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Childhood lead exposure is a commonly known risk factor affecting children's health, and 10 governments have taken actions to reduce children's lead exposure sources. Because lab testing for children's blood lead levels (BLLs) was not popularized easily, socioeconomic and behavioural factors have been usually used as predictors of screening methods. Along with the overall decreasing trend of children's BLLs, the lead-exposure-potential-predicting ability of such factors might be limited or changed over time. Our study aims to compare the predicting ability of multiple factors, including the living environment, economic disparity and personal behaviour differences between 2004 and 2014. With potential predicting factors identified, it could provide direction in identifying individual children facing high-risk lead exposure in the unit of clinics or communities of China. The study was first conducted in 12 cities in China in 2004 and then repeated in 2014 in the same 12 cities with the same method. In total, 27,972 children aged under 7 years were included in this study. With confounding factors adjusted, the child's age, the family's socioeconomic status and the child's personal hygiene habit, especially biting toys, continued to be important predictors of higher blood lead levels among Chinese children. The sex of the child was no longer a predictor. Factors such as the father's occupational contact with lead, residence near the main road and taking traditional Chinese medicine had the potential to be new predictors. [ABSTRACT FROM AUTHOR]

Background: Many studies investigate the variables relating to psychological distress among nurses, but little is known about the underlying mechanism(s) among job insecurity, self-esteem, and psychological distress. Aims: This cross-sectional study examines the prevalence of psychological distress among nurses and the relationships among job insecurity, self-esteem, and psychological distress; it also explores how self-esteem might mediate between job insecurity and psychological distress. Methods: Questionnaires that assess job insecurity, self-esteem, and psychological distress were collected from 462 nurses in a tertiary hospital in Shandong Province, China. Results: Our results show an 83.3 % prevalence rate for psychological distress among nurses. Regression analysis results show that job insecurity positively correlates with psychological distress, explaining 17.5 % of the variance in psychological distress. Mediation analysis results show that self-esteem partially mediates the effect of the two dimensions of job insecurity on psychological distress. Conclusions: Psychological distress is prevalent among Chinese nurses. Nursing administrators should take effective measures to improve self-esteem and reduce the negative impacts of job insecurity on nurses, including psychological distress. [ABSTRACT FROM AUTHOR]

