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Aim: Guided by the social embeddedness model of thriving at work, this paper explores how nursing organizational culture, work engagement and affective commitment affect nurses' thriving at work. Background: Thriving at work has implications for better employee and organization outcomes. The antecedents of thriving at work among the nursing population needs to be expanded by analysing the cross‐level impact of organizational and individual characteristics. Methods: A cross‐sectional design was used to collect data from 1437 frontline nurses in a tertiary teaching hospital in China between April and May 2020 through an online survey about perceived nursing culture, work engagement, affective commitment and thriving at work. Data were analysed using SPSS, and a structural equation model was established using the PROCESS macro. Results: Our results showed that work engagement and affective commitment mediated the relationship between nurses' perceived nursing culture and their thriving at work. Among nurses, work engagement was positively correlated to affective commitment. Conclusion: Our study confirmed the social embeddedness model of thriving at work by showing that both contextual and dispositional factors can influence nurses' thriving at work. Nurse leaders can foster nursing staff's thriving at work by building an inclusive work environment and by providing adequate resources to staff. Future research is needed to elaborate on employee and organizational outcomes associated with thriving at work. Impact: Nurse leaders should be the advocate for nurses to improve their organizational identification, fostering their thriving at work. Individual nurses can also take an active role in developing work‐related resources to sustain their thriving through self‐adaption processes. Collective thriving in the nursing workforce is needed to overcome adversity and hardship in the ever‐changing and increasingly demanding health care industry and to further contribute to the vitality of the broader social and public environments. Patient or public contribution: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. [ABSTRACT FROM AUTHOR]

Aims: This study investigated self‐care activities and identified their related factors in Chinese patients with type 2 diabetes mellitus. Methods: A cross‐sectional study was conducted in Guangzhou, China, between September 2016 and February 2017, involving 202 Chinese patients with type 2 diabetes mellitus. Measures included the Summary of Diabetes Self‐Care Activities Questionnaire and Revised Illness Perception Questionnaire. Results: Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal overall. Foot care and blood sugar testing were the self‐care activities that were performed the least. One fifth of patients smoked. Some subscales of illness perceptions, receiving health education on diabetes, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in patients with type 2 diabetes mellitus. Conclusion: Health‐care providers and nurses should encourage greater engagement in self‐care activities in patients with type 2 diabetes mellitus, especially foot care and blood sugar testing. Illness perceptions may be used as a framework to guide interventions. Summary statement: What is already known about this topic? Diabetes is a global epidemic, and China has the largest number of patients with type 2 diabetes mellitus.Self‐care activities are a key factor in preventing complications and maintaining long‐term health in patients with type 2 diabetes mellitus.Illness perceptions are amendable to change by health‐care providers. What this paper adds? Self‐care activities in Chinese patients with type 2 diabetes mellitus were suboptimal; the least frequently performed self‐care activities were foot care and blood sugar testing, and one in five patients smoked.Some subscales of illness perceptions, receiving diabetes education, employment status, education level, body mass index, age and time since type 2 diabetes mellitus diagnosis, were related to self‐care activities in Chinese patients with type 2 diabetes mellitus. The implications of this paper: Illness perceptions may be used as a framework to guide interventions aimed at promoting self‐care activities in Chinese patients with type 2 diabetes mellitus.Interventions aimed at promoting self‐care activities should be tailored to the sociodemographic and clinical profiles of individual patients. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the overall status of burnout in nurses in China on a national scale and investigate the demographic characteristics related to burnout and the relationships between demographics, job satisfaction and burnout. Methods: This was a national cross‐sectional study conducted by the Chinese Nursing Association between July 2016 and July 2017. Data were collected using a structured, self‐administered questionnaire. Results: A total of 51 406 registered nurses in 311 Chinese cities completed the questionnaire. Fifty per cent of the participants suffered burnout, and 33.8% of nurses had high scores on emotional exhaustion, 66.6% had high scores on depersonalization and 93.5% had low scores on personal accomplishment; 16.2% reported a high level of job satisfaction, only 0.4% was satisfied with their jobs and 70.7% intended to leave their jobs. Marital status, educational level, income and years of working experience affected job burnout. Nurses with a high level of burnout were more likely to have a high degree of job dissatisfaction and intend to leave their jobs. Conclusion: We found a high prevalence of burnout among nurses in China. Nursing managers need to pay more attention to job burnout and its influencing factors. Interventions to reduce nurse burnout should be implemented. SUMMARY STATEMENT: What is already known about this topic? Burnout is a prolonged response to chronic job‐related stress and it has a negative effect on job satisfaction and quality of nursing care. What this paper adds? The prevalence of burnout among nurses working in China is high.Marital status, educational level, income and years of working experience affect job burnout.Nurses with a high level of burnout have high job dissatisfaction and intend to leave. The implications of this paper: Nursing supervisors and managers need to be more aware of the high prevalence of job burnout among nurses in China.Interventions should be undertaken to prevent or reduce nurse burnout. [ABSTRACT FROM AUTHOR]

Even though Sino-American relations of the Donald Trump era were perceived as predominately confrontational, with a symbolic trade war between the two, the scale of economic interdependencies between the United States and China results in either a need for collaboration or in serious losses on both sides in the case of lack of cooperation. The paper aims at analyzing economic relations between the United States of America and the People's Republic of China at the time of the Trump presidency. Analysis is based on the complex interdependence theory of Robert Keohane and Joseph Nye. The main hypothesis analyzed in the paper states: Asymmetric interdependence between the People's Republic of China and the United States of America limits the scope, intensity and length of a trade war. For the sake of the paper, economic interdependence will be analyzed. Apart from the reference to the state of the art, the document analysis and descriptive statistics are to be applied in the paper. [ABSTRACT FROM AUTHOR]

Background: Video lectures which include the instructor's presence are becoming increasingly popular. Presenting a real human does, however, entail higher financial and time costs in making videos, and one innovative approach to reduce costs has been to generate a virtual speaking instructor. Objectives: The current study examined whether the use of a virtual instructor in video lectures would facilitate learning as well as a human instructor, and whether manipulating the virtual instructor's characteristics (i.e., voice and appearance) might optimize the effectiveness of the virtual instructor. Methods: Our study set four conditions. In the control condition, students watched a human instructor. In the experiment conditions, students watched one of (a) a virtual instructor which used the human instructor's voice and an AI image, (b) a virtual instructor which spoke in an AI voice with an AI image made to speak using text‐to‐speech and lip synthesis techniques, or (c) a virtual instructor with used an AI voice and an AI likable‐image of an instructor. Results and Conclusions: The AI likable instructor condition had a significant positive effect on students' learning performance and motivation, without decreasing the attention students paid to the learning materials. Implications: Our findings suggest that instructional video designers can make use of AI voices and AI images of likable humans as instructors to motivate students and enhance their learning performance. Lay Description: What is already known about this topic: Video lectures which include the instructor's presence are becoming increasingly popular.Presenting a virtual instructor (i.e., a pedagogical agent) in video lectures has been shown to reduce costs of video production, both financially and in terms of time. What this paper adds: An AI‐generated voice and an AI‐generated image facilitated more students' transfer performance than a human instructor.The AI likable instructor condition had a significant positive effect on students' learning performance and motivation, without decreasing the attention students paid to the learning materials. Implications for practice and/or policy: We encourage instructional designers to use AI‐generated voices and AI‐generated images connected to a virtual instructor instead of a human instructor in video lectures.We encourage instructional designers to use likable human images (as defined by the students themselves) as a way to motivate students more and enhance their learning performance. [ABSTRACT FROM AUTHOR]

Purpose: Children with cochlear implants (CIs) have less experience accessing spoken language. Mandarin Chinese uses pitch information to contrast word meaning, and the signal that the CI devices provide is degraded. Thus, Mandarin-speaking children with CIs may face more challenges in the development of language skills. This study examines preschool Mandarin-speaking children's performance in lexical access. We hypothesized that children with CIs and their peers with normal hearing (NH) have comparable naming ability, but they process phonological or semantic information differently. Method: Twenty children with CIs and 20 age-matched children with NH were tested. The cross-modal visual–auditory picture–word interference paradigm was applied. The distractor was either phonologically related (mao55 cat -mao51 hat), semantically related (mao55 cat -shu214 mouse) or unrelated (mao55 cat -zhi214 paper) to the target, and it was aurally presented at four different points in time relative to the picture. Accuracy was compared between the two groups to tap into the children's naming abilities, and reaction time was analyzed to examine the effects of phonological and semantic information. Results: No group difference in accuracy was found. The phonologically related distractors led to significantly higher accuracy scores and shorter reaction times, whereas the semantically related distractors did not. Unlike the NH group, the CI group did not respond significantly faster or slower in phonologically related condition when the distractor and picture occurred simultaneously. Finally, the CI group made overall quicker responses than the NH group. Conclusions: Children with CIs are as successful as children with NH in word retrieval and production, and the two groups both show phonological priming effect and lack semantic effect. However, children with CIs do not process phonological information as early as their NH peers, and they may be more tasks directed and hence make quicker responses. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

