Search

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]

Background: Integrating programming in K‐12 curriculum has become a global consensus. Teachers are central figures in programming instruction. But the majority of current research focuses on teachers' external teaching behaviours and less on teachers' attitudes towards programming. Objectives: The purpose of this study is to validate the K‐12 in‐service Teacher Programming Attitudes Scale (TPAS), to analyse teachers' programming attitudes and their differences in personal, teaching, and environmental factors, and further explore the predictive relationship. Methods: The sample is 888 K‐12 teachers from China. First, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were adopted to validate the availability and reliability of TPAS; Second, independent sample t‐test and one‐way Analysis of Variance (ANOVA) were adopted to explain the differences. Finally, correlation analysis and linear regression analysis were adopted to verify the correlation and prediction relationship. Results and Conclusion: TPAS possess good reliability and validity (χ2/df = 2.488, RMSEA = 0.055, CFI = 0.943, TLI = 0.935, and IFI = 0.943). Further analysis found that, first of all, male teachers possess more positive programming attitudes than female teachers; second, young teachers who are under 30 and the length of teaching under 5 years possess more positive programming attitudes; thirdly, in addition to Information and Communication Technology teachers, primary science teachers also possess high programming attitudes, followed by teachers of Humanities and Arts, reflecting the potential of teaching programming in integrated subjects and the humanities. Finally, primary school teachers possess the best programming attitudes. With the growth of grade, teachers' enthusiasm for programming has gradually decreased. Additionally, discipline, grade and gender factors were considered to predict K‐12 teachers' programming attitudes. Implications: The results of this study contribute to integrating programming teaching of teachers and promoting programming education in K‐12 classrooms. Lay Description: What is already known about this topic:.Integrating programming in K‐12 curriculum has become the consensus for most countries.Teacher is one of the core figures of K‐12 programming teaching.There is currently less attention paid to teachers' attitudes towards programming.K‐12 teachers' programming attitudes measurement tool is needed to analyze the impact of various factors on teachers' programming attitudes. What this paper adds: The K‐12 teacher programming attitude scale (TPAS) is developed and validated.Male teachers and teachers under the age of 30 and under the length of teaching of five years possess more positive programming attitudes.Information and Communication Technology teachers and primary school Science teachers possess high programming attitudes.Discipline, grade and gender factors are considered to predict K‐12 teachers' programming attitudes. Implications for practice and/or policy: The K‐12 Teacher's Programming Attitude Scale (TPAS) fills the gap in measurements of teachers' programming attitudes.The study results provide the guidance for interdisciplinary programming teaching for K‐12 teachers. [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]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Background: Considerable evidence suggests that students' achievement emotions are important contributors to their learning and success online. It is, therefore, essential to understand and support students' emotional experiences to enhance online education, especially under the COVID‐19 context. However, to date, very few studies have investigated how students' achievement emotions might be affected by teaching and learning factors in online learning environments. Objectives: Based on Pekrun's (2006) control‐value theory of achievement emotions, this study examined the influence of students' perceived online teaching quality and appraisals of control and value on their achievement emotions in an online second language (L2) learning context instigated by the COVID‐19. Methods: Data were collected using an online survey of 1503 undergraduates from ten universities across different regions of China. Confirmatory factor analyses (CFA) were performed to test the validity of the instruments and structural equation modelling were conducted to examine the relations between L2 teaching and learning variables. Results and Conclusions: Results revealed that perceived teacher internet and communication technology competence had positive effects on enjoyment, but negative effects on anxiety and boredom, and these effects were fully mediated by perceived control and/or value. Perceived chaotic teaching structure (CTS) had reverse effects for the three emotions. Perceived CTS effects on enjoyment and anxiety were fully and partially mediated by perceived control, respectively. Takeaways: Online teaching quality is critical for students' appraisals and emotions towards L2 learning. Teachers should strive to improve online teaching quality and design interventions targeting students' perceived control and value to temper their affective experiences associated with the crisis‐prompted online teaching practices. Lay Description: What is already known about this topic: Teachers' internet and communication technology (ICT) competence and pedagogical design can enhance students' e‐learning efficacy, motivation and interests.Students' perceived control and value can influence their achievement emotions in online learning.Teacher's ICT competence and pedagogical design can impact students' emotions in online learning. What this paper adds: Perceived teacher ICT competence and chaotic teaching structures can have differential impact on students' perceived control and value for e‐learning.Perceived control and intrinsic value differently mediated the effects of the two teaching factors on students' emotions for e‐learning.Perceived teacher ICT competence and chaotic teaching structures can have both direct and indirect effects on students' e‐learning emotions via perceived control and value. Implications for practice and/or policy: Teacher training and development programs should prepare teachers for varying teaching formats including unplanned online teaching due to a forced switch to remote teaching.Teachers should acquaint themselves with using various online platforms and software to communicate the goals, expectations, structures and requirements of their language lessons to students' in a clear manner.Online language teaching interventions aiming to increase or decrease a specific emotion could directly target specific combinations of teaching characteristics and appraisals. [ABSTRACT FROM AUTHOR]

