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

Introduction: In recent years, tenecteplase has been competing with alteplase as a treatment for acute ischemic stroke given its ease of administration, lower dosage, cost-effectiveness, and better safety data. This paper seeks to analyze academic literature regarding the burgeoning usage of tenecteplase as a treatment for acute ischemic stroke across the world. Method: The Web of Science database was used to collect the data from articles containing the keywords "Tenecteplase" and "Stroke" published from 1999 to 2023. The search resulted in 576 journal articles. This study analyzed metadata related to the country, institution, keywords, and date published for each article in the database pertaining to tenecteplase use for stroke. Results: The United States led in publications (260, 39.93%), followed by Australia (101, 15.51%), and a tie for third place between Canada and China (77, 11.83% each). The three most prevalent keywords were tenecteplase (N = 324), alteplase (N = 284), and thrombolysis (N = 244). The University of Melbourne and the University of Calgary were the leading institutions publishing on the use of tenecteplase as a treatment for stroke. In 2023, the number of publications on the usage of tenecteplase for stroke was the greatest, making up 24.3% of all papers on the topic. Conclusion: The surge in academic papers regarding tenecteplase in stroke in 2023 could be a good indicator of the drug's increasing prevalence as a treatment for stroke. Despite this finding, tenecteplase is currently not an FDA-approved therapy in the US as Genentech, the drug's manufacturer, has yet to file for federal approval for acute ischemic stroke treatment. [ABSTRACT FROM AUTHOR]

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

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

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

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

Fertility punishment is a powerful interpretation of the low birth rate in contemporary China, but it is not consistent with the fact that the proportion of second children has been increasing year by year for some time. From the perspective of Bandura's "Self-efficacy", based on the post-80 s and post-90 s youth samples in the Psychology and Behavior Investigation of Chinese Residents 2021, this paper explores the quantitative relationship between the number of children and individual self-efficacy. The data indicates that: (1) Fertility is closely linked to self-efficacy, with young people who have two children exhibiting higher self-efficacy; (2) The quantitative relationship between the number of children and self-efficacy varies based on parental roles—men/fathers show almost no change in self-efficacy when moving from having no children to one child, but demonstrate a significant increase in self-efficacy when they have two children. In contrast, women/mothers experience the lowest self-efficacy when having one child, which only shows a significant improvement when they have two children. These findings provide a new perspective for theoretically explaining the current fertility situation and expand the application of self-efficacy. In terms of policy efforts, it is necessary to provide support for women's one-child fertility, and to increase the publicity of the view of more children and more efficacy to resist the potential energy of low fertility that arises from the view of more children and more burdens. [ABSTRACT FROM AUTHOR]

With the aging population, the financial burdens associated with chronic diseases continue to escalate. Among various management strategies, family physician contracting stands out as a significant initiative aimed at addressing this challenge, officially introduced in China in 2016. However, current research has given relatively little attention to the economic benefits of family physician contracting in developing countries. This paper evaluates the economic effect of family physician contracting by employing microdata of patients with chronic diseases at the Yuyuantan Community Health Service Center, Haidian District, Beijing, from January 2019 to May 2021. This research contributes to the theoretical discourse in healthcare services by introducing a modified Anderson model. The empirical findings demonstrated that family physician contracting effectively reduced healthcare costs for patients with chronic diseases. Notably, the effect of family physician contracting on healthcare costs was more pronounced among patients with chronic diseases aged less than 65 years. At the same time, it is inferred that expediting the reform of the health insurance payment system, coupled with the promotion of family physician contracting services, would enhance the wellbeing of patients with chronic diseases. This research offers valuable insights into the ongoing and future development of family physician contracting in developing countries. [ABSTRACT FROM AUTHOR]

