be effective in improving EFL learning.MosoTeach was investigated in English learning contexts before, but without experimental design. What this paper addsMosoTeach proved as a valid online learning platform in flipped language learning, and the learning experience points (LEPs) on MosoTeach could predict students' exam performance.Students in the experimental group (MosoTeach‐supported flipped) had better exam performance and a higher level of motivation, participation and feedback.Students in both groups experienced isolation, procrastination and technological anxiety. Implications for practice:Peer discussion boards in MosoTeach provide learning support effectively for students in pre‐class learning.Group projects and peer assessment in MosoTeach integrate pre‐class peer discussion into in‐class interaction successfully.MosoTeach provides equal opportunity for every student in the large‐size Chinese English classes, thus contributing to the equity of in‐class peer interactions. [ABSTRACT FROM AUTHOR]

Background: Integrating programming in K‐12 curriculum has become a global consensus. Teachers are central figures in programming instruction. But the majority of current research focuses on teachers' external teaching behaviours and less on teachers' attitudes towards programming. Objectives: The purpose of this study is to validate the K‐12 in‐service Teacher Programming Attitudes Scale (TPAS), to analyse teachers' programming attitudes and their differences in personal, teaching, and environmental factors, and further explore the predictive relationship. Methods: The sample is 888 K‐12 teachers from China. First, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted to validate the availability and reliability of TPAS; Second, independent sample t‐test and one‐way Analysis of Variance (ANOVA) were adopted to explain the differences. Finally, correlation analysis and linear regression analysis were adopted to verify the correlation and prediction relationship. Results and Conclusion: TPAS possess good reliability and validity (χ2/df = 2.488, RMSEA = 0.055, CFI = 0.943, TLI = 0.935, and IFI = 0.943). Further analysis found that, first of all, male teachers possess more positive programming attitudes than female teachers; second, young teachers who are under 30 and the length of teaching under 5 years possess more positive programming attitudes; thirdly, in addition to Information and Communication Technology teachers, primary science teachers also possess high programming attitudes, followed by teachers of Humanities and Arts, reflecting the potential of teaching programming in integrated subjects and the humanities. Finally, primary school teachers possess the best programming attitudes. With the growth of grade, teachers' enthusiasm for programming has gradually decreased. Additionally, discipline, grade and gender factors were considered to predict K‐12 teachers' programming attitudes. Implications: The results of this study contribute to integrating programming teaching of teachers and promoting programming education in K‐12 classrooms. Lay Description: What is already known about this topic:.Integrating programming in K‐12 curriculum has become the consensus for most countries.Teacher is one of the core figures of K‐12 programming teaching.There is currently less attention paid to teachers' attitudes towards programming.K‐12 teachers' programming attitudes measurement tool is needed to analyze the impact of various factors on teachers' programming attitudes. What this paper adds: The K‐12 teacher programming attitude scale (TPAS) is developed and validated.Male teachers and teachers under the age of 30 and under the length of teaching of five years possess more positive programming attitudes.Information and Communication Technology teachers and primary school Science teachers possess high programming attitudes.Discipline, grade and gender factors are considered to predict K‐12 teachers' programming attitudes. Implications for practice and/or policy: The K‐12 Teacher's Programming Attitude Scale (TPAS) fills the gap in measurements of teachers' programming attitudes.The study results provide the guidance for interdisciplinary programming teaching for K‐12 teachers. [ABSTRACT FROM AUTHOR]

Low fertility willingness has become a major practical reality in China. From the perspective of family gender equality, this paper analyzes the impact of division of housework on women's fertility willingness by using the data of China Family Panel Studies (CFPS). The results of propensity score matching method and instrumental variable method show that husbands' participation in housework can effectively improve wives' fertility willingness. Mechanism analysis shows that husbands' active participation in housework can effectively reduce wives' work–family conflict, increase wives' satisfaction with husbands' housework contribution, and help improve wives' happiness and fertility willingness. Further discussion on whether families have had children or not shows that women who have had children are more sensitive to their husbands' participation in housework. This study provides empirical evidence for the applicability of family gender equality theory in China and the factors affecting women's fertility willingness. [ABSTRACT FROM AUTHOR]

Aim: This review aimed to synthesize the available evidence on the effectiveness of nurse‐led multidisciplinary interventions in primary health care. Methods: The following Chinese and English databases were searched for relevant articles: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang and Chinese Biomedical Literature Database (CBM), from the establishment of the databases until the last updating search 1 April 2022. Two researchers screened the studies independently and extracted the data. Meta‐analysis was performed using the RevMan 5.3 software. Results: A total of 12 studies were included in this review. It was found that nurse‐led multidisciplinary interventions significantly shortened patients' length of stay in hospital (standardized mean differences [SMD] = −1.28, 95%CI: −2.03 to −0.54; P<0.001) and decreased incidences of complications (RR = 0.24, 95%CI:0.10 to 0.54; P = 0.0006) compared to the control group, and lowered patients' anxiety levels (SMD = −1.21, 95%CI: −1.99 to −0.44; P<0.01) and depression levels (SMD = −1.85, 95%CI: −3.42 to −0.28; P<0.0001). Furthermore, the results of subgroup analysis indicated that nurse‐led multidisciplinary interventions had significant effects on patients' self‐management ability (SMD = 4.45, 95%CI:2.45 to 6.44; P<0.0001) and quality of life (SMD = 1.01, 95%CI: 0.63 to 1.40; P<0.0001) compared to the control group. Conclusions: Nurse‐led multidisciplinary interventions had strong effects in primary health care, contributing to shorten patients' length of stay in hospital, decrease incidences of complications and reduce the levels of anxiety and depression. Moreover, nurse‐led multidisciplinary interventions also improved patients' self‐management ability and quality of life. Summary statement: What is already known about this topic? Chronic diseases with long duration and slow recovery are one of the priorities for management in primary health care.In China and other countries around the world, primary health care is highly regarded for its efforts for the health of all.Several randomized controlled trials have explored the effectiveness of nurse‐led multidisciplinary interventions in primary health care, but the findings of these studies are contradictory. What this paper adds? The review demonstrates that nurse‐led multidisciplinary interventions could shorten patients' length of stay in hospital, decrease the incidence of complications and reduce the levels of anxiety and depression.Nurse‐led multidisciplinary interventions also improve patients' self‐management ability and quality of life.Nurse‐led multidisciplinary interventions are beneficial for promoting health and preventing disease in primary health care. The implications of this paper: Community primary health‐care personnel should be aware of the importance of nurse‐led multidisciplinary interventions in preventing disease and safeguarding health.For people with chronic diseases, community health‐care personnel should adopt multidisciplinary care methods to improve outcomes for patients.High‐quality studies are needed to verify the effects of interventions for patients. [ABSTRACT FROM AUTHOR]

