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

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

Background: With the development of computational literacy, there has been a surge in both research and practice application of text‐based and block‐based modalities within the field of computer programming education. Despite this trend, little work has actually examined how learners engaging in programming process when utilizing these two major programming modalities, especially in the context of secondary education settings. Objectives: To further compare programming effects between and within text‐based and block‐based modalities, this research conducted a quasi‐experimental research in China's secondary school. Methods: An online programming platform, Code4all, was developed to allow learners to program in text‐based and block‐based modalities. This research collected multimodal data sources, including programming platform data, process data, and performance data. This research further utilized multiple learning analytics approaches (i.e., clustering analysis, click stream analysis, lag‐sequential analysis and statistics) to compare learners' programming features, behavioural patterns and knowledge gains under two modalities. Results and Conclusions: The results indicated that learners in text‐based modality tended to write longer lines of code, encountered more syntactical errors, and took longer to attempt debugging. In contrast, learners in block‐based modality spent more time operating blocks and attempt debugging, achieving better programming knowledge performances compared to their counterparts. Further analysis of five clusters from the two modalities revealed discrepancies in programming behavioural patterns. Implications: Three major pedagogical implications were proposed based on empirical research results. Furthermore, this research contributed to the learning analytics literature by integrating process‐oriented and summative analysis to reveal learners' programming learning quality. Lay Description: What is currently known about the subject matter: Programming has the potential to improve learners' higher‐order thinking skills.Block‐based and text‐based modalities are two major instructional methods.There has been a growing interest to understand how learning occurs in two modes.Most previous work has evaluated two modalities based on learners' knowledge, skills, and attitudes. What this paper adds: Code4all allows learners to programming in text‐based and block‐based modalities.Quasi‐experimental research was conducted to examine block‐based and text‐based programming modalities.Multimodal learning analytics were used to compare programming under two modalities.Learners' programming features, behaviouralbehavioral patterns, and knowledge gains were identified under two modalities. The implications of study findings for practitioners: Instructors should integrate text‐based and block‐based modalities into programming courses.Process‐oriented assessment should be integrated with summative assessment. Adaptive, timely scaffoldings should be provided with the external support (this should be marked like above two points). [ABSTRACT FROM AUTHOR]

Background: Deep discussions play an important role in students' online learning. However, researchers have largely focused on engaging students in deep discussions in online asynchronous forums. Few studies have investigated how to promote deep discussion via mobile instant messaging (MIM). Objectives: In this study, we applied learning analytical tools (i.e., KBdeX and word clouds) to enhance students' shared epistemic agency and thereby support their deep discussions in MIM. Methods: Forty Chinese college students participated in this study and reflected on their MIM engagement by participating in the learning analytics (LA)‐augmented meta‐discourse sessions. The study used multiple data analysis methods, including content analysis, statistical analysis, epistemic network analysis and lag sequential analysis. Results: We found that LA engaged students in deep discussions and shared epistemic agency‐related discourse, such as creating shared understanding, creating knowledge objects, and projective and regulative processes. In particular, word clouds engaged students in more complete shared epistemic agency discourse trajectory which started from creating awareness of unknowns, then progressed to setting projective plans and sharing information, and ultimately, creating shared understanding. Moreover, our analysis indicated that epistemic agency discourse moves of creating shared understanding led students to a high level of deep discussion. Implications: This study contributes to research by extending the 'comparison paradigm', which focuses on comparing (a)synchronous forums with MIM, to a 'design paradigm', which mobilises design features from (a)synchronous forums to MIM and using learning analytical tools to engage students in deep online discussions by promoting their epistemic agency. Lay Description: What is known in this subject matter: Supporting students' online deep discussions is important.Prior studies have shown multiple technological and pedagogical strategies to support deep discussions in (a)synchronous discussion forums, but few studies in mobile instant messaging (MIM).MIM is a quasi‐synchronous tool. It is difficult to transform the traditional external scaffolds (i.e., scripts or teachers' facilitation) which promote deep discussions from (a)synchronous forums to MIM. What this paper adds to this: We constructed a design framework which used learning analytical tools‐augmented meta‐discourse to engage students in shared epistemic agency discourse moves to promote their deep discussion in MIM.We conducted multiple types of analyses (content analysis, statistical analysis, epistemic network analysis and lag sequential analysis) on students' WeChat message (a major MIM in China).Results indicated both learning analytical tools helped engage students in shared epistemic agency discourse moves, such as creating shared understanding, creating knowledge objects, projective and regulative, thus, to promote students' deep discussions. Word cloud especially engaged students in more complete shared epistemic agency discourse trajectory. Moreover, analysis results indicated that shared epistemic agency discourse moves of creating shared understanding would lead students to a high level of deep discussions. Implications of study findings for practitioners: Our study provides a feasible way to educational practitioners who want to promote students' deep discussions in their online learning course (both fully online and flipped classroom mode).Knowledge Building Discourse Explorer (KBDeX presents the original analysis results of students' written messages in discussion forums as socio‐cognitive networks.) could be implemented in the classroom. The objective is to encourage students to understand the importance of connecting with peers' ideas in a one‐session implementation period.If time allows, teachers could use word cloud and meta‐discourse to engage students in socio‐metacognitive conversations in class to promote their shared epistemic agency discourse in online discussions. [ABSTRACT FROM AUTHOR]

Background Study: Technology‐supported learning environments, act as significant observational and enabling indicators for evaluating and encouraging the digital revolution of education, are of vital importance in current educational research. Keeping track of the dynamics of technology‐supported learning environment research allows for the enrichment of theoretical studies and a prompt innovation of talent‐training environments. Objectives: The present study carried out a bibliometric analysis of the core collection of WoS database over the last two decades. Method: This study is a bibliometric research. We applied CiteSpace and VOSviewer for co‐occurrence and evolution analysis. In addition, we extracted the fundamental ideas and thoughts through reading and analysis. Results: First, the study found that technology‐supported learning environment research is in a growth phase, with core journals such as Interactive Learning Environments or Computers & Education. The findings show that a core research team comprised of such scholars as Hwang Gwo‐Jen, Lester James C. and Wong Lung‐Hsiang. Key nations of publishing and research strength are from China, the United States, the United Kingdom and the Netherlands. Second, the hot topics in research on technology‐supported learning environments were virtual learning environments, technology‐enabled learning environments and interactive learning environments. Nine study specifics were derived from these three topics such as moulding function, generating scenario, stimulating sensation, effect verification, design idea, research reflection, inquiry and research, virtual community, and mixed environment. Lastly, the frontier evolution offers a pattern of development from enhancing performance to changing mode to incorporating experience. Conclusion: Looking ahead, our research recommendations for the field of technology‐supported learning environments include a multifaceted approach. We should aim to enhance research designs and methodologies, develop contemporary guiding theories and strive for a balanced representation across various educational domains, expanding our scope to encompass all academic disciplines. In terms of practical application, it is imperative to focus on the design and implementation of technology‐supported learning environments from three critical perspectives: "change‐demand," "student‐learning" and "online‐offline." These approaches will collectively ensure that technology‐supported learning environments are both innovative and responsive to the diverse needs of the educational landscape. Lay Description: What is already known about this topic: Technology‐supported learning environments are currently a focal and hot research topic in the field of education.Although numerous studies have been conducted on the learning environment of technical support, there has yet to be a systematic and comprehensive review of the related research. What this paper adds: This study provides a comprehensive review of research on the technology‐supported learning environments over the past two decades.This study primarily presents an overview of research on the technology‐supported learning environments over the past two decades, focusing on main literature, research strength, hot topics and frontier evolution. Implications for practice and/or policy: Researchers need to further advance research on technology‐supported learning environments by enriching research designs and methods, constructing up‐to‐date guiding theories and achieving a balance across different educational domains while extending the reach to all disciplines.Educational practitioners need to pay attention to the design and implementation of technology‐supported learning environments from the three viewpoints of "change‐demand," "student‐learning" and "online‐offline." [ABSTRACT FROM AUTHOR]