The purpose of this study of healthcare workers who cared for COVID‐19 patients was to identify factors that affected the duration of wearing personal protective equipment (PPE). The results of this study will provide initial guidance to practicing clinicians and a foundation for further research on this topic. This cross‐sectional study examined 139 frontline healthcare professionals who worked at a single hospital in Wuhan, China, from March 16 to April 1, 2020. General and demographic data, physical and mental status, use of personal protective equipment, type of hospital work, and duration of wearing personal protective equipment were recorded. The mean duration of wearing personal protective equipment was 194.17 min (standard deviation: 3.71). Multiple linear regression analysis indicated that the duration of wearing personal protective equipment was significantly associated with the presence of a chronic disease, working hours when feeling discomfort, lack of patient cooperation and subsequent psychological pressure, prolonged continuous wearing of personal protective equipment, feeling anxious about physical strength, and the presence of fatigue when wearing personal protective equipment. These factors should be considered by practicing healthcare professionals and in future studies that examine the optimal duration of wearing personal protective equipment. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine the effect of a transtheoretical model (TTM)‐based intervention on patients with an ostomy and provide patient‐centred, accessible assistance and dynamic education to improve patient self‐management. Background: Proper self‐management may promote the rehabilitation of patients with an ostomy. TTM‐based interventions have resulted in positive health behavioural changes. Design: Randomised controlled trial performed according to the CONSORT guidelines. Subject and setting: The sample comprised 55 men and 37 women (24–77 years old, mean ± SD = 52.8 ± 11.13 years). The study settings included three tertiary hospitals in Changsha, Hunan, China. Methods: The 92 patients, recruited from August 2012 to March 2013, were randomised into a control group and an intervention group. Randomisation was done by using a block randomisation list with a block size of 4. Self‐management behaviours were assessed at the baseline, 2 days before discharge and after 1, 3 and 6 months of follow‐up. The chi‐squared test, independent sample t test and repeated measures analysis of variance were used to analyse the data. Results: Patients in the intervention group were more likely to be at the action and maintenance stages compared with those in the control group. We also observed significant improvements in the self‐management ability in the process of change, the decisional balance and self‐efficacy in the intervention group compared with those in the control group after four intervention sessions and up to 6 months of follow‐up. No serious intervention‐related adverse events were observed. Conclusions: The TTM‐based intervention had positive effects on self‐management behaviours of patients with an ostomy. Relevance to clinical practice: The TTM‐based intervention had positive effects on self‐management behaviours of patients with an ostomy and may provide a reference for health providers to develop behaviour promotion programmes to improve the self‐management of patients with an ostomy. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between rural and urban residential mobility and cognitive function among middle-aged and older adults in China. Method: We used data from the World Health Organization Study on global AGEing and adult health that included adults age 50+ from China (N = 12,410). We used multivariate linear regressions to examine how residential mobility and age at migration were associated with cognitive function. Results: Urban and urban-to-urban residents had the highest level of cognitive function, whereas rural and rural-to-rural residents had the poorest cognitive function. Persons who migrated to/within rural areas before age 20 had poorer cognitive function than those who migrated during later adulthood. Socioeconomic factors played a major role in accounting for the disparities in cognition; however, the association remained significant after inclusion of all covariates. Discussion: Residential mobility and age at migration have significant implications for cognitive function among middle-aged and older adults in China. [ABSTRACT FROM AUTHOR]

Guided by social exchange theory, this study investigates the association between grandparenting and support from adult children, and the role of children’s international migration in moderating such association. Data were derived from a 2012 survey of older adults in Beijing, China (478 adult children nested in 300 older parents). The results of independent cluster logistic and linear regressions showed that regardless of children’s migration status, grandparenting was significantly associated with a greater likelihood of receiving household help and personal care, but not with emotional or financial support from children. Children’s migration status moderated the associations between grandparenting and receiving support from children. Theoretical implications for research and practical implications for services and policies are discussed. [ABSTRACT FROM AUTHOR]

This study used a quasi-experimental design to investigate the impact of Rapid Reading Skills Training (RRST) on some reading outcomes for primary school students in central China and also examined the influence of cognitive flexibility on intervention outcomes. A sample of 108 students (mean age = 11.75 years) were recruited. Students' cognitive flexibility was measured with the Wisconsin Card Sorting Task. Cluster randomization was used to assign students at the whole class level to either an experimental or control condition. A 12-session RRST intervention was completed with the experimental class (N = 54). Silent reading speed and passage comprehension were measured before and after training for all students. Independent samples t-tests and two-factor repeated measures ANOVA revealed that students in the experimental class displayed higher scores for reading speed and effective reading rate post-intervention than those in the control class. Students who had scored higher on cognitive flexibility showed significantly larger increases post-intervention than those scored lower. Results provide preliminary support for using RRST to increase rapid silent reading speed among Chinese primary school students, though replication and more rigorous experimental designs are needed. Cognitive flexibility may enhance gains associated with this type of intervention. Implications for school psychologists are discussed. [ABSTRACT FROM AUTHOR]

This descriptive comparative study aimed to compare caring ability between Chinese and American nursing students. A survey was conducted in 544 Chinese and 109 American nursing students using Caring Ability Inventory and socio-demographic data sheet. The results indicated that the Chinese nursing students reported significantly lower scores in the Caring Ability Inventory total and three subscales (p < .001) compared with their American counterpart. Years of program and number of siblings were factors affecting the Caring Ability Inventory scores among Chinese students (p < .05), whereas program, marital status, prior work experience, and gender were found to influence the Caring Ability Inventory scores of American students (p < .05). Some gaps and differences between the Chinese and America nursing students’ caring ability were identified. Nurse educator should leverage the influencing factors to strengthen the caring ability of nursing students in both countries. [ABSTRACT FROM AUTHOR]