Background: Little is known about the spontaneous speech characteristics of young children with language delay in Mandarin, relative to their peers. Until the recent development of standardized language assessments normed in China on Mandarin‐speaking children, it was difficult to independently identify atypically developing children to study their spontaneous speech, and only case studies have been available. Aim: To investigate which aspects of spontaneous speech might be distinctive for atypical development in a short play session. Methods & Procedures: A total of 86 Mandarin‐speaking children, boys and girls aged 2;6–4;6, were tested using the new standardized assessment for Mandarin, Diagnostic Receptive Expressive Assessment of Mandarin—Comprehensive (DREAM‐C), at a major urban hospital in China. Of the children, 39 were identified by DREAM‐C as atypically developing in language development (Total Standard score M = 72, SD = 8.9), and 47 scored in the typical range (Total Standard score M = 103, SD = 10.8), using the four scales of Receptive, Expressive Semantics and Syntax. All children then took part in a 15‐min semi‐structured play session during which their spontaneous speech was recorded by professionals. A variety of games and pictures were used in an attempt to elicit spontaneous questions, negatives and descriptions. Their recorded speech samples were then coded by linguists directly into a database in FilemakerPro for different aspects of vocabulary, sentence variety and grammatical morphemes/structures heard. Outcomes & Results: The results describe the characteristics of the speech samples for the typical and atypical groups for age groups 2;6–3.5 (N = 52) and 3;6–4.6 (N = 34). Vocabulary diversity was indicated on an ordinal scale ranging from simple communicative signals including headshakes and words such as 'hi' to 'a rich variety of different content words'. Grammatical diversity similarly ranged from 'only yes/no answers', through to the appearance of multi‐clause sentences. Morphosyntax was coded in terms of which morphemes were observed at all in the session, such as aspect markers (LE, ZAI, GUO), and nominal morphemes (DE, GE), and also whether function words such as pronouns, Wh‐questions and classifiers were singular or varied in the session. There is considerable optionality in morpheme expression in Mandarin, so measurements such as the percentage supplied in obligatory contexts, though useful for languages such as English, are harder to compute. Nevertheless, the data show change over age in all these aspects of language, and reveal what a typically developing child might be expected to produce in a 15‐min sample in such a session. For example, it was rare for the typically developing children by age 3.5 not to have at least simple sentences with some function words, and to use adjectives, nouns and verbs, unlike the children with atypical scores. The morphemes DE, LE and GUO showed significant differences in likelihood across groups for both ages, but BA and ZAI were significantly different only for the older age group. In contrast, GE was common in all groups. The atypical group has markedly lower frequency in several grammatical aspects such as the use of diverse questions, classifiers and pronouns, with much less change across age groups, implying slower growth. The results provide useful information on the relative likelihood of observing different varieties of words, sentence types and morphemes in a short speech sample, which are substantially different in the typical versus atypical groups in both age bands, and change over age. Conclusions & Implications: These data validate the DREAM‐C classifications, but the details can also be used to inform the choice of targets for intervention for young children who experience delays in Mandarin language acquisition. WHAT THIS PAPER ADDS: What is already known on the subject: Spontaneous language samples have been used as a means of studying language in China. However, because of the amount of training and time required to transcribe and analyse spontaneous language samples, there is not yet a sufficient basis for identifying language differences between children with and without language disorder in mainland China. What does this paper add to existing knowledge: After using DREAM‐C to provide an objective measurement of children with and without language disorders, an easy‐to‐administer spontaneous language assessment protocol and scoring record form allowed the comparison of the spontaneous language of 39 children with atypically developing language with 47 children who scored in the typical range to observe language differences between those with and without typical language development. What are the potential or actual clinical implications of this work?: The study documents differences in vocabulary and sentence variety, and use of different morphemes such as classifiers, passives and aspect markers to aid in choosing targets for intervention by demonstrating the path of development. In addition, the spontaneous language assessment protocol and scoring record form holds promise for allowing clinicians and researchers to more easily study the language of individual children to personalize intervention, but also of groups of children to understand the emergence of basic Mandarin linguistic features. [ABSTRACT FROM AUTHOR]

Aim: Smoking is harmful to human health. However, the relationship between smoking and blood pressure (BP) has not been consistent. This study aimed to analyse nurses' smoking behaviours and their relationship with BP. Methods: This cross‐sectional study recruited 128 009 nurses in 11 cities in China. They were surveyed with questionnaires including BP measurements. The main contents of the questionnaire included smoking status and other factors that might be associated with hypertension. Multiple linear regression analyses and binary logistic regression analyses were used to analyse the data. Results: The results showed there was a significant difference in the smoking rate among nurses with different characteristics (P < 0.05). For both male and female nurses, smoking was associated with increased diastolic BP and mean arterial pressure, but only with increased systolic BP of male nurses. The prevalence of hypertension among male and female nurses was not related to smoking. Conclusion: Despite a relatively low overall smoking rate, rates among some groups are high. Different cities, hospitals, and departments can combine local data and conditions to formulate targeted tobacco control measures to improve nurses' physical and mental health. Summary statement: What is already known about this topic?: The number of tobacco‐related diseases has been steadily increasing worldwide over the past few decades.A decrease in the smoking rate of medical staff can lead to a decrease in the smoking rate of the general population.The association between smoking and blood pressure remains controversial, and further clarification is required. What this paper adds?: There was a significant difference between the smoking rates of nurses with different characteristics.The smoking rates were relatively high for nurses in emergency departments and operating rooms and those with >10 night shifts per month within the last 6 months.Among nurses, smoking is related to increase in diastolic blood pressure and mean arterial pressure in both men and women but only to increased systolic blood pressure in men; however, there was no association with hypertension risk. The implications of this paper: This study can support nursing managers to take targeted interventions to target smoking populations to reduce their smoking rates.For nurses who smoke due to high pressure, it is suggested that the working hours and cycles should be adjusted appropriately, the proportion of nurses should be increased, and the work intensity should be reduced to alleviate the work pressure.Nurses with high blood pressure should especially be dissuaded from smoking. [ABSTRACT FROM AUTHOR]

