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Research interest in thriving at work has burgeoned over the past decades, but little is known about how human resource (HR) practices affect employees' thriving at work. Drawing upon self‐determination theory and person‐organization fit theory, we developed and tested a moderated mediation model to explain how fun HR practices influence employees' thriving at work. The results of two studies, a scenario experiment (N = 164) and a time‐lagged survey (N = 253), supported our hypotheses. Specifically, the findings revealed that fun HR practices relates positively to employees' thriving at work. Autonomous motivation partially mediates the abovementioned relationship. Furthermore, fun HR practices translate into higher autonomous motivation and subsequent thriving at work for employees with higher preference for workplace fun. Our research contributes to the existing literature by identifying fun HR practices as an antecedent of thriving at work and revealing the psychological mechanisms through which fun HR practices affect employees' thriving at work. The practical implications, limitations, and future research avenues are also discussed. [ABSTRACT FROM AUTHOR]

Background: Pneumonia has a high incidence in traumatic brain injury (TBI) patients and lacks effective treatments. Early mobilization (EM) may be a potentially effective treatment. Aim: To explore the impact of EM on TBI‐related pneumonia in the neurosurgical intensive care unit (NICU). Study Design: This study was a historical control study. 100 TBI patients who received EM intervention were prospectively included as the experimental group (EM cohort), and 250 TBI patients were retrospectively included as the control group. The propensity score matching (PSM) method was employed to balance baseline and minimize potential bias. The relationship between EM and TBI‐related pneumonia was investigated by univariate and multivariate logistic regression, then further determined by subgroup analysis. The influence of other variables was excluded by interaction analyses. Finally, the effect of EM on the prognosis of TBI patients was analysed by comparing the Glasgow Coma Scale (GCS) and the hospital stay. Results: After screening, 86 patients were included in the EM cohort and 199 patients were included in the control cohort. There were obvious differences between the two cohorts at baseline, and these differences were eliminated after PSM, when the incidence of pneumonia was significantly lower in the EM cohort than in the control cohort (35.0% vs. 61.9%, p <.001). Multivariate logistic regression showed that EM was an independent risk factor for TBI‐related pneumonia and was significantly associated with a decreased incidence of pneumonia. This correlation was present in most subgroups and was not affected by other variables (p for interaction >.05). Patients in the EM cohort had shorter length of ICU stay (6 vs. 7 days, p =.017) and higher GCS at discharge (12 vs. 11, p =.010). Conclusion: EM is a safe and effective treatment for TBI patients in NICU, which can reduce the incidence of pneumonia, help to improve prognosis and shorten the length of ICU stay. Relevance to Clinical Practice: Although the utilization rate of EM is low in TBI patients for various reasons, EM is still an effective method to prevent complications. Our study confirms that a scientific and detailed EM strategy can effectively reduce the incidence of pneumonia while ensuring the safety of TBI patients, which is worthy of further research and clinical application. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. Materials and Methods: The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed‐effects models and generalized propensity score weighting (GPSW) to develop a predictive model. Results: Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento‐enamel junction (MB1), mid‐root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p <.05). Furthermore, a subsequent multivariable mixed‐effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p <.001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986–93.807; OR0.5

This study examined the development of social power perceptions among Chinese children aged 3–5 years (N = 105). After watching videos about various social power cues, such as resource possession, resource control, goal achievement, permission, giving orders, setting norms and popularity, the children were asked to identify the powerful agents (whom do you believe is the more powerful person?) in the videos and provide explanations (why do you think he (she) is a powerful person?). Three‐year‐olds can recognize powerful agents who can grant 'permission' to other agents. By the age of 4, children begin to associate 'popularity', 'resource possession' and 'goal achievement' with social power. Five‐year olds demonstrated the ability to recognize agents who control resources as being more powerful. Analysis of the reasons the children provided for their judgements revealed that for almost every cue (except giving orders), more than 14% of the responses highlighted 'possession of material resources' as an indicator of power. For children aged 3–5 years, 'resource possession' cues may be their preferred basis for inferring and explaining power differences. These results would facilitate researchers to further unravel the mechanisms underlying the development of children's social power perceptions. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) poses significant risks to maternal and fetal health. Current diagnostic methods based on glucose tolerance tests have limitations for early detection. tRNA‐derived small RNAs (tsRNAs) have emerged as potential molecular regulators in various diseases, including metabolic disorders. However, the diagnostic value of tsRNAs in plasma for early GDM or postpartum remains unclear. Methods: This longitudinal study profiled the expression of tsRNAs across different gestational stages and postpartum in women with GDM (n = 40) and healthy control gestational women (HCs, n = 40). High‐throughput small RNA sequencing identified candidate tsRNAs, which were then validated and correlated with clinical biochemical markers such as fasting blood glucose (FBG), HOMA‐IR, and GHbA1c. Results: tRF‐1:32‐Val‐AAC‐1‐M6, tRF‐1:31‐Glu‐CTC‐1‐M2, and tRF‐1:30‐Gly‐CCC‐1‐M4 were consistently upregulated in the GDM group compared to HCs during the second trimester (p < 0.05). Only tRF‐1:31‐Glu‐CTC‐1‐M2 was highly expressed during the first trimester, and tRF‐1:30‐Gly‐CCC‐1‐M4 increased during postpartum. tRF‐1:31‐Glu‐CTC‐1‐M2 showed a significant correlation with FBG levels in the first trimester (R = 0.317, p = 0.047). The expression of tRF‐1:30‐Gly‐CCC‐1‐M4 was significantly correlated with HOMA‐IR (r = 0.65, p < 0.001) and GHBA1c (r = 0.33, p = 0.037) during postpartum. A joint diagnostic model incorporating tsRNAs expression and clinical markers demonstrated enhanced predictive power for GDM (ROC AUC = 0.768). Conclusion: Our results revealed distinct expression patterns of specific tsRNAs in GDM, showcasing their correlation with key metabolic parameters. This underscores their promising role as biomarkers for early prediction and diagnosis of GDM. The integration of tRFs into a composite biomarker panel holds the potential to improve clinical outcomes by enabling personalized risk assessment and targeted interventions. [ABSTRACT FROM AUTHOR]

Bereavement of one or both parents is known to cause many kinds of internalizing and externalizing problems in adolescents. However, less is known about factors that are protective of the mental health of orphaned adolescents and differences by their gender and orphanhood type. To fill these gaps, the current study used a sample from southwestern China to test the association between types of orphans, life satisfaction, adolescents' psychological distress and problem behaviours. The results showed that orphan girls were prone to have lower levels of problem behaviours but higher levels of psychological distress than orphan boys. Female paternal orphans tended to have the highest psychological distress, while male paternal orphans tended to have the lowest psychological distress. In addition, school satisfaction had a stronger association with problem behaviour, and self‐satisfaction had a stronger association with psychological distress. Interventions and preventive measures aimed at reducing the psychological distress of orphans could benefit from the findings regarding the correlates of psychological distress and the most vulnerable group among orphans. [ABSTRACT FROM AUTHOR]

