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IntroductionThis study delves into the multifaceted components of talent-training models within China’s physical education domain through Sino-foreign cooperative initiatives. Employing a mixed-methods approach, it systematically evaluates the innovative systems developed by pilot units and outlines their experiential insights.MethodsUsing a mixed-methods approach, this research extensively evaluates the situation of pilot units by collecting and analyzing data from closed-ended and open-ended questionnaires as well as interview responses. The study categorizes and analyzes the data to comprehensively understand cooperative talent-training models.ResultsThe findings are classified into three main themes: Learning, Integration, and Binary Evaluation and Practice Reform. Under the Learning theme, the study observed a selective integration of foreign educational paradigms into the local context, respecting the distinctiveness of Chinese education and aligning with national policies promoting unique educational systems. Additionally, the Integration theme underscores the necessity of meticulously assimilating introduced educational resources into China’s educational fabric, highlighting the need for adaptability when integrating foreign educational elements. Furthermore, the Binary Evaluation and Practice Reform theme reveal the establishment of a dualistic evaluation and reform system tailored to cooperative education specifics, outlining challenges associated with ideological and cultural disparities when integrating certain foreign education aspects into the Chinese context.DiscussionThis research provides insightful exploration into the complexities of collaborative talent-training models in Physical Education. It not only elucidates the assimilation of foreign paradigms but also highlights nuanced challenges and prospects for developing tailored educational systems within specific regional and national contexts.

This study aimed to explore the effects of acute ingestion of caffeine capsules on muscle strength and muscle endurance. We searched the PubMed, Web of Science, Cochrane, Scopus, and EBSCO databases. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval. Fourteen studies fulfilled the inclusion criteria. The acute ingestion of caffeine capsules significantly improved muscle strength (WMD, 7.09, p < 0.00001) and muscle endurance (WMD, 1.37; p < 0.00001), especially in males (muscle strength, WMD, 7.59, p < 0.00001; muscle endurance, WMD, 1.40, p < 0.00001). Subgroup analyses showed that ≥ 6 mg/kg body weight of caffeine (WMD, 6.35, p < 0.00001) and ingesting caffeine 45 min pre-exercise (WMD, 8.61, p < 0.00001) were more effective in improving muscle strength, with the acute ingestion of caffeine capsules having a greater effect on lower body muscle strength (WMD, 10.19, p < 0.00001). In addition, the acute ingestion of caffeine capsules had a greater effect in moderate-intensity muscle endurance tests (WMD, 1.76, p < 0.00001). An acute ingestion of caffeine capsules significantly improved muscle strength and muscle endurance in the upper body and lower body of males.

Background and objectiveLifestyle modifications aimed at weight loss have been introduced as a cornerstone of nonalcoholic fatty liver disease (NAFLD) management. However, very few patients follow the doctor's prescription to change their lifestyle to achieve weight loss in the real world. The purpose of this study was to use the Health Action Process Approach (HAPA) model to examine the factors that affect adherence to lifestyle prescriptions among patients with NAFLD.MethodsSemi-structured interviews were conducted with patients with NAFLD. Reflexive thematic analysis and framework analysis were used to determine naturally identified themes and allocate them to theoretically driven domains.ResultsThirty adult patients with NAFLD were interviewed, and the identified themes were mapped directly onto the constructs of the HAPA model. This study revealed that key barriers to adhering to lifestyle prescriptions are related to the coping strategy and outcome expectation constructs of the HAPA model. For physical activity, conditional limits, lack of time, symptoms such as fatigue and poor physical fitness, and fear of sports injury are the primary barriers. Barriers to diet are mainly diet environment, mental stress, and food cravings. Key facilitators for adherence to lifestyle prescriptions include developing simple and specific action plans, coping strategies to flexibly deal with obstacles and difficulties, receiving regular feedback from doctors to improve self-efficacy, and using regular tests and behavior recording to enhance action control.ConclusionsFuture lifestyle intervention programs should pay particular attention to the planning, self-efficacy, and action control-related constructors of the HAPA model to promote the adherence of patients with NAFLD to lifestyle prescriptions.

