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

Research involving international research communities has been advocated in the field of behavior analysis (Dymond et al., 2000; Martin et al., 2016). The purpose of the present study was to report the status of behavioral research in mainland China, Hong Kong, and Taiwan, in terms of number of publications, types of research, and frequency of collaboration with international researchers. Fifteen behavioral journals were selected from the list by Cooper et al. (2020). These were searched by hand to find publications conducted in or authored by researchers from mainland China, Hong Kong, and Taiwan dating from each journal's inception to December 2021. The earliest publication we found appeared in 1980 in The Psychological Record. Over the following four decades (1980–1989; 1990–1999; 2000–2009; 2010–2021), the number of publications per decade increased dramatically and continues in recent years to rise. Publications include research reports, review papers, and conceptual articles, with the majority being basic research reports published in Behavioral Processes. Approximately half the publications involve collaboration with international researchers, mostly in North America. Implications for behavioral research, practice, and policy in mainland China, Hong Kong, and Taiwan are discussed. [ABSTRACT FROM AUTHOR]

In the increasing pervasiveness of today's digital society, mobile devices are changing the face of education. Students can interact with mobile devices in context‐aware environment. This paper presents a mobile application based on expert system (Plant‐E) for students to acquire knowledge about plant classification by answering decision‐making questions. In order to study effectiveness of Plant‐E and cognitive load of students who experience different kinds of interaction in learning process, another mobile application (Plant‐G) only providing information pages of plants was developed. A quasi‐experiment was conducted with three classes of 137 seventh graders. The three classes, Class A with 46 students using Plant‐E in campus, Class B with 44 students using Plant‐G in campus, and Class C with 47 students using Plant‐G in a traditional classroom, constitute three groups with different interaction complexity. The research conducted pretest, posttest, and delayed test to evaluate learning performance of students in three classes and used a questionnaire to investigate their perceptions and attitudes towards proposed system. Results show that interaction complexity has an impact on students' learning performance and mental effort in mobile learning; the higher the interaction complexity is, the higher mental effort and the better learning performance in mobile learning will be. Lay Description: What is already known about this topic: Mobile devices can be used to meet the urgency of learning need and can provide guidance and clues for learners in context‐aware environment.During mobile learning in context‐aware environment, students need to interact with mobile devices and environment.Mental effort reflects cognitive load related to interaction complexity, and it can affect learning performance.Self‐efficacy affects the degree of mental effort by affecting the firmness of performance goal.Cognitive load and learning performance are the main concerns that need to be considered when evaluating the effectiveness of mobile learning. What this paper adds: Interaction complexity has an impact on students' learning performance and mental effort in mobile learning.In terms of the three levels of interaction complexity in this study, the higher the interaction complexity is, the better the results that students will get in mobile learning.The higher the interaction complexity is, the higher the mental effort that students invested into in mobile learning would be.The medium self‐efficacy group invested the most mental effort and got the best grades, rather than the high or low group.Rule‐based mobile learning expert system is feasible and effective for students to learn by interacting with learning objects in context‐aware environment. Implications for practice and/or policy: Efforts should be made to make mobile learning systems more interactive; for example, learners can learn more effectively by interacting with mobile system, which can improve the frequency of observing learning objects.Rule‐based mobile learning expert system can give learners more opportunities to know how experts do when solving problems and can provide a potential method for students to learn in context‐aware environment. [ABSTRACT FROM AUTHOR]

In the medical practice in China, giving and taking "red envelopes" (monetary gifts) is a common phenomenon although few openly admit it. This paper, based on our empirical study including data collected from interviews and questionnaires with medical professionals and patients, attempts to explore why "red envelopes" have become a serious problem in the physician-patient relationship and how the situation can be improved. Previous studies show that scholars tend to correlate the spread of "red envelopes" in health care sector to the commercialization trend, the general erosion of traditional values, and the lowering of the moral level in the medical field. However, in this paper, the authors argue that medical professionals' choice of taking "red envelopes" is actually more a way to compensate for their problematic self-image and marred dignity in real practice. Medical professionals in China as a whole are in an embarrassing situation where the work pressure and income, and the sense of pride that used to be part of their profession are not comparable to each other. Under this circumstance, we believe that the effective way to deal with the "red envelopes" issue does not lie solely in introducing more stringent regulations or granting medical professionals higher payments, but rather in protecting and enhancing the professional dignity of all those working in healthcare. And on top of that, there must also be effort to cultivate a more favorable moral environment. [ABSTRACT FROM AUTHOR]

Aim: To characterize the clinical and genetic characteristics of a large cohort of patients with pyridoxine-dependent epilepsy (PDE).Method: We retrospectively collected clinical and genetic information of 33 (15 males, 18 females; mean [SD] age 4y 11mo [2y 5mo]; 1y 3mo-10y 4mo) patients with PDE from 31 unrelated families at a single centre.Results: There were many types of seizures, with focal seizures in 32 cases. Dravet syndrome was suspected clinically in two patients. Electroencephalogram (EEG) was normal in seven patients at the initial stage and then in 17 patients during pyridoxine maintenance therapy. Genetic studies revealed 26 kinds of variants in ALDH7A1 and four in PLPBP with 18 variants unreported previously, and 48 ALDH7A1 variants were located in exon 11, 12, 14, and 17 or intron 9 and 11. In addition, three patients carried different exons deletion. Among these, seizures could be controlled for several years in one patient by levetiracetam monotherapy. Another patient remained seizure free for up to 7 months without therapy. All patients received oral pyridoxine treatment, with only one case (with exon 8-13 deletion) showing poor control.Interpretation: This study illustrates the range of clinical presentations and genetic causes in PDE, as well as responsiveness to antiepileptic drugs. A relationship between EEG and pyridoxine therapy could be seen in many cases. Seizure control was seen in all with pyridoxine monotherapy except for one patient.What This Paper Adds: There is a parallel relationship between electroencephalogram and pyridoxine therapy in many patients. Patients with pyridoxine-dependent epilepsy may respond well to low-dose pyridoxine. [ABSTRACT FROM AUTHOR]

