Search

An increasing number of employees are using social media for their daily work. But the relationship between social media use and job performance is controversial. To address this issue, this study explores the impact of different social media platform usage on job performance based on different usage purposes. The media synchronicity theory provides the theoretical foundation. Surveys were conducted in an Internet commerce company in China, generating 301 valid responses for analysis. The results showed that both work-related and social-related use of enterprise social media had a U-shape effect on job performance. Also, work-related use of general social media had a U-shape effect on job performance, whereas social-related use of general social media had no effect on job performance. These results offer insights about how organisations may guide their employees in their use of social media to improve job performance. [ABSTRACT FROM AUTHOR]

Background: The incidence of rabies exposure is high and increasing in China, leading to an urgent demand of rabies post-exposure prophylaxis (PEP) clinics for the injured. However, the spatial accessibility and inequality of rabies-exposed patients to rabies PEP clinics is less known in China. Methods: Based on rabies exposure data, PEP clinic data, and resident travel origin-destination (OD) matrix data in Guangzhou City, China, we first described the incidence of rabies exposure in Guangzhou from 2020 to 2022. Then, the Gaussian two-step floating catchment area method (2SFCA) was used to analyze the spatial accessibility of rabies-exposed patients to rabies PEP clinics in Guangzhou, and the Gini coefficient and Moran's I statistics were utilized to evaluate the inequality and clustering of accessibility scores. Results: From 2020 to 2022, a total of 524,160 cases of rabies exposure were reported in Guangzhou, and the incidence showed a significant increasing trend, with an average annual incidence of 932.0/100,000. Spatial accessibility analysis revealed that the overall spatial accessibility scores for three scenarios (threshold of driving duration [d0] = 30 min, 45 min, and 60 min) were 0.30 (95% CI: 0.07, 0.87), 0.28 (95% CI: 0.11, 0.53) and 0.28 (95% CI: 0.14, 0.44), respectively. Conghua, Huangpu, Zengcheng and Nansha districts had the higher accessibility scores, while Haizhu, Liwan, and Yuexiu districts exhibited lower spatial accessibility scores. The Gini coefficient and Moran's I statistics showed that there were certain inequality and clustering in the accessibility to rabies PEP clinics in Guangzhou. Conclusions: This study clarifies the heterogeneity of spatial accessibility to rabies PEP clinics, and provide valuable insights for resource allocation to achieve the WHO target of zero human dog-mediated rabies deaths by 2030. [ABSTRACT FROM AUTHOR]

Objectives: Surrogate decision-making by family caregivers for patients with severe brain injury is influenced by the availability and understanding of relevant information and expectations for future rehabilitation. We aimed to compare the consistency of family caregivers' perceptions with clinical diagnoses and to inform their expectation of prognosis in the future. Methods: The Coma Recovery Scale-Revised was used to assess the diagnosis of inpatients with severe brain injury between February 2019 and February 2020. A main family caregiver was included per patient. The family caregiver's perception of the patient's consciousness and expectations of future recovery were collected through questionnaires and compared consistently with the clinical diagnosis. Results: The final sample included 101 main family caregivers of patients (57 UWS, unresponsive wakefulness syndrome, 37 MCS, minimally conscious state, 7 EMCS, emergence from MCS) with severe brain injury. Only 57 family caregivers correctly assessed the level of consciousness as indicated by the CRS-R, showing weak consistency (Kappa = 0.217, P = 0.002). Family caregivers' demographic characteristics and CRS-R diagnosis influenced the consistency between perception and clinical diagnosis. Family caregivers who provided hands-on care to patients showed higher levels of consistent perception (AOR = 12.24, 95% CI = 2.06-73.00, P = 0.006). Compared to UWS, the family caregivers of MCS patients were more likely to have a correct perception (OR = 7.68, 95% CI = 1.34–44.06). Family caregivers had positive expectations for patients' recovery in terms of both communication and returning to normal life. Conclusion: Nearly half of family caregivers have inadequate understanding of their relative's level of consciousness, and most of them report overly optimistic expectations that do not align with clinical diagnosis. Providing more medical information to family caregivers to support their surrogate decision-making process is essential. [ABSTRACT FROM AUTHOR]

Background: Patients with primary hyperparathyroidism (PHPT) are at risk for severe hypocalcemia (SH) following parathyroidectomy (PTX), but limited data exist on the predictors of SH. We aimed to identify risk factors for early postoperative SH after PTX in patients with PHPT and to evaluate the predictive value of clinical parameters. Methods: A retrospective review of patients with PHPT who underwent PTX between January 2010 and December 2022 was performed. A total of 46 patients were included in the study, with 15 (32.6%) experiencing postoperative SH, 19 (41.3%) having calculi in the ureter or kidney, and 37 (80.4%) having osteoporosis. Patients were divided into SH and non-SH groups based on postoperative serum calcium levels. Preoperative biochemical indicators, bone turnover markers, and renal function parameters were analyzed and correlated with postoperative SH. Results: Statistically significant (P < 0.05) differences were found in preoperative serum calcium (serum Ca), intact parathyroid hormone, serum phosphorus (serum P), serum Ca/P, percentage decrease of serum Ca, total procollagen type 1 intact N-terminal propeptide, osteocalcin (OC), and alkaline phosphatase levels between the two groups. Multivariate analysis showed that serum P (odds ratio [OR] = 0.989; 95% confidence interval [95% CI] = 0.981–0.996; P = 0.003), serum Ca (OR = 0.007; 95% CI = 0.001–0.415; P = 0.017), serum Ca/P (OR = 0.135; 95% CI = 0.019–0.947; P = 0.044) and OC levels (OR = 1.012; 95% CI = 1.001–1.024; P = 0.036) were predictors of early postoperative SH. The receiver operating characteristic curve analysis revealed that serum P (area under the curve [AUC] = 0.859, P < 0.001), serum Ca/P (AUC = 0.735, P = 0.010) and OC (AUC = 0.729, P = 0.013) had high sensitivity and specificity. Conclusion: Preoperative serum P, serum Ca/P and osteocalcin levels may identify patients with PHPT at risk for early postoperative SH after PTX. [ABSTRACT FROM AUTHOR]

Background: The role of red blood cell (RBC) counts as potential independent risk factors for deep vein thrombosis (DVT) in patients with spinal cord injury (SCI) remains uncertain. This study aims to clarify the associations between RBC counts and DVT incidence among this population. Methods: A retrospective analysis was performed on 576 patients with SCI admitted to the rehabilitation medicine department from January 1, 2017 to December 31, 2021. After exclusions, 319 patients were analyzed, among which 94 cases of DVT were identified. Results: Mode of injury, D-dimer and anticoagulant therapy were significant covariates (P < 0.05). Age, fibrinogen, D-dimer, anticoagulant therapy and American Spinal Cord Injury Association impairment scale (AIS) grades were associated with RBC counts and DVT incidence (P < 0.05). Adjusting for these factors, a 1.00 × 10^12/L increase in RBC counts correlated with a 45% decrease in DVT incidence (P = 0.042), revealing a "U" shaped relationship with a pivot at 4.56 × 10^12/L (P < 0.05). Conclusion: RBC counts below 4.56 × 10^12/L serve as a protective factor against DVT, while counts above this threshold pose a risk. These findings could inform the development of DVT prevention strategies for patients with SCI, emphasizing the need for targeted monitoring and management of RBC counts. [ABSTRACT FROM AUTHOR]

Background: As the U.S. population ages, family members increasingly act as informal caregivers, particularly for minority patients and those with limited English proficiency (LEP). However, physicians often do not identify or engage caregivers until there is a health crisis. This study aims to further our understanding of characteristics associated with having a caregiver present at a primary care visit, and better understand the specific roles family caregivers engage in to support older Chinese and Latino primary care patients. Methods: Primary care patients were surveyed by telephone in a study of language access and communication. Participants included Chinese and Latino primary care patients (≥ 65 years old) from an academic general medicine practice. We asked patients if anyone was in the room with them during their most recent primary care visit (yes = caregiver accompanied). We asked about caregiving support for various needs, and examined associations of patient and visit characteristics with being accompanied, and frequency of caregiver support roles overall and by caregiver accompaniment. Results: Among 906 participants, 80% preferred a non-English language, 64% were women, 88% had Medicare, and mean age was 76 years (range 65–97). 43% were accompanied to their most recent visit. Speaking English 'not at all' vs. 'very well' was associated with being caregiver accompanied (OR 3.5; 95% CI 1.3–9.7), as was older age ≥ 75 vs. 65–74 (OR 2.7; 95% CI 2.0-3.7). The most common roles being supported by caregivers included: transportation to medical appointments (63%), helping with medical decisions (60%), and talking with the doctor about the patient's medical care (54%). Even among unaccompanied patients, substantial proportions reported caregiver support with medical decisions (45%), talking with the doctor (33%), and medical needs at home (26%). Conclusions: Opportunities for physicians to engage caregivers who have active support roles may be missed, especially if those caregivers are not present at the visit. Future interventions should aim to help physicians identify which patients have caregivers and for what needs, so they may effectively engage caregivers before a health crisis occurs. [ABSTRACT FROM AUTHOR]