Aims: To explore how family functioning and family resilience mediate the relationship between disability severity and quality of home‐based care among families with disabled older adults. Methods: A cross‐sectional survey was conducted with 431 families with Uygur and Kazakh disabled older adults in Xinjiang, China, in 2020. The data were collected using the Katz Activity of Daily Living Scale; Mini‐Mental State Examination; Family Adaptation, Partnership, Growth, Affection and Resolve Index Scale; Family Resilience Assessment Scale; and Family Caregiving Consequences Inventory Scale. All mediation effects were estimated in SPSS26.0. Results: Disability severity, family functioning and family resilience were all significantly correlated with home‐based care quality. Disability severity had a 46.16% direct effect on home‐based care quality and a 53.84% indirect effect on home‐based care quality independently and in series through family functioning and family resilience. Conclusions: Disability severity directly affected home‐based care quality and had an indirect influence via family functioning and family resilience. Multidisciplinary care teams should focus on families with disabled older adults and help them improve family functioning and family resilience by implementing targeted interventions, so as to improve home‐based care quality. Summary statement: What is already known about the topic? Literature has clarified that social support and caregiver competence mediate the path relationship between disability severity and home‐based care quality from the perspective of individuals.Long‐term care for disabled older adults affects not only informal caregivers but also the whole family.The role of the family, such as family functioning and family resilience, in the whole process remains unclear. What this paper adds? Findings indicated relationships between disability severity, family functioning, family resilience and home‐based care quality.Disability severity can indirectly influence home‐based care quality not only through family functioning or family resilience but also through family functioning affecting family resilience. The implications of this paper Findings indicate that community nurses should not only pay attention to disabled older adults and their informal caregivers but also consider the impact of family functioning and family resilience when formulating interventions to improve the quality of home‐based care.When disabled older adults are transferred from hospitals to home, community rehabilitation nurses should intervene as early as possible, providing guidance on rehabilitation training and daily living skills for disabled older adults to restore and maintain function and prevent complications.Community nurses can conduct case counselling services for family members to understand and satisfy their care needs, enhancing their confidence, cohesion and problem‐solving abilities to improve the quality of home‐based care. [ABSTRACT FROM AUTHOR]