Background: Investigating emotion sequence patterns in the posts of discussion forums in massive open online courses (MOOCs) holds a vital role in shaping online interactions and impacting learning achievement. While the majority of research focuses on the relationship between emotions and interactions in MOOC forum discussions, research on identifying the crucial difference in emotion sequence patterns among different interaction groups remains in its infancy. Objectives: This research utilizes deep learning and sequential pattern mining to investigate whether there are differences in emotion sequence patterns across different groups of learners who exhibit various types of interactions in online discussion forums. Methods: Data from a comprehensive array of sources, including log files, discussion texts and scores from 498 learners in online discussion forums, were collected for this study. The agglomerative hierarchical algorithm is used to classify learners into groups with different levels of interactions. Additionally, we implement and evaluate multiple deep learning models for detecting different emotions from online discussions. Relevant emotion sequence patterns were identified using sequence pattern analysis and the identified emotion sequence patterns were compared across different groups with different levels of interactions. Results and Conclusions: Using an agglomerative hierarchical algorithm, we classified learners into three distinct groups characterized by different levels of interactions: high, average and low level. Leveraging the bi‐directional long short‐term memory model for emotion detection yielded the highest predictive performance, with an impressive F‐measure of 94.01%, a recall rate of 93.83% and an accuracy score of 95.01%. The results also revealed that learners in the low‐level interaction group experienced more emotion transition from boredom to frustration than the other two groups. Therefore, the aggregation of students into groups and the utilization of their MOOC log data offer educators the capability to provide adaptive emotional feedback, customize assessments and offer more personalized attention as needed. Lay Description: What is currently known about the subject matter: Emotions are dynamic over time when learners experience cognitive disequilibrium/equilibrium.Online interactions are critical components, which influence learners' emotional state, cognitive processes and learning achievement.It is not clear what are differences in emotion sequence patterns across the groups with different interaction types. What the paper adds: An agglomerative hierarchical algorithm was implemented to cluster learners into three groups by analysing behavioural data.We explore possibilities for automated classification of emotions using deep learning approaches.Learners in the low‐level interaction group experienced more emotion transition from boredom to frustration. Implications for practitioners: A considerable amount of effort should be expended to identify and respond to learners who experience boredom and frustration emotions.Designing interventions or scaffolding to facilitate learners' interaction and promote favourable emotions.Educators could provide more personalized support based on learners' online interaction cluster. [ABSTRACT FROM AUTHOR]

Background: Painting is the foundational expression across all art forms and is one of the key creative practices for fostering students' aesthetic ability and creativity within fine arts courses. Collaborative painting in the form of socially shared regulation of learning (SSRL) can be recognized as an effective strategy for enhancing creativity in both individual and group work. However, the absence of contextual experiences and collaborative spaces poses challenges for students in cultivating their creativity in painting. Objectives: The present study explores students' creativity, socially shared regulation (SSR) and positive painting behaviours using an SSRL‐based collaborative painting approach in the metaverse (Meta‐CP). Methods: Via a quasi‐experimental design, a total of 40 Chinese students in fifth grade were recruited and were randomly divided into an experimental group and a control group, with 20 students utilizing the Meta‐CP approach, while the remaining 20 students followed the conventional SSRL‐based paper‐and‐brush collaborative painting (C‐CP) approach. The Meta‐CP approach not only offers an authentic painting context and a collaborative space but also facilitates the collaborative process through the SSRL framework. The data collection included students' creative tendency, painting works and painting process. Results and Conclusions: The Meta‐CP approach effectively enhances students' creativity concerning adventure, curiosity and imagination, as well as results in the creation of more distinctive and logical artistic works. Furthermore, the approach significantly improved the quality of students' SSR. Additionally, students utilizing the Meta‐CP approach displayed more positive painting behaviours compared with those employing the C‐CP approach. Lay Description: What is already known about this topic:Collaborative painting is an effective strategy for enhancing creativity.Socially shared regulation of learning (SSRL) fosters collaborative learning.Students in collaborative painting may lack a contextual and synchronized painting space.The metaverse benefits in terms of contextual experiences and collaborative spaces. What this paper adds:Using an SSRL‐based collaborative painting approach in the metaverse (Meta‐CP) is effective in improving students' creativity.The Meta‐CP approach has the potential to improve students' quality of socially shared regulation (SSR), and positive painting behaviours. Implications for practice and/or policy:The metaverse provides an immersive synchronized painting space for art education to stimulate students' creative potential.The metaverse with proper learning strategies (e.g., SSRL) provides an effective collaborative learning environment for creation. [ABSTRACT FROM AUTHOR]

Background: Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied. Objective: The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively. Methods: The Symptom Checklist 90 (SCL‐90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age‐ and gender‐matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons. Results: 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001). Conclusions: Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. Design: A cross‐sectional survey was conducted. Methods: A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. Results: A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081–2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595–3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542–3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760–6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038–4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904–7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124–3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. Patient or Public Contribution: After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. Implication for Practice: It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers. [ABSTRACT FROM AUTHOR]

Aim: Extending working life is considered as an important initiative to respond to the population aging and pension payment dilemma. This study aimed to investigate whether work after retirement is related to improved health‐related quality of life. Methods: We used two waves of data from the China Health and Retirement Longitudinal Study in 2011 and 2018. Work after retirement was ascertained based on self‐reported retirement and work status, and health‐related quality of life (HRQOL) was measured with the three‐level EuroQol five‐dimensions. The impact of work after retirement on HRQOL was analyzed using the propensity score matching with difference‐in‐difference approach. Results: A total of 1043 retirees were included. The results showed that work after retirement was associated with significant improvement in HRQOL among retirees (β = 0.072, P < 0.001). Heterogeneity analyses did not show specificity on sex (P for sex interaction >0.05), but older‐aged retirees seemed more sensitive to the benefits of work after retirement on HRQOL than their younger‐aged counterparts (≥65 years: β = 0.167, P < 0.001 vs <65 years: β = −0.047, P > 0.05; P for age interaction = 0.010). Conclusions: Work after retirement shows a positive impact on HRQOL among community‐dwelling adults in China. Policy‐makers should take the health of retirees into account when implementing policies related to delayed retirement, and reduce health inequity. Geriatr Gerontol Int 2024; 24: 722–729. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the characteristics of assistive device users and influencing factors among disabled elderly in China. Methods: A total of 13,510 disabled elderly in Sichuan Province were surveyed. Disability was assessed using the Barthel Activities of Daily Living Scale, mental status, sensory perception, and social engagement evaluation. Univariate analysis and logistic regression analysis were employed to identify the impact factors. Results: The prevalence of assistive device utilization among participants was 79.2% (10,700/13,510, 95% CI 78.5%–79.9%), with the wheelchair being the most commonly used device. Various factors were found to influence the usage of the device, including disability level, somatic disability, age, caregivers, income, caregiver fees, and living situation (p <.05). Additionally, several factors were identified associated with the frequency of device usage, such as somatic disability, education background, income, caregiver fees, living situation, access to acquire assistive devices, duration of assistive device usage, education on assistive devices, and satisfaction level (p <.05). Conclusions: The use of assistive devices among elderly individuals in China is prevalent. There are many factors that affect the use of assistive devices, which can provide a reference for the formulation of policies in the field of assistive devices. [ABSTRACT FROM AUTHOR]

Objective: To analyze the co‐existing patterns of health‐related behaviors among children and adolescents at different education stages and the association with obesity. Design: Cross‐sectional study. Sample: A total of 5651 primary and secondary school students were drawn from the National Student Physical Health Survey in 2014 with an average age of 13.53 ± 2.87 years. Measurements: Physical measurements and questionnaires were completed, which concluded height, weight, and health‐related behaviors (sleep, physical activity, dietary, and screen behavior et al.). Latent profile analysis (LPA) was conducted using Mplus 8.3 and SPSS 26.0 was used for other statistical analysis. Results: Three latent classes of health‐related behaviors were fitted for each of the education stages. After adjustment for age, gender, and region, the high‐screen behavior group were 2.217 (95%CI = 1.030–4.772, p =.042) times more likely to be obesity than the health‐behavior group in primary school, and the poor‐diet group and poor‐diet and high‐screen behavior group were 2.101 (95%CI = 1.396–3.396, p <.001) and 1.788 (95%CI = 1.003–3.190, p =.049) times more likely to be overweight than the health‐behavior group in junior middle school respectively. Conclusion: Obesity is mainly influenced by screen behavior and dietary patterns among children and adolescents. Health‐related behavior patterns should be accurately identified and comprehensive joint interventions should be carried out to prevent obesity. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the mode of school physical activity, the relationship with obesity, and participation willingness and behavior in the relationship between modes of school physical activity and BMI in students with overweight or obesity. Design: Cross‐sectional study. Sample: Data from the 2014 Physical Fitness and Health Surveillance of Chinese School Students was used, wherein physical measurements and questionnaires of 3476 middle school students were collected. Measurements: Physical measurements and questionnaires were completed. Latent profile analysis and mediated effects analysis were conducted using Mplus 8.3 and IBM SPSS 26.0 for data description and statistical analysis. Result: After latent profile analysis divided into poor (9.35%), medium (65.16%), and good (25.49%) groups of school physical activity, among junior middle school students, medium (OR = 0.428, 95% CI = 0.259–0.707, p =.001) and good (OR = 0.448, 95% CI = 0.255–0.718, p =.002) groups were positive for controlling overweight. Among students with overweight or obesity, participation willingness mediated the relationship between the mode of school physical activity and BMI, with effect coefficients of −0.120 (95% CI = −0.264 to −0.016) and −0.240 (95% CI = −0.426 to −0.099). Conclusions: School physical activity modes have a positive effect only on preventing and controlling overweight in junior middle school students. For middle school students with obesity, weight‐specific measures should be considered for their prevention and control. [ABSTRACT FROM AUTHOR]

Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self‐determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother–infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self‐efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p < 0.001), 6 weeks post‐partum (MD: 5.06; 95% CI: 3.80 to 6.31; p < 0.001) and 3 months post‐partum (MD: 5.24; 95% CI: 4.12 to 6.35; p < 0.001). Similarly, the intervention group reported significantly higher connection and mother's self‐perception scores at discharge (MD: 4.31; 95% CI: 3.07 to 5.56; p < 0.001), 6 weeks post‐partum (MD: 4.69; 95% CI: 3.71 to 5.68; p < 0.001) and 3 months post‐partum (MD: 4.93; 95% CI: 4.14 to 5.72; p < 0.001), compared to the control group. In contrast, the pressure from significant others scores were higher in the control group relative to the intervention group at discharge (MD: −2.09; 95% CI: −2.88 to −1.31; p < 0.001), 6 weeks post‐partum (MD: −4.35; 95% CI: −5.20 to −3.49; p < 0.001) and 3 months (MD: −4.89; 95% CI: −5.70 to −4.08; p < 0.001). Finally, the intervention group also reported higher Instrumental Needs scores at all three time points: at discharge (MD: 1.96; 95% CI: 1.35 to 2.58; p < 0.001), 6 weeks post‐partum (MD: 3.58; 95% CI: 3.05 to 4.11; p < 0.001) and 3 months post‐partum (MD: 1.18; 95% CI: 0.68 to 1.69; p < 0.001). BSE scores were significantly higher in the intervention group compared to the control group at discharge (MD: 14.29; 95% CI: 10.38 to 18.21; p < 0.001), 6 weeks post‐partum (MD: 14.04; 95% CI: 11.05 to 17.02; p < 0.001) and 3 months post‐partum (MD: 6.80; 95% CI: 4.66 to 8.94; p < 0.001). The rates of exclusive breastfeeding were higher in the intervention group than in the control group at each stage of the intervention (p < 0.01). At 6 weeks post‐partum, the intervention group's infants showed slower weight (t = −0.90, p = 0.371) and length (t = −0.69, p = 0.495) growth compared to the control group, though not significantly. By 3 months post‐partum, there was a significant difference in both weight (t = −3.46, p = 0.001) and length (t = −2.95, p = 0.004) between the groups. The findings in this study suggest that the RBF intervention programme based on SDT may be effective in improving mothers' motivation to breastfeed, building breastfeeding self‐confidence and increasing the rate of exclusive breastfeeding. The effects of the intervention on infant physical development will need to be verified with longer follow‐up in future research. Key messages: This study validated the application of responsive breastfeeding (RBF) intervention during the exclusive breastfeeding phase of Chinese infants.The RBF intervention may help to increase mothers' level of autonomous motivation for breastfeeding, enhance breastfeeding self‐efficacy and increase exclusive breastfeedingrates. The intervention had no significant effect on the weight and length of 6 week old infants but significantly impacted 3monthold infants, with slower growth observed in the intervention group compared to the control group.Future intervention programmes shouldinclude extended follow‐up periods to investigate the long‐term effects of RBF on infant growth and development. [ABSTRACT FROM AUTHOR]

Aim: To identify risk factors that associated with the occurrence of venous thromboembolism (VTE) within 30 days after hysterectomy among gynecological malignant tumor patients, and to explore the value of machine learning (ML) models in VTE occurrence prediction. Methods: A total of 1087 patients between January 2019 and January 2022 with gynecological malignant tumors were included in this single‐center retrospective study and were randomly divided into the training dataset (n = 870) and the test dataset (n = 217). Univariate logistic regression analysis was used to identify risk factors that associated with the occurrence of postoperative VTE in the training dataset. Machine learning models (including decision tree (DT) model and logistic regression (LR) model) to predict the occurrence of postoperative VTE were constructed and internally validated. Results: The incidence of developing 30‐day postoperative VTE was 6.0% (65/1087). Age, previous VTE, length of stay (LOS), tumor stage, operative time, surgical approach, lymphadenectomy (LND), intraoperative blood transfusion and gynecologic Caprini (G‐Caprini) score were identified as risk factors for developing postoperative VTE in gynecological malignant tumor patients (p < 0.05). The AUCs of LR model and DT model for predicting VTE were 0.722 and 0.950, respectively. Conclusion: The ML models, especially the DT model, constructed in our study had excellent prediction value and shed light upon its further application in clinic practice. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the psychometric characteristics of the Pictorial Scale of Perceived Movement Skill Competence (PMSC) in Chinese children, utilizing the principles of item response theory (IRT). Methods: A total of 284 children (147 boys), aged 4–10 years (Mage = 7.39, SD = 2.18), from four schools were recruited for testing, adhering to the principle of random sampling. The Rasch model was applied to evaluate the rating scale validity, local independence, scale dimensionality, person and item fit statistics, and differential item functioning (DIF). Results: (1) The rating scale validity was confirmed by the monotonically increasing trend in both average item difficulty measures and Andrich thresholds. (2) However, the observation that standardized residual correlations for all items remained below 0.3 unequivocally confirmed the presence of local independence among the variables. (3) The scale's dimensions were substantiated, with Rasch measures explaining 40.6% of total variance, exceeding the 40% threshold. Additionally, the first contrast had an eigenvalue of 1.8 and explained 8.80% of the variance, both exceeding the minimum 3:1 ratio. Consequently, the unidimensionality assumption of the item was supported. (4) Person and item fit statistics indicated requisite reliability and separation, with all achieving suitable infit and outfit measures, and point‐biserial correlations exceeding 0.55. (5) Regarding gender DIF, it was observed that the majority of items did not exhibit statistically significant gender DIF effects (p > 0.05) except item 8 (Bounce a ball, t = −2.74, p < 0.01, DIF = −0.51). Conclusion: Rasch analysis revealed that the instrument exhibited strong scale validity among Chinese children, adhering to the Rasch model's unidimensionality and local independence principles, with robust person and item reliability and separation. All items demonstrated a good fit. Additionally, the significant gender difference in item 8 (Bounce a ball) warrants further consideration. In conclusion, PMSC is suitable for assessing the PMSC of Chinese children. [ABSTRACT FROM AUTHOR]

Background: Postintensive care syndrome (PICS) has adverse multidimensional effects on nearly half of the patients discharged from ICU. Mental disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are the most common psychological problems for patients with PICS with harmful complications. However, developing prediction models for mental disorders in post-ICU patients is an understudied problem. Aims: To explore the risk factors of PICS mental disorders, establish the prediction model and verify its prediction efficiency. Study Design: In this cohort study, data were collected from 393 patients hospitalized in the ICU of a tertiary hospital from April to September 2022. Participants were randomly assigned to modelling and validation groups using a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to select the predictors, multiple logistic regression analysis was used to establish the risk prediction model, and a dynamic nomogram was developed. The Hosmer-Lemeshow (HL) test was performed to determine the model's goodness of fit. The area under the receiver operating characteristic (ROC) curve was used to evaluate the model's prediction efficiency. Results: The risk factors of mental disorders were Sepsis-related organ failure assessment (SOFA) score, Charlson comorbidity index (CCI), delirium duration, ICU depression score and ICU sleep score. The HL test revealed that p = .249, the area under the ROC curve = 0.860, and the corresponding sensitivity and specificity were 84.8% and 71.0%, respectively. The area under the ROC curve of the verification group was 0.848. A mental disorders dynamic nomogram for post-ICU patients was developed based on the regression model. Conclusions: The prediction model provides a reference for clinically screening patients at high risk of developing post-ICU mental disorders, to enable the implementation of timely preventive management measures. Relevance to Clinical Practice: The dynamic nomogram can be used to systematically monitor various factors associated with mental disorders. Furthermore, nurses need to develop and apply accurate nursing interventions that consider all relevant variables. [ABSTRACT FROM AUTHOR]