Background: Nursing students encounter various stressors during their clinical practicum; however, the stressors are not the same during different periods. At present, studies on the stressors and coping styles of nursing students in the middle period of their clinical practicum are rare. Aims: The current study aimed to explore the stressors and coping styles of nursing students in the middle period of their clinical practicum. Methods: A qualitative study with a descriptive phenomenological method was conducted to collect data from 10 nursing students undergoing the middle period of their clinical practicum from December 2020 to February 2021. The data were collected by semistructured interviews using interview outlines prepared in advance. The data were analyzed by Colaizzi's analysis method. Results: The stressors experienced by nursing students in the middle period of their clinical practicum mainly included personal reasons, teaching arrangements, interpersonal relationships, occupational particularity and career planning. Additionally, nursing students coped with the stressors that they face in the clinical practicum by eliminating stressors and regulating emotions. Conclusions: Nursing students experienced various stressors and used a variety of coping styles in the middle period of their clinical practicum, which was different from what occurred in the early and late periods. Targeted interventions should be formulated and implemented to relieve nursing students' stress and guide them to adopt effective coping styles. [ABSTRACT FROM AUTHOR]

Background: Surgery is the primary treatment for benign breast disease and causes some disruption to the normal physiology of the breast, even when this disruption is localised, it remains unclear whether it affects women's ability to breastfeed. There are only a few studies describing the experience of breastfeeding in women who have undergone benign breast disease (BBD) surgery. Methods: We retrospectively analysed data from patients aged 20–40 years in Guangdong, China, who underwent breast lumpectomy for BBD in our department between 01 January 2013 and 30 June 2019, with a follow-up date of 01 February 2022. Patients were included who had a history of childbirth between the time of surgery and the follow-up date. By collecting general information about this group of patients and information about breastfeeding after surgery, we described the breastfeeding outcomes of women of a fertile age who had previously undergone surgery for benign breast disease. Results: With a median follow-up of 5.9 years, a total of 333 patients met the inclusion criteria. From the breastfeeding data of the first child born postoperatively, the mean duration of 'exclusive breastfeeding' was 5.1 months, and the mean duration of 'any breastfeeding' was 8.8 months. The rate of 'ever breastfeeding' is 91.0%, which is lower than the national average of 93.7%, while the exclusive breastfeeding rate at six months was 40.8%, was higher than the 29.2% national average. The any breastfeeding rate at 12 months was 30.0%, which was well below the 66.5% national average. The common reason for early breastfeeding cessation was insufficient breast milk. A total of 29.0% of patients who had ever breastfed after surgery voluntarily reduced the frequency and duration of breastfeeding on the operated breast because of the surgery. Conclusions: There are some impacts of BBD surgery on breastfeeding and some may be psychological. Institutions should provide more facilities for mothers who have undergone breast surgery to help them breastfeed, such as conducting community education on breastfeeding after breast surgery, training professional postoperative lactation consultants in hospitals, and extending maternity leave. Families should encourage mothers to breastfeed with both breasts instead of only the non-operated breast. [ABSTRACT FROM AUTHOR]

Background: Oral nutritional supplements are one of the preferred methods of nutritional support for postoperative patients. This study aims to investigate the current status of oral nutritional supplements compliance in postoperative patients with digestive tract tumors and its influencing factors. Methods: Convenience sampling was employed to select 242 patients who underwent surgery for digestive tract tumors at a tertiary hospital in Shanghai from October 2022 to July 2023 as the study subjects. Data following a normal distribution were analyzed using independent sample t-tests, ANOVA single-factor analysis, Pearson correlation analysis, and multiple linear regression analysis to determine the factors influencing compliance with oral nutritional supplements. Results: A total of 252 questionnaires were distributed, with 10 invalid questionnaires excluded, resulting in an effective questionnaire rate of 96.03%. The compliance score for oral nutritional supplements in postoperative patients with digestive tract tumors was (2.40 ± 1.45), General Self-efficacy Scale (GSES) score was (24.72 ± 4.86), Multidimensional Scale of Perceived Social Support Scale (MSPSS) score was (58.67 ± 11.09), and Belief about Medicines Questionnaire Scale (BMQ) score was (0.17 ± 2.78). Multiple linear regression analysis revealed that age, adverse reactions, educational level, self-efficacy, medication beliefs, and social support were factors influencing compliance with oral nutritional supplements in postoperative patients with digestive tract tumors (P < 0.05). Conclusion: Our study revealed that the compliance to oral nutritional supplements among postoperative patients with digestive tract tumors was at a moderate level and was closely associated with age, educational level, adverse reactions to oral nutritional supplements, medication beliefs, social support, and self-efficacy. Nursing staff should conduct nursing assessments based on the specific circumstances of patients and their families, provide personalized health education management plans based on the patients' educational level, enhance patients' nutrition knowledge, improve patient self-efficacy, and enhance social support for patients, while further improving patient nutrition management. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit-acquired weakness (ICU-AW) is very common in ICU patients. It is important to understand the status quo of knowledge, attitude and behavior of ICU nurses about ICU-AW. This survey aimed to investigate the knowledge, attitude and behavior of ICU nurses about ICU-AW, to provide useful implications for clinical care. Methods: ICU nurses from two tertiary hospitals in China from October 10 to November 15, 2023 were included. The ICU-AW knowledge, attitude and behavior questionnaire of ICU nurses with 31 items were used for survey. SPSS24.0 statistical software was used for data analysis. Results: A total of 364 ICU nurses were included for survey. The ICU-AW knowledge of ICU nurses was 21.96 ± 5.72 (< 50% of the total knowledge score), the ICU-AW attitude of ICU nurses was 30.24 ± 5.05(< 75% of the total attitude score), the ICU-AW behavior of ICU nurses was 26.77 ± 5.81(< 75% of the total behavior score), the total score was 79.21 ± 12.69(< 75% of the total score). Nurses' ICU-AW knowledge, attitude and behavior were all correlated (all P < 0.05). Multiple linear regression analyses indicated that age, years of ICU work experience, professional ranks and titles, had received the training about the ICU-AW were the influencing factors of knowledge, attitude and behavior of ICU nurses about ICU-AW (all P < 0.05). Conclusions: The knowledge, attitude and behavior of ICU nurses' ICU-AW needs to be improved, and there are many influencing factors. Hospital nursing administrators should strengthen the training of nurses' ICU-AW knowledge and improve the cognitive and practical ability of ICU nurses on ICU-AW, so as to reduce the occurrence of ICU-AW. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM). Methods: Baseline data, encompassing basic information, lifestyle habits, and treatment of 305 T2DM patients from March 2021 to January 2023, were collected and analyzed using SPSS 26.0 software. Results: Univariate and multivariate logistic regression analyses identified insulin therapy (OR = 2.233; 95%Cl = 1.013–4.520; P = 0.026) and regular clinic visits (OR = 0.567; 95%Cl = 0.330–0.973; P = 0.040) as independent factors influencing glycemic control. No observed interactions between the two variables were noted. Conclusion: History of insulin therapy and regular clinic visits were significantly and independently associated with glycated hemoglobin control in T2DM patients. Tailored interventions based on individual circumstances are recommended to optimize glycemic control. [ABSTRACT FROM AUTHOR]

A growing body of literature shows that adherence to some aspects of Western masculinity norms, including the suppression of emotional vulnerability, avoidance of seeking support from others, and exaggerated physical toughness, is associated with poorer psychological and social outcomes. While existing research suggests that parental gender beliefs and caregiving behaviors might influence the development of children's gendered behaviors, little is known about the developmental origins of individual differences in adherence to masculinity norms. The current study aims to address this gap and presents a longitudinal investigation of how parental gender beliefs and maternal sensitivity during infancy contribute to children's adherence to masculinity norms during middle childhood. Data were drawn from a mixed-method 9-year longitudinal study of 374 urban Chinese families (48.40% with daughters). Parental gender beliefs were assessed at 24 months, maternal sensitivity was assessed with mother–child interaction observations at 14 and 24 months, and children's self-reported adherence to masculinity norms were assessed at age 10 years. Results indicate that while parental gender beliefs had no associations with children's adherence to masculinity norms, maternal sensitivity predicted children's adherence to masculinity norms (β = −.18, p =.008) above and beyond parental gender beliefs and parental education level; moreover, there was a significant interaction of sex on the effect of maternal sensitivity on children's adherence to masculinity (β = −.23, p =.025), and the association was significant only for boys. Public Significance Statement: This is the first longitudinal study to examine the developmental influence of parenting sensitivity and gender beliefs on boys' and girls' adherence to masculinity norms. Results demonstrate that sensitive parenting may have long-term protective effects on boys' adherence to harmful gender norms and represent a pathway for intervention. [ABSTRACT FROM AUTHOR]