IntroductionSince September 2020, Chinese populations aged > 3 years have been encouraged to receive a two-dose inoculation with vaccines against coronavirus disease 2019 (COVID-19). This study aims to evaluate the cost-effectiveness of the current vaccination strategy amongst the general population in mainland China from a societal perspective.MethodsIn this study, we construct a decision tree with Markov models to compare the economic and health consequences of the current vaccination strategy versus a no-vaccination scenario, over a time horizon of one year and an annual discount rate of 5%. Transition probabilities, health utilities, healthcare costs, and productivity losses are estimated from literature. Outcome measures include infection rates, death rates, quality-adjusted life years (QALYs), and costs. The incremental cost-effectiveness ratio (ICER) is then calculated to evaluate the cost-effectiveness of the current vaccination strategy, and both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA) are applied to assess the impact of uncertainties on results.ResultsOur simulation indicates that compared with a no-vaccination scenario, vaccination amongst the general population in mainland China would reduce the infection rate from 100% to 45.3% and decrease the death rate from 6.8% to 3.1%. Consequently, the strategy will lead to a saving of 37,664.77 CNY (US$5,256.70) and a gain of 0.50 QALYs per person per year on average (lifetime QALY and productivity loss due to immature death are included). The cost-saving for each QALY gain is 74,895.69 CNY (US$10,452.85). Result of the PSA indicates that vaccination is the dominating strategy with a probability of 97.9%, and the strategy is cost-effective with a probability of 98.5% when the willingness-to-pay (WTP) is 72,000 CNY (US$10,048.71) per QALY.ConclusionCompared with a no-vaccination scenario, vaccination among the general population in mainland China is the dominating strategy from a societal perspective. The conclusion is considered robust in the sensitivity analyses.

The transmission of SARS-CoV-2 leads to devastating COVID-19 infections around the world, which has affected both human health and the development of industries dependent on social gatherings. Sports events are one of the subgroups facing great challenges. The uncertainty of COVID-19 transmission in large-scale sports events is a great barrier to decision-making with regard to reopening auditoriums. Policymakers and health experts are trying to figure out better policies to balance audience experiences and COVID-19 infection control. In this study, we employed the generalized SEIR model in conjunction with the Wells–Riley model to estimate the effects of vaccination, nucleic acid testing, and face mask wearing on audience infection control during the 2021 Chinese Football Association Super League from 20 April to 5 August. The generalized SEIR modeling showed that if the general population were vaccinated by inactive vaccines at an efficiency of 0.78, the total number of infectious people during this time period would decrease from 43,455 to 6,417. We assumed that the general population had the same odds ratio of entering the sports stadiums and becoming the audience. Their infection probabilities in the stadium were further estimated by the Wells–Riley model. The results showed that if all of the 30,000 seats in the stadium were filled by the audience, 371 audience members would have become infected during the 116 football games in the 2021 season. The independent use of vaccination and nucleic acid testing would have decreased this number to 79 and 118, respectively. The combined use of nucleic acid testing and vaccination or face mask wearing would have decreased this number to 14 and 34, respectively. The combined use of all three strategies could have further decreased this number to 0. According to the modeling results, policymakers can consider the combined use of vaccination, nucleic acid testing, and face mask wearing to protect audiences from infection when holding sports events, which could create a balance between audience experiences and COVID-19 infection control.

Introduction: The prevalence of pediatric obesity remains high all over the world. Various exercise interventions have been applied to decrease the visceral fat in young individuals with obesity. But the evidence remains controversial on the effect of the exercise on visceral fat. Moreover, it is unclear which type of the exercise is the most effective for young individuals with overweight or obesity to reduce visceral fat.Objective: The objective of this review and meta-analysis is to evaluate and compare the effectiveness of different exercise interventions on visceral fat in young individuals with overweight or obesity.Methods: Four databases consisting of PubMed, Web of Science, EBSCO, and Cochrane Library were searched prior to May 2022. Fifteen studies with a total of 30 data points involving 1,134 participants were included in this meta-analysis. And the interventions were limited to 4 exercise types [i.e., aerobic exercise (AE), resistance exercise (RE), aerobic exercise combined with resistance exercise (CE), and high-intensity interval training (HIIT)].Data Synthesis: The results showed that AE (Standardized Mean Difference = −0.32; 95% CI = −0.50 to −0.13; p = 0.0007; I2 = 37%) and HIIT (SMD = −0.59; 95% CI = −0.87 to −0.31; p < 0.0001; I2 = 0%) had a significant reduction effect on visceral fat. And the effect of HIIT seemed better than AE. However, RE (SMD = −0.58; 95% CI = −1.34 to 0.17; p = 0.13; I2 = 76%) and CE (SMD = −0.21; 95% CI = −0.81 to 0.38; p = 0.48; I2 = 63%) had a non-significant effect on visceral fat decline. Additionally, compared with the control group, exercise interventions had a significant effect on reducing visceral fat in adolescents (SMD = −0.54; 95% CI = −0.82 to −0.26; p = 0.0001; I2 = 64%) and young adults (SMD = −0.42; 95% CI = −0.69 to −0.15; p = 0.003; I2 = 0%) rather than children (SMD = −0.15; 95% CI = −0.32 to 0.02; p = 0.08; I2 = 0%). And the gender-based subgroup analysis indicated that the effectiveness of the exercise on the reduction of visceral fat was more significant in males (SMD = −1.27; 95% CI = −1.67 to −0.87; p < 0.00001; I2 = 0%) than that in females (SMD = −0.31; 95% CI = −0.48 to −0.14; p = 0.0004; I2 = 0%).Conclusion: This review and meta-analysis demonstrates that exercise interventions are efficient to decrease visceral fat in adolescents (12–18 years old) and young adults (18–24 years old). Among different exercise types, AE and HIIT are helpful for young individuals with overweight or obesity to reduce visceral fat and HIIT appears to be the most effective exercise intervention. In addition, the effect of exercise interventions on the consumption of visceral fat is more significant in males than that in females.Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022310878].