Aim: This paper aimed to investigate the relationship between social support and quality of life for nurses in infectious disease departments in China, as well as the function of psychological resilience in mediating this relationship. Background: Nurses in infectious disease departments play a critical role in the prevention and control of infectious diseases and in public health care services in general, and their quality of life can affect the quality of clinical nursing work they do. However, there are few studies on the relationship between nurses' social support networks and their quality of life. Methods: A cross‐sectional study was conducted using a sample of 866 clinical nurses from the infectious disease departments of 10 general hospitals in China. Data were collected using a questionnaire survey from January to May 2021. The mediating influence of psychological resilience on social support and quality of life was investigated using structural equation modelling. Results: The score of quality of life was (36.36 ± 7.64). Quality of life was positively correlated with social support and psychological resilience (r1 = 0.521, r2 = 0.583; p <.01), and psychological resilience was positively correlated with social support (r = 0.426; p <.01) as well. The mediating effect of psychological resilience between social support and quality of life was 0.233, accounting for 37% of the total effect. Conclusion: The quality of life of nurses working in infectious disease departments is in the middle level. Psychological resilience is a mediating variable between social support and quality of life. Implications for Nursing Management: Managers can improve the quality of life of nurses by both increasing social support and strengthening psychological resilience. Managers should pay attention to the degree of social support provided to nurses and take proactive measures to build psychological resilience so that nurses can effectively manage stress and negative emotions from work and life in order improve their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under‐five nursing in China. Background: Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low‐ and middle‐income countries like China, due to the overwhelming COVID‐19 crisis. Method: The 890 nurses and midwives from 12 hospitals were investigated in this cross‐sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses. Results: The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P <.05). Conclusions: The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence. Implications for Nursing Management: Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners. [ABSTRACT FROM AUTHOR]

Investigations have found maternal adverse childhood experiences (ACEs) cause an intergenerational danger to their children's health. However, no study has investigated the effects of maternal ACEs on behavioral problems of preschool children in China and gender differences on these effects. This paper aims to investigate the role of maternal ACEs on behavioral problems of preschool children in China and explore gender differences as related to these behavioral problems. Stratified cluster sampling method was used to select 7318 preschool children from 12 districts in Hefei city, China. A questionnaire survey was conducted to collect information on maternal exposure to ACEs and Conners' Parent Rating Scales. Logistic regression was used to analyze the relationship between maternal ACEs and children's behavioral problems. The prevalence of behavioral problems in preschool children was 16.0%, while it was higher among girls (18.4%) than boys (13.92%) (χ2 = 27.979, p < 0.001). The rate of behavioral problems in children in the group of mothers with ACEs was higher than those without ACEs (all p < 0.05). Maternal ACEs were associated with increased risk of the behavior problems in preschool children (adjusted OR 2.91, 95% CI 2.45–3.45), and no gender difference (in girls 3.01, 2.38–3.81, in boys 2.79, 2.17–3.58, respectively) was found. Maternal ACEs were associated with increased risk of each type of the behavioral problems of preschool children, except that maternal emotional neglect was not associated with psycho-physical problems, impulse-activities, and anxiety. The only gender differences found were higher conduct problems related to maternal emotional abuse and ACEs and higher anxiety related to maternal physical abuse and community violence in girls compared with boys. Mothers exposured to ACEs are more likely to have children with behavioral health problems in preschool period. Further research is needed to explore the mechanisms by which maternal ACEs influence children's behavioral problems. [ABSTRACT FROM AUTHOR]

Social determinants of public health have gained increasing attention. This paper studied whether social support from online communities related to maternal mental health. We focused on online maternity communities that group users with a similar prenatal status to facilitate their exchange of personal experiences and knowledge about maternal caring during pregnancy. Such online maternity communities are getting increasingly popular and can be found across countries and societies. We invited users—currently pregnant and gave birth within 1 year at the time of the study—from one such community in China to participate in a survey. The survey measured their perceived social support (PSS) exclusively from the peer group in the online community, their mental health and newborns' birth outcomes (N = 500). Users reported high score in PSS from the online peer group which was comparable to the ones from family, significant other and friends in other studies. We used linear regression models to examine the effects of PSS on mental health and birth outcomes. We found that a one‐point increase in the PSS score was associated with a 0.19‐point (p < 0.1) decrease in the prenatal depression and a 0.26‐point (p < 0.01) decrease in the postnatal depression, which was equivalent to 3% and 4.5% of the average respectively. Moreover, a one‐point increase in the PSS score was associated with a 14.49‐gram increase in a newborn's weight (p < 0.01). [ABSTRACT FROM AUTHOR]

The role of formal volunteering in mental health promotion among older adults in China has been widely discussed during recent decades. However, the relationship connecting mental health with cross‐level interaction (i.e., average levels of participation in the community vs. individual participation) is still unclear. This paper examined the effects of cross‐level formal volunteering on depressive symptoms among older adults living in China. Using two waves of the China Longitudinal Aging Social Survey, a sample of 3128 Chinese older adults was surveyed in 2014 and 2016. Depressive symptoms were measured using the abbreviated CES‐D‐9. Individual fixed‐effects ordinary least squares regression models assessed the associations between individual‐ and community‐level formal volunteering and depressive symptoms in urban and rural areas separately. We found that in the urban sample, formal volunteering activities were negatively associated with depressive symptoms at the individual level (β = −0.49, SE = 0.22, p < 0.05). Higher community‐level formal volunteering was positively associated with depressive symptoms (β = 2.82, SE = 1.42, p < 0.05). When adding interactions between individual and community levels, engagement in individual‐level formal volunteering was associated with lower rates of depressive symptoms as community volunteering participation levels increased (β = −3.07, SE = 1.07, p < 0.01). High community‐level volunteering participation was detrimental for non‐volunteers. In rural areas, neither community‐ nor individual‐level formal volunteering was associated with changes in depressive symptoms. The current findings demonstrate formal volunteering may not always benefit mental health for all. The effects may depend on the community context and individual choices. Social policies aimed to promote mental health through formal volunteering need to be tailored according to the specific community social environment. [ABSTRACT FROM AUTHOR]

Background: The paper version of the training assessment was time-consuming and labor-consuming. It is an inevitable trend to change the appraisal method utilizing information technology. This study aimed to realize convenient and rapid management of the whole process of clinical nursing operation technology through information-based training and assessment platform. Methods: Combined with the operation mode of clinical nursing operation skills and set the basic functions of the information platform of clinical nursing operation training and assessment, the information-based training and evaluation platform for clinical nursing operation skills was established. The platform was officially operated in a tertiary level A general hospital in Shandong Province in 2018. Results: The information-based training and assessment platform is composed of Management Center (Computer Terminal) and a client terminal (APP terminal). The computer terminal contains 11 modules, and the APP terminal contains 8 modules. By December 2020, a total of 12,619 nurses had completed the training in nursing operation skills, and a total of 11,986 nurses had completed the examination. The examination results of nursing operation skills of the same nurses in 2018 were significantly higher than those in 2017(P < 0.05), and the error rate was significantly lower (P < 0.05). From 2016 to 2020, the scores of nasal feeding, CPR, and respiratory airbag of N1 level nurses significantly increased after using the information-based training and Assessment Platform (P < 0.05). Conclusion: Based on the information terminal training assessment can realize the management of the whole process of clinical nursing operation technology training and assessment, which is better than the traditional method, and is a very practical and convenient clinical training and assessment method. [ABSTRACT FROM AUTHOR]

At present, percutaneous nephrolithotomy has become an option for hospitals increasingly to treat calculus. However, due to the certain risk of percutaneous nephrolithotomy, it may lead to postoperative complications. Analyzing the preoperative factors of septic shock after percutaneous nephrolithotomy can provide guidance for reducing the incidence of septic shock after PCNL. This article establishes a logistic regression model based on preoperative factors, uses statistical methods, and uses the professional statistical software SPSS to create a database and analyze the data. The method of classification data analysis was used to determine various influencing factors including patient factors, stone factor, and preoperative factors and combined B-ultrasound guidance and percutaneous nephrolithotomy to reduce the risk of surgery. The experimental results found that the percutaneous nephroscope laser lithotripsy guided by the smart Internet of Things can effectively perform lithotripsy; in this paper, the preoperative data of different complications are obtained, and the risk of surgery is closely related to the operation time. The operation time exceeds 90 minutes and causes the risk of severe bleeding after PCNL. It is twice the operation time of less than 90 minutes and 5 times the operation time of less than 60 minutes. [ABSTRACT FROM AUTHOR]