Although global warming is a serious problem that influences numerous people worldwide, individuals are still reluctant to change their behaviours. The present research investigates how local hot temperatures affect climate action in non‐Western groups. In Study 1, an analysis of temperature and information acquisition by Shanghai residents in 122 days found that heat increased attention and awareness of climate change. In Study 2 and Study 3, participants who were primed with heat‐related perceptions were more likely to take climate action in private and public spheres. In Study 4, we further identified that people who experienced hot temperature events increased their beliefs and efficacy about climate change, which in turn motivated them to take more climate action. Importantly, the mediating effects were significant both in the manipulation of heat and real‐world settings. Consistent with our theoretical perspective, seeing is more than believing because personal experience increases climate action by fostering climate change beliefs and efficacy. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to investigate the current status of the core competencies and self‐directed learning ability of diabetes specialist nurses and to explore the relationship between these core competencies and their self‐directed learning ability. Design: A cross‐sectional survey design was used. Methods: This cross‐sectional study was conducted via a web‐based questionnaire platform in China from January 14 to April 24, 2023. The survey included a general information questionnaire, a diabetes specialist nurses' core competencies self‐assessment scale, and a nursing staff's self‐directed learning ability evaluation scale. The data was collected online. Descriptive, correlation and multiple linear regression analyses were conducted using SPSS 26.0 software. Results: 118 diabetes specialist nurses from 11 cities participated in this study. A positive correlation was observed between the core competencies of diabetes specialist nurses and their self‐directed learning ability. The characteristics affecting the core competencies of diabetes specialist nurses included age, participation in external learning and communication and self‐directed learning. Conclusions: The training of diabetes specialist nurses can focus on core competencies, and the ability to self‐direct learning can be used as an entry point to customize feasible theoretical and practical courses. The training system can further improve diabetes specialist nurses' core competencies and self‐directed learning abilities. Relevance to Clinical Practice: A reference can be established that nursing managers and nursing educators can use to develop training programs for specialist nurses by validating the link between their core competencies and self‐directed learning skills. Patient or Public Contribution: Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation. [ABSTRACT FROM AUTHOR]

Scholars have identified that interviewers prefer applicants who are both emotionally restrained and exuberant. To reconcile these inconsistent results, we investigated how the magnitude of applicants' expressed enthusiasm influences interviewer perceptions of job suitability. In two experimental studies with recruiters in China, we show that expressing intense as opposed to mild enthusiasm reduces applicants' chances to be perceived as suitable for the job (Study 1). We further demonstrate that expressions of intense enthusiasm do not always undermine their perceived job suitability but can also lead to a positive interview outcome. We find that the negative consequences of intense enthusiasm are explained by interviewer perceptions of decreased appropriateness, whereas the positive consequences are driven by interviewer perceptions of the applicant's attraction to the organization (PAAO; Study 2). We also report how interviewer trait information processing motivation (IPM) influences the way applicants expressing intense enthusiasm are evaluated. Only interviewers with low trait IPM interpret applicants' intense enthusiasm as less appropriate. We propose to incorporate the social signaling character of emotions in future theorizing and research on nonverbal communication in job interviews. [ABSTRACT FROM AUTHOR]

Objective: Incontinence seriously affects the lives of middle‐aged and older people. Pelvic floor muscle assessment is very important for incontinence, and handgrip strength can be used as an auxiliary diagnostic tool. Our study aims to find new cutoff points of handgrip strength as early indicators of incontinence and analyze the association between low handgrip strength and incontinence among Chinese middle‐aged and older people. Methods: Participants were recruited from the 2015 China Health and Retirement Longevity Study. Receiver operating characteristic (ROC) curves were used to find the handgrip strength cutoff point. Logistic regression analysis was performed to explore other incontinence‐related risk factors. Results: The study included 10,229 middle‐aged and older people. Compared with normal handgrip strength participants, medium strength participants had 1.510 [men, 95% confidence interval (CI) = 1.017–2.243] and 1.792 (women, 95% CI = 1.294–2.480) times greater risk of incontinence, and low strength participants had 2.420 (men, 95% CI = 1.787–3.277) and 1.516 (women, 95% CI = 1.130–2.032) times greater risk of incontinence. Trend test results showed that the risk of incontinence increased with decreasing handgrip strength in middle‐aged and older people. Conclusions: Our study suggests that handgrip strength < 31 kg in men and < 20.5 kg in women is significantly associated with higher risk of incontinence in Chinese middle‐aged and older people. The risk of incontinence increases with decreasing handgrip strength. Handgrip strength should be measured in routine physical examinations in middle‐aged and older people for timely assessment and intervention in incontinence. [ABSTRACT FROM AUTHOR]

Objective: Sarcopenia is a geriatric syndrome that occurs with age and is characterized by a gradual decline in muscle mass, power, and functionality. It serves as a prominent contributor to frailty, disability, and mortality among older individuals. Currently, no standardized global guidelines exist for the diagnosis of sarcopenia. This study aimed to establish the correlation between sarcopenia and the constitutions of traditional Chinese medicine (TCM), considering the connection between physical functioning and sarcopenia. Methods: A total of 1441 participants in this study were diagnosed with sarcopenia. The Asian Working Group for Sarcopenia (AWGS) proposed a sarcopenia definition algorithm. To determine the constitution of each participant, classification and determination standards were used in traditional Chinese medicine. This study evaluated the demographics, lifestyles, and self‐reported medical history of individuals diagnosed with sarcopenia through a self‐administered questionnaire. The constitution of the participants was determined using TCM classification and determination standards. Subsequently, we analyzed the results of univariate analysis and multivariate regression and constructed a receiver operating characteristic (ROC) curve. Results: Participants who were diagnosed with sarcopenia had substantially lower original Neutral constitution scores (P < 0.050). In comparison to those without sarcopenia, individuals with sarcopenia exhibited notably elevated original Qi‐deficiency, Yang‐deficiency, Yin‐deficiency, Blood‐stagnation, and Qi‐stagnation scores in contrast to those in the healthy group (P < 0.050). The identified risk factors associated with sarcopenia included the following: Neutral (OR = 0.903), Qi‐deficiency (in males, OR = 1.126), Yang‐deficiency (OR = 1.062), Phlegm‐dampness (in males, OR = 0.833), and Blood‐stagnation (in females, OR = 1.089). The highest area under the curve (AUC) was observed for the original neutral constitution score, followed by the Yang‐deficiency and blood‐stagnation scores (0.644, 0.613, and 0.611, respectively). Additionally, the AUC for the combined original scores of all nine constitutions among males reached 0.778. Conclusions: In this cross‐sectional study of older people with higher original Qi‐deficiency, Yin deficiency, Yang‐deficiency, Blood‐stagnation, and Qi‐stagnation were associated with sarcopenia. Notably, various TCM constitutions are significantly linked to sarcopenia. There was a significant occurrence of various body constitution types among individuals diagnosed with sarcopenia. The mixture of the nine original constitution scores exhibited good diagnostic performance for sarcopenia in males. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to describe the differences in body composition among different body parts of the elderly in the community and its relationship with sarcopenia. Methods: Elderly people aged ≥65 underwent bioelectric impedance analysis testing and were categorized into a sarcopenia group, possible sarcopenia group, and control group. The characteristics of body composition indicators in different parts and their relationship with different stages of sarcopenia were analyzed. Results: The sarcopenia group illustrated the lowest values of FFM, FFM%, BFM, BFM%, ICW, and limb PhA, along with higher ECW/TBW in the trunk and left leg compared to the control group. The possible sarcopenia group showed lower FFM% in limbs and trunk, and higher BFM% compared to the control group. Gender differences in elderly body composition were observed, with an increase in BFM% in various body parts posing a risk factor for possible sarcopenia in elderly males, whereas an increase in BFM% except in the left arm was a protective factor for sarcopenia in elderly females. Conclusion: The body composition of the elderly in the community varied significantly in different stages of sarcopenia and genders, which correlated with sarcopenia. [ABSTRACT FROM AUTHOR]