Some studies show that athlete students are more likely to engage in health-risk behaviors with negative health consequences, while others suggest that they lead a healthier life than their non-athlete peers. Given these inconsistent results, this study aims to compare health behaviors, depression, and perceived health status between athlete and non-athlete students, and explore the associations between health behaviors and health outcomes. An online questionnaire survey including Heath Habits Scale for five health-risk behaviors and five health-promoting behaviors, Patient Health Questionnaire-9 (PHQ-9), and 5-point scale for perceived health status was conducted in Beijing Sports University in March 2021. Data from 372 athlete students and 252 non-athlete students aging from 18 to 22 were included in this study. Chi-squared tests and t-tests were used to determine differences between athlete and non-athlete samples, and logistic regression analyses were conducted to examine the associations of health behaviors with depression and perceived health status. The significance level was p

Background: Few studies have identified the links between physical activity (PA), clinical symptoms, and the quality of life (QoL) among mildly infected individuals with COVID-19. This cross-sectional study aims to evaluate how PA levels before infections affect the infectious symptoms and the QoL in mildly infected patients with COVID-19. Methods: An online questionnaire link including participants’ sociodemographic and anthropometric characteristics, clinical symptoms during the COVID-19 infectious period, the QoL of the worst symptomatic day, and PA in the last seven days before COVID-19 infections was disclosed. Logistic regression and multiple linear regression analyses were applied to assess the relationships between PA levels in the last seven days before infections and COVID-19-related outcomes. The level of statistical significance was set at p < 0.05. Results: Compared to the low-PA-level group, the moderate-PA-level group presented a higher risk of headaches (OR = 1.34, 95% CI = 1.03 to 1.75, and p = 0.03) and the high-PA-level group presented a higher risk of muscle/body aches (OR = 1.42, 95% CI = 1.04 to 1.93, and p = 0.03). The adjusted linear regression analysis showed that no associations were found between PA levels in the last seven days before infections and the QoL index value on the worst symptomatic day (moderate-PA-level group: β = −0.04, and p = 0.08; high-PA-level group: β = −0.04, and p = 0.17). However, for the mobility and usual activities dimensions of EQ-5D-5L, the lower-PA-level group had a lower burden of QoL than the higher-PA-level group did on the worst-symptomatic day. Conclusions: Among mildly infected patients with COVID-19, a higher PA level is associated with a higher risk of experiencing clinical symptoms and a lower QoL.

Abstract Background Understanding the long-term inpatient service cost and utilization of psychiatric patients may provide insight into service demand for these patients and guide the design of targeted mental health programs. This study assesses 3-year hospitalization patterns and quantifies service utilization intensity of psychiatric patients in Beijing, China. Methods We identified patients admitted for one of three major psychiatric disorders (schizophrenia, bipolar and depressive disorders) between January 1 and December 31, 2013 in Beijing, China. Inpatient admissions during the following 3 years were extracted and analyzed using sequence analysis. Clinical characteristics, psychiatric and non-psychiatric service use of included patients were analyzed. Results The study included 3443 patients (7657 hospitalizations). The patient hospitalization sequences were grouped into 4 clusters: short stay (N = 2741 (79.61% of patients), who had 126,911 or 26.82% of the hospital days within the sample), repeated long stay (N = 404 (11.73%), 76,915 (16.26%) days), long-term stay (N = 101 (2.93%), 59,909 (12.66%) days) and permanent stay (N = 197 (5.72%), 209,402 (44.26%) days). Length and frequency of hospitalization, as well as readmission rates were significantly different across the 4 clusters. Over the 3-year period, hospitalization days per year decreased for patients in the short stay and repeated long stay clusters. Patients with schizophrenia (1705 (49.52%)) had 78.4% of cumulative psychiatric stays, with 11.14% of them in the permanent stay cluster. Among patients with depression, 23.11% had non-psychiatric hospitalizations, and on average 46.65% of their total inpatient expenses were for non-psychiatric care, the highest among three diagnostic groups. Conclusion Hospitalization patterns varied significantly among psychiatric patients and across diagnostic categories. The high psychiatric care service use of the long-term and permanent stay patients underlines the need for evidence-based interventions to reduce cost and improve care quality.