Aims: To examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life. Design: Observational study. Methods: Paper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis. Results: Among the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p =.028) and more decision regret (p =.013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p =.015), more decision regret (p <.001), and higher self‐stigma (p =.034) than women who chose breast conservative surgery. Decisional conflict (r = −.430), decision regret (r = −.495), and self‐stigma (r = −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life. Conclusion: Decisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors. Impact Future studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Because of increasingly stressful, dangerous and unpredictable psychiatric nursing work, psychiatric nurses have experienced higher job stress than general ward nurses.Little is known about the factors that affect the turnover intention of Chinese psychiatric nurses. Understanding the influencing factors of nurses' turnover intention will help to formulate targeted measures to stabilize psychiatric nursing teams. What does this paper add to existing knowledge: The results showed that 70.2% of psychiatric nurses had higher turnover intention. The strong turnover intention of Chinese psychiatric nurses is a problem that needs to be considered by managers.The results showed that having more children, between 31 and 39 years old, and having a part‐time job were strongly associated with turnover intention. In addition, "job stress" was also an important factor, psychiatric nurses' turnover intention decreased as their job stress level decreased. What are the implications for practice: Nursing managers should pay attention to nurses who have more children, between 31 and 39 years old, and take on part‐time jobs. Additionally, nursing managers should reduce job stress and implement targeted programmes to prevent psychiatric nurses' turnover.Experience‐sharing meetings and mindfulness‐based stress reduction training are also useful to improve the mental health status of psychiatric nurses with great job stress. Nursing managers should arrange human resources and shifts appropriately to give nurses with more children more time with their families. Provide more development opportunities for psychiatric nurses between 31 and 39 years old. Managers explore the reasons why nurses take on part‐time jobs and take targeted interventions (such as increasing income) to reduce the behaviour that happens. Introduction: Nurses' turnover is the main cause of nursing shortages, greatly affected by nurses' intention to leave. Nurses' turnover rate is particularly high in psychiatric wards. Several factors influencing the turnover intention of psychiatric nurses have not been well identified in China, and the association between job stress and turnover intention is still limited. Aims: To examine the relationship between job stress and turnover intention and identify the influencing factors of psychiatric nurses' turnover intention. Methods: Data were collected from 2355 psychiatric Chinese nurses using a cross‐sectional design with an online questionnaire investigation. Results: Psychiatric nurses had higher turnover intention. Significant factors influencing their turnover intention were job stress, having more children, age between 31 and 39 years old, part‐time jobs, education, income and patient‐to‐nurse ratio. Discussion: Demographics and job‐related factors should be considered when developing strategies to reduce the turnover intention of psychiatric nurses. Implications for practice: Nursing managers should pay attention to nurses with higher job stress levels and different demographic characteristics. Effective measures should be taken to reduce psychiatric nurses' job stress and turnover intention, such as arranging reasonable shifts, implementing targeted family‐friendly policies, increasing their occupational possibilities and promoting mental health. [ABSTRACT FROM AUTHOR]

The ongoing COVID‐19 pandemic has had a profound worldwide impact on the laboratory hematology community. Nevertheless, the pace of COVID‐19 hematology‐related research has continued to accelerate and has established the role of laboratory hematology data for many purposes including disease prognosis and outcome. The purpose of this scoping review was to assess the current state of COVID‐19 laboratory hematology research. A comprehensive search of the literature published between December 1, 2019, and July 3, 2020, was performed, and we analyzed the sources, publication dates, study types, and topics of the retrieved studies. Overall, 402 studies were included in this scoping review. Approximately half of these studies (n = 202, 50.37%) originated in China. Retrospective cohort studies comprised the largest study type (n = 176, 43.89%). Prognosis/ risk factors, epidemiology, and coagulation were the most common topics. The number of studies published per day has increased through the end of May. The studies were heavily biased in favor of papers originating in China and on retrospective clinical studies with limited use of and reporting of laboratory data. Despite the major improvements in our understanding of the role of coagulation, automated hematology, and cell morphology in COVID‐19, there are gaps in the literature, including biosafety and the laboratory role in screening and prevention of COVID‐19. There is a gap in the publication of papers focused on guidelines for the laboratory. Our findings suggest that, despite the large number of publications related to laboratory data and their use in COVID‐19 disease, many areas remain unexplored or under‐reported. [ABSTRACT FROM AUTHOR]

Aim: To psychometrically test the Chinese version of Self‐Care of Coronary Heart Disease Inventory. Background: Self‐care is a significant step to impede the progression of coronary heart disease and serves as the primary outcome in self‐care interventions. In China, however, no instrument is available to measure self‐care in patients with coronary heart disease. To address this gap, we introduce the Self‐Care of Coronary Heart Disease Inventory into China. Design A cross‐sectional design. Methods: We translated the inventory into Chinese using standardized methods. Then, it was psychometrically tested on a convenience sample of 301 patients with coronary heart disease (October 2017 to May 2018). Construct validity was evaluated via exploratory factor analysis and testing hypotheses. Internal consistency reliability was measured with Cronbach's alpha or composite reliability. Results: Both self‐care maintenance and management subscales showed a two‐factor structure, whereas self‐care confidence subscale showed a one‐dimension structure. All subscales were significantly correlated with associated variables (disease‐related knowledge and perceived control). The internal consistency reliability for all three subscales was acceptable. Conclusion: The Chinese version showed acceptable psychometric properties when applied to the sample group of this study. It is recommended for use in self‐care interventions targeting coronary heart disease. SUMMARY STATEMENT: What is already known about this topic? Self‐care is important for patients with coronary heart disease to control risk factors, reduce recurrence and improve the prognosis.Self‐Care of Coronary Heart Disease Inventory is developed based on the middle‐range theory of self‐care of chronic illnesses and shown acceptable psychometric properties.Self‐care of CHD is a growing focus of research and clinical practice; however, a tailored instrument to measure self‐care in Chinese patients with CHD is lacking. What this paper adds? This study provides the evidence of the construct validity and internal consistency reliability of the Chinese version of Self‐Care of Coronary Heart Disease Inventory.The Chinese version is a reliable and valid measure to assess the self‐care in patients with coronary heart disease. The implications of this paper: This study fills an important gap concerning measures of self‐care related to CHD in China.The Chinese version of Self‐Care of Coronary Heart Disease Inventory has the potential to be an ideal outcome measure in self‐care interventions and promote the research focusing on self‐care of CHD.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Background: To better meet people's growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals' health resource allocation in Guangdong Province and explores ways to change the current situation. Methods: Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results: From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion: The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency. [ABSTRACT FROM AUTHOR]

Background. Observational studies from China suggest that Kangbingdu oral liquid (KBD) may be effective in treating the common cold. Objective. Reevaluation of efficacy and safety of Kangbingdu oral liquid after marketing and expanding population. Design. Prospective, Pragmatic randomized controlled trial (Chictr.org.cn registration number: chiCTR-TRC-12002399). Setting. Eleven hospitals from 3 provinces in China. Patients were recruited through 11 centers, including 7 teaching hospitals, 2 University health services, one military clinic, and one community hospital. Patients. 2647 persons aged 18 to 75 years with Common cold. Intervention. Patients were randomly allocated to 2 groups: the treatment group Kangbingdu oral liquid (composed of 9 Chinese herbal medicines and honey) and the placebo group were divided into a standard-dose group of 10 ml every time, a middle dose group of 20 ml every time, high dose group of 30 ml every time, 3 times daily. Interventions and control were given for 5 days. Measurements. The primary outcome is the mean amount of total scores measured by the 11-primary symptoms: to observe the change of main symptoms from severe to disappear and to calculate and compare the mean amount of total scores after the periods of observation. Secondary outcomes are the disappearance rate of each symptom and the median time of body temperature returned to normal. Results. On day 5, the Kangbingdu liquid group had significant reductions in the mean amount of total scores measured by the 11-primary symptoms (7.39 [95% CI 7.26 to 7.51] compared to the placebo group (6.43 [95%: CI 6.24 to 6.62]). The Kangbingdu liquid can improve the remission rate of accompanying symptoms on day 5 including aversion to wind, aversion to cold, fever, cough, stuffy, runny nose, sore throat, muscular aches, headache, fatigue, and sweat (P < 0.0001). Significant reductions in time of body temperature to return to normal in the Kangbingdu liquid group (P50, 48.33 [95% CI 46.00 to 52.50] compared with the control group (P50, 64.59 [95% CI 51.08 to 70.50] (P = 0.0022). 13 (0.7%) participants in the Kangbingdu liquid group and 1(0.2%) participants in the placebo group (P > 0.05) had treatment-related AEs, which mainly include diarrhea and dyspepsia in the Kangbingdu liquid group and constipation in the placebo group. Conclusion. The study's conclusion in this paper was based on the placebo, Kangbingdu oral liquid two groups which clinically diagnosed the common cold and flu. (1) Kangbingdu oral liquid can effectively improve the comprehensive clinical symptoms of common adult cold, also improved main symptoms, including sore throat, muscle aches, headache, and so on. (2) Kangbingdu oral liquid effectively shortens the time of body temperature to return to normal. [ABSTRACT FROM AUTHOR]