This study examines the moment-to-moment within-person associations between maternal and child behaviors during a challenging puzzle task and compares these associations between mother–child dyads from the United States (n = 99, 52 boys, Mchild age = 56.05 months, SD = 6.44) and China (n = 101, 46 boys, Mchild age = 57.41 months, SD = 6.58). Maternal autonomy support and intrusive control and child agency and defeat were rated in 15-s intervals by native and bicultural coders. Country was examined as a moderator of the moment-to-moment within-person associations between maternal and child behaviors. The results showed that for both U.S. and Chinese dyads, increases in maternal intrusive control predicted subsequent decreases in child agency, and increases in child defeat predicted subsequent increases in maternal autonomy support. Furthermore, increases in maternal autonomy support predicted subsequent increases in child defeat, but for the Chinese dyads only. Public Significance Statement: This study examined how maternal and child behaviors change in response to each other during a challenging puzzle task among U.S. and Chinese dyads. For both U.S. and Chinese preschoolers, children's eagerness and confidence to complete the task decreased immediately after mothers exerted more intrusive control. Additionally, Chinese preschoolers, but not U.S. preschoolers, expressed more defeat and negative emotion immediately after mothers provided more support of the child's autonomy. The findings showed both cultural similarities and differences in the real-time dynamics of mother–child interaction. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the factors associated with extended length of stay (LOSE) for patients with tuberculosis (TB) in China, and construct a nomogram to predict it. In addition, the impact of extended hospital stay on short-term readmission after discharge was assessed. Methods: A retrospective observational study was conducted at Changsha Central Hospital, from January 2018 to December 2020. Patients ( ≥ 18 years who were first admitted to hospital for TB treatment) with non-multidrug-resistant TB were selected using the World Health Organization's International Classification of Diseases, 10th Revision (ICD-10-CM), and the hospital's electronic medical record system. Results: A multivariate logistic regression analysis was used to evaluate the associations between TB and LOSE. The relationship between length of hospital stay and readmission within 31 days after discharge was assessed using a univariate Cox proportional risk model. A total of 14 259 patients were included in this study (13 629 patients in the development group and 630 in the validation group). The factors associated with extended hospital stays were age, smear positivity, extrapulmonary involvement, surgery, transfer from other medical structures, smoking, chronic liver disease, and drug-induced hepatitis. There was no statistical significance in the 31-day readmission rate of TB between the LOSE and length of stay ≤ 14 days groups (hazards ratio: 0.92, 95% CI: 0.80-1.06, P = 0.229). Conclusion: LOSE with TB was influenced by several patient-level factors, which were combined to construct a nomograph. The established nomograph can help hospital administrator and clinicians to identify patients with TB requiring extended hospital stays, and more efficiently plan for treatment programs and resource needs. [ABSTRACT FROM AUTHOR]

The aim of the present study was to illuminate the causal relationships between self‐esteem and test anxiety, as well as between general self‐efficacy and test anxiety using two‐wave longitudinal research design with a sample of 252 Chinese college students. After controlling for gender, grade and autoregressive effects, the results revealed that (1) self‐esteem at T1 did not significantly predict test anxiety at T2; (2) general self‐efficacy at T1 did not significantly predict test anxiety at T2; (3) test anxiety at T1 significantly and negatively predicted self‐esteem at T2; and (4) test anxiety at T1 marginally significantly and negatively predicted general self‐efficacy at T2. These results suggest that test anxiety is more likely to affect self‐esteem and general self‐efficacy rather than vice versa, and that the causal relationship between self‐esteem and test anxiety are clearer than the causal relationship between general self‐efficacy and test anxiety. However, given the limitation of the longitudinal research using cross‐lagged analysis for revealing causality, these results should be viewed with caution. [ABSTRACT FROM AUTHOR]

The job crafting literature has not devoted much attention to the effects of specific forms of job crafting, particularly cognitive crafting. The present study builds on Conservation of Resources theory to explain how cognitive crafting might influence work meaningfulness for employees, and in turn, increase their experienced thriving at work. Moreover, we hypothesise that the impact of cognitive crafting on these outcomes is influenced by two motivational job characteristics: skill variety and job autonomy. To test our hypotheses, we collected three‐wave survey data from 223 employees employed in a variety of occupations and industries in China. Results indicate that engaging in cognitive crafting enhances employees' work meaningfulness, resulting in thriving at work. Furthermore, skill variety and job autonomy are crucial moderators of these relationships. Specifically, when employees perceived low levels of skill variety or job autonomy, engaging in cognitive crafting was more likely to lead to enhanced work meaningfulness, which in turn resulted in higher levels of thriving at work. Implications for research, theory and practice are discussed. [ABSTRACT FROM AUTHOR]

The ability to decode nonverbal cues is essential for effective cross-cultural communication. Despite the significance of nonverbal communication, research in this area has primarily focused on spoken language. This is particularly problematic during indirect communication, where there is a discrepancy between the surface meaning and the true intention (e.g., "Well, there is still room for improvement in your writing skills"). Misinterpretation of nonverbal cues during indirect communication can impede the decoding of true intention and potentially create hostile situations. The present study investigated cross-cultural differences in the use of nonverbal cues in decoding indirect messages. British and Chinese raters watched silent video clips and identified the types of replies from models of their own and the other culture. Results revealed that British raters were able to recognize indirect replies from British models but not from Chinese models above chance level, whereas Chinese raters were able to recognize indirect replies from models of both cultures above chance level. Furthermore, British raters showed higher accuracy and confidence in identifying indirect replies from British models than Chinese models. In contrast, Chinese raters were equally skilled and confident in identifying indirect replies from both British and Chinese models. Additionally, British and Chinese raters employed different nonverbal cues to recognize indirect replies from models of their respective cultures. These findings underscore the importance of cross-cultural differences in identifying indirect replies through nonverbal communication and provide insights to enhance intercultural communication between British and Chinese individuals. [ABSTRACT FROM AUTHOR]

Background During the coronavirus disease 2019 (COVID-19) pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. Methods An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. Results The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. Conclusion Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality. [ABSTRACT FROM AUTHOR]

Background: Delayed extubation and transfer to the intensive care unit (ICU) in children undergoing major scoliosis surgery may increase postoperative complications, prolong hospital stay, and increase medical expenses; however, whether a child will require delayed extubation or transfer to the ICU after scoliosis orthopedic surgery is not fully understood. In this study, we reviewed the risk factors for delayed extubation and transfer to the ICU after scoliosis orthopedic surgery in children. Method: The electronic medical records of pediatric patients (≤ 18 years) who underwent posterior spinal fusion surgery between January 2018 and November 2021 were reviewed and analyzed. Patient characteristics (age, sex, body mass index, American Society of Anesthesiologists, ASA, grade, preoperative lung function, and congenital heart disease), preoperative Cobb angle, scoliosis type, correction rate, vertebral fusion segments, pedicle screws, surgical osteotomy, intraoperative bleeding, intraoperative allogeneic transfusion, intraoperative hemoglobin changes, intraoperative mean arterial pressure changes, intraoperative tidal volume (ml/kg predicted body weight), surgical time, postoperative extubation, and transfer to the ICU were collected. The primary outcomes were delayed extubation and transfer to the ICU. Multivariate logistic regression models were used to determine the risk factors for delayed extubation and ICU transfer. Results: A total of 246 children who satisfied the inclusion criteria were enrolled in this study, of whom 23 (9.3%) had delayed extubation and 81 (32.9%) were transferred to the ICU after surgery. High ASA grade (odds ratio [OR] 5.42; 95% confidence interval [CI] 1.49–19.78; p = 0.010), high Cobb angle (OR 1.04; 95% CI 1.02–1.07; p < 0.001), moderate to severe pulmonary dysfunction (OR 10.9; 95% CI 2.00–59.08; p = 0.006) and prolonged surgical time (OR 1.01; 95% CI 1.00–1.03; p = 0.040) were risk factors for delayed extubation. A high Cobb angle (OR 1.02; 95% CI 1.01–1.04; p = 0.004), high intraoperative bleeding volume (OR 1.06; 95% CI 1.03–1.10; p = 0.001), allogeneic transfusion (OR 3.30; 95% CI 1.24–8.83; p = 0.017) and neuromuscular scoliosis (OR 5.38; 95% CI 1.59–18.25; p = 0.007) were risk factors for transfer to the ICU. A high Cobb angle was a risk factor for both delayed extubation and ICU transfer. Age, sex, body mass index, number of vertebral fusion segments, correction rate, and intraoperative tidal volume were not associated with delayed postoperative extubation and ICU transfer. Conclusion: The most common risk factor for delayed extubation and ICU transfer in pediatric patients who underwent posterior spinal fusion was a high Cobb angle. Determining risk factors for a poor prognosis may help optimize perioperative respiratory management strategies and planning of postoperative care for children undergoing complicated spinal surgery. [ABSTRACT FROM AUTHOR]