Background: Many ICUs worldwide are striving to integrate early mobilization as part of critical care rehabilitation. However, ICU nurses, who are essential contributors to the early mobilization of critically ill patients, still lack comprehensive surveys assessing their knowledge, beliefs, and practices regarding the early mobilization of mechanically ventilated patients. Aim: To analyse the knowledge, attitudes, and practices of intensive care unit (ICU) nurses regarding the early mobilization of mechanically ventilated patients and to explore the effects of these practices. Study Design: A multicentre cross‐sectional study. ICU nurses in five tertiary hospitals in Zhejiang Province, China, were selected by convenience sampling and invited to complete an online questionnaire between 1 June 2021 and 15 June 2021. Sociodemographic data and the knowledge, attitudes, and practices of ICU nurses regarding early mobilization. Results: A total of 296 valid questionnaires were collected, for a response rate of approximately 77.5%. The average scores for knowledge, attitudes, and practices of ICU nurses regarding the early mobilization of mechanically ventilated patients were 42.7 ± 7.4, 34.3 ± 6.5, and 47.1 ± 6.5, respectively, which were good scores. Quantile regressions showed that at the 25% and 50% quartiles, increases in knowledge and attitude scores resulted in increases in practice scores (p <.001); however, at the 75% quartile, increases in knowledge scores did not result in practice score increases (t = 0.000, p =.999); moreover, there was still a 0.5‐point increase in practice scores per 1‐point increase in attitude scores (t = 0.500, p <.001). Conclusions: The knowledge, attitudes, and self‐reported practices of ICU nurses were good, although there is room for improvement. Considering that the influence of attitudes on practice improvement is more important than knowledge, ICU managers should promote knowledge transformation, strengthen attitudes, and adopt comprehensive measures to promote the early mobilization of mechanically ventilated patients in the ICU. Relevance to Clinical Practice: To optimize the early mobilization of mechanically ventilated patients in the ICU, introducing multipronged support strategies based on the knowledge and attitudes of ICU nurses is recommended to promote the implementation of such practices. [ABSTRACT FROM AUTHOR]

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

Children recognise the praiseworthiness of others' moral actions from quite a young age. The work we propose here focuses on whether and how children's judgements of moral praiseworthiness may be affected by cost incurred by the agents. Recent work has revealed developmental changes in how children consider physical and psychological costs in their judgements of moral praiseworthiness. However, this question has only been examined among US children, and little is known about how much the findings can be generalised across cultures. In this article, we examine the consideration of different types of costs (psychological, physical) in moral evaluation by children in China, and compare to the US data. We choose to study children in China not only because it is a non‐WEIRD culture, but also because recent work has suggested that there are cultural differences between the US and China in terms of how children conceptualise desire inhibition and self‐control. This research will have implications for research on children's moral cognition across cultures. [ABSTRACT FROM AUTHOR]

Background: The International Classification of Functioning, Disability and Health (ICF) offers a standardized international terminology to operationalize function management across multiple domains, but the summary score of the ICF qualifier scale provides limited information on the comparison of personal abilities and functioning difficulties. Objectives: To enhance the interpretative power of the ICF‐based Health‐oriented Personal Evaluation for the community‐dwelling older person (iHOPE‐OP) scale through the implementation of the item response theory (IRT) modelling. Methods: This cross‐sectional, multi‐centre study administrated 161 ICF categories (58 on body functions, 15 on body structures, 60 on activities or participation and 28 on environmental factors) to evaluate the functional level of 338 older citizens (female = 158, male = 180) residing in community or supportive living facilities. The validation process encompassed assessing the IRT model fitness and evaluating the psychometric properties of the IRT‐derived iHOPE‐OP scale. Results: The age of participants ranged from 60 to 94.57, with the mean age of 70. The analysis of non‐parametric and parametric models revealed that the three‐parameter logistic IRT model, with a dichotomous scoring principle, exhibited the best fit. The 53‐item iHOPE‐OP scale demonstrated high reliability (Cronbach's α = 0.9729, Guttman's lambda‐2 = 0.9749, Molenaar‐Sijtsma Statistic = 0.9803, latent class reliability coefficient = 0.9882). There was a good validity between person abilities and the Barthel Index (p <.001, r =.83), as well as instrumental activities of daily living (p <.001, r =.84). Conclusions: IRT methods generate the reliable and valid iHOPE‐OP scale with the most discriminable and minimal items to represent the older person's functional performance at a comprehensive level. The use of the Wright map can aid in presby‐functioning management by visualizing item difficulties and person abilities. Implications for practice: Considering the intricate and heterogeneous health status of older persons, a single functional assessment tool might not fulfil the need to fully understand the multifaceted health status. For use in conjunction with the IRT and ICF framework, the reliable and valid iHOPE‐OP scale was developed and can be applied to capture presby‐functioning. The Wright map depicts the distribution of item difficulties and person abilities on the same scale that facilitates person‐centred goal setting and tailors intervention. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis, a syndrome of organ dysfunction caused by an unregulated host response to infection. This study aimed to develop a novel sepsis diagnostic model of hematological parameters and evaluate its effectiveness in the early identification and prognosis of sepsis in emergency departments. Methods: A retrospective study was conducted in Emergency Department. Cell population data parameters related to monocytes and neutrophils were obtained using the Mindary BC‐6800 plus hematology analyzer. Receiver operating characteristic (ROC) curve analysis, logistic regression analysis was performed to assess the performance of the parameters and establish a diagnostic and prognostic model of sepsis, which was then verified with a validation cohort. Results: Mon_XW exhibited the best diagnostic performance (area under the ROC curve [AUC] = 0.848, 95% confidence interval [CI]: 0.810–0.885, p < 0.001), followed by Neu_Y and Neu_YW (AUC = 0.777 95% CI: 0.730–0.824, p < 0.001). Logistic regression analysis identified Mon_XW and Neu_Y as independent predictors, which were used to establish a diagnostic model named hematological parameter for sepsis (HPS). HPS demonstrated the best diagnostic performance with an AUC of 0.862 (95% CI: 0.826–0.898, p < 0.001), sensitivity of 70.0%, and specificity of 87.1%, compared to C‐reactive protein (CRP) and procalcitonin (PCT). The validation cohort also found that the positive predictive value of HPS was 70.4% and the negative predictive value was 92.2%. Conclusion: The developed HPS model showed promising diagnostic efficacy for sepsis in the emergency department, which outperformed CRP and PCT in terms of sensitivity and specificity. By enabling early identification and prognosis of sepsis, that contributes to reducing sepsis‐related mortality. [ABSTRACT FROM AUTHOR]

Objective: The prognostic value of the variables were evaluated in 418 postoperative oral cancer patients with oral cancer in southwest China between January 2013 and December 2020. Nomogram was developed based on the study, and its predictive performance and clinical utility were evaluated. Results: The univariate analysis showed gender, preoperative fibrinogen, preoperative platelet‐to‐lymphocyte ratio (PLR), and preoperative neutrophil‐to‐lymphocyte ratio, flap repair of defect, functional neck dissection (FND), tumor differentiation, tumor, node, metastasis stage, lymph node metastasis, the maximum tumor diameter, and postoperative radiotherapy had a significant influence on the survival of patients with oral cancer in southwest China (p < 0.05).The multivariate analysis showed preoperative PLR value, FND, and tumor differentiation had significant influence on the prediction of survival (p < 0.05). However, smoking and drinking are not prognostic risk factors for oral cancer. The discriminant analysis showed 66.3% of the patients could be correctly predicted for postoperative survival, while both the C‐index and decision curve analysis (DCA) showed this study may be taken as a reference for predicting the postoperative survival of patients with oral cancer. Conclusion: Preoperative PLR, FND, and tumor differentiation are independent prognostic factors for patients with oral cancer in southwest China. The results of this study have been visualized using a nomogram and a DCA. [ABSTRACT FROM AUTHOR]