Hedonia and eudaimonia have been proposed as pathways to well-being. However, the direction of the causal relationship between them remains unclear. This study examined if happiness motivations may be resources leading to a happy life, or vice versa. Cross-lagged associations between happiness motivations (i.e. hedonic motivation and eudaimonic motivation) and subjective well-being (i.e. positive affect, negative affect, and life satisfaction) were tested. Four hundred and ninety-four Chinese adolescents (233 males; mean age 13.26 ± 0.70 years) participated in a two-wave paper and pencil study. The cross-lagged analysis showed that eudaimonic motivation was a significant predictor of positive affect and life satisfaction over time. No cross-lagged effects between eudaimonic motivation and negative affect, or between hedonic motivation and subjective well-being components were established. The results highlight the predictive power of eudaimonic motivation on adolescents' subjective well-being later on. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. A total of 18 journal papers were included in this review. The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population. [ABSTRACT FROM AUTHOR]

Background: Self‐regulated learning (SRL) ability is the key determinant of the success of full‐time online learning. Thus, exploring the influencing factors of SRL and their influencing mechanisms is necessary to improve this ability among K‐12 students. Objectives: The purpose of this study was to investigate the influence mechanism of teacher autonomy support on students' online SRL by examining the structural relationship among teacher autonomy support, parental autonomy support, students' self‐efficacy, and students' online SRL. Methods: We use structural equation modelling and effect analysis to analyse the collected data from 961 Chinese K‐12 students who engaged in full‐time online learning in their homes during the coronavirus disease 2019 (COVID‐19) outbreak. Results and Conclusions: Parental autonomy support and students' self‐efficacy play crucial independent mediating roles in the influence of teacher autonomy support on students' online SRL. Parental autonomy support and students' self‐efficacy have a chain mediating effect on the influence of teacher autonomy support on students' online SRL. Implications: On the basis of the results, we suggest that in order to develop students' online SRL ability, it is important for teacher to improve parental autonomy support and students' self‐efficacy. In addition, base on the chain mediating effect, to improve students' online SRL, teacher autonomy support needs focus on parental autonomy support, and then parental autonomy support needs focus on improving students' self‐efficacy. Lay Description: What is already known about this topic: • Self‐regulated learning (SRL) ability is the key determinant of the success of online learning. • To improve K‐12 students' SRL ability, it is important to explore the influencing factors and their influencing mechanisms on students' online SRL. • Teacher autonomy support play an important role for students' learning. What is not known about this topic?: • How does teacher autonomy support influence students' online SRL, especially in full‐time online learning? • Do parental autonomy support and student' self‐efficacy play a chain mediating role in the influence of teacher autonomy support on students' online SRL? What this paper adds: • Parental autonomy support and students' self‐efficacy play crucial independent mediating role in the influence of teacher autonomy support on students' online SRL. • Teacher autonomy support has a indirect influence on students' online SRL through the chain mediating effect of parental autonomy support and students' self‐efficacy. Implications for practice and/or policy: • Given that parental autonomy support and students' self‐efficacy mediating the influence of teacher autonomy support on students' online SRL, it is important to improve parental autonomy support and students' self‐efficacy. • In order to improve students' online SRL ability, teachers need focus on parental autonomy support, and parental autonomy support focus on improving students' self‐efficacy. [ABSTRACT FROM AUTHOR]

Background: Peer‐to‐peer feedback exchanges have been recognized as crucial to language learning. While studies on peer feedback proliferate, little is known about whether and how peer feedback is affected by learners' motivational levels. Objectives: Situated in a mobile collaborative learning context, the current study examined how English as a Foreign Language (EFL) students with different motivational levels participated in mobile‐assisted peer feedback provision, as well as the characteristics of the feedback they provided. Methods: A total of 61 sophomores majoring in Business English at a Chinese university participated in this 16‐week‐long study. They were asked to complete oral assignments and give and receive peer feedback via MosoTeach (a popular mobile learning application in China). Multiple types of data (peer feedback records, questionnaires, reflective journals and interviews) were collected, analysed, and triangulated. Results and Conclusions: Results revealed that EFL learners with higher motivation were more likely to provide feedback on time using more words. Unique characteristics of mobile‐assisted peer feedback among highly motivated learners were also observed. Implications: The study highlights the importance of learner motivation in mobile‐assisted peer feedback practice and provides pedagogical suggestions for better designing and implementing peer feedback in mobile collaborative learning contexts. Lay Description: What is already known about this topic: Previous research has recognized mobile‐assisted peer feedback as an effective way of mobile collaborative language learning.Previous studies on mobile‐assisted oral peer feedback have examined different dimensions of feedback in relation to their effects on speaking performance.Previous research is less clear about how learners' motivational characteristics may influence peer feedback performance. What this paper adds: Situated in a mobile learning context, this study investigated how English as a Foreign Language (EFL) students with different motivational levels participated in mobile‐assisted peer feedback provision, and examined the characteristics of the feedback they provided.Results revealed that EFL students with higher motivation were more likely to provide feedback on time using more words. Some unique characteristics of mobile‐assisted peer feedback among students with different motivational levels were also observed. Implications: This study demonstrates the importance of considering learners' motivational levels in teachers' design and implementation of peer feedback with technology.It is crucial for teachers to provide training and scaffolding to students in their construction of peer feedback with mobile technologies.Teachers are suggested to encourage the students to provide detailed positive comments for their peers, which may increase students' confidence and reduce their anxiety. [ABSTRACT FROM AUTHOR]

Taoism and Confucianism both exited simultaneously as philosophies of living in dynastic China. Although there has been an increasing popularity in scientometric studies, religion and health (R&H) literature lacks a holistic evaluation investigating articles relevant to Taoism and Confucianism. All publications produced in Taoism and Confucianism literature and indexed in Web of Science (WoS) databases between 1975 and 2018 were included in this study. Database search on health and Taoism literature retrieved 199 documents from WoS databases. Main research areas were Psychology, Religion and Behavioral Sciences (24.121, 21.608 and 20.603, respectively). The USA ranked first with 38 papers followed China, Taiwan and the UK (n = 35, 20 and 6 documents, respectively). Hong Kong Polytechnic University from China was the most contributor institution in health and Taoism literature. A total of 448 documents were published in health and Confucianism literature between 1975 and 2018, and original articles covered 93.08% of all literature. China was leading country with 126 articles followed by the USA, South Korea and Taiwan (n = 97, 35 and 35 items, respectively). The most productive institutions were City University of Hong Kong (China), Karolinska Institute (Sweden) and University of Hong Kong (China). Researchers from developing and least developed countries should be encouraged to carry out novel scientometric studies in R&H literature. [ABSTRACT FROM AUTHOR]

The incidence of cancer is increasing today, particularly lung and chest cancer. Employing novel methods to detect cancer in its earliest stages and discover painless, noninvasive treatments are urgently needed. The goal of the proposed study is to investigate the value of automated breast volume scanning (ABUS) in conjunction with contrast-enhanced ultrasonography (CEUS) in properly diagnosing breast cancer in its early stages and the effectiveness of neoadjuvant chemotherapy (NAC) in treating the disease. For the research study, information on 98 patients who had NAC and surgery in the breast surgery department of the Shaanxi Provincial Cancer Hospital has been gathered. All patients have received four cycles of NAC and underwent conventional ultrasound (HUSS), CEUS, ABUS, and pathological examination. At the same time, receiver operating characteristic (ROC) curve analysis, single factor, multiple linear regression, and other methods have also been used to analyze the diagnostic efficacy of breast cancer and NAC efficacy evaluation results. The study of this paper is totally based on the data collected from Shaanxi Provincial Cancer Hospital. The statistical and computational analyses are performed on the data collected for drawing inferences. When the findings are compared to the results of the pathological examination, HUSS has demonstrated a significant distinction between benign and malignant diagnoses with a statistical value of P < 0.05.ABUS combined with CEUS has shown no considerable differences in correlation study. Except for negative likelihood ratio, the diagnostic performance indexes of CEUS+ ABUS are substantially higher than HHUS with P < 0.05. ROC curve analysis is also performed which shows that CEUS and ABUS combination has higher precision in the analysis of breast cancer. ABUS pooled with CEUS shows great application value in the judgment of breast cancer as per the results obtained from the statistical analysis on data of 98 patients. [ABSTRACT FROM AUTHOR]