Objectives: This systematic review and meta‐analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. Methods: We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta‐analysis. Subgroup analyses and meta‐regression were employed to explore potential moderating variables and heterogeneity. Results: The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%–59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%–47.6%). Subgroup analyses and meta‐regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. Conclusions: This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population. Key points: Informal carers of people with dementia contend with unique circumstances that render them susceptible to both loneliness and social isolation.There is a significant prevalence of loneliness and social isolation in informal carers of individuals with dementia.Several significant moderators influence the prevalence of loneliness and social isolation among informal carers of individuals with dementia.Moderator analysis can guide targeted interventions and support systems for at‐risk informal carers of people with dementia to alleviate loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach‐supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi‐experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non‐flipped mode. Results and Conclusions: The independent t‐test results showed that the experimental MTFL group outperformed the control group in post‐test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post‐test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open‐ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety. Lay Description: What is currently known about this topicFlipped language learning is mostly reported to be effective in improving EFL learning.Peer learning is mostly reported to be effective in improving EFL learning.MosoTeach was investigated in English learning contexts before, but without experimental design. What this paper addsMosoTeach proved as a valid online learning platform in flipped language learning, and the learning experience points (LEPs) on MosoTeach could predict students' exam performance.Students in the experimental group (MosoTeach‐supported flipped) had better exam performance and a higher level of motivation, participation and feedback.Students in both groups experienced isolation, procrastination and technological anxiety. Implications for practice:Peer discussion boards in MosoTeach provide learning support effectively for students in pre‐class learning.Group projects and peer assessment in MosoTeach integrate pre‐class peer discussion into in‐class interaction successfully.MosoTeach provides equal opportunity for every student in the large‐size Chinese English classes, thus contributing to the equity of in‐class peer interactions. [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]

Background: Atypical speech prosody has been commonly found among autistic children. Yet it remains unknown whether prosody impairment originates from poor pitch ability in general or whether it is the result of the difficulty in understanding and using prosody for communicative purposes. Aims: To investigate whether native Mandarin Chinese‐speaking autistic children with intellectual impairment were able to accurately produce native lexical tones, which are pitch patterns that distinguish word meaning lexically and serve little social purpose. Methods & Procedures: Using a picture‐naming task, thirteen 8–13‐year‐old Mandarin Chinese‐speaking autistic children with intellectual impairment were tested on their production of Chinese lexical tones. Chronical age‐matched typically developing (TD) children were included as the control group. Perceptual assessment and phonetic analyses were conducted with the produced lexical tones. Outcomes & Results: The majority of the lexical tones produced by the autistic children were perceived as accurate by adult judges. Phonetic analysis of the pitch contours found no significant difference between the two groups, and the autistic children and TD children used the phonetic features in comparable ways when differentiating the lexical tones. However, the lexical tone accuracy rate was lower among the autistic children than among the TDs, and the larger individual difference was observed among the autistic children than the TD children. Conclusions & Implications: These results indicate that autistic children are able to produce the global contours of the lexical tones, and pitch deficits do not seem to qualify as a core feature of autism. What this paper adds: What is already known on the subject: Atypical prosody has been considered a maker of the speech of autistic children, and meta‐analysis found a significant difference in mean pitch and pitch range between TD children and autistic children. Yet it remains unknown whether the pitch deficits are the result of impaired perceptual–motoric ability or if they reflect failure in learning sentential prosody, which requires an understanding of the interlocutors' mind. In addition, research on pitch ability of autistic children with intellectual disabilities has been scarce, and whether these children are able to produce pitch variation is largely unknown. What this paper adds to existing knowledge: We tested native Mandarin Chinese autistic children with intellectual impairment on their production of native lexical tones. The lexical tones in Chinese are pitch variations realized on individual syllables that distinguish lexical meaning, but they do not serve social pragmatic purposes. We found that although these autistic children had only developed limited spoken language, the majority of their lexical tones were perceived as accurate. They were able to use the phonetic features in comparable ways with the TD children when distinguishing the lexical tones. What are the potential or actual clinical implications of this work?: It seems unlikely that pitch processing at the lexical level is fundamentally impaired in autistic children, and pitch deficits do not seem to qualify for a core feature of their speech. Practitioners should be cautious when using pitch production as a clinical marker for autistic children. [ABSTRACT FROM AUTHOR]

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

This paper explores the components of Chinese college counsellors' mental models in their daily work based on a rich content analysis of the story accounts of 152 exemplary college counsellors over the past 8 years. On the basis of a rigid three‐step coding procedure, this study reveals that Chinese college counsellors' mental models generally comprise four common constituents, namely a love‐filled faith system, a rule‐based thinking system, a professionalism‐based knowledge system and action‐based performance. These components jointly illustrate the general landscape of Chinese college counsellors' internal well‐being and fill a research gap regarding the sparse attention given to counsellors in the global literature on faculty professionalism. [ABSTRACT FROM AUTHOR]

Background: Video conferencing learning offers a more accessible and flexible learning mode for students who cannot attend face‐to‐face class in person. However, research about the video conferencing learning is still lacked, especially for students' engagement in this setting. Objectives: This study adopts the self‐system model of motivational development to uncover effects of the video conferencing learning environment (VCLE) to students' engagement. Methods: Two hundred and ninety‐eight primary school students involved in the VCLE were surveyed. The partial least square structural equation modelling was employed to explore the link between the VCLE and students' engagement with a mediating role of basic psychological needs satisfaction (BPNS). Results and Conclusions: Results showed that the BPNS played a mediating role in the processes from the VCLE to engagement. Both pedagogical and social affordance had a significant effect on the BPNS. However, their influences were different. Specifically, pedagogical affordance yielded a stronger effect on the BPNS for autonomy than social affordance. The predicting power of social affordance on BPNS for relatedness and competence was stronger than pedagogical affordance. Generally, social affordance yielded more contributions to behavioral and emotional engagement than pedagogical affordance. Moreover, BPNS for competence was the only significant mediator between the VCLE and behavioral engagement, and it owned the strongest mediating power on the relationship between the VCLE and emotional engagement, followed by autonomy, and the smallest of relatedness. This study suggests that practitioners and researchers should give more consideration to improve social affordance of the VCLE and to meet students' BPNS especially for competence in order to design and implement an engaged video conferencing course. Lay Description: What is already known about this topic: Video conferencing learning provides an accessible and flexible learning mode.Mechanism from learning environment to engagement is helpful to design an engaged video conferencing course.Less is known about how video conferencing learning affects students' engagement. What the paper adds: This study uncovered the functioning process of video conferencing learning to students' engagement.PLS‐SEM was employed to verify the mediating role of BPNS in this process.BPNS for autonomy, competence, and relatedness played mediating roles and their powers were different. Implications for practice and/or policy: More attention is needed to improve to social affordance to enhance students' emotional engagement.BPNS especially for competence deserves special consideration to improve students' behavioral and emotional engagement. [ABSTRACT FROM AUTHOR]