Background Study: The effects of the flipped classroom (FC) on students' academic performance remain ambiguous, and the use of pre‐class videos may be one of the main factors hindering students' progress. A software package called GeoGebra has been proposed as a substitute for pre‐class videos to aid students' learning. Objective: This study investigates the effect of the FC using GeoGebra (FCG) on mathematical performance and memory among senior secondary students. Methods: One hundred and sixty students of a senior high school in China were selected. A quasi‐experimental design was implemented in which the classes were split into the intervention group (FCG), control group A (FCV) and control group B (TL) by random assignment. Pretest, Post‐test 1 and Post‐test 2 were introduced. Results and Conclusion: The results indicate that both the FCG and the FC with pre‐class videos (FCV) were more effective than traditional lectures in enhancing students' academic test scores, and that the effect of the FCG was comparable to its video counterpart, F(2, 136) = 3.752, ρ = 0.026, η2 = 0.052. Although their effects were similar, the qualitative results revealed some hidden benefits associated with the replacement of pre‐class video with GeoGebra. Furthermore, although they were equally effective in promoting students' performance in the short‐term, the long‐term effects on academic performance of both forms of FC were non‐significant when compared with traditional lectures. Lay Description: What is already known about this topic: Flipped classroom is an effective strategy in teaching mathematics.Among those challenges, video may be one of the main factors hindering the effect of flipped classroom. What this paper adds: GeoGebra could be an effective alternative to video.Effect between the flipped classroom using GeoGebra and the flipped classroom using video were similar.Both the flipped classroom with GeoGebra and the flipped classroom with videos were more effective than traditional lectures. Implications for practice and/or policy: Students' short‐term performance could be enhanced by visualisation provided by flipped classroom.To enhance students' long‐term performance, an appropriate amount of homework is suggested. [ABSTRACT FROM AUTHOR]

Aim: We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID‐19 pandemic and its potential influences. Methods: This cross‐sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi‐squared test, one‐way analysis of variance, and multivariable logistic regression analysis were used to analyze the data. Results: In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P <.001). PI score was the independent predictive factor for both "want to be a nurse" and "willingness to serve during COVID‐19 or other pandemics". Conclusions: PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID‐19 pandemic revealed the necessity of developing individual management strategies for nursing education. [ABSTRACT FROM AUTHOR]

Lung cancer remains a leading cause of cancer‐related mortality, with surgical resection as a primary treatment modality. However, postoperative wound infections (PWIs) pose significant risks following thoracoscopic radical resection. This study aims to identify the risk factors and pathogenetic characteristics associated with PWIs in lung cancer surgery. A comprehensive retrospective study was conducted from August 2021 to June 2023 at our institution. The study included 30 patients who developed PWIs and 60 controls who did not, following thoracoscopic radical resection for lung cancer. We evaluated various factors including age, hospital stay, intraoperative blood loss, body mass index (BMI), operation time, prophylactic antibiotic use, diabetes mellitus and tumour staging. Diagnostic criteria for PWIs were based on clinical signs and microbiological confirmation. Statistical analysis was performed using SPSS software, utilizing chi‐square tests, and univariate and multivariate logistic regression analyses. The predominant pathogens identified in PWIs were Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Univariate analysis revealed operation time (≥4 h) and diabetes mellitus as significant risk factors for PWIs, while prophylactic antibiotic use was associated with a lower incidence of PWIs. Multivariate analysis further confirmed these findings, highlighting prolonged operation time and diabetes as significant predictors of PWIs, and antibiotic use as a protective factor. Prolonged operation time and diabetes mellitus significantly increase the risk of PWIs following thoracoscopic radical resection for lung cancer, whereas prophylactic antibiotics play a protective role. These findings underscore the importance of tailored preventive strategies in clinical practice to minimize the occurrence of postoperative infections and improve surgical outcomes in lung cancer patients. [ABSTRACT FROM AUTHOR]

Aim: This study aims to examine the relationship between older adults' health literacy and their psychological well‐being and the role of worry about future unmet needs for medical care in mediating this relationship. Methods: We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single‐item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well‐being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks. Results: Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well‐being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker‐Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi‐square test = 50.96, P = 0.321). Conclusions: The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults. Geriatr Gerontol Int 2024; 24: 202–207. [ABSTRACT FROM AUTHOR]

It is recommended that pregnant women be physically active to promote maternal and child health. This study aimed to explore the prevalence of physical inactivity and its modifiable predictors in the three trimesters in Chinese pregnant women. Four hundred forty-four pregnant women completed the Pregnant Physical Activity Questionnaire in the first, second, and third trimesters. The prevalence of physical inactivity reached its highest (66.2%) in the first trimester and lowest (19.4%) in the second trimester. Pregnant women with inadequate physical activity knowledge and low self-efficacy were at higher risk for physical inactivity. Monitoring physical inactivity could be incorporated into antenatal care and start from the first trimester. Prenatal care professionals should take action to increase pregnant women's physical activity self-efficacy and knowledge to enhance their physical activity. [ABSTRACT FROM AUTHOR]

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health. [ABSTRACT FROM AUTHOR]

This study aimed to explore the relationship between intrusive and deliberate rumination, to identify distinct trajectories of intrusive and deliberate rumination, and to examine their predictors in young and middle-aged stroke survivors. This study employed a longitudinal design in which 200 young and middle-aged stroke survivors were investigated at 1-week pre-discharge (T0), 1 month (T1), 3 months (T2), and 6 months (T3) post-discharge. The Event-Related Rumination Inventory, Simplified Coping Style Questionnaire, and Perceived Social Support Scale were used for data collection. The results showed that intrusive rumination was positively correlated with deliberate rumination at T0 and T1, and negatively correlated with deliberate rumination at T3. Growth mixture modeling identified three classes of intrusive rumination: Stable-low, Declined, and Elevated group, and two classes of deliberate rumination: High-level and Low-level group. Furthermore, number of children or dysfunctions, type of stroke, family history of stroke, negative coping, and social support were found to predict intrusive rumination. These findings can help healthcare providers timely intervene on survivors in the Elevated and Stable-low intrusive rumination groups, and the Low-level deliberate rumination group. [ABSTRACT FROM AUTHOR]

Background: Health‐related quality of life (HRQOL) is unequal between countries and regions, and the emphasis on HRQOL of populations of low‐income countries and regions is unprecedented. Objectives: To examine the association between family health and HRQOL among middle‐aged and older adults in rural China, and determine whether this association differs by age, gender and chronic disease subgroup. Methods: Cross‐sectional survey carried out from July to September 2021. The participants were 1059 people aged 46 and over living in rural China. We used the European Quality of Life Five Dimension Five Level (EQ‐5D‐5L) and Family Health Scale‐Short Form (FHS‐SF) to assess health‐related quality of life (HRQOL) and family health, respectively. Results: The mean EQ‐VAS was 75.66, the mean EQ index score was 0.92, and the mean FHS was 37.90 in rural middle‐aged and older adults. After Bonferroni correction, generalised linear regression models showed that FHS was significantly associated with the EQ‐VAS (β = 0.829; 95% confidence interval [CI]: 0.660 to 0.997; p <.001) and the EQ index score (β = 0.003; 95%CI: 0.001 to 0.004; p <.001). Binary logistic regression models showed that FHS was associated with three dimensions of HRQOL (mobility, self‐care and usual activities) (p <.01). Based on subgroup analyses, the effect of FHS on EQ‐VAS and the EQ index score was significant in three subgroups after Bonferroni correction (p <.01), but the association between FHS and the dimensions of HRQOL differed by age, gender and chronic disease group (p >.01). Conclusions: This study is the first to explore that family health and its dimensions are significant positive predictors of HRQOL among middle‐aged and older adults in rural China. Family‐based measures may have more potential and value because better family health significantly improves HRQOL. Implications for practice: In the health strategy, the government and primary health care workers should include family health as an indicator and assess it before and after the implementation of the strategy. [ABSTRACT FROM AUTHOR]