Purpose: The Chinese Emotional Speech Audiometry Project (CESAP) aims to establish a new material set for Chinese speech audiometry tests, which can be used in both neutral and emotional prosody settings. As the first endeavor of CESAP, this study demonstrates the development of the material foundation and reports its validation in neutral prosody. Method: In the development step, 40 phonetically balanced word lists consisting of 30 Chinese disyllabic words with neutral valence were first generated. In a following affective rating experiment, 35 word lists were qualified for validation based on the familiarity and valence ratings from 30 normal-hearing (NH) participants. For validation, performance-intensity functions of each word list were fitted with responses from 60 NH subjects under six presentation levels (−1, 3, 5, 7, 11, and 20 dB HL). The final material set was determined by the intelligibility scores at each decibel level and the mean slopes. Results: First, 35 lists satisfied the criteria of phonetic balance, limited repetitions, high familiarity, and neutral valence and were selected for validation. Second, 15 lists were compiled in the final material set based on the pairwise differences in intelligibility scores and the fitted 20%–80% slopes. The established material set had high reliability and validity and was sensitive to detect intelligibility changes (50% slope: 6.20%/dB; 20%–80% slope: 5.45%/dB), with small covariance of variation for thresholds (15%), 50% slope (12%), and 20%–80% slope (12%). Conclusion: Our final material set of 15 word lists takes the initiative to control the emotional aspect of audiometry tests, which enriches available Mandarin speech recognition materials and warrants future assessments in emotional prosody among populations with hearing impairments. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the association between negative aging stereotypes and goal pursuit in daily life among older adults. We also explored the roles of stereotype threat and stereotype challenge reactions in mediating this association. Additionally, this study investigated whether variations in these associations exist among older adults based on their self-integrity levels. Methods Participants were 100 older adults who completed daily measures assessing negative aging stereotype experiences, threat and challenge reactions, goal pursuit activities, and self-integrity over a week. Results More daily experiences of negative aging stereotypes were associated with greater avoidance of responsibilities in goal pursuit and less progress toward goals. Increased threat reactions and decreased challenge reactions were mediators of the association between stereotype experiences and avoidance of responsibilities, as well as that between stereotype experiences and progress toward goals, respectively. Moreover, the associations between threat reactions and avoidance of responsibilities as well as between stereotype experiences and challenge reactions were more pronounced in older adults with lower self-integrity levels. Discussion This study is pioneering in demonstrating the real-life interplay between aging stereotypes and goal pursuit among older adults. Its findings not only expand upon the literature concerning aging stereotypes, but also offer theoretical insights for the development of interventions aimed at goal pursuit. These insights have significant implications for fostering healthy aging. [ABSTRACT FROM AUTHOR]

Objectives Household consumption significantly affects the quality of life and successful aging of older adults. However, prior research has often overlooked the connection between household consumption and long-term care insurance (LTCI). This study aims to investigate the influence of LTCI on consumption patterns within older Chinese households. Methods We used harmonized data from the China Health and Retirement Longitudinal Study and merged it with data from cities that implemented LTCI in China. We analyzed a total of 6,494 households consisting of individuals who were 60 years of age or older. To ensure accurate and stable research findings, we employed a series of difference-in-differences models. Results We found that LTCI has a significant impact on consumption levels, including total and per capita consumption within older households. Furthermore, our research demonstrates that LTCI significantly enhances enjoyable consumption across the consumption types. Through a heterogeneous analysis, it is shown that LTCI has a unique effect on both the total and enjoyable consumption of urban older households and also promotes comprehensive consumption improvements in older rural and disabled households. Discussion These findings highlight the crucial role of LTCI in improving the financial security and well-being of older households. They also have considerable policy implications for dealing with the challenges of an aging population. [ABSTRACT FROM AUTHOR]

This study develops a comprehensive genotype-phenotype model for predicting the effects of resistance training on leg press performance. A cohort of physically inactive adults (N=193) underwent 12 weeks of resistance training, and measurements of maximum isokinetic leg press peak force, muscle mass, and thickness were taken before and after the intervention. Whole-genome genotyping was performed, and genome-wide association analysis identified 85 novel SNPs significantly associated with changes in leg press strength after training. A prediction model was constructed using stepwise linear regression, incorporating seven lead SNPs that explained 40.4% of the training effect variance. The polygenic score showed a significant positive correlation with changes in leg press strength. By integrating genomic markers and phenotypic indicators, the comprehensive prediction model explained 75.4% of the variance in the training effect. Additionally, five SNPs were found to potentially impact muscle contraction, metabolism, growth, and development through their association with REACTOME pathways. Individual responses to resistance training varied, with changes in leg press strength ranging from −55.83% to 151.20%. The study highlights the importance of genetic factors in predicting training outcomes and provides insights into the potential biological functions underlying resistance training effects. The comprehensive model offers valuable guidance for personalized fitness programs based on individual genetic profiles and phenotypic characteristics. [ABSTRACT FROM AUTHOR]

Purpose: So far, there have been no in-depth analyses of the connection between tinnitus sensation--level loudness and sleep quality. Accordingly, the present study was formulated as a mediation analysis focused on exploring this relationship. Method: Overall, 1,255 adults with consecutive subjective tinnitus who had sought outpatient treatment were enrolled in the present study. Results: Direct effects of tinnitus sensation--level loudness on sleep quality were not statistically significant (95% confidence intervals [CI] include zero), as measured by the point estimate, -0.016. However, the 95% CI for indirect effects did not include zero when assessing the Self-Rating Anxiety Scale (SAS) scores, the Self-Rating Depression Scale (SDS) scores, the visual analogue scale (VAS) scores, and self-reported tinnitus annoyance. Conclusions: These results suggest that tinnitus sensation--level loudness does not directly have an effect on sleep quality. However, it indirectly impacts sleep quality, mediated by SAS scores, SDS scores, the impact of tinnitus on life measured using the VAS, and self-reported tinnitus annoyance. As such, alleviating anxiety and depression in patients with tinnitus may result in reductions in their insomnia even if there is no reduction in tinnitus loudness. Importantly, otolaryngologists and other clinicians treating tinnitus should refer patients with tinnitus suffering from insomnia with comorbid depression or anxiety for appropriate psychological and/or psychiatric treatment. [ABSTRACT FROM AUTHOR]

Objectives: Dolutegravir + lamivudine (DTG + 3TC) is a first‐line regimen for people with HIV. However, there are still concerns about its efficacy in people with tuberculosis (TB)/HIV due to the lack of available evidence and drug–drug interaction with rifampicin. Methods: A single‐centre retrospective observational case series was conducted in Guangxi Zhuang Autonomous Region, China. We included all people with TB/HIV on combined use of once‐daily (q.d.) dosing DTG + 3TC and rifampicin (RIF)‐containing anti‐TB regimens between 2020 and 2022. HIV‐RNA, CD4 cell counts were collected and analysed. Results: In all, 21 people with HIV (PWH) were included in this study. All the PWH were treatment‐naïve and told to take DTG + 3TC q.d. with food. The median age was 53 years, and 71.43% were male. A total of 71.43% PWH had baseline viral load (VL) > 100 000 copies/mL, and 33.33% had baseline VL greater than 500 000 copies/mL. Only one PWH had CD4 cell count greater than 200 cells/μL, and the median CD4 count was 20 cells/μL. A total of 16 PWH started DTG + 3TC after initiation of the RIF‐based anti‐TB regimen, and the other five PWH initiated DTG + 3TC before the treatment of TB. All the PWH had at least 24 weeks of follow‐up visits and all of the TB treatments were successful. A total of 20 PWH (95.24%) achieved viral suppression (VL <50 copies/mL). All detected viral loads between weeks 24 and 48 were less than 200 copies/mL. Among the PWH who started DTG + 3TC after the initiation of RIF‐based anti‐TB regimen, all achieved viral suppression by week 24 except the non‐suppressed PWH. CD4 counts were greatly improved after antiretroviral treatment: the median CD4 counts were raised from 20 to 171 cells/μL at week 48. No serious adverse events were reported. Conclusions: This case series preliminarily validates the efficacy of DTG + 3TC q.d. with food when combined with RIF‐based anti‐TB regimens in people with TB/HIV. [ABSTRACT FROM AUTHOR]