In recent years, IIoT scenarios show increasing demand for high-precision positioning. Cellular-based positioning plays a very important role in this application area. The cellular-based positioning system can be categorized as an asymmetric processing system. In this system, multiple base stations transmit positioning reference signaling to one device and the device derives its coordinates based on the measurement of the positioning reference signal by using certain positioning algorithms. The classical positioning algorithms encounter great challenges in satisfying the stringent precision requirement. Meanwhile, artificial intelligence (AI)-based positioning solutions draw great attention due to their strong ability in improving positioning accuracy in IIoT scenarios. For AI-based algorithms, generalization capability is one important metric. It demonstrates the ability to adapt to different environments. However, there is little literature touching on the investigation of generalization capability. In this article, we will tackle this issue by considering typical features in IIoT scenarios including the clutter distribution, network synchronization error, and receiving timing error. The impact of these typical features on the generalization capability is firstly evaluated and then the feasibility of existing popular generalization improvement solutions, i.e., optimized training data set and fine-tuning are tested under different cases. At last, directions to further guarantee the generalization capability are presented. The results of this article provide useful experience for developing AI models for positioning in realistic IIoT scenarios.

Abstract Background Emergence agitation after general anesthesia may cause several undesirable events in the clinic during patient anesthesia recovery, and acute alcohol intoxication, while rare in surgery, is one of the risk factors. Case presentation A 66-year-old male patient was found to have pancreatic tail neoplasm upon computed tomography (CT) examination. The surgeon planned to resect the pancreatic tail under general anesthesia. However, the surgeon found extensive tumor metastasis in the abdominal cavity, and thus performed a neurolytic celiac plexus block (NCPB) with 40 ml 95% ethyl alcohol and finished the surgery in approximately 1 h. Twenty minutes later, the patient was extubated and developed significant emergence agitation in the postoperative care unit, characterized by restlessness, uncontrollable movements, confusion and disorientation. The patient was flushed and febrile with an alcohol smell in his breath and was unable to follow commands. Patient symptoms were suspected to be due to acute alcohol intoxication. Thus, the patient was given 40 mg of propofol intravenously. Following treatment, the patient recovered with less confusion and disorientation after approximately 10 min. After treatment with propofol twice more, he regained consciousness, was calm and cooperative, had no pain, and could obey instructions approximately 1 h and 40 min following the last treatment. Following this treatment, the patient was transferred to the inpatient ward and felt well. Conclusions It is paramount to correctly identify the underlying cause of emergence agitation in order to successfully manage patient symptoms, since treatment plans vary between different etiological causes. Emergence agitation may be due to acute alcohol intoxication after intraoperative use of alcohol.

Methamphetamine (METH) abuse remains a significant public health concern globally owing to its strong addictive properties. Prolonged abuse of the drug causes irreversible damage to the central nervous system. To date, no efficient pharmacological interventions are available, primarily due to the unclear mechanisms underlying METH action in the brain. Recently, microRNAs (miRNAs) have been identified to play critical roles in various cellular processes. The expression levels of some miRNAs are altered after METH administration, which may influence the transcription of target genes to regulate METH toxicity or addiction. This review summarizes the miRNAs in the context of METH use, discussing their role in the reward effect and neurotoxic sequelae. Better understanding of the molecular mechanisms involved in METH would be helpful for the development of new therapeutic strategies in reducing the harm of the drug.

Abstract Background Psychiatric readmissions negatively impact patients and their families while increasing healthcare costs. This study aimed at investigating factors associated with psychiatric readmissions within 30 days and 1 year of the index admissions and exploring the possibilities of monitoring and improving psychiatric care quality in China. Methods Data on index admission, subsequent admission(s), clinical and hospital-related factors were extracted in the inpatient medical record database covering 10 secondary and tertiary psychiatric hospitals in Beijing, China. Logistic regressions were used to examine the associations between 30-day and 1-year readmissions plus frequent readmissions (≥3 times/year), and clinical variables as well as hospital characteristics. Results The 30-day and 1-year psychiatric readmission rates were 16.69% (1289/7724) and 33.79% (2492/7374) respectively. 746/2492 patients (29.34%) were readmitted 3 times or more within a year (frequent readmissions). Factors significantly associated with the risk of both 30-day and 1-year readmission were residing in an urban area, having medical comorbidities, previous psychiatric admission(s), length of stay > 60 days in the index admission and being treated in tertiary hospitals (p