Background: This study aimed to systematically evaluate the effectiveness of a clinical nurse specialists training program in Zhejiang Province, China, from participants' perspectives. Methods: This cross-sectional study was conducted with 209 PICU nurse specialists who participated in the training program from 2016 to 2021. All participants completed an online questionnaire two years after graduation. We collected their demographic characteristics and their development status after the training (e.g., continuous improvement of core competence, research skills, and promotion). Chi-squared test was applied to assess the differences in effectiveness across subgroups. Results: In total, 209 (87.8%) out of 238 nurses responded to the survey among whom 73.7% launched new projects in their hospital after training and 75% published research articles in peer-reviewed journals. Also, 32.4% received promotions, and 67% participated in ICU-related continuing education programs. Based on multivariate regression analysis, the execution of new projects was closely related to the nurse's position and the level of their working hospitals. The job title and position were associated with publication, research performance, promotion, and continuing education. Conclusions: The nurse specialists of the PICU carried out a set of new projects implanting new skills that they had learned from the training program. Their core competence was improved, including theoretical knowledge and operation skills, teaching capacities, and scientific research abilities. Many trainees published papers, applied for research grants, got promotions, and had further opportunities for continuing education. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Prior research has demonstrated that childhood trauma can increase adolescents' suicidal ideation, and perceived stress plays a mediating role in the relationship between childhood trauma and adolescents' suicidal ideation. Character strengths, which are trait‐like positive personality characteristics, have also been found to be closely related to decreased stress and suicidal ideation. However, it is unclear whether character strengths act as a transfer mechanism that links childhood traumatic experiences with perceived stress and eventually suicidal ideation. What the paper adds to existing knowledge?: This study found that character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation. Specifically, childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. This study provided important theoretical implications for preventing suicidal risk among adolescents who are exposed to traumatic events during childhood. What are the implications for practice?: This study highlighted the roles of character strengths and perceived stress in the relationship between childhood traumatic experiences and suicidal ideation, which provided suggestions for designing nursing interventions to reduce adolescents' suicidal ideation, especially for those with traumatic childhood experiences. In addition to family nursing, school‐based regular monitoring and interventions of character strengths and perceived stress are necessary. Aim: This study sought to examine the mediating effects of character strengths and perceived stress on the relationship between childhood trauma and suicidal ideation among adolescents. Methods: A cross‐sectional survey was conducted on a sample of 1069 Chinese adolescents. The Chinese versions of the Suicidal Ideation Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and Character Scale for Adolescents were used to assess adolescents' suicidal ideation, childhood trauma, perceived stress and character strengths. Results: The findings showed that childhood trauma influenced suicidal ideation directly and indirectly via perceived stress. Moreover, character strengths and perceived stress serially mediated the association between childhood trauma and suicidal ideation, implying that childhood trauma was associated with inferior character strengths, and the impaired character strengths further triggered high perceived stress, which was finally linked to a heightened risk of suicidal ideation. Conclusions: This study highlighted the joint contribution of childhood trauma, character strengths and perceived stress to suicidal ideation, providing theoretical and practical implications to guide mental health nurses to reduce the suicide risk among adolescents. Implications for Practice: These findings highlighted the importance of developing character strengths and stress‐coping strategies. Family nursing and school‐based regular monitoring and interventions of character strengths and perceived stress are necessary among adolescents who exposed to a high level of childhood trauma experiences to reduce their suicidal ideation and foster mental health. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recurrence is common in patients diagnosed with major depressive disorder (MDD). Psychological resilience has been shown to be a protective factor against recurrence of depression. It has important clinical nursing significance to analyse the influencing factors of psychological resilience in major depressive disorder in remission (MDDR) patients. What the paper adds to existing knowledge?: There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with MDDR. We found the education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience in patients diagnosed with MDDR. What are the implications for practice?: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. Nurses should strengthen the nursing of patients with <12 years of education, and patients with personal monthly income less than 5000 RMB. In addition, nurses should cultivate patients' awareness of social support and identity, cultivate their ability to strive for social support, cultivate interpersonal skills and positive emotional experience to improve subjective well‐being and carry out self‐efficacy training to improve psychological resilience by enhancing patients' internal protective factors. Aim: Psychological resilience is closely related to recurrence of depression. There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with major depressive disorder in remission (MDDR). Here, we investigated the current status of resilience in patients diagnosed with MDDR and its influencing factors. Methods: A descriptive cross‐sectional study was conducted from June 2019 to April 2021. One hundred and forty‐two patients diagnosed with MDDR were recruited from the Department of Psychiatry and Psychology of the General Hospital of Northern Theater Command. Demographic information, social support, well‐being, self‐efficacy and psychological resilience were collected using self‐reported questionnaires. Results: The psychological resilience of MDDR patients was lower than that of the healthy Chinese adults in China. Multiple logistic regression analysis showed that education, personal monthly income, social support, well‐being and self‐efficacy were associated with psychological resilience. Receiver operating characteristic (ROC) curve analysis further confirmed that social support, well‐being and self‐efficacy were associated with psychological resilience. Conclusion: The psychological resilience of MDDR patients was lower than that of the general population in China. The education levels, personal monthly income, social support, well‐being and self‐efficacy were influencing factors of psychological resilience. Implications for Practice: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. [ABSTRACT FROM AUTHOR]

To explore the effects of social support on the mental health of older adults in different age groups in China, and to provide reference for the development of social support policies to promote the mental health of older adults in China. This paper uses a random sampling method to conduct a questionnaire survey of 3,000 older adults aged 60 years or older in Nanjing and a dichotomous logistic regression model for empirical analysis. The two dimensions of mental health and social adjustment were used to measure the mental health status of the elderly. The results showed that the overall mental health status of the elderly in Nanjing city was more optimistic, and the nonempty nesters with male gender, higher education level, and partners were generally healthier; objective and subjective support had significant positive effects on the mental health of middle and high aged elderly, while the utilization of support had more significant effects on the health of low-aged elderly. This paper proposes that government departments should develop a localized elderly support system and social support policies adapted to the actual situation in Nanjing according to the quantitative distribution and demand characteristics of the mental health of elderly people in different age groups. The study is structured as follows: the second part contains data sources and statistical methods. The third part is the analysis of empirical results. The fourth part is the discussion and conclusion part of the article. [ABSTRACT FROM AUTHOR]

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

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

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

Objective: This paper aims to explore the determinants of the online health information seeking (OHIS) and usage (OHIU) behaviours of consumers based on the perceived benefits and costs of such activities. Methods: This study applies questionnaires and empirical research methods. A questionnaire is designed according to the hypothesis model. A total of 282 questionnaires are obtained from patients and their accompanying families in two large hospitals, and the SPSS 17.0 and AMOS 17.0 (IBM, Almond, NY, USA) software are used to analyse the sample data and to test the research models. Results: Three key findings are obtained from the analysis. Firstly, functional, learning, social and personal integrative benefits positively affect the OHIS intent of consumers. Secondly, cognitive costs negatively influence the OHIU behaviour of consumers. Thirdly, personal integrative benefits and OHIS behaviour significantly influence the OHIU behaviour of consumers. Conclusion: This paper highlights the differences between OHIS and OHIU based on their impact factors and applies social exchange theory to understand such factors. Online health information providers must improve the ease of use of their websites or applications, enhance the quality of their health information and focus on their functionality. [ABSTRACT FROM AUTHOR]