Background: The security of medical insurance fund is very important to health equity. In China, the expenditure of medical insurance fund has increased sharply year after year, and the balance of local medical insurance fund is difficult to sustain. To realize the equitable distribution of the medical insurance burden, the central government has to continuously increase transfer payments, which causes regional unfairness in the distribution of central financial resources. This paper explores the influence of central transfer payments on the balance of medical insurance fund, influential mechanisms, and the strategic behavior of local governments. Methods: First, we constructed a dynamic game model between central government and local governments and analyzed the mechanism of central transfer payments affecting the balance of local medical insurance fund. Then, based on the provincial panel data of 28 provincial administrative regions in China from 2004 to 2014, an empirical test was made. The spatial regression model was constructed, and the transfer payments obtained by neighboring provinces in the previous year were taken as instrumental variables. Results: Central transfer payments led to strategic behaviors by local governments that resulted in increased local health insurance fund expenditures and lower balance rates. Moreover, the central transfer payments demonstrated "path dependence". Central transfer payments had a significant negative influence on the local NCMS fund balance rate. The local government subsidy and per capita GDP had a significant positive impact on the local NCMS fund balance rate. The obtained transfer payments of local governments had a significant space correlation. This study based on NCMS data remains valid. Conclusions: Central transfer payments induced the strategic behavior of local governments, which neglected to supervise the expenditure of medical insurance fund, reducing the efficiency of medical insurance fund management and use. The financial resources of medical insurance fund are unevenly distributed among provinces. Measures such as strengthening the supervision ability and initiatives of local governments, refining the central transfer payment mechanism, promoting the economic growth of western regions, and increasing rates for individual contributions appropriately can ensure that the medical insurance fund are used well and distributed equitably. [ABSTRACT FROM AUTHOR]

Background: The security of medical insurance fund is very important to health equity. In China, the expenditure of medical insurance fund has increased sharply year after year, and the balance of local medical insurance fund is difficult to sustain. To realize the equitable distribution of the medical insurance burden, the central government has to continuously increase transfer payments, which causes regional unfairness in the distribution of central financial resources. This paper explores the influence of central transfer payments on the balance of medical insurance fund, influential mechanisms, and the strategic behavior of local governments. Methods: First, we constructed a dynamic game model between central government and local governments and analyzed the mechanism of central transfer payments affecting the balance of local medical insurance fund. Then, based on the provincial panel data of 28 provincial administrative regions in China from 2004 to 2014, an empirical test was made. The spatial regression model was constructed, and the transfer payments obtained by neighboring provinces in the previous year were taken as instrumental variables. Results: Central transfer payments led to strategic behaviors by local governments that resulted in increased local health insurance fund expenditures and lower balance rates. Moreover, the central transfer payments demonstrated "path dependence". Central transfer payments had a significant negative influence on the local NCMS fund balance rate. The local government subsidy and per capita GDP had a significant positive impact on the local NCMS fund balance rate. The obtained transfer payments of local governments had a significant space correlation. This study based on NCMS data remains valid. Conclusions: Central transfer payments induced the strategic behavior of local governments, which neglected to supervise the expenditure of medical insurance fund, reducing the efficiency of medical insurance fund management and use. The financial resources of medical insurance fund are unevenly distributed among provinces. Measures such as strengthening the supervision ability and initiatives of local governments, refining the central transfer payment mechanism, promoting the economic growth of western regions, and increasing rates for individual contributions appropriately can ensure that the medical insurance fund are used well and distributed equitably. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this paper is to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Methods. In this experiment, a total of 160 patients with coronary heart disease and heart failure who were diagnosed and treated in our hospital from June 2019 to March 2021 were recruited as the study group. All were examined by colour Doppler ultrasound instrument, SPSS statistical software was used to analyse the data obtained, and Spearman correlation was used to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Results. In the study group, there were 68 patients with grade II cardiac function, accounting for 42.50%; 74 patients with grade III, accounting for 46.25%; and 18 patients with grade IV, accounting for 11.25%. The ultrasound parameters of the patients in the study group were profiled and calculated, and then statistically analysed with cardiac function grading. Cardiac function classification was significantly positively correlated with LVMI, LAD, and LVEDd (r = 0.689/0.915/0.928, P = 0.001) and significantly negatively correlated with CI, LVFS, and LVEF (r = −0.689/−0.878/−0.912), P = 0.001). Conclusion. Cardiac ultrasound-related indicators are associated with patients with coronary heart disease and heart failure. With the decline of cardiac function in patients with coronary heart disease and heart failure, the patient's condition is aggravated. Therefore, cardiac ultrasound-related indicators play a major role in the diagnosis of clinical disease progression. [ABSTRACT FROM AUTHOR]

There are many thyroid diseases affecting people all over the world. Many diseases affect the thyroid gland, like hypothyroidism, hyperthyroidism, and thyroid cancer. Thyroid inefficiency can cause severe symptoms in patients. Effective classification and machine learning play a significant role in the timely detection of thyroid diseases. This timely classification will indeed affect the timely treatment of the patients. Automatic and precise thyroid nodule detection in ultrasound pictures is critical for reducing effort and radiologists' mistake rate. Medical images have evolved into one of the most valuable and consistent data sources for machine learning generation. In this paper, various machine learning algorithms like decision tree, random forest algorithm, KNN, and artificial neural networks on the dataset create a comparative analysis to better predict the disease based on parameters established from the dataset. Also, the dataset has been manipulated for accurate prediction for the classification. The classification was performed on both the sampled and unsampled datasets for better comparison of the dataset. After dataset manipulation, we obtained the highest accuracy for the random forest algorithm, equal to 94.8% accuracy and 91% specificity. [ABSTRACT FROM AUTHOR]

In the face of COVID-19, many schools have to educate their students using online activities. During this time, whether and how parents are involved may be of particular importance for young children—who are less able to learn independently via the Internet due to their developmental immaturity. Therefore, this study examined the cross-sectional association of maternal involvement in child online learning with child adjustment during the COVID-19 pandemic and tested maternal mindfulness as a moderator. Data were collected from 236 mothers of kindergarten-aged children (mean age = 55.91 months; 75% of them were girls) during the fourth wave of COVID-19 outbreak in Hong Kong, China. Using paper-and-pencil questionnaires, mothers rated their involvement and mindfulness and their children's pre-academic ability and internalizing and externalizing behaviors and provide demographic information. Regression models revealed that maternal involvement was associated positively with child pre-academic ability and negatively with child internalizing behaviors, but such associations were only significant for children with more mindful mothers. Maternal mindfulness did not moderate the negative association between maternal involvement and child externalizing behaviors. Findings highlighted the role of maternal mindfulness in child development, suggesting that it may be crucial to promote maternal involvement and mindfulness during the pandemic and perhaps beyond. [ABSTRACT FROM AUTHOR]

Objectives: The global coronavirus disease 2019 (COVID‐19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID‐19 vaccine attributes, especially the influence of ANA on the estimated results. Methods: A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL‐EC) was used to analyse the heterogeneity of respondents' preferences for COVID‐19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC‐homogeneity model considered only ANA and the ECLC‐heterogeneity model considered both ANA and preference heterogeneity. Results: Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC‐heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC‐heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL‐EC model, the ECLC‐homogeneity model obtained lower WTPs for COVID‐19 vaccine attributes, and the ECLC‐heterogeneity model obtained mixed WTP results. In the ECLC‐heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs. Conclusions: The RPL‐EC, ECLC‐homogeneity and ECLC‐heterogeneity models obtained inconsistent WTPs for COVID‐19 vaccine attributes. The study found that the results of the ECLC‐heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC‐homogeneity model and the RPL‐EC model. The results showed that the probability of ANA was still high in the ECLC‐heterogeneity model, although it was lower than that in the ECLC‐homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue. Public Contribution: Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID‐19 vaccine choice questions generated through the DCE design. [ABSTRACT FROM AUTHOR]

Life expectancy in China has increased. This paper explores the age when older adults (aged 60 and above) consider themselves to be an 'older person' and how age-related loss of resources (five dimensions: early cumulative factors, decline and loss of health resources, reduction and loss of economic resources, weakening and loss of social support resources, and personal role transition and experiences of losing family members) could impact their perceived old age. Using two waves of data from the China Longitudinal Ageing Social Survey (CLASS) in 2014 and 2016 (6,244 participants in 2014 and 2,989 participants in both 2014 and 2016), we found that the mean perceived old age is around 70 years at baseline (2014). Higher level of educational attainment and occupational types (early cumulative factors), better health condition, receiving support from friends and taking care of grandchildren are significantly associated with the perception that old age begins at an older age at baseline, while being Han-Chinese, being an urban resident (early cumulative factors) and reporting better health condition have significant positive effects on the perception that old age begins at an older age in the later wave. Our findings suggest that the age standard of older adults should be adjusted dynamically in response to social development and longevity, and also highlight the importance of early cumulative factors in shaping the ageing process besides age-related factors. [ABSTRACT FROM AUTHOR]