Aims: This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. Background: Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. Design: This cross‐sectional study was designed based on the theory of unpleasant symptoms. Methods: Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) Results: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. Conclusion: The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self‐coping and symptom management for kidney transplant recipients. Summary statement: What is already known about this topic? Fatigue is a common symptom of kidney transplant recipients and can impair postoperative recovery, reemployment, quality of life, social activities and physical and mental states, causing the body to be in a state of chronic energy consumption.Owing to the imperceptible physical injury upon kidney transplant recipients, fatigue is often underappreciated or even disregarded. What this paper adds? It was found that the rate of fatigue in kidney transplant recipients was high.The risk factors for fatigue in kidney transplant recipients based on the theory of unpleasant symptoms were analysed in three ways: physiological, psychological and situational. The results showed that sleep quality, duration after transplantation, serum potassium level, anxiety, depression, education level, financial burden and social support were associated with fatigue in kidney transplant recipients. The implications of this paper: Clinical nurses should conduct timely and multidimensional fatigue evaluations of kidney transplant recipients and pay more attention to those with a high level of fatigue.The findings can provide a scientific basis for kidney transplant specialist nurses to conduct targeted interventions and facilitate fatigue management for kidney transplant recipients. They can also help to develop fatigue intervention models based on the displeasure symptom theory to improve fatigue in kidney transplant recipients. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to introduce the Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) into China and test its applicability in Chinese infertile population. Background: Infertility‐related stress not only influences patients' psychological well‐being but is also strongly associated with reduced pregnancy rates and poorer assisted conception outcomes, thus warranting focussed attention. Design: The design used in this study is a cross‐sectional survey. Methods: A total of 418 participants were recruited by convenience sampling from March to July 2022. The data were randomly divided into two parts: one for item analysis and exploratory factor analysis and the other for confirmatory factor analysis and reliability test. The critical ratio and homogeneity test were used to verify the differentiation and homogeneity of the COMPI‐FPSS; the construct validity was determined by explanatory and confirmatory factor analyses; Cronbach's α coefficient and Spearman–Brown coefficient were used to assess the reliability; and criterion validity was expressed using correlation coefficients for the Perceived Stress Scale and the Negative Affect Scale as the validity criteria. Results: The revised Chinese version of COMPI‐FPSS has 11 items and 2 dimensions (i.e., personal stress domain and social stress domain). Exploratory factor analysis showed that the cumulative variance contribution rate of the two factors was 68.6%, and confirmatory factor analysis indicated that the model fitted well. The score of the COMPI‐FPSS was significantly and positively associated with perceived stress and negative affect. The Cronbach's α coefficient of the total scale was 0.905, and the Spearman–Brown coefficient was 0.836, explaining excellent reliability. Conclusion: The revised Chinese version of COMPI‐FPSS shows good reliability and validity, and it can be used to evaluate the infertility‐related stress of infertile patients in China. Summary statement: What is already known about this topic? With the number of infertile people on the rise globally, infertility‐related stress needs attention.Copenhagen Multi‐Centre Psychosocial Infertility (COMPI)‐Fertility Problem Stress Scales (COMPI‐FPSS) with its brief and accessible entries is extensively applied abroad.China currently lacks such a tool. What this paper adds? This study translated the COMPI‐FPSS into Chinese and the Chinese version of COMPI‐FPSS contains 11 items and 2 dimensions, including personal stress domain and social stress domain, which has good reliability and validity. The implications of this paper: The Chinese version of COMPI‐FPSS could provide a short and reliable tool for clinical practice and research, which will reduce the burden on researchers and patients. [ABSTRACT FROM AUTHOR]