Background: Gender differences in illicit drug use are becoming increasingly recognized. However, there are few studies concerning differences between male and female heroin users in China. Objectives: The study aimed to explore gender differences in terms of socio-demographic characteristics, drug-related behaviors, and treatment history among a heroin-using population in China. Methods: A cross-sectional study was conducted in four cities in December 2013. A total of 788 participants were recruited from several types of sites in each city: compulsory detoxification centers, methadone maintenance treatment clinics, and detention facilities. The data were collected via a self-administered questionnaire. Analysis of variance, chi-square test, and multivariate logistic regression analyses were conducted to examine gender differences in socio-demographic characteristics, drug-related behaviors, and treatment history. Results: Female heroin users were more likely to be unemployed, have more education, and use heroin with their spouse/companion (p <.05). Male heroin users were more likely to be in detention facilities and MMT clinics, and relapse when they felt hopeless (p <.05). Conclusions/Importance: Although there were some similarities between male and female heroin users, significant gender differences do exist in some aspects of socio-demographic characteristics and heroin use. The data provide evidence that interventions aimed at preventing the initiation of heroin use and reducing relapse should take gender into account. [ABSTRACT FROM AUTHOR]

American youth are more prone to storm and stress during adolescence than are Chinese youth (e.g., American youth's engagement in school declines more). However, it is unclear why. This research examined differences in conceptions of adolescence in the United States and China. Using both open- and closed-ended measures, youth ( N = 397; 50 % female; mean age = 13.19 years) reported on their views of teens. American (vs. Chinese) youth were more likely to see adolescence as a time of decreased family responsibility along with increased individuation from parents, school disengagement, and peer orientation. Conceptions of adolescence as a time of dampened family responsibility and heightened school disengagement contributed to American (vs. Chinese) youth being less engaged in school over the seventh and eighth grades. The findings suggest that culture shapes ideas about adolescence, which contribute to differences in American and Chinese youth's engagement in school over this phase. [ABSTRACT FROM AUTHOR]

Despite the vigorous global efforts to reduce stigma, HIV-related stigma continues to undermine the health status of people living with HIV (PLHIV). Internalized HIV stigma may cause stress adversely affecting the health of PLHIV. Resilience is the process of an effective coping and positive adaption in the face of adversities. To date, limited data are available on the mediating role of resilience in the relationship of internalized HIV stigma and health status among PLHIV in China. A cross-sectional survey was conducted among 2987 PLHIV in Guangxi Autonomous Region (Guangxi) in China. A mediation analysis was employed and Sobel test was used to test the mediation effect of individual resilience. Of the 2987 PLHIV, 62.8% were men. The mean age of the sample was 42.5 years (SD = 12.8). Over 57.7% of PLHIV reported their overall health status being poor. About 72% of PLHIV reported experiencing internalized HIV stigma. Internalized HIV stigma had a negative direct effect on self-rated health status (p < .001). Individual resilience resources mediated the relationship between internalized HIV stigma and self-rated health status (p < .001). Sobel test confirmed the mediation effect of resilience (z = −8.359, SE = 0.003,p < .001). Resilience as a protective factor might buffer the effect of internalized HIV stigma on health status. Multilevel interventions are needed to foster resilience of PLHIV in order to mitigate the negative impact of HIV stigma and to improve the overall health status of PLHIV. [ABSTRACT FROM AUTHOR]