This paper uses the China Family Panel Studies to investigate the relationship between educational difference between partners and wife's happiness. Employing some econometric models, this paper finds that the status of wife having more education than husband has a negative impact on wife's happiness. To alleviate the endogeneity of educational difference, this paper uses an instrument variable approach to identify the causal relationship between them, and obtains conclusions consistent with the baseline regression. Heterogeneous analysis shows that for women who are less educated and subject to external traditional cultural norms, the negative happiness effect of wife having more education than husband is particularly significant. While greatly influenced by traditional cultural norms, these women are not only unwilling but also afraid to deviate from the role orientation of women in the existing social norms. Therefore, once women transcend the traditional norms to have more education than their husbands, their happiness will be reduced. [ABSTRACT FROM AUTHOR]

The risk quotient (RQ) related to Estrone (E1), 17β–E2 (E2), Estriol (E3) and 17α-ethynylestradiol (EE2) in sediment of water resources in China was calculated using Monte Carlo Simulation (MCS) method. Fifty-four papers with 64 data-reports included in our study. The rank order of steroid hormones in sediment based on log-normal distribution in MCS was E1 (3.75 ng/g dw) > E3 (1.53 ng/g dw) > EE2 (1.38 ng/g dw) > E2 (1.17 ng/g dw). According to results, concentration of steroid hormones including E1, E2 and E3 in sediment of Erhai lake, northern Taihu lake and Dianchi river was higher than other locations. The rank order of steroid hormones based on percentage high risk (RQ > 1) was EE2 (87.00%) > E1 (70.00%) > E2 (62.99%) > E3 (11.11%). Hence, contamination control plans for steroid hormones in sediment of water resources in China should be conducted continuously. [ABSTRACT FROM AUTHOR]

Background This analysis estimates the association between smoking-related knowledge and smoking behaviour in a Chinese context. To identify the specific knowledge most directly related to smoking status, we used a novel latent variable analysis approach to adjust for the high correlations between different measures of knowledge about tobacco smoking. Method Data are from the Global Adult Tobacco China Survey, a nationally representative sample of 13 354 household-dwelling individuals 15 years of age or older. Multinomial logistic regressions estimated the association between smoking status (ie, never smoked, current smoker or past smoker) and four smoking-related beliefs: whether or not smoking causes lung cancer, heart attack and stroke, and whether or not low-tar cigarettes are less harmful. A latent variable approach reassessed these associations while taking into account the general level of knowledge about smoking. Results After demographic variables and general knowledge about smoking had been controlled for, the belief that low-tar cigarettes are not less harmful was more prevalent in persons who had never smoked than in current smokers (OR=1.3 (95% CI 1.0 to 1.7) in men and OR=2.8 (95% CI 1.3 to 5.9) in women); this association was even stronger when past smokers and current smokers were compared (OR=2.1 (95% CI 1.5 to 3.0) in men and OR=5.0 (95% CI 1.3 to 20.1) in women). Conclusions Compared with those who have never smoked and those who have ceased smoking, current smokers in China are more likely to believe that low-tar cigarettes are less harmful than regular cigarettes. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine to what extent Chinese media coverage of tobacco issues in 17 Chinese cities comprises messaging known to motivate healthy behaviour. Methods This study involved a content analysis of 4821 articles that contained at least one full paragraph focused on tobacco issues from newspapers published in cities that participated in the Tobacco-Free City—Gates Tobacco Control Project in China between 1 January 2008 and 30 June 2011. Results The number of tobacco-focused articles increased over the study period. The number of articles varied considerably among different newspapers and cities. Education, prevention and cessation programs (35%) were the most frequent theme. There was also considerable variation in the volume of coverage each month. News articles were the most frequent article type (70%). The majority of the articles (72%) were positive for tobacco control. There were significant differences between party newspapers and local newspapers in prominence, article type, slant and fear appeal. One quarter (n=729) of the articles mentioned the severity of tobacco use, while only 10% of the articles referred to susceptibility to the threat. Conclusions The coverage of events was predominantly positive toward tobacco control. However, media reports could better support tobacco control efforts if they did a better job at provoking an emotional response to the harms of tobacco use and promoting a sense among smokers that they can succeed in quitting smoking. [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]

Aims and Objectives: This study aims to propose a self‐management clusters classification method to determine the self‐management ability of elderly patients with mild cognitive impairment (MCI) associated with diabetes mellitus (DM). Background: MCI associated with DM is a common chronic disease in old adults. Self‐management affects the disease progression of patients to a large extent. However, the comorbidity and patients' self‐management ability are heterogeneous. Design: A cross‐sectional study based on cluster analysis is designed in this paper. Method: The study included 235 participants. The diabetes self‐management scale is used to evaluate the self‐management ability of patients. SPSS 21.0 was used to analyse the data, including descriptive statistics, agglomerative hierarchical clustering with Ward's method before k‐means clustering, k‐means clustering analysis, analysis of variance and chi‐square test. Results: Three clusters of self‐management styles were classified as follows: Disease neglect type, life oriented type and medical dependence type. Among all participants, the percentages of the three clusters above are 9.78%, 32.77% and 57.45%, respectively. The difference between the six dimensions of each cluster is statistically significant. Conclusion(s): This study classified three groups of self‐management styles, and each group has its own self‐management characteristics. The characteristics of the three clusters may help to provide personalized self‐management strategies and delay the disease progression of MCI associated with DM patients. Relevance to clinical practice: Typological methods can be used to discover the characteristics of patient clusters and provide personalized care to improve the efficiency of patient self‐management to delay the progress of the disease. Patient or public contribution: In our study, we invited patients and members of the public to participate in the research survey and conducted data collection. [ABSTRACT FROM AUTHOR]