Computational thinking (CT), the ability to devise computational solutions for real‐life problems, has received growing attention from both educators and researchers. To better improve university students' CT competence, collaborative programming is regarded as an effective learning approach. However, how novice programmers develop CT competence through collaborative problem solving remains unclear. This study adopted an innovative approach, quantitative ethnography, to analyze the collaborative programming activities of a high‐performing and a low‐performing team. Both the discourse analysis and epistemic network models revealed that across concepts, practices, and identity, the high‐performing team exhibited CT that was systematic, whereas the CT of the low‐performing team was characterized by tinkering or guess‐and‐check approaches. However, the low‐performing group's CT development trajectory ultimately converged towards the high‐performing group's. This study thus improves understanding of how novices learn CT, and it illustrates a useful method for modeling CT based in authentic problem‐solving contexts. Lay Description: What is already known about this topic: Computational thinking competence includes computational concepts, computational practices, and computational perspectives.Collaborative programming has the potential to foster computational thinking competence development.What this paper adds: The low‐performing student group adopted a bottom‐up perspective at the beginning but transformed to a top‐down approach by the end.The low‐performing group's computational thinking development trajectory had convergent evolution towards the high‐performing group's trajectory.Implications for practice and/or policy: Computational thinking competence can be developed in collaborative contexts even when students begin with a bottom‐up approach.Computational thinking should go beyond the cognitive development of computational concepts to connect computational practice and computational identity.Quantitative ethnography approach has potential to model computational thinking competence in collaborative programming context. [ABSTRACT FROM AUTHOR]

How health care providers are paid affects how medicine is practiced. It is thus important to assess provider payment models not only from the economic perspective but also from the ethical perspective. China recently started to reform the provider payment model in the health care system from fee-for-service to case-based payment. This paper aims to examine this transition from an ethical perspective. We collected empirical studies on the impact of case-based payment in the Chinese health care system and applied a systematic ethical matrix that integrates clinical ethics and public health ethics to analyze the empirical findings. We identified eleven prominent ethical issues related to case-based payment. Some ethical problems of case-based payment in China are comparable to ethical problems of managed care and diagnosis related groups in high-income countries. However, in this paper we discuss in greater detail four specific ethical issues in the Chinese context: professionalism, the patient-physician relationship, access to care and patient autonomy. Based on the analysis, we cautiously infer that case-based payment is currently more ethically acceptable than fee-for-service in the context of China, mainly because it seems to lower financial barriers to access care. Nonetheless, it will be difficult to justify the implementation of case-based payment if no additional measures are taken to monitor and minimize its existing negative ethical implications. [ABSTRACT FROM AUTHOR]

There is increasing evidence that citations to Chinese research publications are rising sharply. A series of reasons have been highlighted in previous studies. This research explores another possibility-whether there is a 'clubbing' effect in China's surge in research citations, in which a higher rate of internal citing takes place among influential Chinese researchers. Focusing on the most highly cited research articles in nanotechnology, we find that a larger proportion of Chinese nanotechnology research citations are localized within individual, institutional, and national networks within China. Both descriptive and statistical tests suggest that highly cited Chinese papers are more likely than similar U.S. papers to receive internal and localized citations. Tentative explanations and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Based on two years' ethnographic research on doctor-patient relations in urban China, this paper examines the causes of patients' mistrust of physicians. I identify the major factors at the societal, institutional, and interpersonal levels that lead to patients' mistrust of physicians. First, I set the context by describing the extent of mistrust at the societal level. Then, I investigate the institutional sources of mistrust. I argue that the financing mechanism of public hospitals and physicians' income structures are the most crucial factors in inducing patients' mistrust. Hospitals' heavy reliance on self-finance has basically caused public hospitals to run like private hospitals, resulting in blatant conflicts of interest between hospitals and patients. Related to this is physicians' reliance on bonuses and commissions as part of their regular incomes, which has inevitably resulted in overtreatment and, hence, mistrust from the patients. At the interpersonal level, I describe how individual physicians' attitudes toward and interaction with patients may also affect patients' sense of trust or mistrust in physicians. In conclusion, I discuss the ethical implications of the mistrust problem, and suggest changes at the institutional and interpersonal levels to mitigate the problem. [ABSTRACT FROM AUTHOR]

Background Welfare for the disabled is becoming an important issue in China and care for people with intellectual disability is challenging because of the inadequacies in formal support and the social service system. Material and Method Based on ethnographic research in two villages in North China, this paper analyses the dilemmas of family care for people with intellectual disability. The essential data is the ethnographic record of three cases. Results Rural families strive to provide care through a set of arrangements and bear tremendous stress in the process. Conclusion Family care for people with intellectual disability in rural China has been increasingly challenged by the forces of labour migration, demographic changes and the ever-growing processes of commoditization. The role of the state has to be strengthened in welfare provision to balance the weakened family care ethos in transforming societies. [ABSTRACT FROM AUTHOR]