Terror management research shows that existential terror motivates people to live up to social norms. According to terror management theory ( TMT), people can achieve a sense of self-worth through compliance with social norms. However, this has not yet been empirically tested. Modesty has long been known as an important social norm in Eastern cultures, such as China, Japan, and Korea. The current research examined whether conforming to the modesty norm in response to reminders of death concerns increases self-esteem for Chinese. In Study 1, following the modesty norm (i.e., explicit self-effacement) led to decreased implicit self-esteem, however, this was only the case if mortality was salient. In Study 2, violating the modesty norm (i.e., explicit self-enhancement) increased implicit self-esteem - however - again, this was only the case when mortality was salient. These findings indicate that self-esteem cannot be maintained through compliance with the modesty norm. Implications of this research for understanding the interplay between self-esteem and social norms in terror management processes are discussed. [ABSTRACT FROM AUTHOR]

Aim: To evaluate nurse staffing levels and nursing care delivery in adult general medical or surgical wards of hospitals in the Pudong district of Shanghai, China. Background: Rapid economic development and improved Chinese living standards have spurred increased demands for high-quality health care. Thus, the quality of nursing services has become a focus of attention. Design: A cross-sectional, descriptive design was used for the study. Methods: We used an anonymous survey to collect data from 1614 nurses from 98 wards in seven general hospitals in Pudong, Shanghai. Results: During day shifts, the nurse-to-patient ratios were >1:10. However, these ratios were much higher during evening and night shifts. The clinical frontline nursing workforce primarily consisted of nurses with junior college degrees that had limited working experience. Junior nurses with different educational backgrounds, professional levels and work experiences were assigned almost similar nursing care work as senior nurses. Conclusions: In the surveyed hospitals in the Pudong district, nurse staffing levels and skill mix may be inadequate to meet the increasing demands of patient care. The clinical nursing workforce needs to be strengthened and used effectively to enhance the quality and safety of patient care. Relevance to clinical practice: We should focus on the quantity and quality of the nursing workforce, as well as nursing skill utilisation. [ABSTRACT FROM AUTHOR]

Background: This study explores patterns of drug use and related correlates among a sample of men who have sex with men (MSM) and men who sell sex to other men (aka 'money boys') in China. Objectives: Data were collected from MSM and money boys (MBs) in Shanghai, China using a Community Popular Opinion Leader (CPOL) research design with a self-administered cross-sectional survey to: (1) describe drug use and drug use correlates and (2) examine relationships between drug use and sexual behaviors in general MSM and MBs. Methods: The sample consisted of 402 MSM (203 MBs) who live in Shanghai, China. Descriptive statistics and regression analyses were used to explore associations between drug use and sexual behaviors and make comparisons between MBs and general MSM. Results: MBs reported using more drugs in the last week, 3 months and ever; sex after using drugs, and unprotected sex after using drugs more frequently than general MSM. Additionally, many MBs reported receiving free drugs from their clients and those who did receive free drugs were very likely to report having unprotected sex. Conclusions: It is crucial to increase research and include Chinese MSM and their drug use in the Chinese policy conversation. These data suggest that drug use and sexual behaviors after drug use among Chinese MSM differ widely based upon selling sex and separate intervention strategies may be appropriate. [ABSTRACT FROM AUTHOR]

The current study was designed to examine the trend of depression among children affected by HIV (n = 1,221) in rural China over a period of 3 years and to explore baseline psychosocial factors that can predict depressive symptoms at 1- and 2-year follow-ups. Baseline depression score, trusting relationship with caregivers, perceived public stigma against children affected by HIV, and future expectation at baseline positively predicted the 1-year follow-up depression, while children' self-report health status, self-esteem, and perceived social support negatively predicted depression at 1-year follow-up survey. Depression and self-report health status at baseline significantly predicted depression at the 2-year follow-up. The data in the current study suggested that depressive symptoms were chronic or recurring among some children affected by HIV/AIDS. The findings also underscore the importance of early identification, early intervention, and ongoing counseling for mental health problems among children affected by HIV/AIDS. Future psychological support programs need to target both mental health symptoms and resilient factors that will help these children to cope with adverse life events associated with HIV/AIDS. [ABSTRACT FROM AUTHOR]