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

Reasonably allocating medical resources can effsectively optimize the utilization efficiency of such resources. This paper took Taiyuan City as an example and established a model to evaluate the rationality of medical resource spatial allocation, incorporating two key dimensions: the spatial layout and the supply and demand of medical resources. In terms of the spatial layout, three indexes were included: Firstly, the service coverage rates of different levels of medical institutions, based on residents' medical orientations, were calculated using network analysis methods. Secondly, the Huff-2SFCA method was improved to calculate the accessibility of medical resources for four different modes of transportation. Then, the Health Resource Agglomeration Degree (HRAD) and Population Agglomeration Degree (PAD) were used to quantify the equity of medical resources. In terms of the supply and demand of medical resources, one index was included: the supply–demand ratio of medical resources during sudden public health events, which was calculated using the number of beds per thousand people as an indicator. These four indexes were weighted using the entropy weight method to obtain the rationality grade of medical resource spatial allocation in Taiyuan City. The study found that the rationality evaluation level of medical resource allocation in the central urban area of Taiyuan City followed a "concentrically decreasing" pattern. The rating ranged from "very reasonable" to "less reasonable", with the area of each level expanding gradually. The areas rated within the top two categories only accounted for 19.92% of the study area, while the area rated as "less reasonable" occupied 38.73% of the total area. These results indicate that the model accounted for residents' travel for various medical orientations and the availability of resources during public health emergencies. It considered both the spatial layout and supply and demand of medical resources, offering recommendations for the precise allocation of urban medical resources. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses. Background: Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear. Methods: A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale‐Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T‐test and one‐way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research. Results: Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth. Conclusions: Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth. Summary statement: What is already known about this topic? Psychiatric patients generally have complex and special conditions, which makes psychiatric nursing work high‐risk and stressful, which often poses significant challenges for psychiatric nurses, such as compassion fatigue.There is a correlation between compassion satisfaction, compassion fatigue and posttraumatic growth among nurses. What this paper adds? Psychiatric nurses have low levels of posttraumatic growth and moderate levels of compassionate satisfaction, burnout and secondary traumatic stress, and posttraumatic growth is influenced by sleep hours per day, marital status, children and job satisfaction.Compassion satisfaction and secondary traumatic stress have a positive impact on posttraumatic growth of psychiatric nurses, whereas burnout has a negative impact on posttraumatic growth of psychiatric nurses. The implications of this paper: This study emphasizes that policy makers should clarify the relationship between posttraumatic growth, compassion satisfaction and compassion fatigue as soon as possible to support the rapid growth of psychiatric nurses in nursing work.This study provides a basis for nursing managers to explore and implement interventions to improve compassion satisfaction among psychiatric nurses, reduce burnout and promote personal psychological growth. [ABSTRACT FROM AUTHOR]

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

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

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

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

Aim: This study investigated the scientific research ability of Chinese specialist nurses (SNs) in the Guangxi Zhuang Autonomous Region and its influencing factors. Design: A cross‐sectional design. Methods: A total of 652 SNs in the Guangxi Zhuang Autonomous Region were investigated from March to October 2021. The nursing scientific research ability level was measured using the Nursing Research Competence of Nurses Self‐evaluation Scale. Descriptive statistics, univariate analysis and ordinal logistic regression analysis were used to evaluate factors affecting the scientific research ability of SNs. Results: The median score of scientific research ability of SNs was 31 (interquartile range: 19–41). Approximately 74.8% of clinical speciality nurses had low scientific research ability. Educational background, working hospital level, being the first author of a published paper and successful application for scientific research projects were identified as factors influencing scientific research ability score. [ABSTRACT FROM AUTHOR]