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

As a healthcare ICT4D solution, mobile health (mHealth) can potentially improve users' well‐being during pandemics, especially in developing countries with limited healthcare resources. Recent ICT4D research reveals that providing end‐users with access to ICT is insufficient for improving well‐being and, thus, understanding how mHealth empowers end‐users to enhance well‐being against stressful events is important. However, prior research has rarely discussed the issue of empowerment in the domain of mHealth or the context of major disruptive events. This paper contributes to the literature by conceptualizing the psychological empowerment of mHealth users (PEMU) and investigating its nomological network during pandemics. Drawing upon theories of psychological empowerment and event characteristics, we developed a research model and tested it through a mixed‐methods investigation, containing a quantitative study with 602 Chinese mHealth users during COVID‐19 and a follow‐up qualitative study of 326 online articles and reviews. We found that PEMU, driven by three technological characteristics (perceived response efficacy, ease of use, and mHealth quality), affects well‐being through both (a) a stress‐buffering effect, which counterbalances the detrimental, stress‐increasing effects of event criticality and disruption, and (b) a vitality‐stimulating effect, which is intensified by event criticality. These findings have important implications for ICT4D research and practice. [ABSTRACT FROM AUTHOR]

Background: With a rapidly aging population in mainland China, dysphagia has become one of the common geriatric disorders which creates a huge demand on speech and language therapists (SLTs). The major challenge is the shortage of SLTs in China. In addition, frontline practitioners in mainland China may not be well equipped with the knowledge and practical skills in dysphagia management due to lack of systematic training and the work nature. Aims: This study evaluates the self‐perceived effectiveness and feasibility of an online training program that aims to enhance the self‐assessed knowledge and skills of SLTs providing dysphagia care in residential aged care homes. Methods and Procedures: Sixteen SLTs working in a residential aged care homes in mainland China attended a three‐hour pilot online training program which consists of didactic lecture and practical skills activity components. A total of 10 participants completed an online questionnaire one month after the training to evaluate the feasibility and effectiveness of this online training program. Outcomes and Results: The preliminary results demonstrated participants' self‐perception of high training effectiveness in theoretical knowledge and practical skills. A majority of the participants perceived that the training enhanced their theoretical knowledge and all of them perceived that they acquired practical skills. All respondents were satisfied with the online training approach. They also highlighted the advantage and challenges of the online training approach. Conclusions and Implications: Online training is an effective and feasible approach for theoretical knowledge and practical skills transfer in SLT training and could ultimately benefit the delivery of services for individuals with dysphagia in mainland China. What this paper adds: What is already known on the subject: Previous studies have shown that online training approach is as effective as face‐to‐face training in increasing professional knowledge. Online training programs may be more cost efficient and time efficient when compared with face‐to‐face training. What this study adds: The present study provided preliminary evidence to support the feasibility and effectiveness of using online training on dysphagia for speech and language therapists working in residential aged care homes in mainland China. What are the clinical implications of this work?: From the participants' perception, online training approach is effective and feasible in delivering theoretical knowledge and practical skills. It may be a better training approach for mainland China considering the lack of expertise and accessibility to training. [ABSTRACT FROM AUTHOR]

Background: Socially shared regulation is a vital factor that affects students' collaborative programming performance. However, students' weak group metacognitive skills or inability to adopt shared regulation mechanisms lead to unsatisfactory collaborative programming learning. Objectives: This study proposes an approach to support socially shared regulation in collaborative programming learning in order to enhance students' programming achievements and group metacognition. Methods: A quasi‐experimental study was conducted in a junior high school over a 10‐week period to investigate the impact of the proposed approach on programming achievements, group metacognition, and cognitive load. Forty eighth‐grade students participated in the study, with the experimental group learning via the proposed approach, while the control group used the conventional collaborative programming learning approach. Results and Conclusions: The analysis included data from 38 participants. The experimental results showed that the programming achievements and group metacognition of the experimental group were significantly better than those of the control group. Additionally, the proposed approach did not increase the cognitive load of the students. Implications: This study has important implications for teachers, learners, and researchers in collaborative programming and social regulation. Our proposed collaborative programming learning approach enhances learners' social regulation and performance, providing teachers with an effective tool for improving collaborative programming learning. This study also extends the field of socially shared regulation of learning (SSRL), demonstrating its potential to improve the effectiveness of collaborative programming learning and highlighting the need for future research to explore the mechanisms of SSRL in this context. Lay Description: What is already known about this topic?: Programming learning is difficult for most learners.Collaborative programming is an effective method of programming learning.Students' weak group metacognitive skills or inability to adopt shared regulation mechanisms lead to unsatisfactory collaborative programming learning. What this paper adds?: This study proposes a method to enhance collaborative programming learning by supporting socially shared regulation among students.The study utilized a quasi‐experimental to demonstrate the effectiveness of the approach in improving students' programming learning performance.The shared regulation approach was found to significantly improve students' programming achievements and group metacognition when compared to conventional collaborative programming approaches.Importantly, the shared regulation approach did not increase the cognitive load of the students, indicating its potential for practical implementation in programming education. The implications of study findings for practitioners: This study has shown that an approach that supports social shared regulation can improve student performance in collaborative programming learning, and that teachers can use this approach to help students learn programming better collaboratively.This study also contributes to the field of social shared regulated learning by demonstrating how it can support collaborative programming and improve its effectiveness. [ABSTRACT FROM AUTHOR]

Background: Zoomorphism, an obverse of conventional anthropomorphism, has been shown in many cases to be a powerful tool with respect to the metaphorical use of animals. Objectives: This study introduced zoomorphism into the instructional video design of pedagogical agents (PAs). Method: We first developed three image sets, each of which corresponded to a type of zoomorphic PA image construct (full panda, a human face with a panda body, and a human body with panda head imagery). Then, we conducted an image‐screening experiment in which 177 second‐grade students from a primary school were asked to select their favourite PA image for each image construct set. We used a realistic human PA as the baseline. Next, 114 second‐grade students from another school were randomly assigned to learn instructional videos on the topic of pandas using a PA with one of four imageries. Results and Conclusions: ANOVA and Kruskal–Wallis tests indicated that students presented with PAs with full‐panda imagery achieved significantly higher learning performance, learning experience, social presence, and learning interest than those presented with other imageries of PAs. The regression results showed that the effect of zoomorphic PAs with full‐panda imagery on learning performance was exerted in a direct way and that its effect on learning experience was mediated by social presence and learning interest. Implications: Our findings suggest that zoomorphic appearance is an essential quality for video learning that merits further investigation for the efficient imagery construction of PAs. Lay Description: What is already known about this topic: The inclusion of pedagogical agents with images that are attributed human qualities to animals known as anthropomorphism is very popular in multimedia education; however, the existing studies on the effects of such images on learning have shown inconsistent results. What this paper adds: We introduced the alternative philosophy of animal use‐zoomorphism, which is the obverse of anthropomorphism, into agent image building. Implications for practice and/or policy: Our study demonstrated that the zoomorphism of agent images increases learning performance and experience; thus, our findings suggest the prospect of zoomorphism in the development of agent image patterns. [ABSTRACT FROM AUTHOR]