Background: Transseptal puncture (TSP) is a crucial technique for catheter ablation of atrial fibrillation (AF). Although intracardiac echo (ICE) facilitates a safe and accurate TSP, it is not widely used in developing countries because of the expense. This study evaluated the efficiency and safety of a novel cardiac multidetector computed tomography (MDCT)‐guided TSP during AF catheter ablation. Methods: The study consisted of two cohorts. In the index cohort, TSP procedure was performed under the guidance of ICE, and we recorded the angulation of right anterior oblique of X‐ray projection. In the validation cohort, we compared the efficiency and safety of TSP guided by MDCT‐calculated angulation with propensity‐score‐matched patients who underwent TSP guided by ICE. Results: We included 50 patients in the index cohort, and the mean angles of interatrial septum (IAS) measured from MDCT and ICE were 34.8 ± 6.3 and 35.1 ± 6.5, respectively. In the validation cohort, 376 patients were enrolled in the MDCT‐guided group and ICE‐guided group. Both groups had 1 case of cardiac tamponade. The mean axial plane angle was 35.46 ± 6.17 degrees, which was not influenced by age, gender, BMI, and LA size, while a moderate positive linear correlation between EF and the axial plane angle (R2 = 0.14, p =.006). Conclusion: Cardiac MDCT can provide a clear vision of IAS orientation, and provide the appropriate RAO angle and height for TSP. The efficiency and safety of our MDCT‐guided TSP were comparable to ICE‐guided TSP, which may serve as an alternative method for TSP with ICE unavailable. [ABSTRACT FROM AUTHOR]

There are many debates regarding the risk factors of surgical site infection (SSI) following posterior cervical surgery in previous studies. And, till now there is no such a study to examine cervical laminoplasty surgery. From January 2011 through October 2021, a total of 405 patients who were treated with unilateral open‐door laminoplasty surgeries were enrolled in this study. We divided the patients into the SSI group and the non‐SSI group and compared their patient‐specific and procedure‐specific factors. Univariate and multiple logistic regression analysis were performed to determine the risk factors. Of the 405 patients, 20 patients had SSI. The rate of SSI found to be 4.93%. There were significant differences between groups in the thicker subcutaneous fat thickness (FT) (p < 0.001), the higher ratio of subcutaneous FT to muscle thickness (MT) (p < 0.001), the higher preoperative Japanese Orthopaedic Association (JOA) Scores (p < 0.003), the decreased preoperative serum albumin (p < 0.001), the more postoperative drainage (p < 0.05) and the longer time of draining (p < 0.001). Logistic regression analysis of these differences showed that the higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining were significantly related to SSI (p < 0.05). The higher ratio of subcutaneous FT/MT, the higher preoperative JOA scores, the decreased preoperative serum albumin and the longer time of draining are identified as the independent risk factors of SSI in cervical laminoplasty. Identification of these risk factors could be useful in reducing the SSI incidence and patients counselling. [ABSTRACT FROM AUTHOR]

Introduction: Newspapers are a predominant channel through which the Chinese public learns about nurses and the nursing profession. However, little nursing research has been performed in China to investigate the newspaper portrayal of nurses, and how the public perceives the role of nurses in the Chinese context is still an ambiguous phenomenon. This study aimed to clarify the public portrayals of nurses in China, and to analyze whether there are changes over time in news content related to nurses in the national newspapers. Design: A content analysis of the newspaper articles citing nurses that have been published since each newspaper was established. Method: We selected two national daily newspapers as sources to systematically search for articles about nurses from 1949 to 2022. A coding instrument was developed to quantitatively extract the contents of the articles identified. Then, using a mixed methods approach, we analyzed newspaper content to show the roles of nurses presented to the public by the media. Results: A total of 317 articles were analyzed. Nurses have been depicted with heterogeneous images in both newspapers with positive wordings and up to 28 types of public images. More than half of the articles portrayed two, three, or more types of images. Among the images of nurses identified, "overworked" appeared the most frequently, followed by "dedicated," "philanthropic and benevolent," and "with a sense of responsibility," and then "technically skilled." By analyzing the image of nurses in both newspapers over time, we found that images related to virtue have largely increased with time, while images about professionalism have decreased. Conclusion: Nursing continues to be depicted as a virtuous caregiving profession, often forgetting the wide need for knowledge, skill, and expertise required in the occupation. The public image of nurses portrayed in the national newspapers does not accurately match their actual roles. Clinical Relevance: The public image of nurses portrayed in the national newspapers does not accurately match their actual roles. To actualize a professional role and increase social status of nurses, intentional image management is needed. Nursing schools, nursing associations, and nursing professionals should be more proactive in overcoming the stereotypical image portrayed of them and use the news media as a tool to invite attention from and dialogue with the public about the value of nursing to reframe the public's understanding of the expert role of the professional nurse in health care and to create a new and more professional image for nursing. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the psychosocial markers associated with pre‐hospital delay among patients with diabetic foot (DF). Design: This study has a cross‐sectional design. Methods: The participants completed a questionnaire including pre‐hospital time, demographic characteristics, Social Support Rate Scale, Brief Illness Perception Questionnaire and Type D Personality Scale‐14. Bivariate and multivariate analyses were conducted to explore independent associations with pre‐hospital delay. Results: Only 1.8% (3/164) of participants arrived at the hospital for medical care in 24 h of symptom onset. Patients with low utilization of social support (p = 0.029), low negative illness perceptions (p = 0.014) and high levels of negative affectivity (p = 0.009) are likely to arrive late at the clinic. Medical staff should pay attention to identifying diabetic patients' Type D personalities and take actions to improve their social support as well as illness perception, so as to reduce the occurrence of hospital delay. Implications for the Profession and/or Patient Care: Psychosocial factors play a vital role in the delay in seeking medical treatment for patients with DF. Medical staff need to improve patients' illness perception as well as self‐management ability through health education. Importantly, key family members provide an emotional and psychological support system for diabetic patients. Therefore, nurses need to work with family members together to give information and psychological support during family visits. Additionally, building and maintaining trust with patients is crucial to encouraging individuals to express their concerns and worries. In this case, nurses may identify patients' negative emotions and conduct timely intervention, so as to achieve favourable outcomes. Patient or Public Contribution: This study used a convenience sample of 164 participants with DF recruited from the wound clinic of Northern Jiangsu People's Hospital and Yangzhou Hospital of TCM in China. [ABSTRACT FROM AUTHOR]

Aim: This study is to investigate the current status of knowledge, attitude and self‐reported practice in hospice care among nurses in Hainan, China, and then to analyse its influencing factors and mediating effects. This provides a basis for formulating scientific and standardized hospice care training programmes for nurses. Methods: This cross‐sectional study investigated knowledge, attitude and self‐reported practice in hospice care among 1819 nurses in Hainan, China. Convenience sampling was used to select participants from 45 hospitals and nursing homes in 14 cities and counties from October to December 2021. A scale of knowledge, attitude and self‐reported practice of healthcare providers in hospice care (Chinese version) was administered to collect data during the study period. Statistical analyses, including t‐tests, one‐way ANOVA, post‐hoc analysis and multiple linear regression, assessed the status of knowledge, attitude and self‐reported practice of hospice care in nurses and identified influencing factors. The PROCESS macro program model 4.0 was employed to explore the mediating effect of attitude on knowledge and self‐reported practice in hospice care. Results: Nurses in Hainan displayed low knowledge (mean = 7.68, SD = 3.53), moderate attitudes (mean = 88.13, SD = 12.10) and self‐reported practice (mean = 51.81, SD = 9.82) in hospice care. Current employment and willingness to engage in hospice care were significant factors influencing knowledge, attitude and self‐reported practice in hospice care. Attitude partially mediated the relationship between knowledge and self‐reported practice. Patient or Public Contribution: This study focuses on nurses' knowledge, attitude and self‐reported practice in hospice care and does not directly involve patients or the public. However, the findings enhance hospice care provided to patients and the broader community by improving nurses' knowledge and skills. This study informs evidence‐based training programmes and interventions, benefiting those in need of hospice care services. [ABSTRACT FROM AUTHOR]