Background: Emergency department crowding is an obstacle in the process of obtaining emergency care services, which will lead to the increase of time cost. Most studies focused on the direct access to emergency medical resources, and few studies took the crowding of hospital emergency department as an evaluation index to reflect the convenience of obtaining emergency medical resources. It is a significance for the identification of areas with insufficient access to emergency service resources with this method. Methods: This paper utilizes the improved potential model and the inverted Two-Step Floating Catchment Area method, combined with network map API service data to evaluate response time, delivery time and waiting time (for emergency department crowding) spent in different residential areas of Xi'an City in the process of emergency. Meanwhile, the vulnerable regions of gaining emergency medical resources are identified through the comprehensive analysis of the three stages of emergency. Results: The studies show that the residents in built-up area are more convenient to get ambulance service and arrive at care hospitals than those in suburban areas, but they may face greater hospital crowdedness. Although suburban residents are faced with low hospital crowdedness, they spend more time on getting ambulances and going to care hospitals. The accessibility of emergency medical resources varies greatly among residents in different regions, with 5.38% of the residents were identified in the high-risk area distributing in suburban residential areas in the south of the city center, 21.92% in the medium risk area in the southern mountainous areas and the periphery of the core suburban areas of the city, and 46.11% in the low-risk area which are mainly distributed in built-up areas in gaining emergency medical services. Conclusions: Obviously, getting an ambulance and arriving at the nearest hospital quickly shows that it is conducive to access to emergency resources. However, the impact of hospital emergency crowding can not be ignored, especially in the area surrounded by high-grade hospitals in the central area of the city. In considering the spatial layout of emergency stations and emergency hospitals, the dislocation distribution of hospitals at different levels should be reasonably adjusted to balance the equity of residents in obtaining emergency medical resources. [ABSTRACT FROM AUTHOR]

Aim: To identify factors influencing readiness for hospital discharge among Chinese patients having undergone a laryngectomy and to provide evidence for developing future processes. Background: Laryngectomy changes the functional and psychological state of laryngeal cancer patients considerably. However, influencing factors for discharge readiness among laryngectomy patients have hardly been investigated. Methods: A descriptive, cross‐sectional design was used with Meleis' transitions theory as a guiding framework. This survey‐based study was performed with 212 laryngeal cancer patients undergoing laryngectomy at a regional tertiary medical centre between August 2012 and September 2013. Results: Quality of discharge teaching and having a designated caregiver after discharge were found to influence patients' readiness for discharge. Conclusion: Clinical interventions such as nursing assessment on discharge readiness, assistance to coordinate postdischarge support and individualized follow‐up planning should be integrated into future clinical processes in China. However, further investigations are needed to systematically align relevant results before clinical practices in Chinese settings are eventually changed. SUMMARY STATEMENT: What is already known about this topic? Hospital discharge readiness is a measure of a patient's perception of being prepared for hospital discharge.Factors affecting readiness for discharge include age, living standards and quality of discharge teaching. What this paper adds? Most laryngectomy patients are ready for this by the time they are discharged.Quality of discharge teaching and having a designated caregiver after discharge are the leading influencing factors for discharge readiness in laryngectomy patients in China. The implications of this paper: The influential factors established in the current study for the discharge readiness of laryngectomy patients in China could be useful measures to consider in nursing assessment and care to personalize discharge plans for optimal outcomes.Ruling out other factors such as medical insurance allows clinicians and clinical managers to focus their attention on the two factors promising to make an impact.Besides serving as a reference for our fellow researchers, this work may direct future studies further into the subject of discharge preparedness and the potential clinical interventions for optimizing the clinical outcomes for laryngectomy patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine whether patient–provider communication interacts with treatment outcomes to influence patients' risk perception. Background: Medical uncertainties and risks are among the most serious problems faced by patients. This is exacerbated by communication failure in patient–provider relationships and poor treatment outcomes. However, we do not know how communication and treatment outcomes shape patients' risk perception and concern about uncertainty. Design The study is a two‐by‐two between‐subjects design. Methods: Two studies were conducted and data were collected in 2019. Each study used a different research design and different samples: Study 1 used a scenario experiment with 120 undergraduate students; and Study 2 surveyed 200 inpatients in clinical settings. Results: The convergent results found a significant interaction between patient–provider communication and treatment outcome on the perception of medical risks among the participants. Conclusion: Patient–provider communication interacts with treatment outcome to influence patients' perceived risk about uncertainties for healthcare. Clinicians and nurses should be aware of the effects of patient–provider communication on patients' risk perception in their concerns about the uncertainties of treatment and pay much more attention to good healthcare relationship building in addition to the improvement of objective treatment outcome. SUMMARY STATEMENT: What is already known about this topic? Medical uncertainties and risks are exacerbated by communication failure in healthcare relationship.Communicating information to patients is important when they are evaluating the risks and benefits of treatment.Current theories to explain medical risk assume particular psychological processes to reproduce empirical observations of financial risk‐sensitive behaviour. What this paper adds? A scenario experiment explored the interaction effect of patient‐provider communication and treatment outcomes on the perceived risk of medical treatment.We verified the results in the clinical context and revealed a significant interaction of patient‐provider communication with patients' perceived risk of treatment outcomes.Our model predicts that patients' risk perceptions are both path dependent and affected by the patient‐provider communication and treatment outcome. The implications of this paper: Healthcare providers, for example, physicians and nurses, are reminded to adhere to preferred communication and relationship building methods, in support of good treatment outcomes.Providing patients with humanized support and compassion from healthcare professionals may help them understand their illness and symptoms as well as improve their concerns about the uncertainties of treatment. [ABSTRACT FROM AUTHOR]

With the advent of mobile technologies, well‐designed fraction apps can be used to help children gain fraction knowledge, a challenging topic for both teachers and students. The present pilot study adopted a quasi‐experimental design to investigate whether children can learn fraction concepts equally well if half of the lesson time (20 min) is replaced with game‐based learning. Keeping the total lesson time (40 min) identical, the control group (N = 33) received traditional instruction, and the experimental group (N = 32) was presented with a blended learning approach spending half of the class time (20 min) playing tablet‐based fraction games, where each of the learners had their own tablet. The results suggested that in the posttest, the experimental group achieved similar learning gains to the control group and appear to have achieved better performance in the transfer test than the control group. This paper also discusses the efficiency of game‐based learning, the mechanism of how fraction games might enhance learning, and the potential of integrating game‐based learning in educational settings. Lay Description: What is already known about this topicAs a significant mathematical concept in daily life, fractions are crucial for later success in math learning.As a promising new technology, educational games show a great potential for improving learning.Well‐designed fraction apps can be used to help children gain fraction knowledge.What this paper addsGame‐based fraction learning can be combined with formal learning in school education.Game‐based fraction learning might provide a more efficient approach to increasing students' conceptual knowledge of fractions.The result showed that the experimental group achieved a similar cognitive level as the control group although they spent half of the time playing a game, suggesting that children can gain knowledge from the experiences of playing games.What are the implications for practice and/or policyThe result suggests that the proper use of educational games in teaching fractions can make learning more efficient.Further research needs to be done to determine whether the fraction understanding gained through playing these games will have an impact on students' future learning of more complicated fraction concepts. [ABSTRACT FROM AUTHOR]

The rate of early misdiagnosis in patients with nodular fasciitis of the ear is high. To provide a basis for clinical diagnosis and treatment, we aimed to summarise the clinical manifestations, imaging results, pathological findings, treatment strategies, and postoperative follow-up results for three cases of paediatric nodular fasciitis (two girls, one boy) treated in the Department of Otorhinolaryngology, Head and Neck Surgery, at Beijing Children's Hospital of Capital Medical University from 2018 to 2020. The average age at diagnosis was 24 months. Lesions occurred in the left ear in two cases and right ear in one case. All patients had a history of biopsy before surgery. Rapid growth was observed following biopsy in two patients, and anti-inflammatory treatment was ineffective in all three cases. Fluorescence in situ hybridisation analysis of ubiquitin-specific peptidase 6 (USP6) was performed in two of the three cases, with positive results. The lesions exhibited hypo-intensity or iso-intensity on T1-weighted magnetic resonance imaging (MRI) and heterogeneous hyper-intensity on T2-weighted MRI. "Fascial tail" signs were observed on imaging in all cases. Surgical resection was performed in all cases. Intact ear appearance was observed at follow-up, and there were no cases of recurrence. Conclusion: Combining clinical features with imaging findings may improve the accuracy of preoperative diagnosis in patients with nodular fasciitis. In addition to pathological findings, genetic testing for USP6 may aid in diagnosis. The final diagnosis should be based on comprehensive assessment. Complete surgical resection can prevent recurrence. What is Known: • Paediatric NF around the ear is rare and is easily misdiagnosed as other inflammatory masses that have a higher incidence in children. • Most previous reports of NF were case reports. What is New: • Combining clinical and imaging findings with genetic testing for USP6 rearrangement may improve the accuracy of preoperative diagnosis in patients with NF. Nonetheless, the final diagnosis should be based on comprehensive assessment. • The present paper is significant in that it represents the only report of three cases of ear NF in children with a complete medical history and prognosis. [ABSTRACT FROM AUTHOR]