Abstract Background Measuring family members’ satisfaction with inpatient psychiatric care may help improve the quality of healthcare in psychiatric hospitals. This survey aimed to investigate the satisfaction of family members with inpatient psychiatric care and to explore its associated factors, using a newly-developed 5-item questionnaire. Methods This study included 1598 family members of psychiatric inpatients in 32 tertiary public psychiatric hospitals in 29 provinces of China. Satisfaction and demographic data were collected by research staff while patient and hospital data were retrieved separately. Results We found that the overall satisfaction level was 93.84% (23.46/25). The total satisfaction score in Northeast China was the highest, followed by the East, Middle and West regions (p

Abstract Background Surveying patients’ satisfaction is essential to improve patient-centered care, however, studies on satisfaction and their correlates among psychiatric inpatients are rare in China. This study aimed to measure satisfaction levels of psychiatric inpatients in a national sample and to examine individual and institutional correlates. Methods As part of the National Survey for the Evaluation of Psychiatric Hospital Performance, psychiatric inpatients from 32 tertiary psychiatric hospitals in 29 Chinese provinces were interviewed on the day of discharge by trained research staff. Satisfaction was assessed using a five-item questionnaire. Patients’ sociodemographic and clinical information were manually retrieved from medical records and institutional data were provided by participating hospitals. Multilevel linear regression was used to assess factors associated with level of satisfaction. Results Among 1663 inpatients, the reported satisfaction levels were high, with a mean score of 23.3 ± 2.4 out of 25. Education level was positively associated with global satisfaction, satisfaction with costs, and satisfaction with privacy protection. Treatment response was associated with global satisfaction and with the doctor-patient communication subscore. The number of psychotherapy sessions was positively associated with the privacy protection subscore (coefficient = 0.0, P = 0.046). The Global Assessment of Function score was positively associated with the doctor-patient communication subscore (coefficient = 0.0, P = 0.003). Total satisfaction scores and all five subscores were positively associated with hospital-level factors, and patients discharged from hospitals with better staffing and resources reported significantly higher levels of satisfaction. Conclusion Overall, psychiatric inpatients in China were satisfied with the services they received. To further improve patient satisfaction, mental health professionals should optimize their patients’ treatment response as much as possible before discharge and provide more psychological treatment during the hospitalization. The government should also provide more resources to increase the number of mental health professionals (nurses, psychologists, and psychiatrists) working in psychiatric hospitals.

Background/Aims: Phorbol myristate acetate (PMA) exerts a pleiotropic effect on the growth and differentiation of various cells. Protein kinase Cs (PKCs) plays a central role in mediating the effects of PMA on cells. The present study investigated whether the down-regulation of protein kinase C-ε (PKC-ε) is involved in the inhibition of vascular smooth muscle cell (VSMC) proliferation caused by prolonged PMA incubation. Methods: Using cell counting, Cell Counting Kit-8 (CCK-8) and EdU incorporation assay on VSMCs, we evaluated the inhibitory effects of prolonged incubation of PMA, of lentiviruses carrying the short-hairpin RNAs (shRNA) of PKC-ε and of the PKC-ε inhibitor peptide on the proliferation and viability of cells. The effect of PKC-ε down-regulation on growth of rat breast cancer SHZ-88 cells was also measured. Results: The prolonged incubation of VSMCs with PMA for up to 72 hours resulted in attenuated cell growth rates in a time-dependent manner. The expression of PKC-ε, as assessed by Western blotting, was also decreased accordingly. Notably, the number of EdU-positive cells and the cell viability of VSMCs were decreased by shRNA of PKC-ε and the PKC-ε inhibitor peptide, respectively. The proliferation of rat breast cancer SHZ-88 cells was also attenuated by lentivirus-induced shRNA silencing of PKC-ε. Conclusions: Prolonged incubation of PMA can inhibit the expression of PKC-ε. The effect results in the inhibition of VSMC proliferation. PKC-ε silencing can also attenuate breast cancer cell growth, suggesting that PKC-ε may be a potential target for anti-cancer drugs.