Background: Learning‐by‐teaching is a generative learning strategy in which students are told they will have to teach what they are learning to others. Although learning‐by‐teaching has been shown to be effective in some cases, few studies have established guidelines for how to optimize the benefits of learning‐by‐teaching as a generative learning strategy from a social presence perspective. Objectives: This study seeks to clarify the learning‐by‐teaching hypothesis and to pinpoint the optimal level of social presence during learning‐by‐teaching that is most conducive to learning. Methods: In Experiment 1, college students received a lesson with instructions that afterwards they would explain the material to others by making a video, explain the material aloud to themselves, or restudy the material. In Experiment 2, college students viewed a multimedia lesson with instructions that afterwards they would explain the materials by making a video, explain to an onscreen student, or explain to a student in person. Results and Conclusions: Teaching by making a video was better than restudying, self‐explaining, and teaching face‐to‐face or online. Teaching quality was better in video teaching than self‐explaining and face‐to‐face or online teaching. Teaching by making a video is ideal because it primes generative processing while minimizing extraneous processing. Implications: This study is the first to manipulate different levels of social presence of oral teaching to determine the optimal form of learning‐by‐teaching, which preliminarily clarifies generative learning and social presence theory and has implications for both empirical and theoretical research. Lay Description: What is already known about this topic: Learning‐by‐teaching is a generative learning strategy in which learners are told they will explain the material in the lesson to others after the lesson.Although learning‐by‐teaching has been shown to be effective in some cases, few studies have established guidelines for how to optimize the benefits of learning‐by‐teaching as a generative learning strategy from a social presence perspective. What this paper adds: Teaching by making a video was better than restudying, self‐explaining, and teaching face‐to‐face or online.Teaching quality was better in video teaching than self‐explaining and face‐to‐face or online teaching.Making a video creates suitable and lower social presence but more generative processing.This work shows the importance of balancing the positive effects of a moderate amount of social presence as a motivator with the potential negative effects of too much social presence as a distractor. Implications for practice and/or policy: Instructors should encourage students to record an instructional video explaining what they learned from a lesson. This serves as a generative learning activity that is more effective than self‐explaining or restudying the materials.The sense of social presence during teaching activities should not be too high. Thus, asking students to teach face‐to‐face is not a recommended approach.Instructors should set an appropriate level of social presence and take care to avoid adding extraneous distractions when implementing learning‐by‐teaching to help students achieve an optimal learning performance. [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]

Background: Inquiry‐based learning is a salient instructional approach to cultivate students' higher order thinking skills (HOTS). With the presence and advancement of new technologies, their usage for inquiry learning in university context is increasingly ubiquitous. However, in most circumstances, college students cannot integrate technologies to their inquiry learning in efficient ways or their abilities to use technologies are not good enough. Previous studies found that intrinsic motivation (IM), peer interaction (PI) and classroom connectedness (CC) were key factors to influence students' approaches to using technologies from the personal, behavioural and environmental perspectives. Objectives: This study investigated the influence of these three essential learning factors (IM, PI and CC) on students' HOTS and the mediate influence of deep approach to using technologies (DAUT) between these learning factors and HOTS in the technology‐enhanced open inquiry‐based learning context. Methods: A questionnaire was administered to 80 university students who had studied with the technology‐enhanced open inquiry‐based learning approach. The partial least squares method was employed to investigate the relationships among learning factors, DAUT and HOTS. Results and Conclusions: Results showed that CC and PI were positively directly related to HOTS. DAUT was a significant mediator between two (i.e., IM and PI) of the three learning factors and HOTS. The findings of the study have practical implications for instructors, indicating that they should pay attention to students' IM and PI in deepening their approach to using technologies as well as to improve students' HOTS in technology‐enhanced open inquiry‐based learning. Lay Description: What Is Already Known About This Topic: Inquiry‐based learning is considered to be a salient instructional approach to cultivate students' higher order thinking skills (HOTS).Technologies usage in inquiry learning is ubiquitous in university context.In most cases, college students are not able to integrate technologies in their inquiry learning in effective ways. What This Paper Adds: This paper proposed a research model that explains and predicts the mediating influence of deep approach to using technologies on the association between learning factors and HOTS in the technology‐enhanced open inquiry‐based learning context.The mediating effect of approaches to using technologies between learning factors and HOTS was identified.Two of the three learning factors (peer interaction and classroom connectedness) had direct effect on HOTS.Deep approaches to using technologies variable significantly mediates two of the three learning factors (peer interaction and intrinsic motivation) and HOTS. Implications for Practice or Policy: Instructors should pay attention to students' intrinsic motivation (IM) and peer interaction in order to deepen their approach to using technologies.Instructors should pay particular attention to peer interaction and classroom connectedness when conducting technology‐enhanced open inquiry‐based learning activities to improve college students' HOTS.Students' interest improvement and IM in using technologies, the integration of technologies and open inquiry‐based learning activities could be discussed and decided by both the instructor and students. [ABSTRACT FROM AUTHOR]

Background: As adequate support, virtual reality (VR) has been increasingly introduced into the classroom to help students learn a new language. However, empirical studies exploring the educational potential of using 360° spherical video‐based virtual reality (SVVR) in high‐school Chinese language classrooms are still lacking. Objectives: A mind mapping‐based SVVR learning system is proposed for international high‐school students' Chinese courses and examines its effects on improving Chinese learning achievements and perceptions among Grade 10 students who learn Chinese as a foreign language. Methods: This study adopted a quasi‐experiment design. Participants (N = 66) were assigned to one of three conditions: mind mapping‐based SVVR (MMBSVVR), conventional SVVR (CSVVR), or traditional lecturing (TL). Our mixed‐method approach employed pre‐and post‐tests to measure Chinese learning achievements, questionnaires to measure Chinese learning motivation, problem‐solving ability, and self‐efficacy, and semi‐structured interviews to further explore students' feelings and attitudes about Chinese courses in corresponding learning environments. Results and Conclusions: The results showed that the MMBSVVR classroom significantly improved high students' Chinese learning achievements in Chinese vocabulary and making sentence, problem‐solving ability, and self‐efficacy. Moreover, SVVR stimulates students' learning interest and class participation, and mind mapping provides students with a clear guide to arrange the knowledge. These findings help interpret the relationships between MMBSVVR and learning achievements, Chinese learning motivation, problem‐solving ability, and self‐efficacy in an international high school Chinese courses, thus providing insight on integrating MMBSVVR into existing classrooms. Lay Description: What is Already Known about this Topic: By creating fully immersive 3D environments, 360° spherical video‐based virtual reality (SVVR) in promoting language learning has been confirmed by many scholars with a focus on English language learning.Mind mapping effectively enables second language learners to review and retain new words in the target language meaningfully. Also, it can create a more vivid learning atmosphere through images and graphics and promote learners' memory and learning motivation. What This Paper Adds: A mind mapping‐based SVVR learning system has been developed with the support of the constructivism theory.A mind mapping‐based SVVR learning system is proposed to facilitate international students' Chinese learning performance in Chinese vocabulary acquisition and sentence construction.In addition to promoting international students' learning outcomes, the proposed approach indicated promising results in learning motivation, problem‐solving ability, and self‐efficacy. Implications for Practice and/or Policy: This study provides an evidence base for further research through the utilization of VR learning environments in Chinese language classrooms.This study advocates introducing SVVR technology in the Chinese learning classrooms to increase the learning context for international students. It is also worth encouraging scholars to design VR learning systems with different learning strategies.Due to the cognitive requirements of the Chinese language learning process, it is necessary to introduce mind maps in the SVVR learning system to assist students in constructing knowledge and combining prior and new knowledge to generate long‐term memory. [ABSTRACT FROM AUTHOR]