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

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

Background: Irinotecan is a standard chemotherapeutic agent in small cell lung cancer (SCLC), however, as a common adverse reaction, diarrhea limits the use of irinotecan. Shengjiang Xiexin decoction (SXD) has been used in various gastrointestinal diseases in China two thousand years ago. We designed this clinical trial to supply more evidences on the use of SXD as prophylaxis for irinotecan-induced diarrhea, especially for high-risk population predicted by gene testing of uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1). Methods: In this clinical trial, 120 patients with SCLC were recruited from six hospitals in China. They received two cycles of chemotherapy, meanwhile they were randomized to receive SXD or placebo for 14 days of oral administration in each cycle of chemotherapy. The primary outcome is the incidence of diarrhea. And secondary outcomes include the the degree of diarrhea and neutropenia, the number of chemotherapy cycles with diarrhea, first occurrence time and duration of diarrhea. To evaluate the effect of SXD on the intestine, a rat model with delayed-onset diarrhea induced by irinotecan was established, and the expression of inflammatory factors including IL-1β, IL-6 and TNF-α, anti-inflammatory factors including IL-10, TGF- β in jejunal tissue was detected by ELISA. Results: 101 patients (53 in SXD group, 48 in placebo group) completed the trial. The incidence of diarrhea in SXD group and placebo group were 26.42% (14/53) and 52.08% (25/48), respectively (P < 0.05), and the degree of diarrhea also had significant differences (P < 0.05). In UGT1A1 high-risk population, the incidence of diarrhea in two groups were 9.09% and 66.67% (P < 0.05), but there was no significant differences in UGT1A1 low-risk population. The incidence of neutropenia with degree 1–3 between two groups was 20.75% vs 20.83%, 13.21% vs 18.57%, 9.43% vs 20.83% (P < 0.05). No severe adverse events were reported in any group. And animal studies had shown SXD reduced content of IL-1β, IL-6, TNF-α, increased content of IL-10, TGF-β in jejunum tissue. Conclusions: SXD had a prophylactic effect in the diarrhea induced by irinotecan, especially for UGT1A1 high-risk population, and this effect from SXD appeared to be maintained the completion of chemotherapy schedule. The mechanism of action of SXD was related to the regulation of inflammatory factors. Trial registration Chinese Clinical Trial Register: ChiCTR1800018490. Registered on 20 September 2018. https://www.chictr.org.cn/showproj.html?proj=25250. The preliminary protocol of this clinical study has been published in the journal "Trials" in the form of protocol before this paper (Deng et al. in Trials 21:370, 2020). [ABSTRACT FROM AUTHOR]

Background: The social culture, gender stereotypes, and social status of nursing in China impact the professional commitment of male nursing students. Increasing the professional commitment of male nursing students is critical for alleviating the shortage of nurses and addressing the gender gap. The outbreak of the COVID-19 pandemic has caused widespread public concern about the nursing profession and may have changed people's perception of the profession, which in turn may have a positive impact on the professional commitment of male nursing students in China. Objective: This research aimed to assess how the COVID-19 pandemic affected the professional commitment of male nursing students in China and to analyze the impact of the COVID-19 pandemic on potential factors that might affect their professional commitment. Methods: A descriptive comparative study was conducted. This study involved total 368 male nursing students from five 4-year universities in Henan Province, China. 190 male nursing students were included before the COVID-19 pandemic (October to November 2019) and 178 were included after the COVID-19 pandemic (April to May 2023). The data, such as the sociodemographic characteristics and professional commitment of the two samples, were collected using a paper-and-pencil questionnaire. The research instruments used included the Professional Commitment Scale, the Multidimensional Scale of Perceived Social Support and the General Self-efficacy Scale. The data analysis employed χ2-tests, t-tests and hierarchical regression models. Results: The proportion of Chinese male nursing students who are interested in nursing and do not intend to leave the major has increased after the pandemic (65.17% vs. 29.47%, 61.80% vs. 39.47%, respectively). Male nursing students exhibited greater professional commitment (3.30 ± 0.63) after the pandemic compared to before the pandemic (2.77 ± 0.43). The various factors, such as grade, intend to leave the major, interest in nursing, social support, and general self-efficacy, were linked to professional commitment of male nursing students in China. Conclusions: Male nursing students in China exhibited greater professional commitment after the pandemic. This phenomenon may be attributed to the public's increased recognition of the significance of nursing work during the pandemic, and the social status and image of nursing profession have been improved. Given the changes brought about by the COVID-19, strategies should be considered by nursing decision makers and schools to strengthen the professional commitment of male nursing students and increase the number of male nurses in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Background: New graduate nurses often have certain potential safety hazards for patients due to insufficient knowledge and lack of clinical practice ability. To address these challenges, China has implemented a standardized training strategy. The improvements in the quality of this training involve not only the intervention of teaching methods but also the consideration of personality traits. Methods: The application software based on the BFI-2 Chinese scale was utilized to administer personality tests to nursing students; nursing students were invited to scan the QR code and voluntarily fill in a questionnaire, including basic information, personality test results, and a professional self-efficacy test scale; offline paper-based theoretical examination results of nursing students were collected before and after training. The data was then analyzed using SPSS software version 26.0, which involved descriptive analysis, one-way between-groups analysis of variance (ANOVA) and Spearman correlation analysis. Results: Based on the data, there were no observable differences in the theoretical results before and after training across different personality traits. In terms of skill assessment, conscientiousness exhibited the highest score at 78.91 ± 2.98 points, while negative emotionality showed the lowest score at 74.59 ± 2.12 points. These differences between different personality traits are statistically significant (P < 0.001). In terms of professional self-efficacy, conscientiousness scored the highest at 98.48 ± 12.69, while negative emotionality scored the lowest at 85.89 ± 11.71, with significant differences between different personality traits (P < 0.001). Professional self-efficacy was negatively correlated with agreeableness (r = -0.150, P = 0.044) and positively correlated with conscientiousness (r = -0.310, P < 0.001). Skill scores were negatively correlated with negative emotionality (r = -0.257, P < 0.001) and positively correlated with conscientiousness (r = 0.182, P = 0.014). Conclusions: This study shows that personality traits affect the skills test results and professional self-efficacy of nursing students. Conscientiousness scored the highest in this study, while negative emotionality scored the lowest. Therefore, personalized training plans are recommended to improve the quality of care for such nursing students and to further enhance patient safety. [ABSTRACT FROM AUTHOR]