Objectives: To explore the mediating role of self‐esteem in social anxiety and QoL during the COVID‐19 local epidemic in China. Design: A cross‐sectional survey. Methods: This study conveniently selected 344 hypertensive patients from a Grade‐A tertiary hospital in Wuhu, Anhui Province, as the study population. Participants completed the demographic questionnaire, the social phobia inventory, the self‐esteem scale and the 36‐item short‐form health survey. Results: Social anxiety, self‐esteem and QoL were significantly correlated with each other. Social anxiety showed no direct effect on QoL (β = 0.011, p > 0.05). Social anxiety showed an indirect effect on QoL (β = −0.248, p < 0.001). Self‐esteem fully mediated the association between social anxiety and QoL in hypertensive patients. Patient or Public Contribution: Hypertensive patients in this study were participants during the data collection process. Nursing staff from the cardiology department at the hospital of a hospital in Wuhu City, Anhui Province assisted in the recruitment phase of the data collection process. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyse the risk factors for sepsis in patients with trauma and develop a new scoring system for predicting sepsis in patients with trauma based on these risk factors. This will provide a simple and effective early warning method for the rapid and accurate detection and evaluation of the probability of sepsis in patients with trauma to assist in planning timely clinical interventions. We undertook a retrospective analysis of the clinical data of 216 patients with trauma who were admitted to the emergency intensive care unit of the emergency medicine department of the Hebei Medical University Third Hospital, China, between November 2017 and October 2022. We conducted a preliminary screening of the relevant factors using univariate logistic regression analysis and included those factors with a p value of <0.075 in the multivariate logistic regression analysis, from which the risk factors were screened and assigned, and obtained a total score, which was the sepsis early warning score. The incidence of sepsis in patients in the intensive care unit with trauma was 36.9%, and the mortality rate due to sepsis was 19.4%. We found statistically significant differences in several factors for patients with sepsis. The risk factors for sepsis in patients with trauma were the activated partial thromboplastin time, the New Injury Severity Score, growth differentiation factor‐15 levels, shock, mechanical ventilation and the Acute Physiology and Chronic Health Evaluation II score. The area under the receiver operating characteristic curve of the sepsis early warning score for predicting sepsis in patients with trauma was 0.725. When the cutoff value of the early warning score was set at 5.0 points, the sensitivity was 69.9% and the specificity was 60.3%. The incidence of sepsis in patients with trauma can be reduced by closely monitoring patients' hemodynamics, implementing adequate fluid resuscitation promptly and by early removal of the catheter to minimize the duration of unnecessary invasive mechanical ventilation. In this study, we found that the use of the sepsis early warning score helped in a more accurate and effective evaluation of the prognosis of patients with trauma. [ABSTRACT FROM AUTHOR]

Aim: This study investigated anxiety, depression, and stress and their influencing factors among nurses during the COVID‐19 pandemic and after the flood in Henan Province, China. It aimed to provide the theoretical foundation for the management of relevant hospital departments, improvement of nursing quality, implementation of antiepidemic work, and other relevant studies. Background: In December 2019, COVID‐19 was reported in Wuhan, China and became a global pandemic. In July 2021, unprecedented flooding occurred in Henan Province, China. Under the dual pressure of COVID‐19 and the flood, nurses' mental health problems deteriorated. Methods: In August 2021, 1229 nurses from various departments of the First Affiliated Hospital of Xinxiang Medical University in Xinxiang City, Henan Province,China were invited to participate in a questionnaire survey using a general condition questionnaire and the Chinese version of the Depression–Anxiety–Stress Scale. Descriptive statistics were used to analyze the status of nurses' anxiety, depression, and stress. Analysis of variance, t‐test, and multiple linear regression models were used to analyze the factors influencing anxiety, depression, and stress among nurses. Results: Of the participants, 36.1%, 10.1%, and 15.5% had moderate to high levels of anxiety, stress, and depression, respectively. Moreover, 42 (3.4%) participants experienced high to severe levels of stress, anxiety, and depression. The scores showed significant differences based on gender, harmonious family relationships, department position, work intensity, sleep quality, physical exercise, participation in leisure activities, health status, involvement in emotion management‐related training, and attending self‐care‐related training (all P < 0.05). Gender, work intensity, harmonious family relationships, health condition, sleep quality, and participation in leisure activities influenced stress, anxiety, and depression scores. Department position influenced anxiety and stress scores, and average monthly earnings influenced anxiety scores. Conclusion: All the nurses experienced various levels of stress, anxiety, and depression. Related departments should pay special attention to male nurses and nurses with high work intensity, unharmonious family relationships, poor health, and sleep quality, and who engage in fewer leisure activities. Implications for nursing and health policy: It is recommended that departments allocate human resources and arrange schedules reasonably, encourage nurses to participate in more recreational activities, and implement emotion management and self‐care‐related training to relieve emotional distress, and ultimately maintain nurses' mental health. [ABSTRACT FROM AUTHOR]

Previous studies have shown that the school-based physical activity programme entitled "11 for Health" has been effective in improving the physical fitness, well-being and overall health profile of European children. The main purpose of the present study was to examine whether the "11 for Health" programme can have a positive impact on the physical fitness of primary school pupils in China. A total of 124 primary school pupils aged 9-11 years were included in the experiment, randomly divided into the experimental group (EG, n = 62) and the control group (CG, n = 62). EG carried out three weekly 35-minute sessions of small-sided football for a total of 11 weeks. All data were analysed by a mixed ANOVA with the Student-Newman-Keuls post hoc test. The results showed greater improvements (p<0.001) in EG than CG in relation to systolic blood pressure (-2.9 vs +2.0 mmHg). Moreover, greater improvements (all p<0.05) were observed in postural balance (13 vs 0%), standing long jump (5.0 vs 0.5%), 30-metre sprint (4.1 vs 1.3%) and Yo-Yo IR1C running performance (17% vs 6%). In both EG and CG, physical activity enjoyment was observed to be higher (P<0.05) compared to the start of the intervention with increases of 3.7 and 3.9 AU respectively. In conclusion, the study revealed that the "11 for Health" programme has positive effects on aerobic and muscular fitness, and it appears to be a relevant tool in the physical activity promotion in the Chinese school system. [ABSTRACT FROM AUTHOR]

As a healthcare ICT4D solution, mobile health (mHealth) can potentially improve users' well‐being during pandemics, especially in developing countries with limited healthcare resources. Recent ICT4D research reveals that providing end‐users with access to ICT is insufficient for improving well‐being and, thus, understanding how mHealth empowers end‐users to enhance well‐being against stressful events is important. However, prior research has rarely discussed the issue of empowerment in the domain of mHealth or the context of major disruptive events. This paper contributes to the literature by conceptualizing the psychological empowerment of mHealth users (PEMU) and investigating its nomological network during pandemics. Drawing upon theories of psychological empowerment and event characteristics, we developed a research model and tested it through a mixed‐methods investigation, containing a quantitative study with 602 Chinese mHealth users during COVID‐19 and a follow‐up qualitative study of 326 online articles and reviews. We found that PEMU, driven by three technological characteristics (perceived response efficacy, ease of use, and mHealth quality), affects well‐being through both (a) a stress‐buffering effect, which counterbalances the detrimental, stress‐increasing effects of event criticality and disruption, and (b) a vitality‐stimulating effect, which is intensified by event criticality. These findings have important implications for ICT4D research and practice. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25‐hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low‐latitude, high‐altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital‐based participants (age, 1 day–96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital‐based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0–6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = −0.53, 0.60, 0.31, −0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China. [ABSTRACT FROM AUTHOR]

Aim: This study is aimed to explore the association between the occupational stress and mental health among Chinese nurses during the COVID‐19 pandemic. Design: Cross‐sectional study. Methods: There were 2913 nurse participants enrolled in the study. Demographic characteristics and other data were measured by a self‐reported questionnaire. Occupational stress was measured by using the effort–reward imbalance (ERI) questionnaire. Mental health was measured by the Patient Health Questionnaire‐9 and the General Anxiety Disorder‐7. Results: Among the participants, 14.32% (417) experienced ERI; 8.1% (237) and 7.2% (210) reported depressive and anxiety symptoms, respectively. Compared with a reference group at the lowest quartile of the ERI, participants in the highest quartile had an adjusted odds ratio (OR) (95% CI) of 11.17 (4.42, 28.25) for incident depressive symptoms. For anxiety symptoms, the OR and 95% CI was 2.28 (1.21, 4.29). The ERI was shown to have a detrimental effect on mental health, especially depressive symptoms. [ABSTRACT FROM AUTHOR]