Background: Spontaneous reporting of adverse drug reactions (ADRs) is essential for the post-marketing safety evaluation of drugs. Therefore, good monitoring of ADRs is vital for strengthening drug supervision, management, and guiding rational drug use. Chinese medical institutions are the primary source of ADR case reports, but the proportion of the reports in grade IIIA hospitals is still low due to serious under-reporting. The 3rd Affiliated Hospital of Chengdu Medical College, Chengdu Pidu District People's Hospital, also has such a problem. Objective: To improve the quantity and quality of ADR reports and enhance the level of pharmacovigilance in hospitals, the Third Affiliated Hospital of Chengdu Medical College, People's Hospital of Chengdu Pidu District experienced 10 years to gradually establish a management model to improve the medical staff's reporting rate of spontaneous reporting of ADRs. The management model is led by clinical pharmacists and combines the PDCA with Teach-back methods. The purpose of this paper is to introduce the management model and discuss its advantages and shortcomings of this model. Methods: This study was conducted at the Third Affiliated Hospital of Chengdu Medical College—Chengdu Pidu District People's Hospital. From 2016, the daily management of reporting, auditing, and data improvement of adverse drug reactions in the hospital was carried out by clinical pharmacists, who used the PDCA method combined with the Teach-back method to continuously improve the reporting program of ADRs in the hospital during 2016–2021. Then, the proportion of spontaneous reports of total, new, and serious ADRs was compared before and after the intervention. Also, we performed a time series analysis using an autoregressive moving average model to assess changes in the total number of spontaneous ADR reports before the intervention (2013–2015), the first intervention (2016–2018), and the second intervention (2019–2021). Results: After the combined PDCA and Teach-back method intervention, the median number of reported ADRs per year increased from 50 (range 37–55) in the pre-intervention period to 88 (range 83–162) in the first intervention period and to 374 in the second (range 312–566). Breakpoint regression analysis of the spontaneous reporting rate of ADRs showed that the instantaneous increase after the first intervention was not statistically significant (P = 0.526). However, the reporting rate of ADRs increased at a month-by-month growth rate during the second intervention compared to the first intervention. Its spontaneous reporting rate improved 1.034 times (P = 0.002). After the second intervention, the spontaneous reporting rate of ADRs transiently increased 6.111-fold (P < 0.001), and the month-to-month growth rate increased 1.024-fold (P < 0.001) again. Conclusion: The management model that combines the PDCA and the Teach-back method significantly improves the reporting rate of adverse drug reactions. [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]

Background: Video conferencing learning offers a more accessible and flexible learning mode for students who cannot attend face‐to‐face class in person. However, research about the video conferencing learning is still lacked, especially for students' engagement in this setting. Objectives: This study adopts the self‐system model of motivational development to uncover effects of the video conferencing learning environment (VCLE) to students' engagement. Methods: Two hundred and ninety‐eight primary school students involved in the VCLE were surveyed. The partial least square structural equation modelling was employed to explore the link between the VCLE and students' engagement with a mediating role of basic psychological needs satisfaction (BPNS). Results and Conclusions: Results showed that the BPNS played a mediating role in the processes from the VCLE to engagement. Both pedagogical and social affordance had a significant effect on the BPNS. However, their influences were different. Specifically, pedagogical affordance yielded a stronger effect on the BPNS for autonomy than social affordance. The predicting power of social affordance on BPNS for relatedness and competence was stronger than pedagogical affordance. Generally, social affordance yielded more contributions to behavioral and emotional engagement than pedagogical affordance. Moreover, BPNS for competence was the only significant mediator between the VCLE and behavioral engagement, and it owned the strongest mediating power on the relationship between the VCLE and emotional engagement, followed by autonomy, and the smallest of relatedness. This study suggests that practitioners and researchers should give more consideration to improve social affordance of the VCLE and to meet students' BPNS especially for competence in order to design and implement an engaged video conferencing course. Lay Description: What is already known about this topic: Video conferencing learning provides an accessible and flexible learning mode.Mechanism from learning environment to engagement is helpful to design an engaged video conferencing course.Less is known about how video conferencing learning affects students' engagement. What the paper adds: This study uncovered the functioning process of video conferencing learning to students' engagement.PLS‐SEM was employed to verify the mediating role of BPNS in this process.BPNS for autonomy, competence, and relatedness played mediating roles and their powers were different. Implications for practice and/or policy: More attention is needed to improve to social affordance to enhance students' emotional engagement.BPNS especially for competence deserves special consideration to improve students' behavioral and emotional engagement. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Background: Talent is a crucial resource for economic and social development, serving as the driving force behind urban progress. As China experiences rapid growth in digital city construction, the capability of e-services continues to improve incessantly. In China, the new-generation highly educated migrants (NGHEMs) account for ~ 20–30% of the total floating populations. This study aimed to explore the settlement intention of new-generation highly educated migrations in China from the new perspective of urban e-service capabilities. Furthermore, the mechanism of the urban e-services on the settlement intention on the NGHEMs will be proved. Methods: This paper employed data of China Migrants Dynamic Survey in 2017 and Evaluation Report of Government E-service Capability Index (2017). Descriptive analyses were conducted to investigate the factors influencing the settlement intention of NGHEMs in the destination city. Based on the principle of utility maximization, LASSO regression was employed to select individual and city characteristics that determined the settlement intention of NGHEMs. The impact of urban e-services on settlement intention was analyzed by using ordinal logit model. Additionally, robustness check, endogeneity analysis, and heterogeneity analysis were performed to validate the benchmark regression results. Finally, mediation model was employed to examine whether urban e-services enhance the settlement intention of NGHEMs by improving urban livability and urban innovation. Results: The results indicate that the urban e-services promote the NGHEMs' settlement intention in the destination cities. Moreover, the results are still robust through a series of robustness tests. Furthermore, from the perspective of individual and regional heterogeneity, urban e-services significantly enhances the settlement intention of NGHEMs with male and female, married and urban household registration, and urban e-services can promote the settlement intention of NGHEMs with over 3 million inhabitants and those in the eastern regions of China. Finally, the intermediary effect test shows that urban e-services promote the settlement intention of NGHEMs through urban livability and urban innovation. Conclusion: This study highlights the important impact of urban e-services on the settlement intention of new-generation highly educated migrants. The conclusions of this study provide suggestions for the government to use when designing policies to enhance the settlement intention of the NGHEMs and to improve the development of urban e-services. [ABSTRACT FROM AUTHOR]

Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas. This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems. Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments. This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance. This study mainly refers to children with difficulty in social inclusion and psychological development. The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children. The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation. [ABSTRACT FROM AUTHOR]

Adolescent suicide has become an increasingly serious social problem in China. Bullying victimization was found to be an influential factor of suicidal tendency, but less attention has been paid to the internal mechanisms of the relationship. This paper examined the relationship between adolescents' bullying victimization and suicidal tendency, and the mediating effects of internalizing problems and non-suicidal self-injury (NSSI). Generalized Structural Equation Model was employed to a sample of 3,575 Chinese secondary school students. Bullying victimization has a direct positive impact on adolescents' suicidal tendency, but also has an indirect impact on suicidal tendency through three paths: the independent mediating role of internalizing problems and NSSI, and the chain mediating role of internalizing problems and NSSI. The results suggested that students who are bullied tend to have a higher risk of suicidal tendency, and internalizing problems and NSSI are usually the prelude to suicidal behaviors. [ABSTRACT FROM AUTHOR]

Background: At the beginning of the 21st century, international adoptions of children with cleft lip and/or palate increased dramatically in Sweden. Many children arrived partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. To date, the speech development of internationally adopted (IA) children has been described up to age 7–8 years, but later development remains unstudied. Aims: To investigate speech development between ages 5 and 10 years in children born with cleft lip and palate (CLP) adopted from China and to compare them with non‐adopted (NA) children with CLP. A secondary aim was to compare the frequencies of secondary palatal surgery and number of visits to a speech and language pathologist (SLP) between the groups. Methods & Procedures: In a longitudinal study, 23 IA children from China were included and matched with 23 NA children born in Sweden. Experienced SLPs blindly reassessed audio recordings from routine follow‐ups at ages 5 and 10 years. Velopharyngeal function (VPF) was assessed with the composite score for velopharyngeal competence (VPC‐Sum) for single words and rated on a three‐point scale (VPC‐Rate) in sentence repetition. Target sounds in words and sentences were phonetically transcribed. Per cent correct consonants (PCC) were calculated at word and sentence levels. For in‐depth analyses, articulation errors were divided into cleft speech characteristics (CSCs), developmental speech characteristics (DSCs) and s‐errors. Information on secondary palatal surgery and number of visits to an SLP was collected. Outcomes & Results: VPF differed significantly between the groups at both ages when assessed with VPC‐Sum, but not with VPC‐Rate. Regardless of the method for assessing VPF, a similar proportion in both groups had incompetent VPF but fewer IA than NA children had competent VPF at both ages. IA children had lower PCC at both ages at both word and sentence levels. More IA children had CSCs, DSCs and s‐errors at age 5 years, and CSCs and s‐errors at age 10. The development of PCC was significant in both groups between ages 5 and 10 years. The proportion of children receiving secondary palatal surgery did not differ significantly between the groups, nor did number of SLP visits. Conclusions & Implications: CSCs were more persistent in IA children than in NA children at age 10 years. Interventions should target both cleft and DSCs, be comprehensive and continue past the pre‐school years. WHAT THIS PAPER ADDS: What is already known on this subject: At the beginning of the 21st century, IA children with cleft lip and/or palate arrived in Sweden partially or totally unoperated, despite being at an age when palatoplasty has usually been performed. Studies up to age 7–8 years show that adopted children, compared with NA peers, have poorer articulation skills, demonstrate both cleft‐related and developmental articulation errors, and are more likely to have velopharyngeal incompetence. Several studies also report that adopted children more often require secondary palatal surgery due to fistulas, dehiscence or velopharyngeal incompetence compared with NA peers. What this paper adds to existing knowledge: This longitudinal study provides additional knowledge based on longer follow‐ups than previous studies. It shows that the proportion of children assessed to have incompetent VPF was similar among IA and NA children. It was no significant difference between the groups regarding the proportion that received secondary palatal surgery. However, fewer IA children were assessed to have a competent VPF. Developmental articulation errors have ceased in most IA and all NA children at age 10 years, but significantly more adopted children than NA children still have cleft‐related articulation errors. What are the potential or actual clinical implications of this work?: Speech and language therapy should target both cleft‐related and developmental articulation errors. When needed, treatment must be initiated early, comprehensive, and continued past the pre‐school years, not least for adopted children. [ABSTRACT FROM AUTHOR]