Drawing data from a study on LGBT parent families that combined in-depth interviews with members of 19 families and a national online survey of 595 families, this paper focuses on the role of grandparents in providing childcare within these families. Similar to their heterosexual counterparts, grandparents are heavily involved in childcare in these lesbian and gay parent families. The participation of the families of origin in childcare not only greatly alleviates the family pressure experienced by our participants due to their alternative sexuality, but also contributes to the normalization of these queer families in the face of public scrutiny. Despite the alternative construction of kinship in queer families, the conventional notion of blood ties still influences grandparents' involvement in childcare. We contend that grandparenting in LGBT parent families exemplifies the complex yet innovative improvisation of intergenerationality in contemporary China, reflecting the ongoing negotiation between family responsibility and individual autonomy. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to investigate the humanistic care ability among surgical nurses in China and identify its statistically significant influencing factors. Design: A cross‐sectional, descriptive and correlational design was used. Methods: A total of 210 surgical nurses were recruited from a tertiary public hospital in Wuhu, Anhui Province. Four with incomplete responses were excluded, leaving 206 participants for data analysis. Variables were measured using the general questionnaire, caring ability inventory (CAI), and General Self‐Efficacy Scale (GSES). Multivariate linear regression analyses were performed to identify the statistically significant influencing factors of participants' humanistic caring ability. Results: The overall average score of the CAI was 190.14 (SD = 19.24), and the average scores for the three dimensions of cognitive, courage, and patience were 70.46 (SD = 7.77), 62.12 (SD = 8.47) and 57.56 (SD = 6.02), respectively. The overall average score of the GSES was 26.05 (SD = 5.77). Professional attitude, perceived care from the department head nurse, perceived care from colleagues and self‐efficacy were the statistically significant factors influencing the humanistic care ability of surgical nurses (R2 = 0.45, adjusted R2 = 0.44, F = 40.64, p < 0.001). [ABSTRACT FROM AUTHOR]