Purpose: This study analyzes the relationship between human papillomavirus (HPV) infection, vaginal microecology, and cervical lesions to provide a basis for the prevention and treatment of cervical cancer (CC) in the Xinjiang region. Methods: Real‐time quantitative PCR was used for HPV genotyping and viral load. The Gram staining and dry biochemical enzyme kit were utilized to diagnose vaginal secretions. The χ2 test and Logistic regression analysis were used for statistical analysis. Results: The HPV infection rate among women in the Xinjiang region was 30.29%, of which the single HPV infection accounts for 77%. HPV16 and HPV52 were the main infection types. There was significant differences in the HPV infection rate and infection types among the Han, Uighur, Hui, and Kazakh ethnic groups. The viral load of HPV16 and HPV52 increases with the upgrade of cervical lesions. There were significant differences in vaginal microecology evaluation indicators H2O2, SNA, LE, GUS, trichomonas, clue cells, and lactobacilli among different ethnic groups. HPV negative patients with varying grades of cervical lesions exhibit a notable variance in H2O2 and LE, which is statistically significant. Single HPV infection and high viral load HPV significantly increase the risk of CC. Conclusions: This study indicates that HPV infection and vaginal microecology differ among ethnic groups, which have a strong correlation with the progression of CC, offering guidance on CC screening and interventions in the Xinjiang area. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the relative risk of risk factor in male and female breast cancer (BC) deaths in China and analyzed the changing trends in BC mortality rates from 1990 to 2019. Methods: Open data from the Global Burden of Disease database from 1990 to 2019 were analyzed to assess the number of BC deaths and age‐standardized mortality rates (ASMR) in China. The age‐period‐cohort model was employed to study age effects, period effects, cohort effects, as well as local drift and net drift of the data, determining the impact of changing risk factors on crude mortality rates and ASMR of BC. Results: In 2019, the number of BC deaths across all age groups in China increased by 130.38% compared to 1990, with an increase of 125.68% in females and 648.80% in males. The ASMR for BC and male BC increased in 2019, while female BC ASMR declined. Overall, alcohol consumption and smoking as risk factors contributed to increased mortality rates of BC with advancing age. Over the entire study period, the net drift of alcohol consumption in females for BC was 0.06% (95% confidence interval [CI]: −0.24% to 0.36%), while for smoking it was −0.64% (95% CI: −0.83% to −0.45%). For males, the net drift of alcohol consumption for BC was 6.75% (95% CI: 5.55% to 7.96%), and for smoking, it was 6.09% (95% CI: 2.66% to 9.64%). Conclusion: Hence, improving awareness of BC‐related risk factors and implementing prevention strategies are necessary to alleviate future BC burdens. [ABSTRACT FROM AUTHOR]

Objectives Nucleotide-binding oligomerization domain-like receptor family, pyrin domain containing 3-associated autoinflammatory disease (NLRP3 -AID) is a rare autosomal dominant systemic autoinflammatory disease. We aimed to summarize the phenotypic and genotypic features of Chinese adult NLRP3 -AID patients with hearing loss. Methods A retrospective cohort study of twenty-one adult patients with NLRP3 -AID was conducted in Peking Union Medical College Hospital between July 2015 and March 2023. All patients underwent whole exome sequencing and otorhinolaryngologic assessments. Clinical features and therapeutic data were collected and analysed. Results We found that 13/21 (61.90%) of patients had hearing loss with high-frequency impairment in the majority, and most patients presented with vestibular dysfunction as a new finding. The NLRP3 -AID patients with early-onset, cold or stress triggered episodes, red eyes, fatigue, hypopsia and mutations located in the NACHT domain of the NLRP3 protein were more likely to suffer from hearing loss, especially sensorineural hearing loss, perhaps as a result of pathogenic variants of high penetrance. By a series of audiological evaluations, TNF-α inhibitors were confirmed to improve or reverse hearing loss. Conclusions We reported the first cohort of Chinese adult NLRP3 -AID patients with hearing loss and characterized vestibular dysfunction, highlighted the necessity for attention to high-frequency hearing and provided potential alternative treatment. [ABSTRACT FROM AUTHOR]

Objectives Frequent gout attacks in the initial introduction of urate-lowering therapy (ULT) are significant causes of poor drug adherence and ULT discontinuation. Initial low-dose urate-lowering drugs may be effective in reducing gout flares, however robust evidence is sparse. The aim of this study was therefore to assess the association of initial dose urate-lowering drugs with gout flares in adult males with gout during the initial introduction of ULT. Methods This cohort study obtained data on consecutive gout patients from a single-centre gout cohort study from August 2017 to October 2020. A standard questionnaire was applied to collect demographic and clinical information, and biochemical parameters were tested on the same day. The primary endpoint was to estimate the association of initial dose febuxostat with gout flares, using Cox hazard models with inverse probability of treatment weighting (IPTW). Results A total of 582 gout patients were included in this study. During the 6-week follow-up, 71 (12.2%) patients suffered gout flares. In the main analysis using Cox hazard models with IPTW, compared with colchicine prophylaxis, initial low-dose febuxostat alone had no statistical significance with the increased risk of gout flares [hazard ratio (HR) 1.26; 95% CI 0.58, 2.72], while initial high-dose febuxostat was associated with an increased risk of gout flares (HR 3.08; 95% CI 1.34, 7.07). Conclusions This observational study demonstrated that initial low-dose febuxostat was equally effective in preventing gout flares as colchicine prophylaxis, while initial high-dose febuxostat alone was associated with an increased risk of gout flares. [ABSTRACT FROM AUTHOR]

Background: The condition and correlation of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. This survey aimed to evaluate the current status and influencing factors of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas. Methods: Patients undergoing pituitary adenoma resection in two tertiary hospitals from November 2019 to November 2021 were included. The general data questionnaire, Multidimensional Fatigue Inventory (MFI‐20), Pittsburgh Sleep Quality Index (PSQI) and international physical activity questionnaire were used for data analysis. Results: In total, 184 patients with pituitary adenomas were included. The postoperative patients with pituitary adenomas had a high level of fatigue. In total, 34 (18.5%) patients had low level of physical activity, 76(41.3%) patients had medium level of physical activity and 74 (40.2%) had high level of physical activity. Postoperative time, PSQI, physical activity level and gender were the influencing factors of fatigue in patients with pituitary adenomas (all P < 0.05). Conclusions: Postoperative patients with pituitary adenomas have a higher level of fatigue, and it is related to reduced sleep quality and activity. Relevant nursing measures should be taken according to the influencing factors of fatigue to reduce the fatigue of postoperative patients with pituitary adenomas. Summary statement: What is already known about this topic? The postoperative nursing care of patients is very important to the quality of life in patients with pituitary adenomas.Fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. What this paper adds? There is a high level of fatigue in patients with pituitary adenomas within 1 year after operation.The degree of fatigue is negatively correlated with the course of disease and the level of physical activity. The implications of this paper: Interventions and nursing care strategies targeted on the factors affecting postoperative fatigue of patients with pituitary adenomas are needed. [ABSTRACT FROM AUTHOR]

Objectives: To conduct psychometric testing of the Chinese version of the National Health Service Sustainability Model as an instrument to assess the sustainability of innovation in the Chinese nursing setting. Background: Evidence‐based practice is recognized worldwide as a way to improve the quality of healthcare; however, many evidence‐based practice programmes decline over time and do not sustain the benefits of their improvements. A sustainability assessment tool is used internationally but its use has not been validated in China. Design: A methodological study to test instrument validity and reliability. Methods: The data collection was conducted from 15 June 2022 to 31 August 2022. The internal consistency of the Chinese version of the sustainability model was measured with Cronbach's alpha. Confirmatory factor analysis was used to test the model's structural validity. Results: Four hundred eighty‐three questionnaires were returned, of which 478 were valid. The short time taken to evaluate the Chinese version of the sustainability model demonstrated its efficiency and ability to adapt to a busy clinical environment. The confirmatory factor analysis showed a good fit model and supported the convergence validity of the sustainability model. The Cronbach's alpha coefficient was 0.905 for the total scale, which indicated good internal consistency. Conclusions: The results of this study suggest that the Chinese version of the sustainability model is a valid, reliable and efficient tool for measuring the sustainability of evidence‐based practices in Chinese nursing settings. Summary statement: What is already known about this topic? As evidence‐based care grows in China, there are increasing numbers of programmes for evidence‐based practice.Evidence‐based practice leaders in China are currently focused on the implementation of evidence, with little focus on the maintenance of evidence after implementation.There is a lack of tools to assess the sustainability of evidence‐based practice in China. What this paper adds? This study further validates and refines the National Health Service Sustainability Model (NHS SM) in China's busy, centralized and paternalistic nursing clinical settings.Bridges the gap in sustainability assessment tools in China by introducing an evidence‐based practice sustainability assessment tool and further validating and refining the model in busy, centralized and paternalistic nursing clinical settings. The implications of this paper: Provide support to nursing professionals when selecting tools to assess the sustainability of evidence‐based practice in order to promote programme maintenance, avoid wasted upfront resource investment and achieve long‐term programme benefits.Provide a reference for professionals in other countries to introduce sustainability assessment tools. [ABSTRACT FROM AUTHOR]