Background: Assignments that involve writing based on several texts are challenging to many learners. Formative feedback supporting learners in these tasks should be informed by the characteristics of evolving written product and by the characteristics of learning processes learners enacted while developing the product. However, formative feedback in writing tasks based on multiple texts has almost exclusively focused on essay product and rarely included SRL processes. Objectives: We explored the viability of using product and process features to develop machine learning classifiers that identify low‐ and high‐performing essays in a multi‐text writing task. Methods: We examined learning processes and essay submissions of 163 graduate students working on an authentic multi‐text writing assignment. We utilised learners' trace data to obtain process features and state‐of‐the‐art natural language processing methods to obtain product features for our classifiers. Results and Conclusions: Of four popular classifiers examined in this study, Random Forest achieved the best performance (accuracy = 0.80 and recall = 0.77). The analysis of important features identified in the Random Forest classification model revealed one product (coverage of reading topics) and three process (elaboration/organisation, re‐reading and planning) features as important predictors of writing quality. Major Takeaways: The classifier can be used as a part of a future automated writing evaluation system that will support at scale formative assessment in writing tasks based on multiple texts in different courses. Based on important predictors of essay performance, a guidance can be tailored to learners at the outset of a multi‐text writing task to help them do well in the task. Lay Description: What is already known about this topic?: Both product and process features should be used to inform formative feedback on writing.Providing product‐ and process‐oriented feedback to learners is challenging.Automatic writing evaluation systems have mainly relied upon product features.Automated analysis of learners' trace data and their essay drafts is a promising venue. What this paper adds?: An accurate machine learning classifier that identifies low‐ and high‐scoring essays.The classifier utilized both product and process features.We obtained process features from learners' trace data in digital learning environment.We computed product features using state‐of‐the‐art text analytical methods. Implications for practice and/or policy: The classifier can be used as a part of a future automated writing evaluation system.We revealed learning processes and essay characteristics that influence performance.Based on important predictors of performance, formative feedback can be given to learners. [ABSTRACT FROM AUTHOR]

Background: Pragmatics has generally been defined as the ability to use language in social situations, it is commonly regarded as the third major component of language ability. To date, there is no tool for assessing early pragmatic development of Chinese‐speaking children. Aims: To describe the translation of the Language Use Inventory (LUI) from English to Mandarin Chinese and to report findings on the Chinese version's reliability, validity and developmental sensitivity. Methods & Procedures: The original English version of the LUI was translated into Mandarin Chinese. Parents of 177 typically developing (TD) toddlers and preschool children completed the inventory to examine its internal reliability and construct validity and how scores differed across ages and sexes. A total of 31 parents out of the 177 completed the LUI‐Mandarin, again within 4 weeks, to assess test–retest reliability. To examine discriminative validity, 43 parents of age‐ and sex‐matched TD children and children with autism spectrum disorder (ASD) recruited from Nanjing Brain Hospital affiliated with Nanjing Medical University completed the LUI‐Mandarin. Outcomes & Results: Cronbach's alpha values for the LUI‐Mandarin's three parts and for 11 of 12 LUI‐Mandarin subscales were 0.707–0.992, with most values in the 0.825–0.992 range. Test–retest reliability ranged from 0.66 to 0.95, indicating good to excellent reliability. Factor analysis of the LUI‐Mandarin revealed two different factors, and the total variance explained was 74.38%. The LUI‐Mandarin total scores and subscale scores increased with age for both boys and girls, providing evidence of the inventory's developmental sensitivity. Girls, however, had higher total scores than boys at earlier ages (18–23 months). The results of the discriminant validity study revealed that performance was significantly lower in the ASD group than in the TD group with respect to LUI total scores and subscale scores (except for subscale A). Conclusions & Implications: The LUI‐Mandarin is the first and only questionnaire available in China that evaluates the pragmatic language skills of children aged between 18 and 47 months. The results of the study show that the LUI‐Mandarin is a valid and reliable tool for Chinese toddlers and preschool children. What this paper adds: What is already known on this subject: The LUI is a parent‐report questionnaire that can provide comprehensive information about very young children's communicative competence. It is widely used both for assessment and to guide intervention. Additionally, it has been translated into French, Italian, Polish, Arabic, Portuguese and Norwegian and it shows good reliability and validity. What this paper adds to existing knowledge: In the present study we describe the translation of the LUI from English to Mandarin Chinese and report findings on the Chinese version's reliability, validity and developmental sensitivity. What are the potential or actual clinical implications of this work?: The LUI‐Mandarin is the first and only questionnaire available in China that can evaluate pragmatic language skills of children aged between 18 and 47 months. The results show that the LUI‐Mandarin is a valid and reliable tool for use with Chinese toddlers and preschool children. [ABSTRACT FROM AUTHOR]

Background: While a number of learner factors have been identified to impact students' collaborative learning, there has been little systematic research into how patterns of students' collaborative learning may differ by their learning orientations. Objectives: This study aimed to investigate: (1) variations in students' learning orientations by their conceptions, approaches, and perceptions; (2) the patterns of students' collaborations by variations in their learning orientations and (3) the contribution of patterns of collaborations to academic achievement. Methods: A cohort of 174 Chinese undergraduates in a blended engineering course were surveyed for their conceptions of learning, approaches to learning and to using online learning technologies, and perceptions of e‐learning, to identify variations in their learning orientations. Students' collaborations and mode of collaborations were collected through an open‐ended social network analysis (SNA) questionnaire. Results and Conclusions: A hierarchical cluster analysis identified an 'understanding' and 'reproducing' learning orientations. Based on students' learning orientations and their choices to collaborate, students were categorized into three mutually exclusive collaborative group, namely Understanding Collaborative group, Reproducing Collaborative group and Mixed Collaborative group. SNA centrality measures demonstrated that students in the Understanding Collaborative group had more collaborations and stayed in a better position in terms of capacity to gather information. Both students' approaches to learning and students' average collaborations significantly contributed to their academic achievement, explaining 3% and 4% of variance in their academic achievement respectively. The results suggest that fostering a desirable learning orientation may help improve students' collaborative learning. Lay Description: What is currently known about the subject matter: There are variations in students' learning orientations.Various learner factors have been found to shape patterns of students' collaborations. What this paper adds: Patterns of students' collaborations differed by variations in students' learning orientations.Students' average collaborations significantly contributed to academic achievement. Implications of the findings for practioners: Fostering a desirable learning orientation may improve collaborative learning. [ABSTRACT FROM AUTHOR]

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

Background: Peer‐to‐peer feedback exchanges have been recognized as crucial to language learning. While studies on peer feedback proliferate, little is known about whether and how peer feedback is affected by learners' motivational levels. Objectives: Situated in a mobile collaborative learning context, the current study examined how English as a Foreign Language (EFL) students with different motivational levels participated in mobile‐assisted peer feedback provision, as well as the characteristics of the feedback they provided. Methods: A total of 61 sophomores majoring in Business English at a Chinese university participated in this 16‐week‐long study. They were asked to complete oral assignments and give and receive peer feedback via MosoTeach (a popular mobile learning application in China). Multiple types of data (peer feedback records, questionnaires, reflective journals and interviews) were collected, analysed, and triangulated. Results and Conclusions: Results revealed that EFL learners with higher motivation were more likely to provide feedback on time using more words. Unique characteristics of mobile‐assisted peer feedback among highly motivated learners were also observed. Implications: The study highlights the importance of learner motivation in mobile‐assisted peer feedback practice and provides pedagogical suggestions for better designing and implementing peer feedback in mobile collaborative learning contexts. Lay Description: What is already known about this topic: Previous research has recognized mobile‐assisted peer feedback as an effective way of mobile collaborative language learning.Previous studies on mobile‐assisted oral peer feedback have examined different dimensions of feedback in relation to their effects on speaking performance.Previous research is less clear about how learners' motivational characteristics may influence peer feedback performance. What this paper adds: Situated in a mobile learning context, this study investigated how English as a Foreign Language (EFL) students with different motivational levels participated in mobile‐assisted peer feedback provision, and examined the characteristics of the feedback they provided.Results revealed that EFL students with higher motivation were more likely to provide feedback on time using more words. Some unique characteristics of mobile‐assisted peer feedback among students with different motivational levels were also observed. Implications: This study demonstrates the importance of considering learners' motivational levels in teachers' design and implementation of peer feedback with technology.It is crucial for teachers to provide training and scaffolding to students in their construction of peer feedback with mobile technologies.Teachers are suggested to encourage the students to provide detailed positive comments for their peers, which may increase students' confidence and reduce their anxiety. [ABSTRACT FROM AUTHOR]