Objectives: Non-coding RNA (ncRNA) plays a role in the development of diabetes and coronary heart disease. However, there is limited research on the association between ncRNA and these conditions. This study aims to conduct a bibliometric analysis and visualization of existing research to provide a comprehensive reference for future investigation in this field. Methods: We searched the China National Knowledge Infrastructure (CNKI) and Web of Science Core Collection (WoSCC) databases for articles published from 2012 to 2024. We analyzed publication volume, country of origin, authors, and keywords using Microsoft Office Excel, CiteSpace, and VOSviewer. Results: A total of 414 papers from 56 countries/regions, involving 298 authors, were analyzed. China had the highest number of publications (177), followed by the USA (90) and Italy (28). The number of publications generally shows an increasing trend. Collaborative research efforts were prevalent, with Katare Rajesh being the most cited author on average. International Journal of Molecular Sciences emerged as the most prolific journal in this field, while the article "MicroRNA profiling unveils hyperglycaemic memory in the diabetic heart" was identified as the most frequently cited. The analysis of keywords and literature indicates that current research predominantly focuses on the expression and mechanisms of ncRNA in disease, as well as its potential as a biomarker. Conclusion: Research on ncRNA in the context of diabetes and coronary heart disease has made notable strides, although it warrants further exploration. Through bibliometric and visual analysis, we elucidate the collaborative relationships among researchers, which can facilitate the identification of potential collaborators. Additionally, we delineate the key areas and emergent trends in this field, providing valuable insights that can guide researchers in selecting future research directions. Plain Language Summary: Tables and pictures are used to show the research status of ncRNA in diabetes mellitus with coronary heart disease This research explores the connection between a type of RNA called ncRNA and two common diseases: diabetes and coronary heart disease. We used a method called bibliometrics to analyze over 400 research papers published on this topic from 2012 to 2024. What we found: • The number of studies on ncRNA and diabetes with heart disease has been increasing over the past 12 years, indicating growing interest in this area. • China and the United States have published the most research on this topic, but international collaboration could further enhance the impact of these studies. • Some scientists, like Rajesh Katare, have made significant contributions to this field with their research on miRNA as a potential biomarker for heart disease in diabetes patients. • The most common journals publishing research on this topic include the International Journal of Molecular Sciences and the Journal of the American College of Cardiology. • The main focus of current research is understanding how ncRNA is expressed and functions in these diseases, and its potential as a biomarker for early diagnosis and treatment. Why this is important: • Diabetes and coronary heart disease are major health problems worldwide, causing significant illness and death. • ncRNA has the potential to be used as a biomarker for these diseases, which could lead to earlier diagnosis and better treatment options. • Understanding the role of ncRNA in these diseases could also help develop new treatments that target the underlying causes of the diseases. What's next: • Future research should focus on understanding the role of long noncoding RNA in diabetes and heart disease, as this type of RNA is thought to be important in regulating genes related to these diseases. • Increased international collaboration could. help further advance the field and improve the impact of research findings. [ABSTRACT FROM AUTHOR]

Aim s : The objective of this study was to examine the relationship between caregiving burden and pre‐death grief, with a specific focus on adult‐child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. Methods: A convenience sample of 320 adult‐child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit‐Meuser Caregiver Grief Inventory‐Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist‐Revised. Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre‐death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre‐death grief, but in the male group, this mediating effect did not exist. Conclusion: The study found evidence supporting the link between caregiving burden and pre‐death grief among adult‐child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre‐death grief. These associations only existed in the female group. Implications: This paper presented the importance of active coping skills in the dementia caregiving process. Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre‐death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre‐death grief. Community‐based and personal care support services should be promoted to alleviate their caregiving burden. Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. Patient or Public Contribution: 'No patient or public involvement'. [ABSTRACT FROM AUTHOR]