Aims: Dehydration is one of the common complications of dysphagia and poses significant risks including hospitalization and mortality, but the relationship between dysphagia and dehydration has received little attention. This study aims to determine the prevalence and risk factors for dehydration of patients with dysphagia in eastern China, and to provide reference for early identification and prevention of dehydration. Methods: A descriptive, cross‐sectional design was conducted. Three hundred and thirty‐seven (n = 337) patients with dysphagia participated in the study between August and December 2022. Information relating to participants' demographic variables, nutrition, cognition, functional, hydration status and fluid intake was collected. Univariate analysis was used to examine related impact factors, and then binary logistic regression analysis was conducted to determine reliable impact factors. Results: Among 337 patients with dysphagia, the average age was 63.47 ± 16.96, most participants were male (72.1%) and married (91.7%). The prevalence of dehydration was calculated to be 43.9%, the mean plasma osmolality score was 293.53 mmol/L. Diseases with the highest prevalence were stroke (78.3%), followed by hypertension (63.5%). The risk for dehydration increased with older age, usage of more medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake. Conclusion: This study found a high percentage of dehydration in patients with dysphagia. Findings can provide a basis for targeted nursing interventions for clinical prevention and treatment of dehydration. Summary statement: What is already known about this topic? Dehydration is one of the adverse consequences of dysphagia, and it causes physical stress to sufferers and enormous costs to the health care system.Previous studies have identified that personal factors (age, gender, health condition etc.), living environment, and social support may affect dehydration What this paper adds? Results showed high percentages of dehydration among patients with dysphagia; older age, greater use of medicines such as diuretics and beta‐blockers, worse functional status and lower fluid intake played a crucial role in hospital patients with dysphagia, leading to dehydration. The implications of this paper: This paper reveals prevalence and risk factors associated with dehydration of patients with dysphagia in hospital.Findings could provide reference data for development of nursing preventive interventions, to reduce the incidence of dehydration and improve the health level of patients. [ABSTRACT FROM AUTHOR]

We aimed to explore and analyse the dietary intake patterns of 3‐6 year‐old children left behind by one or both parents and to assess their associations with body mass index (BMI) and the prevalence of childhood anaemia in rural Anhui, eastern China. We used random cluster sampling to recruit rural children aged 3–6 years in two rural areas in Anhui province. Sociodemographic information and dietary intake were collected by self‐reported questionnaires. Height, weight and prevalence of anaemia were measured by trained nurses blinded to parental migration status. Factor analysis was applied to determine that major dietary patterns, binary logistic regression and generalised linear regression were used to explore the associations between anaemia and BMI Z‐score with dietary patterns. Of 1720 children aged 3–6 years, 236 were left by both parents and 388 were left by a single parent. The prevalence of stunting and underweight among left‐behind children with migration of both parents (BLBC) was significantly higher than that of non‐left‐behind children (NLBC). Three dietary patterns—"grain–vegetable," "meat–egg" and "fast food–sweet"—were identified in our study, and the total variance explained was 46.9%. The meat–egg dietary pattern was associated with a decreased risk of anaemia after adjustment for confounding factors in the left‐behind children with migration of both parents (BLBC), left‐behind children with single parent migration (SLBC) and non‐left‐behind children (NLBC) groups. After adjusting for confounding factors, the fast food–sweet dietary pattern was found to be associated with an increased risk of anaemia (OR [95% CI]: Q4: 2.21 [1.14, 4.57], p = 0.034). In addition, children with obesity had a lower intake of vegetables and fruits (β = −0.08, 95% CI: −0.13, −0.02) compared with children with a normal weight. In conclusion, there are correlations between different types of parental migration and children's nutritional status in rural Anhui. The meat–egg dietary pattern may have a preventive effect on anaemia in comparison with other dietary patterns, irrespective of whether children are left behind or not. Children with overweight and obesity had a higher intake of pork and red meat and snacks compared with children with normal BMI. [ABSTRACT FROM AUTHOR]

Background: This study aims to analyze breast cancer burden attributable to high body mass index (BMI) and high fasting plasma glucose (FPG) in China from 1990 to 2019. Methods: Data were obtained from the Global Burden of Disease (GBD) study 2019. Deaths and disability‐adjusted life years (DALYs) were used for attributable burden, and age‐period‐cohort (APC) model was used to evaluate the independent effects of age, period and birth cohort. Results: In 2019, the age‐standardized mortality and DALY rates of breast cancer attributable to high BMI were 1.107 (95% UI: 0.311, 2.327) and 29.990 (8.384, 60.713) per 100 000, and mortality and DALY rates attributable to high FPG were 0.519 (0.095, 1.226) and 13.662 (2.482, 32.425) per 100 000. From 1990 to 2019, the age‐standardized mortality and DALY rates of breast cancer attributable to high BMI increased by 1.192% and 1.180%, and the trends of high FPG were not statistically significant. The APC results showed that the age effects of high BMI and high FPG‐mortality and DALY rates increased, with the highest rates in the age group over 80 years. The birth cohort effects of high BMI showed "inverted V" shapes, while high FPG showed downward trends. Conclusions: Age was the main reason for the increase of attributable burden, and postmenopausal women were the high‐risk groups. Therefore, targeted prevention measures should be developed to improve postmenopausal women's awareness and effectively reduce the prevalence of obesity and diabetes, thereby reducing the breast cancer burden caused by metabolic factors in China. [ABSTRACT FROM AUTHOR]

BACKGROUND: Providing effective health education is essential for patients with cancer-related pain. One solution is leveraging instant messaging tools for teach-back health education. OBJECTIVES: This study investigated the effects of WeChat-based teach-back health education on patients with advanced cancer who underwent patient-controlled intrathecal analgesia implantation and used hydromorphone. METHODS: This retrospective study evaluated 150 hospitalized patients with advanced cancer pain. Patients were classified into a conventional health education group (N = 50) and a teach-back group (N = 100) based on whether they received WeChatbased teach-back health education. Pain was rated using a numeric rating scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index at one, two, and three months postdischarge. FINDINGS: Patients who received remote teachback health education better managed their pain. Data also demonstrated improvements in patients' sleep quality and caregiver satisfaction, and reductions in the occurrence of adverse reactions. [ABSTRACT FROM AUTHOR]

This study examined the association between Internet use and loneliness among Chinese older adults (aged 60+) over a two-year period using nationally representative survey data from China. Using data from the 2016 and 2018 waves of the China Longitudinal Ageing Social Survey (N = 8,059), we estimated difference-in-differences regression models to assess the association between Internet use and levels of loneliness over time. Compared to Internet non-users, Chinese older adults who were new Internet users, as well as those who were continuous Internet users, reported lower levels of loneliness over time (B = −0.21, p < 0.001 and B = −0.16, p < 0.001, respectively). Conversely, those Chinese older adults who used the Internet in wave 1 but then disengaged from using the Internet in wave 2 demonstrated an upward trend in loneliness over time, similar to Internet non-users (the estimate of difference-in-differences was non-significant for the comparison between disengaged-users and non-users: B = −0.03, p = 0.42). This study provided new evidence to support the potential benefits of Internet use for reducing the risk of loneliness among Chinese older adults. The findings suggested that supporting current Internet users to remain digitally engaged is as important as encouraging Internet non-users to cross the digital divide. [ABSTRACT FROM AUTHOR]