Objectives: The global coronavirus disease 2019 (COVID‐19) pandemic has not been well controlled, and vaccination could be an effective way to prevent this pandemic. By accommodating attribute nonattendance (ANA) in a discrete choice experiment (DCE), this paper aimed to examine Chinese public preferences and willingness to pay (WTP) for COVID‐19 vaccine attributes, especially the influence of ANA on the estimated results. Methods: A DCE was designed with four attributes: effectiveness, protection period, adverse reactions and price. A random parameter logit model with an error component (RPL‐EC) was used to analyse the heterogeneity of respondents' preferences for COVID‐19 vaccine attributes. Two equality constraint latent class (ECLC) models were used to consider the influence of ANA on the estimated results in which the ECLC‐homogeneity model considered only ANA and the ECLC‐heterogeneity model considered both ANA and preference heterogeneity. Results: Data from 1,576 samples were included in the analyses. Effectiveness had the highest relative importance, followed by adverse reactions and protection period, which were determined by the attributes and levels presented in this study. The ECLC‐heterogeneity model improved the goodness of fit of the model and obtained a lower probability of ANA. In the ECLC‐heterogeneity model, only a small number of respondents (29.09%) considered all attributes, and price was the most easily ignored attribute (64.23%). Compared with the RPL‐EC model, the ECLC‐homogeneity model obtained lower WTPs for COVID‐19 vaccine attributes, and the ECLC‐heterogeneity model obtained mixed WTP results. In the ECLC‐heterogeneity model, preference group 1 obtained higher WTPs, and preference groups 2 and 3 obtained lower WTPs. Conclusions: The RPL‐EC, ECLC‐homogeneity and ECLC‐heterogeneity models obtained inconsistent WTPs for COVID‐19 vaccine attributes. The study found that the results of the ECLC‐heterogeneity model considering both ANA and preference heterogeneity may be more plausible because ANA and low preference may be confused in the ECLC‐homogeneity model and the RPL‐EC model. The results showed that the probability of ANA was still high in the ECLC‐heterogeneity model, although it was lower than that in the ECLC‐homogeneity model. Therefore, in future research on DCE (such as the field of vaccines), ANA should be considered as an essential issue. Public Contribution: Chinese adults from 31 provinces in mainland China participated in the study. All participants completed the COVID‐19 vaccine choice questions generated through the DCE design. [ABSTRACT FROM AUTHOR]

With the advent of mobile technologies, well‐designed fraction apps can be used to help children gain fraction knowledge, a challenging topic for both teachers and students. The present pilot study adopted a quasi‐experimental design to investigate whether children can learn fraction concepts equally well if half of the lesson time (20 min) is replaced with game‐based learning. Keeping the total lesson time (40 min) identical, the control group (N = 33) received traditional instruction, and the experimental group (N = 32) was presented with a blended learning approach spending half of the class time (20 min) playing tablet‐based fraction games, where each of the learners had their own tablet. The results suggested that in the posttest, the experimental group achieved similar learning gains to the control group and appear to have achieved better performance in the transfer test than the control group. This paper also discusses the efficiency of game‐based learning, the mechanism of how fraction games might enhance learning, and the potential of integrating game‐based learning in educational settings. Lay Description: What is already known about this topicAs a significant mathematical concept in daily life, fractions are crucial for later success in math learning.As a promising new technology, educational games show a great potential for improving learning.Well‐designed fraction apps can be used to help children gain fraction knowledge.What this paper addsGame‐based fraction learning can be combined with formal learning in school education.Game‐based fraction learning might provide a more efficient approach to increasing students' conceptual knowledge of fractions.The result showed that the experimental group achieved a similar cognitive level as the control group although they spent half of the time playing a game, suggesting that children can gain knowledge from the experiences of playing games.What are the implications for practice and/or policyThe result suggests that the proper use of educational games in teaching fractions can make learning more efficient.Further research needs to be done to determine whether the fraction understanding gained through playing these games will have an impact on students' future learning of more complicated fraction concepts. [ABSTRACT FROM AUTHOR]

Emotions are critical to learning. However, the function of emotions in the emerging context of massive open online courses (MOOCs) has been under‐researched. The present study complemented this line of research by modelling the relation between learner emotions, engagement with videos, engagement with assignments, and self‐perceived achievement in a small private online course—a localized instance of an extended MOOC. The results suggested that whereas enjoyment, excitement, boredom, and annoyance were all significant predictors of video engagement, only excitement and annoyance were significant predictors of assignment engagement. Excitement, in particular, was the strongest or stronger predictor of both types of engagement. In addition, both types of engagement predicted self‐perceived achievement, but video engagement predicted self‐perceived achievement via the mediation of assignment engagement. Implications for designing more effective MOOCs were proposed. Lay Description: What is currently known about the subject Emotions predict engagement in learning settings other than MOOCs.Engagement predicts achievement in learning settings including MOOCs.Assignment engagement predicts achievement in MOOCs better than video engagement. What this paper adds The two types of engagement are predicted by different sets of emotions.Engagement predicts self‐perceived achievement in the SPOC.Video engagement predicts self‐perceived achievement via the mediation of assignment engagement.The majority of systematic reviews did not evaluate the quality of the primary papers which they examined. Implications for practitioners MOOC researchers should pay more attention to the design of assignments.MOOC developers should try to build more emotionally‐sound courses and platforms. [ABSTRACT FROM AUTHOR]

Background: Failure to effectively organize and manage learning time is an important factor influencing online learners' performance. Investigation of time‐investment patterns for online learning will provide educators with useful knowledge of how learners engage in and regulate their online learning and support them in tailoring online course design and teaching. However, understanding of how learners invest and manage their time during online learning remains limited. Objectives: This study aims to discover the typical time‐investment patterns of MOOC learners and their temporal‐learning characteristics based on a systematic time‐investment analysis framework and their relationship with learning performance. Methods: Based on a proposed time‐investment‐analysis framework, this study applied statistical, cluster and lag sequential analyses to investigate learners' time‐investment patterns and their relationships with learning performance, session time allocation, and learning sequences by analysing the learning data from 12,463 participants of a Massive Open Online Course (MOOC) in China. Results and Conclusions: Seven time‐investment patterns of MOOC learners were defined, and learning performance was found to differ among them. Further analysis shows that high performers invested time throughout the whole course and allocated time to multiple activities, exam‐takers performed better in time management and produced more behavioural sequences related to cognitive strategy and recourse use, and learners' motivation and prior knowledge affected the management and effectiveness of their time investment. Implications: The results support the recognition and evaluation of online learning time‐investment patterns and suggest relevant cues for improving MOOC design and teaching. Lay Description: What is currently known about the subject matter: Insufficient learning time affects learning persistence and effectiveness in open and online education programs.Learning time investment and management regarded as an element of self‐regulated learning is a predictor of learning performance.Some proxy behavioural variables or characteristics of online learning time management have been found in previous studies.Learning analysis can be used to dig the knowledge implicit in learning data for online teaching evaluation and improvement. What is paper adds to the subject: Based on a comprehensive analytic framework, seven time‐investment patterns of MOOC learners and their relationship with achievement are identified.Under different time frames, learners' time allocation and learning behaviour pattern are different.Learners performing better in time management across course learning allocate more time to multiple activities in session learning.Exam‐takers perform better in time management across MOOC learning, and produce more behaviour sequences related to cognitive strategy and course recourse use. The implications of study findings for practitioners: The recognition of time investment pattern can support online course design and teaching improvement.MOOC design and teaching need to consider the differences in learners' time resources and their ability of time management.MOOC design and teaching need to encourage learners lacking of performance motivation to engage in various learning activities instead of just watching videos.MOOC design need consider the differences in learners' prior knowledge, and offer personalized learning path based on assessment. [ABSTRACT FROM AUTHOR]