Objective: To study the socio-demographic characteristics, the working environment, and the level of career satisfaction among psychiatry residents in China.Method: This was a part of a large-scale, nation-wide online survey of hospitals, healthcare professionals, and patients. Data, including socio-demographics, work hours, income, job satisfaction, and intention to quit were collected anonymously. Respondents also completed the Minnesota Satisfaction Questionnaire (MSQ).Results: One thousand sixty residents nested in 32 psychiatric hospitals in 29 provinces in China completed the survey. Respondents were predominantly female (69.0%), worked an average of 47.8 ± 11.6 h per week, and 28.97% had experienced medical disputes in the previous year. The top three reported reasons for dissatisfaction were low pay (50.1%), contentious doctor-patient relationships (17.6%), and high workload (10.8%). An intention to quit their current job was reported by 18.7% of residents. The overall mean MSQ score was 73.8 ± 13.8, with significant differences across post-graduate training years and regions. A multilevel regression analysis found that a higher MSQ score was significantly associated with fewer years in residency, shorter work hours, higher monthly pay, having medical liability insurance, and feeling satisfied with the level of doctor-nurse cooperation, their hospitals' medical disputes prevention/management, and the healthcare workers' social environment.Conclusion: Psychiatry residents in China are predominantly female and well-educated. They are only moderately satisfied with their career. Poor salaries, contentious doctor-patient relationships and high workload are among their top complaints and may explain why a considerable proportion are intending to leave their current residency. More support from the government regarding residents' salaries, workload and working environment may help improve their job satisfaction and retention, ensuring that China will have a pool of well-trained and engaged psychiatrists for the future.

Objective: Involuntary admission is one of the most controversial issues in psychiatry in China. This study aimed to examine the implementation of the new risk criteria for involuntary admission, as defined by the new Mental Health Law (MHL), in major psychiatric hospitals; and to explore factors associated with the implementation.Method: We selected 32 psychiatric hospitals in 29 provincial capital cities in mainland China. We included all involuntarily admitted psychiatric inpatients who were discharged from December 25 to 27, 2017. Patients' demographic and clinical data and reasons for admission were retrieved. Hospitals' information was also collected. Multilevel logistic regression was applied to explore factors associated with the implementation.Results: We collected valid data from 814 inpatients. Rates of risk criteria implementation ranged from 7.9 to 88.5% in these hospitals. Only 369 inpatients (45.3%) met the MHL-defined risk criteria. Overall, between 62.2 and 78.5% of the variance in risk criteria implementation was at the patient level, and between 21.5 and 37.8% of the variance was at the hospital level. Patients with higher Global Assessment of Functioning (GAF) scores at admission were less likely to meet the risk criteria (OR 1.02, 95% CI 1.01–1.03). No statistically significant association was found between risk criteria implementation and other patient level or hospital level factors.Conclusion: Our findings show the implementation rate of the MHL's risk criteria overall was low, with only 45.3% of involuntary admissions meeting the MHL-defined criteria. This suggests that some patients' civil rights might have been violated.

OBJECTIVE:To develop a set of structure and process indicators to evaluate tertiary hospitals' performance in the Healthcare Improvement Initiative, a national program with a goal to improve quality of patient-centered care. METHODS:A modified Delphi technique, including literature review, multidisciplinary panel meeting and anonymous rating, was used to generate a set of indicators. A practice test involving both general and special hospitals was conducted to ensure the feasibility of data collection for these indicators. RESULTS:62 indicators were generated by literature review. The panel review procedure involving 39 panelists with diverse backgrounds resulted in a total of 59 indicators, which included 40 qualitative indicators and 19 quantitative indicators. In the practice test, six quantitative indicators were found unfeasible. According to the suggestion of the experts in the hospital evaluation committee, three of those indicators were kept by adjusting their data collection methods, while other three ones were discarded. DISCUSSION:A set of 56 structure and process indicators was developed to evaluate hospitals' performance in the implementation of the Healthcare Improvement Initiative, which could be used in both general and special tertiary hospitals. Results of the indicator measurement could present a panorama of the quality of patient-centered care in tertiary hospitals nation-wide, and inform health administrators of the ways to attain the goal of the Initiative.

Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM). Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS), and Recentered Influence Function Regression (RIF) were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P0.1). On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P

Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM.A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing.412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed.Patients with type D personality were significantly more likely to have poor medication adherence (p

Introduction: This study delves into the multifaceted components of talenttraining models within China's physical education domain through Sino-foreign cooperative initiatives. Employing a mixed-methods approach, it systematically evaluates the innovative systems developed by pilot units and outlines their experiential insights. Methods: Using a mixed-methods approach, this research extensively evaluates the situation of pilot units by collecting and analyzing data from closed-ended and open-ended questionnaires as well as interview responses. The study categorizes and analyzes the data to comprehensively understand cooperative talent-training models. Results: The findings are classified into three main themes: Learning, Integration, and Binary Evaluation and Practice Reform. Under the Learning theme, the study observed a selective integration of foreign educational paradigms into the local context, respecting the distinctiveness of Chinese education and aligning with national policies promoting unique educational systems. Additionally, the Integration theme underscores the necessity of meticulously assimilating introduced educational resources into China's educational fabric, highlighting the need for adaptability when integrating foreign educational elements. Furthermore, the Binary Evaluation and Practice Reform theme reveal the establishment of a dualistic evaluation and reform system tailored to cooperative education specifics, outlining challenges associated with ideological and cultural disparities when integrating certain foreign education aspects into the Chinese context. Discussion: This research provides insightful exploration into the complexities of collaborative talent-training models in Physical Education. It not only elucidates the assimilation of foreign paradigms but also highlights nuanced challenges and prospects for developing tailored educational systems within specific regional and national contexts. [ABSTRACT FROM AUTHOR]