Despite the recognized importance of community social service and community built facility for enhancing older adults' life satisfaction, the mechanisms underlying their relationship have not been thoroughly examined. This study aims to complement the existing knowledge by investigating the mediating role of social disconnectedness and loneliness in the association between community support and life satisfaction among older adults. Using data from the 2018 China Longitudinal Aging Social Survey, the study analyzes responses from 9,874 Chinese older adults (mean age = 71.30 years, SD = 7.30). We conducted descriptive statistics and Pearson's correlation to explore the variables. This study also used Mplus 8.0 to conduct a path analysis model that evaluated both the direct and indirect effects of community social service and built facility on life satisfaction. Social disconnectedness and loneliness were included as mediating variables in this model. The present study results show that both community social service and community built facility are positively associated with life satisfaction among older adults, and community social service is more imporatant for enhancing the life satisfaction. In addition, these associations are mediated by social disconnectedness and loneliness. Our research suggests that strengthening community social service programs and improving the built environment can reduce social disconnectedness and loneliness among older adults, ultimately enhancing their life satisfaction. Specifically, policymakers can invest in targeted interventions to enhance social connectedness and reduce loneliness, with the goal of improving the overall well-being of older adults. [ABSTRACT FROM AUTHOR]

The stereotype and stigma that disabled people experience is a communication proposition that deserves academic attention. How the media reports people with disabilities reflects society's overall perception and evaluation of people with disabilities. This study uses content analysis to demonstrate how People's Daily, the mainstream media in mainland China, has undergone a process in the designation of people with disabilities from canfei (disabled and waste) to canji (disabled and ill) to canzhang (people encountering obstacles). News reports related to the image of people with disabilities often relate to terms such as 'heroes', 'role models', 'builders', 'beneficiaries', and 'free riders'. How the media reports people with disabilities reflects, to some extent, what society thinks and feels about people with disabilities. This study demonstrates how People's Daily, the mainstream media in mainland China, has built and reproduced the image of people with disabilities in different historical periods since 1946. With the development of the Chinese society, People's Daily has been going through a process of naming people with disabilities from canfei (disabled and waste) to canji (disabled and ill) to canzhang (people encountering obstacles). While highlighting the positive aspects of people with disabilities, they are also perceived as weak people who require help from all sectors of society. People with disabilities need to be understood from a 'human' perspective to establish approaches based on equality and pluralism to human values. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effects of vitamin D and/or calcium supplementation on sleep quality in individuals with prediabetes. Methods: A 24-week randomized controlled trial (RCT) was conducted in a 212 Chinese population with prediabetes. Participants were randomly assigned to four groups: vitamin D + calcium group (1600 IU/day + 500 mg/day, n = 53), vitamin D group (1600 IU/day, n = 54), calcium group (500 mg/day, n = 51), and control group (placebo, n = 54). The Pittsburgh Sleep Quality Index (PSQI) was used as the primary outcome to assess sleep quality. Questionnaires and fasting blood samples were collected at baseline and post-intervention for demographic assessment and correlation index analysis. Results: After a 24-week intervention, a significant difference was observed in serum 25(OH)D concentration among the four groups (P < 0.05), and the total PSQI score in vitamin D + calcium group was lower compared to the preintervention levels. Subgroup analyses revealed improved sleep quality with calcium supplementation (P < 0.05) for specific groups, including women, individuals with a low baseline 25(OH)D level (< 30 ng/mL), and individuals in menopause. Moreover, correlation analysis revealed a negative correlation between the extent of change in sleep efficiency scores before and after the calcium intervention and the degree of change in insulin efficiency scores (r = − 0.264, P = 0.007), as well as the magnitude of change in islet beta cell function (r = − 0.304, P = 0.002). Conclusions: The combined intervention of vitamin D and calcium, as well as calcium interventions alone, exhibits substantial potential for improving sleep quality in individuals with prediabetes. Clinical trial registration: The trial was registered in August 2019 as ChiCTR190002487. [ABSTRACT FROM AUTHOR]

Purpose: The associations between dietary patterns and liver cancer risk have received much attention, but evidence among the Chinese population is scarce. This study aims to update the results of two cohort studies and provide the sex-specific associations in the Chinese population. Methods: This study was based on two cohorts from the Shanghai Men's Health Study (SMHS) and the Shanghai Women's Health Study (SWHS). Diet information was collected by validated food frequency questionnaires. Dietary patterns were derived by factor analysis. Cox regression model was utilized to estimate the hazard ratio (HR) and 95% confidence interval (CI) for associations between dietary patterns and liver cancer risk. Results: During median follow-up years of 11.2 (male) and 17.1 (female) years, 427 males and 252 females were identified as incident primary liver cancer cases. In males, vegetable-based dietary pattern was inversely associated with liver cancer (HRQ4-Q1: 0.67, 95%CI 0.51–0.88, Ptrend < 0.001). Interaction analysis indicated that in males lower vegetable-based dietary pattern score and older age/medical history of chronic hepatitis combined increase the hazard of liver cancer more than the sum of them, with a 114% and 1061% higher risk, respectively. In females, the fruit-based dietary pattern was associated with a reduced risk of liver cancer (HRQ4-Q1: 0.63, 95%CI 0.42–0.95, Ptrend = 0.03). In both males and females, null associations were observed between the meat-based dietary pattern and the risk of liver cancer. Conclusion: A vegetable-based dietary pattern in males and a fruit-based dietary pattern in females tended to have a protective role on liver cancer risk. This study provided updated information that might be applied to guide public health action for the primary prevention of liver cancer. [ABSTRACT FROM AUTHOR]

We aimed to estimate the effects of temperature and total cloud cover before birth on newborn vitamin D status. Prospective birth cohort. This study included 2055 mother–newborn pairs in Wuhan, Hubei province, China. The data of temperature and total cloud cover from 30 days before birth were collected, and cord blood 25-hydroxyvitamin D [25(OH)D] were determined. Restricted cubic spline regression models, multiple linear regression models, and logistic regression models were applied to estimate the associations. A "J" shaped curve was observed between temperature and vitamin D status, and an inverse "J" shaped curve was observed between total cloud cover and vitamin D status. Compared to the fourth quartile (75–100th percentile, Q4) of average temperature (30 days before birth), the odds ratio (OR) for Q1 (0–25th percentile) associated with the vitamin D deficiency occurrence (<20 ng/mL) was 3.63 (95% CI, 1.54, 8.65). Compared to Q1 of the average total cloud cover (30 days before birth), the OR associated with the occurrence of vitamin D deficiency was 2.38 (95% CI, 1.63, 3.50) for the Q4. Low temperature and high cloud cover before delivery were significantly associated with an increased probability of vitamin D deficiency in newborns. The findings suggested that pregnancy women lacking sufficient sunlight exposure still need vitamin D supplement to overcome the potential vitamin D deficiency status. [ABSTRACT FROM AUTHOR]

Understanding the preferences of old-age adults for their long-term caregivers can improve person-centred health care and the quality of long-term care (LTC). This study examines Chinese older adults' preferences for long-term caregivers. This is a cross-sectional study. A national representative discrete choice experiment (DCE) surveyed 2031 adults aged 50–70 across 12 provinces in China. Each DCE scenario described five attributes: type of caregivers, place of LTC, contents of LTC, out-of-pocket payments, and quality of life (QoL). Preferences and the marginal willingness to pay (WTP) were derived using mixed-logit and latent class models. Older adults displayed higher preferences for long-term caregivers who improve their QoL, incur lower out-of-pocket payments, and provide medical LTC services at home, with the maximum WTP of $22.832 per month. QoL was rated as the most important LTC factor, followed by the place of LTC and the type of caregivers. When the level of QoL improved from poor to good, respondents would be willing to pay $18.375 per month more (95% confidence interval: 16.858 to 20.137), and the uptake rate increased by 76.47%. There was preference heterogeneity among older people with different sex, education, family size, and knowledge of LTC insurance. QoL was the most important factor in older Chinese adults' preference for caregivers. Home care and medical care from formal caregivers was preferred by older adults. We recommend training family caregivers, raising older people's awareness of LTC insurance, and guiding policymakers in developing people-oriented LTC and a multi-level LTC system. [ABSTRACT FROM AUTHOR]

This study aimed to assess the level of public trust in general practitioners (GPs) and its association with primary care contract services (PCCS) in China. Cross-sectional study. Between September and December 2021, 4158 residents across eastern, central, and western China completed a structured self-administered questionnaire. Trust was assessed using the Chinese version of Wake Forest Physician Trust Scale. Multivariable linear regression models were established to identify predictors of trust. The effect size of PCCS on trust was estimated by the average treatment effect for the treated (ATT) through propensity score matching. The study participants had a mean Wake Forest Physician Trust Scale score of 36.82 (standard deviation = 5.45). Enrollment with PCCS (β = 0.14, P < 0.01), Han ethnicity (β = 0.03, P < 0.05), lower educational attainment (β = −0.06, P < 0.01), higher individual monthly income (β = 0.03, P < 0.05), better self-rated health (β = 0.04, P < 0.05), chronic conditions (β = 0.07, P < 0.01), and higher familiarity with primary care services (β = 0.12, P < 0.01) and PCCS (β = 0.21, P < 0.01) were associated with higher trust in GPs. The ATT of PCCS exceeded 1 (P < 0.05). PCCS are associated with higher levels of trust in GPs. PCCS may become an effective tool to attract public trust in GPs, although the relationship between the two may be bi-directional. [ABSTRACT FROM AUTHOR]