The researchers' aim to quantitatively study the impacts of education, health expenditure, Internet, mobile phone, and open-access articles in medical science on women's health in China. We found that there are very strong significant negative correlations between the data of women's mortality rates and female school enrollment (p≪0.01), whereas there are strong significant negative correlations for open-access papers in eight disciplines of medical science, individuals using the Internet, and mobile cellular subscriptions (p≪0.01). The first principal component explains 96.8%, 96.6%, and 99.6% of the variation in the mortality rate of female infants (p = 0.002 < 0.01), females under-5 (p = 0.003 < 0.01), and female adults (p = 0.002 < 0.01), respectively. There is a similar relationship between open-access medical papers and women's health. The above results could be helpful to interdisciplinary audiences (patients, practitioners, and policymakers) to develop strategies for the effective implementation of knowledge on women's health (how to disseminate knowledge more effectively in the whole society). [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the utility of latent profile analysis of illness perception, in comparison to treating illness perception as several dimensions, to predict breast cancer‐related lymphedema risk management behaviours among Chinese breast cancer patients. Methods: This is a 3‐month longitudinal study. From August 2019 to January 2021, patients who recently underwent breast cancer surgery including axillary lymphadenectomy were recruited. Illness perception and risk management behaviours were measured by breast cancer‐related lymphedema specific questionnaires before discharge following surgery (n = 268) and at 3 months postsurgery (n = 213), respectively. Results: Treating illness perception as several dimensions, 'illness coherence' and 'timeline (cyclical)' dimensions were found to be significantly associated with breast cancer‐related lymphedema risk management behaviours. Using the latent profile analysis, two illness perception profiles were identified and significant differences were revealed in breast cancer‐related lymphedema risk management behaviours between them. Overall, illness perception profiles explained smaller amounts of variability in breast cancer‐related lymphedema risk management behaviours than illness perception dimensions. Conclusion: Future studies could combine these two different perspectives of illness perception regarding breast cancer‐related lymphedema into the design of interventions to improve breast cancer‐related lymphedema risk management behaviours. Summary statement: What is already known about this topic? Risk management behaviours are essential to reduce the risk and severity of breast cancer‐related lymphedema (BCRL).Illness perception is a modifiable predictor of BCRL risk management behaviours.Traditional correlation or regression analysis treat illness perceptions as several isolated elements and make it difficult to synthesize our understanding of it. What this paper adds Treating illness perceptions as several isolated elements, illness coherence and timeline (cyclical) were main components predicting BCRL risk management behaviours.Treating illness perception as a whole, latent profile analysis assigned breast cancer patients into two distinct profiles with similar illness perception.Illness perception dimensions and illness perception profiles showed certain effects on predicting BCRL risk management behaviours. The implications of this paper This study adds our knowledge of illness perception regarding BCRL and its effect on predicting BCRL risk management behaviours.The two analysis approaches provided different perspectives on the design and implementation of future intervention. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study was to identify risk factors for cognitive impairment in advanced cancer patients and to develop predictive models based on these risk factors. Background: Cancer‐related cognitive impairment seriously affects the quality of life of advanced cancer patients. However, neural network models of cognitive impairment in patients with advanced cancer have not yet been identified. Design: A cross‐sectional design was used. Methods: This study collected 494 questionnaires between January and June 2022. Statistically significant clinical indicators were selected by univariate analysis, and the artificial neural network model and logistic regression model were used for multivariate analysis. The predicted value of the model was estimated using the area under the subject's working characteristic curve. Result: The artificial neural network and the logistic regression models suggested that cancer course, anxiety and age were the major risk factors for cognitive impairment in advanced cancer patients. All the indexes of artificial neural network model constructed in this study are better than those of the logistic model. Conclusion: The artificial neural network model can better predict the risk factors of cognitive impairment in patients with advanced cancer. Better prediction will enable nurses and other healthcare professionals to provide better targeted and timely support. Summary statement: What is already known about this topic?: Cancer‐related cognitive impairment has significantly affected the quality of life of patients with advanced cancer.Risk factors associated with cognitive impairment in patients with advanced cancer have not been adequately documented, and neural network models have not been identified. What this paper adds?: This study found that long a cancer course, anxiety and ageing were the most important risk factors for cognitive impairment in patients with advanced cancer.The artificial neural network showed good predictive indicators, indicating that it can be used to predict cognitive impairment in patients with advanced cancer. The implications of this paper: Neural network models can help nurses and other clinicians predict cognitive impairment in advanced cancer patients early which will allow provision of timely intervention. [ABSTRACT FROM AUTHOR]

Background Studies: Captioning and repetition are widely used multimedia instructional devices for non‐native students. Generally, studies in this area have tended to focus on second language literacy skills rather than on learning new content knowledge. Additionally, posttests were administered immediately after the treatments, while the delayed influences of captioning and repetition have never been investigated. Objectives: This paper addressed these research gaps in two separate studies. More specifically, this study attempted to examine the influences of captioning and repetition on non‐native students' immediate and relayed retention. Methods: In Study One, three captioning conditions; word‐by‐word captions, closed captions, and no‐captions; were compared to examine their efficacies in immediate and delayed content knowledge retention on 82 Chinese university students. To address the limitations in Study One as the multimedia lesson was short and played only once, Study Two incorporated captioning and two repetition types in its design. One hundred and eleven Chinese university students watch a video lesson in one of four captioning and repetition conditions. Results: The statistical analyses of Study One indicated that there were no significant differences in both immediate and delayed retention test scores across the three captioning condition. Similarly, in Study Two, there were no significant differences in retention tests scores across the four captioning and repetition conditions. Findings: Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention, which lent support to existing studies. Based on the research results, the limitations and future study possibilities are discussed. Lay Description: What Is Already Known About This TopicEmpirical studies on captioning have focused on immediate learning right after the treatment, so have studies on repetition.Empirical studies on multimedia lessons for non‐native students have focused on English language learning. What This Paper AddsThree types of captioning were compared to examine their efficacies in both immediate and delayed content retention of Chinese students.Two types of repetition were compared to examine their efficacies in both immediate and delayed content retention of Chinese students. Implications for Practice and/or Policy:Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention.The availability of textual keywords adjacent to their corresponding graphics might have compromised the efficacy of captioning. [ABSTRACT FROM AUTHOR]

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]