Background: Suicide is an urgent public health challenge for China. This study aims to examine the prevalence, influence factors, and gender differences of suicidal ideation among general population in Northwestern Urban China.Methods: Data used in this study were derived from the third wave of a cohort study of a randomized community sample with 4291 participants (≥ 20 years) in 2008 in Lanzhou City and Baiyin City, Gansu Province. Data were collected via face-to-face interview by the trained interviewers. Descriptive analyses, chi-square tests and multivariate logistic regressions were performed by using Stata 12.0, as needed.Results: The prevalence of 12-month suicidal ideation was 4.29%, there was no significant difference between males and females [5.04% vs 3.62%, Adjusted Odds Ratio (AOR) = 0.83, p = 0.351]. Several risk factors for suicidal ideation were confirmed, including being unmarried (AOR = 1.55, p = 0.030), having depression symptoms (AOR = 2.33, p < 0.001), having other insurance (AOR = 1.83, p = 0.01) or no insurance (AOR = 1.73, p = 0.024). In addition, several influence factors were significantly different in males and females, such as being currently married (unmarried vs married, AOR = 1.84, p = 0.027, for females; no difference for males), feeling hopeless (hopless vs hopeful, AOR = 1.92, p = 0.06, for females; no difference for males), having other insurances (having other insurances vs having basic employee medical insurance, AOR = 1.92, p = 0.044, for males; no difference for females), having debts (having debts vs no debts, AOR = 2.69, p = 0.001, for males; no difference for females), currently smoking (smoking vs nonsmoking, AOR = 3.01, p = 0.019 for females, no difference for males), and currently drinking (drinking vs nondrinking, AOR =2.01, p = 0.022, for males; no difference for females).Discussion and Conclusion: These findings suggested that comprehensive suicide prevention strategies should be developed or strengthened in order to prevent suicide ideation in China, and the gender-specific differences need to be explored through further researches. [ABSTRACT FROM AUTHOR]

Background: Depression and diabetes have been recognized as major public health issues in China, however, no studies to date examined the factors associated with the development of depression in patients with diabetes in China. This study aimed to estimate the prevalence of co-morbid depression among adults with type 2 diabetes mellitus (DM) and to examine the influence factors of co-morbid depression in a group of patients with type 2 DM. Methods: The study was conducted from March l to May 31, 2012, in the Department of Endocrinology of the First Affiliated Hospital of the General Hospital of the People's Liberation Army (PLA). A systematic random sample of 412 type 2 DM patients aged over 18 years was selected. A structured questionnaire was used for collecting the information about socio-demographic data, lifestyle factors and clinical characteristics. Depression and social support was evaluated by using the Chinese version of Beck Depression Inventory (BDI) and Social Support Rate Scale (SSRS), respectively. Weights and heights were measured. Hemoglobin A1c (HbA1c) was abstracted from each patient directly after the interview. Results: Of the total sample, 142 patients had depression according to the BDI scores (BDI scores ≥14), the prevalence of co-morbid depression in this study population was 5.7 % (142/2500). Of which, 56 had major depression (BDI ≥ 21), and 86 had moderate depression (BDI ≥ 14&BDI < 21). Logistic regression analysis indicated that a high HbA1c level, a high BMI, low quality health insurance, and being single, were significantly associated with the development of depression. However, a family history of diabetes and a high social support level are likely protective factors. Conclusions: The prevalence of co-morbid depression was 5.7 % among Chinese subjects with type 2 DM in this study. High HbA1c level, high BMI score, being single, low social support level, and low quality health insurance were associated with the presence of depression. These findings support a recommendation for routine screening and management in China for depression in patients with diabetes, especially for those in primary care, to reduce the number of the depressed or the misrecognized depressed diabetic patients. [ABSTRACT FROM AUTHOR]