In spite of the potentials promised by MOOCs (massive open online courses), the adoption rate of MOOCs is still low, especially in developing countries. Research on the adoption of MOOCs in developing countries is also limited. To fill this research gap, this research aims to study the adoption of MOOCs by extending current research on innovation and technology adoption in order to promote the diffusion of MOOCs in developing countries. Here, a conceptual framework, technology–user–environment was proposed to identify influential drivers and barriers of MOOC adoption. Eight hundred and twenty‐seven individuals in a developing country, were invited to participate in a questionnaire survey. Data were analysed by hierarchical regression, and the results show that for the (a) technological characteristics, perceived usefulness has the most significant influence, followed by lack of accessibility and performance‐to‐cost value; for the (b)user factors, self‐regulation was the most significant predictor of MOOC adoption, and female learners showed higher willingness to adopt MOOCs; and for the (c) social environmental factors, tradition and social norms and lack of information about MOOCs were negatively associated with adoption of MOOCs. Implications and suggestions are discussed at the end of this paper. Lay Description: What is already known about this topic: MOOCs (massive open online courses), as educational innovations, are supposed to bridge the digital divide and promote educational equity globally.The benefits of MOOCs for learners are obvious.However, the adoption rate of MOOCs is still relatively low while the dropout rate is high, especially in developing countries.Research on the adoption of MOOCs in developing countries is still limited.What this paper adds: This research proposed a conceptual framework, namely, technology–user–environment, in order to identify influential drivers and barriers from the technological characteristics of MOOCs as well as the user and the social environmental factors.After conducting a survey among 827 learners in a developing country, it was found that perceived usefulness of MOOCs, performance‐to‐cost value, and self‐regulation are positively associated with learners' intention of adopting MOOCs, whereas lack of accessibility tradition and social norms and lack of supporting information are negatively associated with their intention of MOOC adoption.Implications for practice and/or policy: For MOOC content provider, it is necessary to enhance the usefulness of MOOCs, as perceived usefulness is ranked as the strongest predictor of MOOC adoption.Universities in developing countries should help students overcome the potential obstacles at the beginning of MOOC learning by providing instructions to learners to search for course materials and how to use MOOCs to supplement their formal learning.Governments of developing countries are encouraged to be involved and support the development and delivery as well as the usage of MOOCs. Such participation by active stakeholders in developing countries has potential to bridge the digital divide between developed and developing countries.For learners, they should be equipped with self‐regulating strategies so that they will be competent to manage challenges (e.g., distractions) while learning in MOOCs. [ABSTRACT FROM AUTHOR]

Aims: To test the direct effects of different surface acting strategies and the interactive effects of surface acting and recovery experiences on nurses' well‐being. Design: A two‐wave study design. Methods: Chinese hospital nurses (N = 372; 47.3% of initial sample) reported on their levels of surface acting, recovery experiences and well‐being using a paper and pencil survey in November 2017 and November 2018. Findings: Surface acting has long‐term effects on nurses' well‐being. Compared with positive expression, negative suppression generally tends to show more negative effects. Recovery experiences play a buffering role in the surface acting – nurses' well‐being relationship. Conclusion: These findings offer initial evidence for long‐term effects of surface acting and show how hospital nurses can avoid adverse effects of surface acting through fostering recovery experiences. Impact: Surface acting is a chronic stressor, having long‐term effects on nurses' well‐being. In contrast to positive expression, negative suppression has more detrimental impacts. Recovery experiences play a protective role by alleviating the adverse effects of surface acting. Managers and individuals are advised to differentiate distinct surface acting strategies. Managers should try best to facilitate employee recovery. Hospital nurses are well recommended to train themselves by adopting several recovery programmes. [ABSTRACT FROM AUTHOR]

Aims: This paper presents updated prevalence estimates of awareness, ever‐use, and current use of nicotine vaping products (NVPs) from 14 International Tobacco Control Policy Evaluation Project (ITC Project) countries that have varying regulations governing NVP sales and marketing. Design, Setting, Participants and Measurements: A cross‐sectional analysis of adult (≥ 18 years) current smokers and ex‐smokers from 14 countries participating in the ITC Project. Data from the most recent survey questionnaire for each country were included, which spanned the period 2013–17. Countries were categorized into four groups based on regulations governing NVP sales and marketing (allowable or not), and level of enforcement (strict or weak where NVPs are not permitted to be sold): (1) most restrictive policies (MRPs), not legal to be sold or marketed with strict enforcement: Australia, Brazil, Uruguay; (2) restrictive policies (RPs), not approved for sale or marketing with weak enforcement: Canada, Malaysia, Mexico, New Zealand; (3) less restrictive policies (LRPs), legal to be sold and marketed with regulations: England, the Netherlands, Republic of Korea, United States; and (4) no regulatory policies (NRPs), Bangladesh, China, Zambia. Countries were also grouped by World Bank Income Classifications. Country‐specific weighted logistic regression models estimated adjusted NVP prevalence estimates for: awareness, ever/current use, and frequency of use (daily versus non‐daily). Findings NVP awareness and use were lowest in NRP countries. Generally, ever‐ and current use of NVPs were lower in MRP countries (ever‐use = 7.1–48.9%; current use = 0.3–3.5%) relative to LRP countries (ever‐use = 38.9–66.6%; current use = 5.5–17.2%) and RP countries (ever‐use = 10.0–62.4%; current use = 1.4–15.5%). NVP use was highest among high‐income countries, followed by upper–middle‐income countries, and then by lower–middle‐income countries. Conclusions: With a few exceptions, awareness and use of nicotine vaping products varied by the strength of national regulations governing nicotine vaping product sales/marketing, and by country income. In countries with no regulatory policies, use rates were very low, suggesting that there was little availability, marketing and/or interest in nicotine vaping products in these countries where smoking populations are predominantly poorer. The higher awareness and use of nicotine vaping products in high income countries with moderately (e.g. Canada, New Zealand) and less (e.g. England, United States) restrictive policies, is likely due to the greater availability and affordability of nicotine vaping products. [ABSTRACT FROM AUTHOR]