Background: Failure to effectively organize and manage learning time is an important factor influencing online learners' performance. Investigation of time‐investment patterns for online learning will provide educators with useful knowledge of how learners engage in and regulate their online learning and support them in tailoring online course design and teaching. However, understanding of how learners invest and manage their time during online learning remains limited. Objectives: This study aims to discover the typical time‐investment patterns of MOOC learners and their temporal‐learning characteristics based on a systematic time‐investment analysis framework and their relationship with learning performance. Methods: Based on a proposed time‐investment‐analysis framework, this study applied statistical, cluster and lag sequential analyses to investigate learners' time‐investment patterns and their relationships with learning performance, session time allocation, and learning sequences by analysing the learning data from 12,463 participants of a Massive Open Online Course (MOOC) in China. Results and Conclusions: Seven time‐investment patterns of MOOC learners were defined, and learning performance was found to differ among them. Further analysis shows that high performers invested time throughout the whole course and allocated time to multiple activities, exam‐takers performed better in time management and produced more behavioural sequences related to cognitive strategy and recourse use, and learners' motivation and prior knowledge affected the management and effectiveness of their time investment. Implications: The results support the recognition and evaluation of online learning time‐investment patterns and suggest relevant cues for improving MOOC design and teaching. Lay Description: What is currently known about the subject matter: Insufficient learning time affects learning persistence and effectiveness in open and online education programs.Learning time investment and management regarded as an element of self‐regulated learning is a predictor of learning performance.Some proxy behavioural variables or characteristics of online learning time management have been found in previous studies.Learning analysis can be used to dig the knowledge implicit in learning data for online teaching evaluation and improvement. What is paper adds to the subject: Based on a comprehensive analytic framework, seven time‐investment patterns of MOOC learners and their relationship with achievement are identified.Under different time frames, learners' time allocation and learning behaviour pattern are different.Learners performing better in time management across course learning allocate more time to multiple activities in session learning.Exam‐takers perform better in time management across MOOC learning, and produce more behaviour sequences related to cognitive strategy and course recourse use. The implications of study findings for practitioners: The recognition of time investment pattern can support online course design and teaching improvement.MOOC design and teaching need to consider the differences in learners' time resources and their ability of time management.MOOC design and teaching need to encourage learners lacking of performance motivation to engage in various learning activities instead of just watching videos.MOOC design need consider the differences in learners' prior knowledge, and offer personalized learning path based on assessment. [ABSTRACT FROM AUTHOR]

Over the past decade, the call to foster computational thinking (CT) in every child has received considerable attention. However, there is little understanding of whether children are developmentally ready to think computationally and what specific CT concepts and skills can be developed at various ages. This study explored the developmental and gender differences in CT skills of 197 Grade 4–6 students (aged 9–13) before being exposed to instruction and investigated the age–gender interaction effects on their CT acquisition in an intervention combining both programming and non‐programming (unplugged) activities. Results show that students' CT skills followed a developmental progression before instruction. Gender difference across ages was insignificant in conditionals, logical operators, pattern recognition and generalization skills. Additionally, students of different ages developed CT differently during the intervention, and their CT acquisition was unaffected by gender. Implications for practice and research in CT education were discussed. Lay Description: What is currently known about the topic: Learning progressions for computational thinking have been defined in K‐12 curricula globally.Engaging in programming and non‐programming (unplugged) activities can increase students' CT skills.Controversial results have been reported on the age–gender interaction effects on CT development.Lack of understanding on children's actual progressive development of CT. What this paper adds: A developmental progression was found in CT skills of students aged 9–13. Students aged 12 and above had some a priori understanding of CT.No gender difference across ages existed in conditionals, logical operators, pattern recognition and generalization skills before instruction.Students aged 9–11 benefitted the most from an intervention combining both programming and unplugged activities compared to older students. Students' CT acquisition in the intervention was unaffected by gender.Given the intervention, students aged 9 and above developed conditionals, logical operators and pattern recognition skills. However, generalization skill was developed only for students aged 12 and above. Implications for practice and policy: The findings lay the foundation for designing evidence‐based age‐appropriate CT learning progression and pedagogies.Age‐appropriate learning content: Given appropriate learning experiences, students aged 9 and above may be ready to learn certain CT concepts and skills, including conditionals, logical operators and pattern recognition.CT pedagogies: Using programming and unplugged activities to develop CT requires careful consideration of students' cognitive development and gender needs. [ABSTRACT FROM AUTHOR]

Objective: Currently, there are no self‐management resources in Australia that support both Chinese immigrant patients affected by cancer and their caregivers. This paper reports on the development and acceptability assessment of a self‐management intervention (WeCope) in terms of its scope, social and cultural relevance and sensitivity. Methods: Using a community participatory approach in this qualitative study, patients, caregivers and community members took part in semi‐structured focus groups or interviews in Cantonese, Mandarin or English to develop and provide feedback on the acceptability of 'WeCope'. Content analysis was performed on the transcripts using inductive (codes) and deductive (themes and categories) methods. Results: Patients (n = 17), caregivers (n = 10) and community members (n = 2) participated. Four themes were developed, guided by the framework of cultural sensitivity in interventions: (1) content preference and satisfaction; (2) perceived usefulness and usability; (3) cultural relevance and acceptability; and (4) layout and presentation. Participants most commonly wanted more information about treatment‐related issues (n = 14) and available support services (n = 14). Conclusion: Chinese patients and caregivers expressed overall satisfaction with the WeCope resource and provided suggestions for improvement, including provision of more treatment‐related information and contact details for available support while reducing the overall resource length. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to analyze the inequalities in general practitioner (GP) distribution in China. Background: GPs-based primary health care (PHC) has been implemented from 2011 in China, aiming to improve the accessibility and quality of basic medical and healthcare services. GPs in China, as the gatekeeper of people's health, mainly undertake integrated health services at the grass-roots level. Methods: The number of GPs and inequality in GPs distribution from 2012 to 2018 was analyzed by the Lorenz Curve/Gini coefficient and Theil L index. Data were extracted from China Health Statistical Yearbook 2013–2019. Findings: The demographic Gini coefficient of GPs changed from 2012 (0.234) to 2018 (0.167), showing high equality in China. In contrast, the Thiel L index from 2012 (0.372) to 2018 (0.345) showed less equality. The decomposition of Thiel L index implicated the inequalities within the divisions. The number of GPs in China shows a fast growth trend since the general practice system established, and the GPs distribution becomes more demographically equitable. However, the shortage of GPs and inequality in their distribution remains severe. More incentive and supportive policies need to be made to enhance the quantity, quality, and structure of GPs in China. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to study the correlation between demographic and clinical factors and warfarin dose of patients in Chinese Han population taking warfarin and study gene polymorphisms impact of related gene loci (CYP2C9*3, VKORC1-1639G > A) on warfarin doses, to establish a model to predict initial standard dose and maintenance dose based on CYP2C9*3, VKORC1-1639G > A genotype. Methods: The study collects the data of patients in our hospital and other subcenters which incorporates 2160 patients to establish the initial dose model and 1698 patients for the stable dose model, and sequences 26 multigene sites in 451 patients. Based on the patient's dosage, clinical data, and demographic characteristics, the genetic and non-genetic effects on the initial dose and stable dose of warfarin are calculated by using statistical methods, and the prediction model of initial standard dose and maintenance dose can be established via multiple linear regression. Results: The initial dose of warfarin (mg/day) was calculated as (1.346 + 0.350 × (VKORC1-1639G > A) − 0.273 × (CYP2C9*3) + 0.245 × (body surface area) − 0.003 × (age) − 0.036 × (amine-iodine) + 0.021 × (sex))2. This model incorporated seven factors and explained 55.3% of the individualization differences of the warfarin drug dose. The maintenance dose of warfarin (mg/day) was calculated as (1.336 + 0.299 × (VKORC1-1639G > A) + 0.480 × (body surface area) − 0.214 × (CYP2C9*3) − 0.074 × (amine-iodine) − 0.003 × (age) − 0.077 × (statins) − 0.002 × (height))2. This model incorporated six factors and explained 42.4% of the individualization differences in the warfarin drug dose. Conclusion: The genetic and non-genetic factors affecting warfarin dose in Chinese Han population were studied systematically in this study. The pharmacogenomic dose prediction model constructed in this study can predict anticoagulant efficacy of warfarin and has potential application value in clinical practice. [ABSTRACT FROM AUTHOR]

• Reducing modifiable risk factors could prevent the onset of cognitive decline. • Physical multimorbidity–cognitive function association was mediated by depression. • Routine screening for depression in multimorbidity patient may delay dementia onset. This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. The mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms ('overall proportion due to mediation'). The association was not found in Indonesia. Cognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline. [ABSTRACT FROM AUTHOR]