Background: In 2009, health-care reform was launched to achieve universal health coverage in China. A good understanding of how China's health reforms are influencing village doctors' income structure will assist authorities to adjust related polices and ensure that village doctors employment conditions enable them to remain motivated and productive. This study aimed to investigate the village doctors' income structure and analyse how these health policies influenced it. Methods: Based on a review of the previous literature and qualitative study, village doctors' income structure was depicted and analysed. A qualitative study was conducted in six counties of six provinces in China from August 2013 to January 2014. Forty-nine village doctors participated in in-depth interviews designed to document their income structure and its influencing factors. The themes and subthemes of key factors influencing village doctors' income structure were analysed and determined by a thematic analysis approach and group discussion. Results: Several policies launched during China's 2009 health-care reform had major impact on village doctors. The National Essential Medicines System cancelled drug mark-ups, removing their primary source of income. The government implemented a series of measures to compensate, including paying them to implement public health activities and provide services covered by social health insurance, but these have also changed the village doctors' role. Moreover, integrated management of village doctors' activities by township-level staff has reduced their independence, and different counties' economic status and health reform processes have also led to inconsistencies in village doctors' payment. These changes have dramatically reduced village doctors' income and employment satisfaction. Conclusions: The health-care reform policies have had lasting impacts on village doctors' income structure since the policies' implementation in 2009. The village doctors have to rely on the salaries and subsidies from the government after the drug mark-up was cancelled. China's national health reforms are attempting to draw village doctors into the national health workforce, but the policies have impacted their income and independence. Further research into these concerns and monitoring of measures to adequately compensate village doctors should be undertaken. Reasonable compensation strategies should be established, and sufficient subsidies should be allocated in a timely manner. [ABSTRACT FROM AUTHOR]

Background: To effectively provide public health care for rural residents, the Ministry of Health formally unveiled the contract service policy in rural China in April 2013. As the counterpart to family medicine in some developed countries, the contract service established a compact between village doctors and local governments and a service agreement between doctors and their patients. This study is a rare attempt to explore the perspectives of health providers on the contract service policy, and investigate the demand side's attitude toward the public health services delivered under the contract policy. This evidence from Xinjian County, Jiangxi Province, the first and most representative pilot site of the contract service, could serve as a reference for policymakers to understand the initial effects of the policy, whereby they can regulate and amend some items before extending it to the whole country. Methods: Official documents were collected and semi-structured interviews with human resources and villagers in Xinjian County were conducted in September 2013. A purposive sampling method was used, and eight towns from the total 18 towns in Xinjian County were selected. Ultimately, eight managers (one in each township health center), 20 village doctors from eight clinics, and 11 villagers were interviewed. A thematic approach was used to analyze the data, which reflected the people's experiences brought about by the implementation of the contract service policy. Results: While the contract service actually promoted the supply side to provide more public health services to the villagers and contracted patients felt satisfied with the doctor-patient relationship, most health providers complained about the heavy workload, insufficient remuneration, staff shortage, lack of official identity and ineffective performance appraisal, in addition to contempt from some villagers and supervisors after the implementation of the contract service. Conclusions: Contract service is a crucial step for the government to promote public health services in rural areas. To inspire the positive perspective and optimal work performance of the health workforce, it is imperative for the Chinese government to fortify financial support to health providers, adopt an advanced management model and escalate administrative capacity. [ABSTRACT FROM AUTHOR]

Background: The Chinese government has increased the funding for public health in 2009 and experimentally applied a contract service policy (could be seen as a counterpart to family medicine) in 15 counties to promote public health services in the rural areas in 2013. The contract service aimed to convert village doctors, who had privately practiced for decades, into general practitioners under the government management, and better control the rampant chronic diseases. This study made a rare attempt to assess the effectiveness of public health services delivered under the contract service policy, explore the influencing mechanism and draw the implications for the policy extension in the future. Methods: Three pilot counties and a non-pilot one with heterogeneity in economic and health development from east to west of China were selected by a purposive sampling method. The case study methods by document collection, non-participant observation and interviews (including key informant interview and focus group interview) with 84 health providers and 20 demanders in multiple level were applied in this study. A thematic approach was used to compare diverse outcomes and analyze mechanism in the complex adaptive systems framework. Results: Without sufficient incentives, the public health services were not conducted effectively, regardless of the implementation of the contract policy. To appropriately increase the funding for public health by local finance and properly allocate subsidy to village doctors was one of the most effective approaches to stimulate health providers and demanders' positivity and promote the policy implementation. County health bureaus acted as the most crucial agents among the complex public health systems. Their mental models influenced by the compound and various environments around them led to the diverse outcomes. If they could provide extra incentives and make the contexts of the systems ripe enough for change, the health providers and demanders would be receptive to the transition of the policy. Conclusions: The innovative fund raising measures could be taken by relatively developed counties of China to conduct public health services. Policymakers could take systems thinking as a useful tool to design plans and predict the unintended outcomes during the process of public health reforms. [ABSTRACT FROM AUTHOR]