Malaysia is a multi-ethnic country with Malay, Chinese and Indian being the dominant ethnic groups. This paper investigates the three ethnic cultures in Malaysia by examining the individual-level values of managers and professionals. Based on 528 responses to a Schwartz Value Survey ( SVS) questionnaire, the paper identifies partial convergence of the value systems of Malay, Chinese and Indian people. It was found that the three ethnic groups do not differ significantly in the individualistic value dimensions of Self-enhancement and Openness-to-change. However, Malays are found to be more conservative and less self-transcendent than Chinese or Indians, while Chinese and Indians attribute the same importance to these two sets of values. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many nursing students have inadequate preparation for practice in mental health nursing in the United States and China. The concept of mental illness has different connotations in different cultures. Studies differ from country to country concerning the influence of nursing education on students’ knowledge about and attitudes towards mental disorders. There is a lack of cross‐cultural research that takes a broad perspective to explore how nursing students’ knowledge and beliefs about mental disorders are influenced by the culture within education and healthcare systems. What this paper adds to existing knowledge?: Nursing students in the United States and China shared similar views on a broad range of intervention options including professional help, psychotropic medications and activity interventions for managing depression and schizophrenia. The major difference between the two nursing student groups was that the Chinese students showed more preference to occasional alcohol consumption and specialized therapies including cognitive‐behavioural therapy and electroconvulsive therapy and the US students held less skepticism towards traditional and religious practices as possible treatment options for depression and schizophrenia. What are the implications for practice?: The Chinese nursing students need to be educated about safe alcohol consumption guidelines adopted by the National Health and Family Planning Commission. The US nursing students need to increase their awareness of national practice guidelines for managing mental disorders, particularly with respect to the use of specialized therapies such as cognitive‐behavioural therapy and electroconvulsive therapy. We support professional and psychosocial interventions in caring for patients with mental disorders. Abstract: INTRODUCTION: Nursing students in the United States and China have reported inadequate preparedness for practice in mental health nursing. It is important to investigate nursing students’ mental health literacy levels for a better understanding of their practice readiness in mental health field upon completion of their education. Aim: This study was aimed at developing an understanding of American and Chinese nursing students’ mental health literacy regarding the effectiveness of specific interventions for managing depression and schizophrenia. Method: The “Australian National Mental Health Literacy Survey” was completed by a group of 310 nursing students including 152 Americans and 158 Chinese between April 2016 and April 2017 to compare students’ rated intervention options on two provided vignettes. Results: The two student groups reached consensus on many intervention options. However, the Chinese students showed more preference to occasional alcohol consumption and specialized therapies and the US students held less skepticism towards traditional practices as treatment options for depression and schizophrenia. Discussion and implications for practice: The findings support professional and psychosocial interventions in caring for patients with mental disorders. There is a significant need for specific education on safe alcohol consumption guidelines for Chinese nursing students and clinical practice guidelines for managing mental disorders for American nursing students. [ABSTRACT FROM AUTHOR]

Abstract: With great increase of international students coming to study in China, more and more challenges occur for Chinese academic libraries to meet their needs. In case of Beijing Normal University Library (BNUL), we conducted a user survey and a five-point Likert Scale questionnaire focusing on the areas of library services, resources and environment was used to explore international students' library usage preference and their perceptions on importance and performance of these three areas. The analysis started with descriptive analysis followed by gap analysis between importance to the users and library's performance, and key findings from suggestions of international students were listed. The main objective of this paper is to know international students' information needs, analyze their assessment to the library, determine where and how gaps exist and find out aspects that BNUL need to improve. The paper finally drew some conclusions on how to improve BNUL service quality to international students. [Copyright &y& Elsevier]