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

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

BACKGROUND: Athletic fatigue is an inescapable issue in competitive sports. It belongs to a physiological response that is triggered when competitive athletes are trained to a critical point. OBJECTIVE: The study aims to explore the relationships involving boxers' social support, mental fatigue, coach leadership behaviors and psychological resilience. METHODS: 1050 boxers were selected in several provinces across China and investigated on the basis of the Social Support Questionnaire for Athletes, Mental Fatigue Scale, Psychological Resilience Scale, and Leadership Scale for Sport. RESULTS: Boxers' social support was negatively correlated with mental fatigue and psychological resilience, while it was positively correlated with coach leadership behaviors. Apart from direct effects on mental fatigue, other impacts are imposed by boxers' social support via mediating effects such as coach leadership behaviors and psychological resilience. The total effect value was -0.18, the direct effect value was -0.08, and the indirect effect value was -0.12; furthermore, coach leadership behaviors and psychological resilience play a mediating role, accounting for 65.57% of the total. CONCLUSION: In order to alleviate the stress from intense competitive training and abate mental fatigue, competitive athletes may be encouraged in subsequent training to seek all-sided social support for social interpersonal relationships. While clarifying the mechanism how the external environment affects individuals, this paper explains the principle of social support on athletes' psychological fatigue and identifies mutual influences between coaches and athletes. [ABSTRACT FROM AUTHOR]

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

Aims: Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Design: Prospective observational study. Methods: This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. Results: The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. Conclusion: In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. Relevance to Clinical Practice: In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. Reporting Method: This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patient or Public Contribution: Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript. [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: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

Background: Training parents to implement language and communication intervention strategies is an effective approach to promote language development for children with language delay. Aims: This study introduces an online parent training program conducted in Hubei province, China, which was designed to help parents of language‐delayed children with a diagnosis of autism spectrum disorder (ASD), developmental language disorder (DLD) or global developmental delay (GDD) apply language intervention strategies into daily interactions and promote their children's language development at home. Methods & Procedures: The Bethel Hearing and Speaking Training Center Family Training for Early Communication & Language Development (Bethel Family Training Program, BFT) (Bethel HSTC, 2020) was designed to improve the language and communication skills for children with language delay in a naturalistic way. The caregivers (including parents, grandparents and other main caregivers) participated in an 8‐h online program, including lectures on milestones in child language development, common misunderstandings of child language development, and three basic family language intervention strategies ('Looking together, playing together, and talking together') incorporating active learning through video analysis and discussion. Tongji Hospital in Hubei then continued with 3 months of online home intervention monitoring to all the caregivers via weekly online Q&As led by BFT certified speech therapists' team. The Gesell Developmental Schedules (GDS) was carried out before the online parent training program and after the 3‐month online home intervention monitoring. Outcomes & Results: 146 families whose children aged 12–68 months with language delay participated in the online training program. The results of the GDS assessments conducted before and after the program showed that not only did the developmental quotient (DQ) of language improve, but so did the DQ of social behaviour and adaptive behaviour (p < 0.001). There is no between‐group difference in the application of three strategies between the ASD group and the DLD or GDD group (p > 0.05). Furthermore, both caregivers' ability to apply 'looking together, playing together, talking together' strategies and the effective interaction time played important roles in improving the child's language abilities. Conclusion & Implications: The online parent training focusing on improving daily interaction with children through speech–language stimulation strategies promoted the development of language skills. It is an economic and practical approach for children with language delay who have limited access to local language intervention programs. WHAT THIS PAPER ADDS: What is already known on the subject: Parent‐implemented language intervention is an effective approach at improving children's language development. Telepractice is an appropriate model of service delivery for audiologists and speech–language therapists and may be the primary mode of service delivery or may supplement in‐person services. What this paper adds to the existing knowledge: This paper explores the effectiveness of an online parent training program and provides new evidence that online training on language support strategies (looking together, playing together, talking together) followed by home intervention monitoring works for Mandarin‐speaking children and it is equally effective for children with ASD and non‐ASD diagnosis. What are the potential or actual clinical implications of this work?: Developmental behavioural paediatricians and speech–language therapists in countries and areas that lack sufficient training resource for every child will have the option to deliver parent training and home intervention monitoring online, which will save time and cost considerably while offering convenience. [ABSTRACT FROM AUTHOR]