Over the past decade, the call to foster computational thinking (CT) in every child has received considerable attention. However, there is little understanding of whether children are developmentally ready to think computationally and what specific CT concepts and skills can be developed at various ages. This study explored the developmental and gender differences in CT skills of 197 Grade 4–6 students (aged 9–13) before being exposed to instruction and investigated the age–gender interaction effects on their CT acquisition in an intervention combining both programming and non‐programming (unplugged) activities. Results show that students' CT skills followed a developmental progression before instruction. Gender difference across ages was insignificant in conditionals, logical operators, pattern recognition and generalization skills. Additionally, students of different ages developed CT differently during the intervention, and their CT acquisition was unaffected by gender. Implications for practice and research in CT education were discussed. Lay Description: What is currently known about the topic: Learning progressions for computational thinking have been defined in K‐12 curricula globally.Engaging in programming and non‐programming (unplugged) activities can increase students' CT skills.Controversial results have been reported on the age–gender interaction effects on CT development.Lack of understanding on children's actual progressive development of CT. What this paper adds: A developmental progression was found in CT skills of students aged 9–13. Students aged 12 and above had some a priori understanding of CT.No gender difference across ages existed in conditionals, logical operators, pattern recognition and generalization skills before instruction.Students aged 9–11 benefitted the most from an intervention combining both programming and unplugged activities compared to older students. Students' CT acquisition in the intervention was unaffected by gender.Given the intervention, students aged 9 and above developed conditionals, logical operators and pattern recognition skills. However, generalization skill was developed only for students aged 12 and above. Implications for practice and policy: The findings lay the foundation for designing evidence‐based age‐appropriate CT learning progression and pedagogies.Age‐appropriate learning content: Given appropriate learning experiences, students aged 9 and above may be ready to learn certain CT concepts and skills, including conditionals, logical operators and pattern recognition.CT pedagogies: Using programming and unplugged activities to develop CT requires careful consideration of students' cognitive development and gender needs. [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]

While the use of experiments is important for developing students' scientific knowledge and skills, challenges may arise when teachers and students are conducting experiments in class, such as non‐reusable experimental resources, safety issues and difficulties simulating some specific effects. Augmented reality (AR) technology affords an alternative approach to conducting experiments by bringing students a virtual–real mixed learning environment. In this study, taking junior high school physics knowledge on the magnetic field as an example, we designed and developed an AR‐based mobile simulated experiment tool. This study investigates the effect of the AR‐based experiment on students' knowledge improvement and cognitive load compared with 3D and traditional experiments. A sample of 122 ninth‐grade students was randomly chosen and assigned to three groups (AR, 3D and Traditional). The results demonstrate that students in the AR group performed better than those in the 3D and Traditional groups in terms of their knowledge improvement. The AR group students also experienced the lowest cognitive load among the three groups. Moreover, students had positive perceptions about AR and 3D tools. The implications of this study are discussed. Lay Description: What is already known about this topic: Experiment is an important method for students' magnetic field learning.Traditional magnetic experiment consists of various procedures that may cause some inconvenience during learning.Augmented reality (AR) provides a virtual–real fusion environment to assist teaching and learning.While some studies indicate positive impact of AR on learner's cognitive load, some do not. What this paper adds: An AR‐based mobile simulated experiment tool was proposed based on the junior high school physics knowledge, the magnetic field.A Comparison was made among AR, 3D and traditional experiment for magnetic field learning.Higher knowledge improvement and lower cognitive load were observed in the AR group.3D and Traditional groups showed similar knowledge improvement and cognitive load. Implications for practice and/or policy: The AR design with hand‐held devices has unlimited scalability of educational applications.Serving the real object as marker and using the professional algorithm to simulate some specific phenomenon were recommended in future AR studies.The findings indicated that AR experimental tool had a statistically significant effect on students' knowledge improvement and cognitive load.The similar result between 3D and Traditional groups implies that not everything virtualized is good; we must consider the actual teaching and learning situations. [ABSTRACT FROM AUTHOR]

Computational thinking (CT) plays a vital role in the fields of science, technology, engineering and mathematics (STEM). However, whether students' learning attitude towards STEM is related to their CT skills remains unknown. Two studies were conducted to address this knowledge gap. In Study 1, we validated a newly developed STEM learning attitude scale among a sample of Chinese primary school students (N = 489). Exploratory and confirmatory factor analysis results revealed that the scale which consisted of three factors (mathematics, science and information technology) could sufficiently measure primary school students' STEM learning attitude in the current sample. In Study 2, we explored the association between students' STEM learning attitude and their CT skills. Evidence revealed that learning attitude towards STEM significantly predicted CT skills. We also found that girls had a more positive learning attitude towards STEM than boys, and the fourth grade might be the key period for the development of CT skills. Implications for promoting primary school students' STEM learning and CT skills were also discussed. Lay Description: What is currently known about this topic: Computational thinking (CT) plays a more and more important role in K‐12 education.STEM has become a natural field for integrating CT into classroom.Students' learning attitude determines their performance and achievements.CT is influenced by personal and situational factors. What this paper adds: Reliability and validity of the STEM learning attitude scale are psychometrically good.Students' STEM learning attitude can positively predict their CT skills.Girls may have more potential for the cultivation of CT in STEM education.The fourth grade may be the key period for the development of CT skills. Implications for practice and/or policy: Promoting CT skills in STEM education by improving students' learning attitude.Adopting teaching methods according to students' psychological and cognitive characteristics.Grasping the key stage of fourth grade to develop students' CT skills.Encouraging and protecting girls' interests and ideas in STEM education. [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]

An instructor's gestures have an effect not only on students' learning but also on teaching itself. In two experiments, this study tested whether instructors' use of gestures while recording video lectures affected their teaching performance, stress, and cognitive load. In Experiment 1, participants recorded video lectures with gestures or without gestures. As hypothesized, t tests showed that participants in the gestures condition had better teaching performance and lower cognitive load than participants in the no‐gestures condition, whereas there was no effect on stress level. In Experiment 2, participants recorded video lectures with either pointing gestures or representational gestures. The t tests indicated that participants in the pointing gestures condition showed better teaching performance and experienced lower stress than those in the representational gestures condition, but there was no difference in cognitive load. Overall, our findings suggest that in the new educational environment of video lectures, instructors should consider using gestures, especially pointing gestures, to improve their teaching and their experience of teaching. Lay Description: What is already known about this topic Instructors' gestures have benefits on learners' learning.Different types of gestures have different effect.Gestures can affect speaker's cognition. What this paper adds This study explored the effect of whether instructors' gestures and different types of gestures (pointing gestures and representational gestures) during recording instructional videos on their teaching.Instructors' gestures improved their teaching performance, induced cognitive load, and enhanced teaching efficacy.Instructors' pointing gestures were outperformed than representational gestures in teaching performance and stress level. Implications for practice and/or policy Instructors should consider using gestures when recording instructional videos, especially pointing gestures. [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]

Objective: The paper characterizes outpatient communication in a major cancer hospital in southern China with regard to the structure, style and focus of doctor–patient communication. Method: Fifty‐one encounters between doctors and patients were recorded in the outpatient department of the cancer hospital and analysed inductively to identify patterns of doctor–patient outpatient communication. Results: Outpatient communication in the cancer hospital is characterized by structuralized conversation, doctor domination of the conversation and a focus on technology during communication. These characteristics suggest an extreme inequality of power between Chinese doctors and patients at the individual level. They are also shaped by the institutional environment of Chinese hospitals. Discussion: Measures should be taken at both the interpersonal and institutional level to improve doctor–patient communication. At the micro‐interpersonal level, public education and professional skills training are needed to improve communication and promote mutual understanding between patients and doctors. At the macro‐institutional level, changes are needed in terms of transforming the structural factors that shape doctor–patient communication. Conclusions: Structuralized conversation, doctor domination of the conversation and a focus on technology during outpatient encounters present challenges to effective doctor–patient communication. These patterns are shaped by the institutional environment of Chinese hospitals and suggest the extreme power imbalance between Chinese doctors and patients. [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]