In recent years, online shopping has been proliferated around the world. Online retailers’ reputation and purchase intentions are critical for survival and profitability of any online store. Thus, this study proposes a research framework to examine the perceived justice effects on customers purchase intention and online retailers’ reputation. A confirmatory factor analysis was conducted to demonstrate the reliability and validity of the measurement model, and the structural equation modelling technique was used to test the research model. The hypothesised model was validated empirically using data collected from 383 online shopping customers in China. The results indicated that perceived procedural, distributive and interactional justice components were strong predictors of customers purchase intention and online retailers’ reputation while online retailers’ reputation had significant effects on purchase intentions. Finally, theoretical and managerial implications are also presented in the paper. [ABSTRACT FROM PUBLISHER]

Background: Very few of the primary care doctors currently working in China's community health centers have a college degree (issued by 5-year medical schools). How to attract college graduates to community services in the future, therefore, has major policy relevance in the government's ongoing efforts to reform community health care and fill in the long-absent role of general physicians in China. This paper examined medical school students' attitudes towards working in communities and the factors that may affect their career choices in primary care to inform policy on this subject. Methods: A cross-sectional survey was designed upon the issuance of community health reform policy in 2006 by the Chinese government The survey was conducted among 2714 medical students from three medical schools in . representative regions in China. Binomial and multinomial regression analyses were carried out using a collection of plausible predictors such as place of rearing, income, etc. to assess their willingness to work in communities. Results: Of the 2402 valid responses, besides 5.7 % objection to working in communities, 19.1 % expressed definite willingness. However, the majority (41.5 %) of students only consider community job as a temporary transition, in addition to 33.7 % using it as their backup option. The survey analyses found that medical students who are more likely to be willing to work in communities tend to come from rural backgrounds, have more exposure to community health reform, and possess certain personally held value and fit. Conclusion: To attract more graduates from 5-year medical schools to work in communities, a targeted recruiting approach or admission policy stands a better chance of success. The findings on the influencing factors of medical students' career choice can help inform policymakers, medical educators, and community health managers to improve the willingness of swing students to enter primary care to strengthen basic health services. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to examine the perceptions of a sample of Hong Kong principals and teachers of the extent to which quality management (QM) has been effectively implemented in primary schools. The features of QM improvement implemented in Hong Kong primary schools include: values and duties, systems and teams(ST) resources and changes(RC) and meeting pupil needs and empowering staff. Design/methodology/approach - A quantitative, survey questionnaire was adopted in this study. A total of 322 respondents (83 principals and 239 teachers) out of 83 primary schools responded to the questionnaire. Findings - The finding shows that all four features of QM are perceived as being implemented in Hong Kong primary schools. There are significant differences between the perceptions of principals and teachers towards "value and duties", "ST", "RC" of QM. However, there is no significant difference between the perceptions of principles and teachers towards "meeting pupil needs and empowering staff" of QM. Originality/value - This paper is a first step towards extending the theory and practice of QM to principals and teachers in Hong Kong primary schools. [ABSTRACT FROM AUTHOR]

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93;p< 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38;p< 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80;p< 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79;p< 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91;p< 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers. [ABSTRACT FROM AUTHOR]

Abstract: Ethnobotanical relevance: Due to the global rise in the use of traditional Chinese medicine (TCM), Chinese materia medica (medicinal materials, or CMM) are giving cause for concern over their evidence base, safety/possible toxicity, questionable quality and use of endangered species of both animals and plants. However, little if anything is actually known about the range of species used to produce CMM used in Europe and even in China. This study represents the first attempt to identify and compare the most important CMM used in both regions, to begin the process of assessing the risks to public health and possible future benefits. Materials and methods: Data were collected from a convenience sample of TCM practitioners in the EU and mainland China, using a paper/online survey. Among other questions, respondents were asked (1) which conditions they most commonly treated using CMM and the likelihood of them using herbal manufactured products and decoctions in addition to raw herbs; (2) the perceived frequency with which they observed adverse events to CMM; (3) the frequency and reasons for use of 1 herbal formula and 6 specific individual herbs; (4) an open question about other CMM they used, including materials of non-plant origin. Data were entered into PASW statistics package and analysed using frequency tables, cross-tabulations and chi-squared tests to compare EU and Chinese results. Results: From a total of 747 useable questionnaires (420 from China, 327 from the EU) of those responding from the EU, TCM was generally more commonly used for obstetric/gynaecological and dermatological conditions, compared to neurological and gastrointestinal diseases in China. Disorders treated by Chinese practitioners were more varied, and often more serious, than those treated by their European counterparts, and the range of materials used in China was wider. The potential for toxicity was not high in either region, but although greater in China due to the use of more potent CMM, the incidence of side effects was perceived to be higher by EU practitioners. Conclusions: Very few of the species used to prepare CMM in the EU in this study give rise to safety concerns from what is known from the scientific and other literature, and in China only a few toxic CMM appear to be commonly used, some of them only after processing and mainly for serious disorders. The main cause for concern is likely to be interaction with prescribed medication, especially in central nervous system and cardiovascular conditions where drug interactions have previously been reported most frequently and which would currently be more applicable in China than Europe. [Copyright &y& Elsevier]