Aims: This study aimed to test the effects of a novel diabetes self‐management education (DSME) programme focused on multilevel social resources utilization on improving self‐management behaviour, social resources utilization and haemoglobin Alc (HbA1c) in patients with type 2 diabetes mellitus (T2DM). Methods: A randomized controlled design was used. A total of 118 participants with T2DM from two communities were recruited through randomized sampling, and randomly assigned to the novel DSME group or the traditional DSME group. DSME focusing on multilevel social resources utilization was implemented in the novel DSME group. Data were collected at baseline (T0), at the end of the intervention (T1) and 3 months after the end of intervention (T2) from 3 March to 16 November 2014. Results: Comparing these two groups, the participants in the novel DSME group reported significantly better improvement in self‐management behaviour and social resources utilization at T1 and T2 (all p < 0.01). A significant difference was found in the mean improvement of HbA1c level between the two groups at T2 (p < 0.05). Conclusions: The novel DSME programme focused on multilevel social resources utilization can effectively enhance T2DM patients' self‐management behaviour and social resource utilization and lower HbA1c levels. More importantly, the effects could last longer. Summary statement: What is already known about this topic? Traditional diabetes self‐management education does not guarantee lifelong effective diabetes self‐management behaviour.The utilization of multilevel social resources has been found to be positively associated with self‐management behaviour and health outcomes of patients with chronic diseases. What this paper adds? The novel diabetes self‐management education programme is beneficial to community patients with type 2 diabetes mellitus as it shows significantly better effects in improving diabetes self‐management behaviour, social resources utilization and HbA1c level, and the effects last longer.Due to the large diabetes patient population and the relative shortage of medical resources in China, focusing on inspiring patients' initiative to actively tap and utilize existing and potential social resources for self‐management is indicated when developing education protocols for diabetes patients. The implications of this paper In addition to traditional self‐management education, community health‐care professionals should pay attention to the education of social resources utilization to further improve and solidify diabetes patients' self‐management behaviour.Especially in places with large population and limited medical resources, it is economical and effective to inspire patients to actively tap and utilize existing and potential social resources for self‐management. [ABSTRACT FROM AUTHOR]

Background: It has been reported that the knowledge, attitudes and practices of nurses play a significant role in preventing incontinence‐associated dermatitis (IAD), and these three factors influence and interact with each other. This study aimed to translate the English version of the Knowledge, Attitudes and Practices of Incontinence‐Associated Dermatitis Questionnaire (KAP‐IAD‐Q) into Chinese and assess the validity and reliability of the Chinese KAP‐IAD‐Q (C‐ KAP‐IAD‐Q) used with Chinese nurses. Methods: The KAP‐IAD‐Q was translated into Chinese strictly in accordance with the Brislin translation model, and a Chinese version of IAD was formed after discussion by experts. From October to November 2021, a total of 259 Chinese nurses were recruited through a convenience sampling method and investigated using the Chinese version of the knowledge, attitudes and practices of the incontinence‐associated dermatitis questionnaire (C‐KAP‐IAD‐Q) and the general self‐efficacy scale to assess its reliability and validity. Results: Three factors were extracted by exploratory factor analysis comprised of 22 items. The Cronbach's α coefficients were 0.961, 0.929 and 0.833, and the intraclass correlation coefficient was 0.98 totally. The scale‐level content validity index (S‐CVI) was 0.95, and the item‐level content validity (I‐CVI) was 0.83–1.00. The correlation coefficient between the general self‐efficacy scale and the C‐KAP‐IAD‐Q was 0.561 (P < 0.01). Conclusion: The 22‐item C‐KAP‐IAD‐Q seems to be culturally well adapted and has good psychometric properties used by Chinese nurses. Summary statement: What is already known about this topic? There is a knowledge gap among nurses, and the attitudes of nurses to prevent incontinence‐associated dermatitis (IAD) have a significant impact on the final implementation of preventive interventions.The Knowledge, Attitudes and Practices of the Incontinence‐associated Dermatitis Questionnaire (KAP‐IAD‐Q) was developed and assessed as a valid and reliable tool in Singapore.China does not currently have such a tool.What this paper adds? This study translated the KAP‐IAD‐Q into Chinese and formed the Chinese version of the KAP‐IAD‐Q (C‐ KAP‐IAD‐Q).The C‐KAP‐IAD‐Q comprises 22 items and three factors, including knowledge, attitudes and practices towards IAD prevention with proper psychometric properties.The implications of this paper: The C‐KAP‐IAD‐Q could be used in clinical practice and research to provide a reference for improving the knowledge, attitudes and practices towards IAD prevention in China.The C‐KAP‐IAD‐Q can make a great contribution to supporting the education and management of IAD. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the incidence of facial pressure injuries in health‐care professionals during the COVID‐19 pandemic in a meta‐analysis. Methods: Related studies were obtained through electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) Chinese Scientific Journal (VIP) China Biomedical Literature service systems (CBM) and Wanfang Data (from inception to 27 November 2021). The pooled incidence and the 95% confidence interval of facial pressure injuries were calculated with Review Manager v5.4 software. Results: Overall, 16 studies with 14 430 health‐care professionals were included. Pooled results showed that the pooled incidence of facial pressure injury in health‐care professionals was 58.8% (95% CI: 49.0%–68.7%; p < 0.01). The results of the subgroup analysis showed that the incidence of facial pressure injury in these staff was high, and predominantly stage I pressure injury, in the following cases: in health‐care professionals who wore personal protective equipment for longer than 4 h, in those without any training experience, and on the nose. Conclusion: Administrators and researchers should pay attention to preventing facial pressure injury related to the wearing of personal protective equipment (PPE) by ensuring all health‐care professionals receive training and by limiting prolonged periods of use. Summary statement: What is already known about this topic? Facial pressure injury was one of the most common effects experiencedby health‐care professionals wearing facial PPE during COVID‐19, which seriously affected their facial comfort and self‐image.A number of studies have reported the incidence of facial pressure injury in health‐care professionals, but the evidence is inconsistent.Medical staff are the main force during the COVID‐19. What this paper adds? This study showed that the pooled incidence of facial pressure injury in health‐care professionals was 56.8% during COVID‐19.This study showed that there was a higher incidence of facial pressure injury in staff who wore PPE for longer than 4 h and in those without any training experience.This study showed that the nose was the most common part of the face with pressure injury, and Stage I pressure injury was the most prevalent injury type in health‐care professionals. The implications of this paper: This study may provide evidence for managers about the development of guidelines for health‐care professionals to prevent and manage facial pressure injuries and promote the health of health‐care professionals. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and confirm the factor structure and item distribution of the Chinese version of Self‐care Ability Scale for the Elderly among older Chinese people. Methods: A cluster random sampling method was used to collect 2856 older people from five different cities of China from July 2018 to July 2019. A questionnaire comprised of socio‐demographic information and the Chinese version of the Self‐care Ability Scale for the Elderly was administered, and SPSS 21.0 and Mplus 7.4 were used for analyses. Results: Participants were aged 60 to 92 years, with a mean age of 71.52 (SD = 7.68) years. In the Exploratory Factor Analysis, the three‐factor structure and item distribution of the Chinese version of the Self‐care Ability Scale for the Elderly were verified to be better than other options. The factor loadings varied from 0.428 to 0.800, and the communality values ranged from 0.426 to 0.792. The modified model showed a good fit in the Confirmatory Factor Analysis. Conclusion: The Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and a good item distribution. It serves as a convenient and accurate assessment tool to assess the self‐care ability of older Chinese people. Summary statement: What is already known about this topic? Assessing self‐care ability plays a significant role in the care of older people.The Chinese version of the Self‐care Ability Scale for the Elderly is often used to assess the self‐care ability of older people in China but whilst it has good reliability and content validity, its factor structure and item distribution are not clearly explained in recent literature.Solid evidence on the factor analysis of the Chinese version of the Self‐care Ability Scale for the Elderly is needed to maintain a high standard of health care assessment for the older Chinese people. What this paper adds? We confirmed that the Chinese version of the Self‐care Ability Scale for the Elderly has a clear three‐factor structure and item distribution.The Chinese version of the Self‐care Ability Scale for the Elderly can now be used as the study confirmed its validity and reliability. The implications of this paper: The instrument can be effective in older Chinese people to identify their self‐care support needs and thereby to enable provision of opportunities to implement appropriate nursing care.Health care professionals can use this instrument to assess the alterations in self‐care ability of older Chinese people after particular interventions. [ABSTRACT FROM AUTHOR]