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]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

Social influence has a great impact on human behavior, which has been widely investigated in various research fields. Even so, it has rarely been investigated in the online health community. In this paper, we focus on the multichannel access in online health communities, defining social influence as the average degree of multichannel access to a physician's colleagues. Based on the multinomial logistic regression model, we examined the direct effects of social influence and patients' rating to multichannel access. In addition, we explored the moderating effect of social influence on the relationship between patients' rating and multichannel access in online health communities. The results of the experiment and robustness testing support the propositions that social influence and patients' rating significantly and positively affect multichannel access in an online health community. The moderating effect of social influence is negative and significantly influences the accessible channels provided by the focal physician. This research contributes to the literature concerning online health communities, social influence, and multichannel access; it also has practical implications. [ABSTRACT FROM AUTHOR]

The term ‘nurse’ (hushi—’caring scholar’) did not enter the Chinese language until the early 20th century. Modern nursing—a fundamentally Western notion popularized by Nightingale and introduced to China in 1884—profoundly changed the way care of the sick was practiced. For 65 years, until 1949, nursing developed in China as a transnational project, with Western and Chinese influences shaping the profession of nursing in ways that linger today. Co‐authored by Chinese, Canadian, and American nurses, this paper examines the early stages of nursing in one province of China as an exemplar of the transnational nature of nursing development. By identifying sociopolitical influences on the early development of nursing in Shandong, the authors aimed not only to contribute to the nascent body of knowledge on China nursing history, but also to heighten readers’ sensitivity to the existence of historical echoes, residue, and resonances in their own nursing practices. Tracing current issues, values, or practices back to their roots provides context and helps us to better understand the present. Whether we are aware of the details or not, the gestalt of nursing practice in a particular place has been shaped by its history—including in Shandong province in China. [ABSTRACT FROM AUTHOR]

Opinion words are crucial information for sentiment analysis. In some text, however, opinion words are absent or highly ambiguous. The resulting implicit opinions are more difficult to extract and label than explicit ones. In this paper, cutting-edge machine-learning approaches - deep neural network and word-embedding - are adopted for implicit opinion mining at the snippet and clause levels. Hotel reviews written in Chinese are collected and annotated as the experimental data set. Results show the convolutional neural network models not only outperform traditional support vector machine models, but also capture hidden knowledge within the raw text. The strength of word-embedding is also analyzed. [ABSTRACT FROM AUTHOR]

The aim of this paper is to visualize the history of evidence-based medicine ( EBM) and to examine the characteristics of EBM development in China and the West. We searched the Web of Science and the Chinese National Knowledge Infrastructure database for papers related to EBM. We applied information visualization techniques, citation analysis, cocitation analysis, cocitation cluster analysis, and network analysis to construct historiographies, themes networks, and chronological theme maps regarding EBM in China and the West. EBM appeared to develop in 4 stages: incubation (1972-1992 in the West vs. 1982-1999 in China), initiation (1992-1993 vs. 1999-2000), rapid development (1993-2000 vs. 2000-2004), and stable distribution (2000 onwards vs. 2004 onwards). Although there was a lag in EBM initiation in China compared with the West, the pace of development appeared similar. Our study shows that important differences exist in research themes, domain structures, and development depth, and in the speed of adoption between China and the West. In the West, efforts in EBM have shifted from education to practice, and from the quality of evidence to its translation. In China, there was a similar shift from education to practice, and from production of evidence to its translation. In addition, this concept has diffused to other healthcare areas, leading to the development of evidence-based traditional Chinese medicine, evidence-based nursing, and evidence-based policy making. [ABSTRACT FROM AUTHOR]

With the information overload of user-generated content in microblogging, users find it extremely challenging to browse and find valuable information in their first attempt. In this paper we propose a microblogging recommendation algorithm, TSI-MR (Topic-Level Social Influence-based Microblogging Recommendation), which can significantly improve users' microblogging experiences. The main innovation of this proposed algorithm is that we consider social influences and their indirect structural relationships, which are largely based on social status theory, from the topic level. The primary advantage of this approach is that it can build an accurate description of latent relationships between two users with weak connections, which can improve the performance of the model; furthermore, it can solve sparsity problems of training data to a certain extent. The realization of the model is mainly based on Factor Graph. We also applied a distributed strategy to further improve the efficiency of the model. Finally, we use data from Tencent Weibo, one of the most popular microblogging services in China, to evaluate our methods. The results show that incorporating social influence can improve microblogging performance considerably, and outperform the baseline methods. [ABSTRACT FROM AUTHOR]

As preliminary research into the childbirth experience of migrants in China, this paper presents a systematic review of Chinese and English literature published between 1999 and 2011 on childbirth in migrants in China. Electronic databases were accessed and papers were found by keyword search. A total of 132 Chinese and 9 English papers were catalogued for review. These papers address migrant maternity issues concerning antenatal, intrapartum, postnatal care, institutional issues, family planning or birth control. Since China's economic reforms, the healthcare infrastructure has been inadequate for childbirth in migrants. They experience more adverse birth outcomes than local residents. This suggests that the effects of change upon childbirth and the existing urban and rural care systems cannot meet the needs of the migrants. There is a lack of research in the childbirth experience of women. Knowledge of their childbirth experience will contribute to the understanding of these needs, informing systems' reform. The medical approach results in many unnecessary interventions and higher costs. It is argued here that a midwifery model of care is most appropriate for the childbirth experience of migrant women. [ABSTRACT FROM AUTHOR]

This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where 'country ownership' of HSR is relatively well established and where there is significant involvement of local researchers and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. [ABSTRACT FROM AUTHOR]

In recent years, the availability of infectious disease counts in time and space has increased, and consequently, there has been renewed interest in model formulation for such data. In this paper, we describe a model that was motivated by the need to analyze hand, foot, and mouth disease surveillance data in China. The data are aggregated by geographical areas and by week, with the aims of the analysis being to gain insight into the space-time dynamics and to make short-term predictions, which will aid in the implementation of public health campaigns in those areas with a large predicted disease burden. The model we develop decomposes disease-risk into marginal spatial and temporal components and a space-time interaction piece. The latter is the crucial element, and we use a tensor product spline model with a Markov random field prior on the coefficients of the basis functions. The model can be formulated as a Gaussian Markov random field and so fast computation can be carried out using the integrated nested Laplace approximation approach. A simulation study shows that the model can pick up complex space-time structure and our analysis of hand, foot, and mouth disease data in the central north region of China provides new insights into the dynamics of the disease. [ABSTRACT FROM AUTHOR]

This paper proposes a diffusion model to measure the evolution of stakeholders' disaster perceptions by integrating a disaster message model, a stakeholder model, and a stakeholder memory model, which collectively describe the process of information flow. Simulation results show that the rate of forgetting has a significantly negative effect on stakeholders' perceptions and the incremental increase in the number of affected individuals has a positive effect on the maximum level of stakeholders' perceptions, but negative effect on the duration of stakeholders' perceptions. Additionally, a delay effect, a stagnation effect, and a cumulative effect exist in the evolution of stakeholders' perceptions. There is a spike at the beginning of the profile of stakeholders' perceptions in the Damped Exponential Model. An empirical test supports the validity of this model of stakeholders' disaster perceptions. [ABSTRACT FROM AUTHOR]