Abstract: Guangzhou has experienced a pattern of dual-track urbanization since economic reforms began in the 1980s. Industrialization and an increasing population have caused the city to relocate jobs and housing to the suburbs. Simultaneously, town governments have developed township and village enterprises (TVEs) and built affordable housing in villages. TVEs have become major industrial processing centers, and the towns that house them have seen the emergence of co-location effects whereby migrant workers become concentrated in urban villages and live near TVEs to optimize their commuting time. It is argued that these co-location adjustments are heavily influenced by institutional policies. This paper reports the results of two surveys, the first a questionnaire survey administered in Shijing Town and the second comprising a series of in-depth interviews carried out in two of Shijing’s urban villages. The results show that a high proportion of the respondents worked and lived in Shijing Town or one of the research villages. Most respondents spent a short time commuting to work. The results also suggest that the pattern of co-location among migrant workers and TVEs observed here reflects the desire to optimize commuting time. Some respondents noted that they had relocated to the research villages because they were ineligible to apply for public housing due to the hukou system. [Copyright &y& Elsevier]

Objective. Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. Design. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. Results. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Conclusions. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians. [ABSTRACT FROM AUTHOR]

Abstract: Background: As cardiovascular diseases have become the leading cause of death in many countries including China, nurses are increasingly required to be abreast of technological advances and the skills necessary to manage this increasing health care problem. Chinese nurses are under pressure to provide skilled electrocardiography monitoring, and be sufficiently skilled to detect myocardial ischemia and infarction, in this large patient population. This presents a challenge for the nursing profession in China, particularly for nurses working in coronary care in a country where advancement has been so rapid, yet little research has been conducted or reported in the literature. Objectives: The two main objectives were: to explore the demographic and educational factors that affect the use of ST-segment monitoring and correct electrode placement by CCU/ICU nurses in China; and to explore the factors both individual and institutional that affect monitoring and lead placement. Methods: A self-administered questionnaire was distributed to nurses in 126 randomly selected tertiary hospitals, which were stratified into three homogeneous regions across China. The instrument examined demographics, information about hospitals, electrocardiogram devices, current practice patterns and perceptions toward monitoring and lead placement. Data from 734 nurses and 59 nurse managers from 59 hospitals were analyzed using t-tests, ANOVA, Chi-square test and logistic regression. Results: Electrocardiogram monitoring was used to detect myocardial ischemia by 43.7% of respondents, and 35.1% selected leads according to electrocardiogram or angiography findings. Most (70%) agreed that monitoring for acute coronary syndrome was important, while 39.2% did so, and 15.7% were able to identify correct placement. Logistic regression revealed a significant relationship between the uses of ST-segment monitoring and number of hospital beds, continuing education and a belief in its use and ease of use. Correct electrode placement was significantly correlated with respondents from university hospitals, hospitals with more acute coronary syndrome admissions and more independent thinking nurses. Conclusions: Despite best practice evidence, less than half of the sample used electrocardiogram monitoring to detect myocardial ischemia and the majority could not identify correct electrode placement, while ST-segment monitoring was not used routinely. This paper highlights the need for improvements in education both in universities and hospitals and discussion addresses conventions in units, which inhibit development of nurses’ skills. [Copyright &y& Elsevier]

Background: Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. Purpose: This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Methods: Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. Results: There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Conclusions: Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this paper is to analyze consumers’ awareness and attitudes towards biofuels implementation in road transportation sector of China with respect to different consumption groups. Firstly, the status and future trends have been reviewed, which focuses on the private vehicles development, energy demands of road transportation sector and biofuels. Furthermore, a comprehensive survey has been conducted for 374 private vehicle drivers (owners) in Nanjing. A questionnaire survey method is implemented to collect information including respondents’ awareness, brief of biofuels, selection attitudes to biofuels and views on policies. Furthermore, the biofuels selection motives of respondents have been concluded into two main factors, “purchasing pressures” and “product attraction”. Then the respondents were divided into three clusters and compared. The results indicate that 90% of the respondents need to know more about biofuels implementation, and the majority of the respondents emphasize the active significance of reducing GHG emissions to improve energy security and mitigate energy crisis. But 55.6% of the respondents think that biofuels technology is still not mature. It is found that the different perceptions of biofuels between 192 passenger vehicle drivers (PVD) and 182 freight vehicle drivers (FVD). The former focuses on fuel price and fuel performance, while the latter pays more attention to fuel availability. Besides, PVD concentrate on fuel-related attributes while FVD focus on policy-related factors. The survey results give rise to some deeply consideration about the various preferences and awareness on biofuels among different consumer groups. These findings in this study will help to understand the consumer''s energy consumption behaviors and improve the further implementation for biofuels in Nanjing city. [Copyright &y& Elsevier]