Aims: To explore predictors of lymphedema self‐management behaviours among Chinese breast cancer survivors based on the Integrated Theory of Health Behaviour Change, and to clarify the interrelationship among these variables. Design: Further analysis of a multicentre cross‐sectional and survey‐based study. Methods: A total of 586 participants with breast cancer were recruited from December 2021 to April 2022 in different cities in China. We used self‐reported questionnaires to collect data. Descriptive analysis, bivariate analysis and structural equation model were performed. Results: The Integrated Theory of Health Behaviour Change is suitable for predicting lymphedema self‐management behaviours. The final structural model showed good model fit. Social support, self‐efficacy and lymphedema knowledge positively affected lymphedema self‐management behaviours, directly and indirectly. Self‐regulation acted as a crucial mediator between these variables and self‐management. The direct path between social support and self‐regulation was not significant. Lymphedema knowledge and social support also influenced self‐management via illness perception, self‐efficacy and self‐regulation, sequentially. These variables explained 55.9% of the variance in lymphedema self‐management behaviours. Conclusions: The modified model based on the Integrated Theory of Health Behaviour Change fitted well in predicting lymphedema self‐management behaviours among breast cancer patients. Lymphedema knowledge, illness perception, self‐efficacy, social support and self‐regulation directly and indirectly influenced lymphedema self‐management behaviours. Impact: This study provides a theoretical basis for the assessment and interventions of lymphedema self‐management behaviours in breast cancer patients. Lymphedema self‐management behaviours should be assessed regularly and comprehensively, taking these predictors into consideration to identify potential barriers. Further research is needed to explore effective interventions integrating these significant predictors. Reporting Method: This study was reported following Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross‐sectional studies. Patient or Public Contribution: No patient or public contributed to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. What Does This Paper Contribute to the Wider Global Clinical Community?: This study focused on identifying and predicting mechanism of self‐management based on a theory of behaviour change. The results can be applied among patients with other chronic diseases or high‐risk populations, and inspire the assessment and interventions facilitating self‐management behaviours. Study Registration: This study was registered as an observational study at Chinese Clinical Trial Registry: http://www.chictr.org.cn (ChiCTR2200057084). Implications for the Profession and/or Patient Care: For breast cancer patients with poor lymphedema self‐management behaviour, attention should be raised among nurses and involved healthcare staffs that lymphedema self‐management is multi‐faced. Strategies targeted at improving social support, self‐regulation, knowledge, self‐efficacy and illness perception should be also addressed in lymphedema self‐management programs, to facilitate more effective improvement of lymphedema self‐management behaviours. [ABSTRACT FROM AUTHOR]

Background: According to the Chinese guidelines for lipid management (2023), evolocumab in combination with statins was recommended as secondary prevention of cardiovascular disease. However, because of the variation in the price of evolocumab and its different methods of confirming clinical efficacy, it was necessary to explore its economics and the impact of different methods of confirming efficacy on its economic studies. Objective: The purpose of this paper was to assess the cost-effectiveness of evolocumab with statins versus statins alone for patients with acute myocardial infarction(AMI) in China and to investigate the impact of different clinical effectiveness modeling approaches on economic outcomes. Methods: A Markov cohort state-transition model was used to estimate the incremental cost-effectiveness ratio (ICER) based on Chinese observational data on cardiovascular event rates, efficacy from the Asian subgroup of the FOURIER trial, cost and utility from the Chinese Yearbook of Health Statistics, health insurance data, and published studies conducted in China. This study conducted subgroup analyses for different populations and dosing regimens; sensitivity analyses for parameters such as cost, utility, and cardiovascular event rates; and scenario analyses on hospital hierarchy, time horizon, starting age, and price for statins. Results: ICERs ranged from 27423 to 214777 Chinese yuan(CNY) per QALY gained, all below the willingness-to-pay threshold of CNY 257094. Only when the time horizon became small, the ICERs were greater than the willingness-to-pay. The probabilities that adding evolocumab to statins was cost-effective ranged from 76 to 98%. When the time horizon became small, i.e. evolocumab was discontinued before the age of 75 (after conversion), the corresponding ICERs were almost always greater than the willingness-to-pay. ICERs for modelling approaches based on clinical endpoints were 1.34 to 1.95 times higher than ICERs for modelling approaches based on reduced LDL-C levels. Conclusions: From the Chinese healthcare and private payer perspectives, adding evolocumab to statin therapy in AMI patients is more likely to be a cost-effective treatment option at the current list price of CNY 283.8. However, evolocumab may not be cost-effective if used for shorter periods of time. The results based on different clinical effectiveness modeling approaches were significantly different. [ABSTRACT FROM AUTHOR]