Aim: To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China. Methods: From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio‐demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi‐squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study. Results: Of the 1712 geriatric outpatients recruited, 1626 participants (60–79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60–79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p =.007), use of a walking assistance device (p <.001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089–11.806, p <.001), living arrangement (p =.004), timed up and go test (TUGT) (p =.007) and three diseases or above (OR = 2.496, 95% CI = 1.358–11.4.586, p =.003) reached statistical significance. Conclusions: Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life. Relevance to Clinical Practice: The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall‐related injuries, which has practical significance for promoting healthy aging. Patient or Public Contribution: The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall‐related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript. [ABSTRACT FROM AUTHOR]

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

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

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

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

To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors. [ABSTRACT FROM AUTHOR]

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

Objectives: This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade‐off. Methods: The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services. Results: Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters. Conclusions: Many families have only one son or one daughter as a result of the one‐child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former. [ABSTRACT FROM AUTHOR]

In the context of the deepening of population aging and the trial implementation of a progressive retirement delay policy in China, understanding the relationship between the labor force participation and health status of the elderly will not only enrich relevant research but also help the elderly better achieve their goals of active aging and aging. Using the 2018 China Health and Retirement Longitudinal Study, this paper first established multiple linear regression models to analyze the impact of labor force participation on the health status of elderly people in China and then established simultaneous equation models using households living on minimum living allowances and the community average of labor participation as instrumental variables to deal with the endogeneity caused by two-way causality. The findings confirmed significant positive correlations between labor force participation and physical and mental health, while caring for grandchildren and participating in social activities were found to be negatively moderated the relationship between labor force participation and the physical and mental health of older adults. The impact of labor force participation on the physical health status of older men and the mental health status of older women may be greater. In addition, labor force participation may have a greater impact on the physical health of the rural elderly, and its impact on mental health was not found to be statistically significant between urban and rural areas. [ABSTRACT FROM AUTHOR]

Improving physical, mental and cognitive health is a strategic choice to help developing countries cross the middle-income trap. This paper used data from the 2019 China Rural Children Health and Nutrition Survey (n = 826), and used the Ordered Probit (Oprobit), Logit and ordinary least squares (OLS) analytical methods to systematically analyze the implications of parental migration on multidimensional health. The results indicate that parental migration significantly harms the physical and mental health of rural children, and that mobile phone addiction has a significant moderating effect. Moreover, parental migration has a greater impact on the physical health, mental health and cognitive ability of boys and rural children with low family income, while parents with higher nutrition knowledge and education can effectively improve the physical health and cognitive ability of their children. In conclusion, in order to improve the multidimensional health of rural children, the government should strengthen the policy of care and support for children whose parents migrate. Schools and families should pay attention to the supervision of rural children's mobile phone addiction. [ABSTRACT FROM AUTHOR]

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

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

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

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

In China, the promotion of sexuality education for children and adolescents is hindered by a relatively conservative culture and insufficient drive from the government. With the government and the market failing to deliver in this area, social organizations, such as the third sector, are playing an important role. This paper mainly discusses how Chinese social organizations promote sexuality education for children and adolescents on a large scale. This paper studied NW, the largest sexuality education support platform in China at present, and 16 frontline implementing organizations in its cooperation network. This research collects empirical data through participatory observation and semi-structured interviews, involving a total of 37 interviewees, plus relevant text data. The study follows the analytical method of process tracking, trying to extract the key mechanisms of how social organizations promote sexuality education from the processes demonstrated by the specific cases. This paper focuses on the key phases of a standardized sexuality education program, from its design to promotion and then to implementation. It is found that, based on the large-scale operation strategy, the operation process of the sexuality education program exhibited three core mechanisms: standardized program design, organizational cooperation network and administrative mobilization. These three mechanisms have become the key force to break through many of the cultural and institutional obstacles and achieve large-scale implementation of sexuality education. Finally, this paper discusses the challenges of operationalizing the sexuality education program, with compromised teaching quality as a major one, and points to the direction for future research. [ABSTRACT FROM AUTHOR]