Abstract: With a growing population and densely populated urban environments, China is looking at alternative methods of underground pipeline installation and replacement of their aging infrastructure. Conventional open trench activities result in disruption to these urban centers through road closures, traffic delays, traffic detours, loss of access to homes and business, unsightliness, noise and general disruption for everyone. Trenchless technologies are a viable and sustainable solution to China’s buried infrastructure. Numerous challenges are present when promoting trenchless technologies in China including minimal local engineering knowledge, lack of trained contractors, lack of specifications, and system impact concerns raised by government owners. This paper presents the results of a survey questions obtained from a cross-section of 209 Chinese engineers from Shanghai, Beijing, Shengyang, Chongqing, and Guangzhou to gain a snapshot of the current level of knowledge on trenchless construction methods. The results reveal an understanding of trenchless technology in general; however, a lack of understanding of technologies such as lining of pipe, trenchless grouting, auger boring, and pipe bursting. Pipe jacking and horizontal directional drilling are currently by far the most recognized and understood trenchless technologies in China. [ABSTRACT FROM AUTHOR]

Environmentalism in China is under transformation from the traditional command and control model to emphasize the advantages of economic tools and encourage the participation of the public. Firms are much more aware of the importance of environmental issues, and some of them have practiced environmental activities beyond compliance. In order to help understand the driving mechanism of proactive corporate environmental behaviors from the firm’s perspective, this paper identifies the drivers affecting the proactive environmental management level (EMLp ) based on the institutional theory, and gives an empirical study on the firms based in Changshu city of Jiangsu Province, China. The usable data, collected from the 117 valid respondents in a questionnaire survey, indicates that EMLp is still moderately low currently. Less than 10% of the samples are practicing all the six categorized types of voluntary environmental activities. The econometric exercise confirms a significantly positive effect of the externally mimetic pressure on EMLp , which may attribute to a higher sensitivity of Chinese companies to the market factors. However, the roles of the general public and industrial associations are not significant, showing the marginal power of selected normative pressures. Regarding internal factors, firms, which view environmental issues as opportunities and often arrange internal environmental training, are more likely to adopt proactive environmental activities. More concerns from the general public like neighborhood communities and mass media shall be addressed to enhance the normative power to improve EMLp in China from the future perspective. [Copyright &y& Elsevier]

Abstract: The main objective of this study is to create a better understanding of public awareness and performance in the promotion of a Circular Economy (CE) in Tianjin, China. The data and information used in this paper were collected by distributing questionnaires randomly in 6 urban districts and interviewing 600 respondents. The results indicate that the residents have limited awareness and a poor understanding about the CE program. However, they hold a positive attitude toward garbage sorting while most of the residents simply classify the garbage into categories that can be sold, reused or exchanged for new ones. People''s awareness of the CE program has a positive correlation to their educational level, whereas their pro-environmental and resource conservation behavior has a positive correlation to the age of the respondents. [Copyright &y& Elsevier]

Background: In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people’s health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Methods: Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. Results: The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P < 0.01; for people in the urban region: 95.5 v 96.8, P < 0.01). Compared with people with moderate inequality, the EQ-5D index of those with high inequality was relatively lower (for people living in the rural region: 91.1 v 95.8, P < 0.01; for people living in the urban region: 95.6 v 97.3, P < 0.01). Adjusted by age, gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Conclusion: Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors. [ABSTRACT FROM AUTHOR]

In September 1998, the Education Department of the fledgling Hong Kong Special Administrative Region implemented a controversial medium-of-instruction policy which compelled around three-quarters of the territory's hitherto English-medium secondary schools to switch to Chinese-medium teaching in Forms 1-3 (years 7-9). Only 112 schools were permitted to remain English-medium, but only on the condition that their content-area teachers make consistent use of English as the language of classroom instruction and interaction rather than, as had been the case in the last two decades of colonial rule, a mixture of Cantonese and English. This article presents the findings of a study which sought to determine the extent to which the post-colonial government's language policy has been translated into classroom practice in the reformed Chinese and English streams since 1998. The findings were derived from a questionnaire survey of a sample of undergraduates from the first two cohorts to complete their studies in the reformed Chinese and English streams, together with semi-structured interviews with students and teachers currently studying and teaching in the two streams. The findings indicate that teachers in both the Chinese and English streams have found it difficult to fully implement the new policy in their classrooms. [ABSTRACT FROM AUTHOR]

This paper describes the design features, data collection methods and analytical strategies of the ITC China Survey, a prospective cohort study of 800 adult smokers and 200 adult non-smokers in each of six cities in China . In addition to features and methods which are common to ITC surveys in other countries, the ITC China Survey possesses unique features in frame construction, a large first phase data enumeration and sampling selection; and it uses special techniques and measures in training, field work organisation and quality control. It also faces technical challenges in sample selection and weight calculation when some selected upper level clusters need to be replaced by new ones owing to massive relocation exercises within the cities. [ABSTRACT FROM PUBLISHER]