Background: Education for asthmatic children in the outpatient department is insufficient. Aim: To evaluate the efficacy of a nurse‐led education pathway, a standard education programme, on children with asthma. Methods: One hundred and eighty participants enrolled and were randomly assigned to either the control group or the intervention group. The intervention group received predetermined step‐by‐step education sessions based on the self‐designed education pathway, while the control group received usual care. Asthma control, health‐related quality of life, and health‐care utilization measures were taken at baseline and at follow‐up visits between February 2016 and May 2018. Results: Significantly higher scores for health‐related quality of life and inhaler technique at the third‐month visit and asthma control test at the sixth‐month visit were seen in the intervention group. The numbers of unscheduled physician visits and school absences were lower in the intervention group than in the control group within 6 months. However, no significant differences were observed in emergency department visits and hospitalizations. Conclusion: The nurse‐led education pathway could be considered effective for children with asthma visiting the outpatient department. SUMMARY STATEMENT: What is already known about this topic? Education for asthmatic children in the outpatient department is fragmented and insufficient.Previous education programmes only provided information and did not check the patient's mastery of knowledge or assess their living environment.Education based on the clinical pathway has been implemented in emergency departments and inpatient hospitals but not in outpatient departments. What this paper adds? This study displays positive evidence of the effects of a nurse‐led education pathway on asthma control, health‐related quality of life, inhaler technique, and health‐care use.Education incorporating the home environment assessment and telephone consultations can be more beneficial for patients' self‐management of asthma.Children with asthma and their families acquire sufficient education related to improvements in health outcomes and health‐care use. The implications of this paper: This study provides evidence to support the use of a predesigned standard educational programme in children with asthma.This study indicates that education based on the clinical pathway can also be used in outpatient departments for continuity of care.The education pathway in this study provides a comprehensive education model for children with asthma that can also be implemented in other studies through the construction of care pathways adapted to specific diseases. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate incidences of inappropriate initial urinary catheter placements within an older inpatient cohort. Methods: A total of 200 inpatients that received urinary catheterizations within 24 hours of admission were recruited for this observational study. The key demographic and clinical factors were recorded. Adverse outcomes were assessed by examining incidences of catheter‐associated urinary tract infection (CAUTI) during hospitalization, after transfer to skilled nursing facilities, second, duration of hospital stay and by scoring changes on the Katz Index of Independence in Activities of Daily Living. Correlative relationships between demographic data and clinical factors with adverse outcomes were analyzed. Results: Inappropriate initial urinary catheterization in our cohort was approximately 39%. This was associated with elevated Charlson comorbidity index scores and increased dependency, with correlations to medical diagnosis. We also observed that the primary rationale for the procedure (inappropriate catheterization) was for neurogenic bladder (where intermittent catheterization was indicated) and in 'convenience‐of‐care' catheterizations. Inappropriate catheter placement was ultimately associated with an elevated CAUTI at point of discharge, with transfers to skilled nursing facilities and also with an increased duration of hospital stay. Conclusions: Inappropriate catheter placement was prevalence in southwestern China and associated with adverse outcomes. SUMMARY STATEMENT: What is already known about this topic? Urinary catheterization is a common procedure for geriatric in‐patients, yet up to half of such placements are inappropriately performed.Reducing inappropriate urinary catheter use is key to minimizing adverse outcomes such as urinary tract infection and genitourinary trauma.Although guidelines for in‐patient catheterization have been developed, there are no uniform standardized national guidelines in China that could advise physicians on the placement of inpatient urinary catheters.What this paper adds? High incidences of inappropriate initial urinary catheterizations in mainland China have been reported (as represented by a hospital in southwestern China).This study finds that inappropriate catheter placements are associated with catheter‐associated UTIs at the point of discharge, with transfers to skilled nursing facilities, and an increased duration of stay.We also find that inappropriate catheter placements occur when catheterization is indicated for neurogenic bladder (with intermittent catheterization), and for 'convenience‐of‐care' purposes.The implications of this paper: The study identifies situations where older in‐patients have an elevated risk of receiving inappropriate initial urinary catheterization which should receive special attention.The findings of this study highlight the need to develop effective uniform strategies to reduce inappropriate catheterization for older Chinese patients.The factors associated with inappropriate catheterization based on our findings could be useful in establishing the proactive strategies. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health‐care reform in China. This paper aimed to explore patient‐ and hospital‐level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient‐oriented health‐care system. Methods: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. Results: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse‐to‐bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. Conclusion: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well‐functioning health‐care delivery system in order to better serve patients in China. [ABSTRACT FROM AUTHOR]

Introduction: The 1-year mortality rate after femoral intertrochanteric fracture is higher than that of femoral neck fracture, which also belongs to hip fracture (Cui et al. in Arch Osteoporos 14(1):55, 2019). With the application of the concept of co-management model of orthopedics and geriatrics, the short-term and long-term mortality of all types of hip fractures has decreased (Van Heghe et al. in Calcif Tissue Int, 2021, https://doi.org/10.1007/s00223-021-00913-5). However, the mortality of Chinese femoral intertrochanteric fracture patients under this model has not been reported in the literatures. Aim: This paper aims to study the risk factors of postoperative all-cause mortality in aged patients with femoral intertrochanteric fracture under the co-management model of orthopedics and geriatrics. Materials and methods: This is a single-center prospective cohort study based on the real world, under the co-management of orthopedics and geriatrics, 363 patients aged ≥ 65 years with femoral intertrochanteric fracture were enrolled and followed up for 2–3 years; 52 patients were lost to follow up. Age, gender, body mass index (BMI), history of comorbidities, hip Bone Mineral Density (BMD), fracture history, 25(OH)D level, hemoglobin level, anti-osteoporosis treatment were risk factors to be tested. Kaplan–Meier survival curves and multivariate Cox proportional hazards models were constructed to analyze the impact of factors on all-cause mortality. Results: (1) Most of the dead patients were older (the mean age was 83.4 years, compared with 79.8 years for surviving patients), with more complications and without anti-osteoporosis medication; gender, pre-fracture history, BMI, total hip BMD, hemoglobin, 25(OH)D had no difference between the dead and the living patients. (2) Elderly patients with Intertrochanteric fracture can benefit from the early treatment of Zoledronic Acid (within 3 days after the operation). Conclusion: Under the co-management of orthopedics and geriatrics, to Chinese patients with Femoral Intertrochanteric fracture, Doctors should pay more attention to their age and chronic disease, and give anti-osteoporosis treatment if allowed. [ABSTRACT FROM AUTHOR]

Aim: To assess the attitudes of newly graduated nurses in China toward their work environment and identify the factors affecting their perception. Background: Newly graduated nurses are the primary supply to cover the nursing shortage, but their stressful transition into clinical work has contributed to high turnover for decades. Although serving as a source of stress, the work environment can also be a source of support for new nurses. Methods: A total of 2361 new nurses at 31 tertiary hospitals in 20 provinces were surveyed from June to November 2018, using the Chinese version of the Practice Environment Scale‐Nursing Work Index. Basic information and their perception about work environment were collected. Results: New nurses rated their work environment with an overall score of 84.67 (12.85). Multiple linear regression identified that education level, monthly income, hospital type and location, participation (or not) in standardized training programmes and having (or not) a mentor/preceptor were factors significantly associated with their perception of the work environment. Conclusion: The perception of newly graduated nurses in China was mainly positive overall. Nursing managers may take full advantage of factors affecting the perception of work environment to support newly graduated nurses better, to help their retention and transition. Summary statement: What is already known about the topic? Newly graduated nurses experience transition shock at the beginning of their work.Supportive work environments can help successful transition. What this paper adds? Newly graduated nurses are not fully supported in their work environment.Staffing and resource inadequacy were the poorest environmental factors.Residency programmes had the most impact on the perceptions of newly graduated nurses about their work environment. Implications for nursing practice: These results can guide nursing managers to support the newly graduated nurses better in their transition process, thus helping retention of nursing human resource. [ABSTRACT FROM AUTHOR]

Due to the COVID‐19 epidemic crisis, students from higher education institutions around the world are forced to participate in comprehensive online curriculums. In such a scenario, it is worth investigating how students perceived their learning outcomes and satisfaction based on this method of teaching and learning online. This study aims to explore the role of six factors, namely, system quality, course design, learner‐learner interaction, learner‐instructor interaction, learner‐content interaction, and self‐discipline, on university students' perceived learning outcomes and their effect on student satisfaction with online curricula during the COVID‐19 epidemic. A structural equation modelling technique was used to assess survey questionnaires obtained from 457 validated students at a Public University in China. The results demonstrated that these determinants had a positive effect on satisfaction and learning outcomes, whereas learner‐instructor interaction had no significant effect. Furthermore, the strongest determinant that affected not only students' satisfaction but also their learning outcomes was the learner‐content interaction. Lay Description: What is already known about this topic?: Online teaching can support students' learning in COVID‐19 epidemic.Various determining factors affect students' learning outcomes and satisfaction towards online learning. What this paper adds?: This study investigates six determinants on students' learning outcomes and satisfaction towards online learning.Learner‐content interaction yielded a stronger effect on university students' learning outcomes and satisfaction.Learner‐instructor interaction has no significant effect. Implications for practice and/or policy: System quality, course design, learner‐learner interaction, learner‐content interaction, and self‐discipline, had a positive impact on university students' perceived learning outcomes and satisfaction in COVID‐19. [ABSTRACT FROM AUTHOR]