Workplace-related factors are associated with the risk of depression. Despite implementation of workplace health promotion (WHP) programmes in China to promote the physical and mental well-being of workers, the relationship between WHP and depression has received limited attention. This study investigated the association between WHP service utilisation and depressive symptoms among workers. This was a cross-sectional survey. A researcher-designed questionnaire was used to collect information on socio-demographic and occupational characteristics, WHP service utilisation, and mental health status. The Lasso method was used for variable selection to achieve dimension reduction, and logistic regression was used to assess the association between WHP service utilisation and depressive symptoms. The analysis included 11,710 workers, of whom 17.0% had depressive symptoms. Lasso regression resulted in 6 of 18 WHP services showing significant negative associations with depressive symptoms, including occupational safety training, mental health services, health check-ups, sports activities, fitness rooms, and healthy canteens. The logistic regression results showed that, after adjusting for sociodemographic and occupational factors, utilisation of these six services was associated with a decreased likelihood of depressive symptoms. The adjusted odds ratio (aOR) was 0.84 (95% confidence interval [CI]: 0.73–0.96) for occupational safety training, aOR: 0.82 (95% CI: 0.68–0.99) for mental health services, aOR: 0.80 (95% CI: 0.71–0.90) for health check-ups, aOR: 0.68 (95% CI: 0.57–0.80) for sports activities, aOR: 0.59 (95% CI: 0.47–0.74) for fitness rooms and aOR: 0.72 (95% CI: 0.59–0.87) for healthy canteens. Utilisation of WHP services was associated with a lower prevalence of depressive symptoms. Implementation of WHP services and the provision of a supportive workplace environment should be prioritised to benefit the mental health of workers. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) might affect all aspects of life including perceived stigma, but research on perceived stigma is still in its infancy among SLE patients. The objective of this study was to assess the relationships among socioeconomic status, clinical parameters, disease activity, quality of life, depression, and the perceived stigma in Chinese patients with SLE. A total of 133 SLE patients (mean age: 39.36 ± 12.91 years) were included in this cross-sectional study. All data were collected consecutively by face-to-face questionnaires from January 2021 to January 2022. SLE patients completed questionnaires for demographic or clinical variables, the 10-cm Visual Analog Scale for pain, the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) for disease activity, the patient health questionnaire-9 (PHQ-9) for depression, the Perceived Devaluation Discrimination (PDD) Scale for the perceived stigma, and the Short Form 12 health survey (SF-12) for quality of life. Independent sample t-test, Spearman or Pearson correlations analysis, and the multivariable linear regression model were used to analyze these data. The mean PDD scale score in the SLE patients was 2.79 ± 0.33, which were statistically significant compared with the midpoint (2.50 ± 0.38) of the scale (P < 0.05). The perceived stigma was significantly correlated with income, pain, disease activity, depression, and quality of life. The SF-12 mental composite summaries (MCS) score and depression were the important predictors of the perceived stigma by the multivariable linear regression. This study demonstrates that psychological status is significantly associated with the perceived illness stigma in Chinese SLE patients; dealing with this stigma may be important in promoting optimal coping for these patients. [ABSTRACT FROM AUTHOR]

This study aims at exploring the relationships between adverse childhood experience (ACEs) and parental burnout. A total of 583 postnatal Chinese mothers were recruited in this cross-sectional study. Maternal ACEs were measured by Adverse Childhood Experience Questionnaire-Revised and parental burnout was measured by Parental Burnout Assessment. Multiple linear and binary logistic regression, and latent class analysis were used to explore the association between each type and cumulative ACEs and parental burnout. We found ACEs were associated with a higher risk of parental burnout. However, the association differed in the type of ACEs. The higher levels of physical abuse (B = 0.971 ~ 0.459, all p < 0.05) and emotional neglect (B = 1.010 ~ 1.407, all p < 0.05) in childhood were correlated with more serious parental burnout. The higher levels of self-threatened (B = 0.429 ~ 0.559, all p < 0.05) and self-deprived experience (B = 0.384 ~ 0.462, all p < 0.05), higher number of ACEs type (B = 2.909 ~ 3.918, all p < 0.05) were associated with more serious parental burnout. Results were consistent after combining four dimensions of parental burnout as a whole in LCA. This study indicated that maternal ACEs were associated with parental burnout. Women with self-deprived, self-threatened and more types of ACEs should be paid special attention. [ABSTRACT FROM AUTHOR]

Physical and mental health problems had been identified as the negative outcomes of workplace violence (WPV) against medical staff. Considering the proven associations between physical and mental health and suicidal ideation, it is reasonable to assume that WPV may associate with suicidal ideation. However, few studies were conducted to explore the relationship between WPV and their suicidal ideation against medical staff. Based on a cross-sectional design, 3, 426 medical staff working in general hospitals were interviewed in Shandong Province, China. Socio-demographic characteristics, work-related factors, psychological variables, WPV, and suicidal ideation were evaluated. Propensity score matching (PSM) was performed to explore the association between WPV and suicidal ideation. The prevalence of suicidal ideation among medical staff was 9.1% (312/3426), and 52.2% (1788/3426) of medical staff reported the WPV experience. Before PSM, we found that the association between WPV and suicidal ideation was statistically significant (aOR = 1.606, p < 0.01). After PSM, there was a statistically significant correlation between WPV and suicidal ideation (aOR = 1.525, p < 0.01). This study supported the correlations between WPV against medical staff and their suicidal ideation. The results of PSM further implied that WPV might cause suicidal ideation among medical staff. Psychological health, especially for suicidal ideation, should be paid attention for medical staff with WPV experiences. [ABSTRACT FROM AUTHOR]

Young adults are at high risk of experiencing economic abuse—a form of intimate partner violence (IPV)—and Chinese young adults in non-marital cohabitation are especially vulnerable. To reduce economic abuse, an important question to answer is: What factors are associated with economic abuse? After controlling for constructs (e.g., demographic information and other types of IPV) that were linked to economic abuse, we investigated how financial behaviors (i.e., individuals' money management capability) were associated with power (im)balance (i.e., whether individuals shared equal influence with the romantic partner) and, in turn, economic abuse among non-marital cohabitating Chinese young adults. We also investigated whether associations among financial behaviors, power (im)balance, and economic abuse varied across young adults' gender and SES. We used a Qualtrics survey to collect data from 445 non-marital cohabitating Chinese young adults (53.3% male vs. 46.7% female; 22.7% lower socioeconomic status [SES] vs. 77.3% higher-SES). A structural equation model was conducted to test the associations of research interests. We found that money management capability (e.g., spending within budget and tracking expenses) is associated with balanced power—the individual sharing equal influence with the partner in the decision-making process—and, in turn, less experience of being economically abused. These associations were statistically equivalent across gender and SES. Collectively, our findings suggested that promoting money management capability be a timely and new avenue for reducing economic abuse among Chinese young adults in non-marital cohabitation, possibly because this population faces common and severe economic abuse but generally lacks the opportunity to learn money management. [ABSTRACT FROM AUTHOR]

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

Home care poverty is the inability of older people to access adequate home care services and their unmet needs for home care. With the increasing number of older adults (60 years old and above) with disability in China, the Chinese government pays more and more attention to home care. In this case, it is of great significance to explore whether older adults with the disability face home care poverty and its influencing factors. The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018 were utilized. SPSS 22.0 was used as a data analysis tool to conduct descriptive statistics and multiple logistic regression analysis on the sample (n = 1932). The study found that in 2018, 48.0% of older adults with disability faced home care poverty. Multiple logistic regression results showed that degree of disability, age, rural and non-eastern regions, income poverty, family caregiver, and reluctant caregivers were positive factors that increased the risk of home care poverty in disabled older adults (p <.05). But care duration, care expenditure, social pensions insurance, community daily life care and community medical services are the positive factors to eliminate the home care poverty for older adults with disability (p <.05). In order to solve the problem of home care poverty of older adults with disability, based on the research conclusions, the study proposed to establish a long-term care insurance system, formulate supportive policies for family caregivers or their families, and establish a wide variety of community care services. [ABSTRACT FROM AUTHOR]