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Background: Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies. Objective: The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas. Methods: The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles. Results: Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05). Conclusion: Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) is an integral part of good quality end-of-life care. This study aimed to explore the role and practice of ACP among health and social care professionals (HSCPs) in a community long-term care facility. Methods: This was a mixed-methods study. The study purposefully sampled 12 HSCPs from one community long-term care facility in Macao, China. All data were collected in November 2022. Results: Some participants had discussed with terminally ill residents or with families in terms of end-of-life care preferences, the average correct rate of ACP knowledge was 67.4%. Interview data showed that HSCPs were primarily concerned with information-giving. The responsibility of decision-making was found to have been placed predominantly on family members of the residents. Conclusion: Study findings raised awareness in that the execution of ACP has remained in discord with the expectations in practicing ACP. The study illuminated that the perceived sense of responsibility among HSCPs was influenced by the potential legal risks involved and consequentially impacted on the adherence to individual's decisions. [ABSTRACT FROM AUTHOR]

Purpose: The Program for the Education and Enrichment of Relational Skills (PEERS®) is a group-based social skills training program for adolescents on the autism spectrum. Although the program has been shown to be effective in improving social skills in autistic adolescents, evidence of its effectiveness from the Mandarin-speaking Chinese population is sparse. The present study used a non-randomized, pre- and post-intervention research design to investigate the feasibility and cultural validity of the program, as well as examine the moderators of intervention outcomes. Methods: Thirty-three autistic adolescents with intelligence quotient above 70 (Mage = 13.57, SDage = 1.43; Male: Female 25:8) and their parents received 14 concurrent 90-minute sessions. Adolescents' autistic traits, challenging behaviors, emotional functioning, socio-cognitive process, social environment factors (school support), and caregivers' well-being were evaluated. Results: The findings suggest that with minor adjustments, the Mandarin version of PEERS® was generally acceptable and feasible for autistic adolescents and their parents. PEERS® may improve the social skills knowledge, reciprocal communication abilities, and emotional well-being of autistic adolescents. Also, participants with a higher level of school support, and parents with lower perceived subjective well-being at baseline may gain more benefits from PEERS®. The cultural adaptation and acceptability of the Mandarin Version of PEERS® were discussed. Conclusion: This feasibility study (Chinese Clinical Trial Registry: ChiCTR2200061417, 2022-06-23, retrospectively registered) provides a basis for further randomized control trials of the Mandarin version of PEERS®. [ABSTRACT FROM AUTHOR]

Policing domestic violence (DV) poses significant challenges in China due to cultural, legal, and organizational complexities. Policing DV in China favors mediation over assertive interventions, complicating law enforcement's role. While previous research has focused on coercive interventions by Chinese police, there is limited information on non-coercive, supportive approaches. This study investigates the relationship between police officers' knowledge and training regarding the Anti-DV law and their willingness to provide supportive services to DV victims in China. It also considers various individual and organizational factors. The data used in this study are derived from the Policing DV in China project, with a sample of 1,353 respondents who had experience dealing with DV cases within the past 3 years. The study focuses on three dependent variables representing supportive approaches to DV cases: Referral, Counseling, and Protection orders. Independent variables include officers' knowledge of the Anti-DV law and agency training. Control variables include the use of body-worn cameras (BWC) and attitudes toward Violence Tolerance, Male Dominance, and Gender Equality. Additionally, demographic variables, working environment, length of service, and police rank are considered. The analytical approach involves a three-step strategy, incorporating descriptive, bivariate analyses, and regression analyses. The results are interpreted using odds ratios and average marginal effects, and statistical software such as SPSS by IBM and R by Open-Source Model is utilized for data analysis. Key findings indicate that more than half of the officers referred intimate partner violence survivors to shelters and assisted victims in filing protection orders. Counseling practices varied across provinces and between male and female officers. Agency training and the use of BWC were positively associated with non-coercive and supportive approaches, while knowledge of the DV Act, male dominance score, and gender equality score did not predict the use of such approaches. Demographic characteristics, including police rank, length of service, and province of employment, influenced the utilization of non-coercive and supportive approaches. This study examines the challenges faced by Chinese police officers when responding to DV cases and their willingness to provide supportive interventions. The study highlights the complexities surrounding the initiation of protection orders due to officers' legal knowledge and discretion. The study emphasizes the importance of police support in addressing DV in China and the role of agency training in promoting non-coercive responses. It highlights regional variations in police support and underscores the need for addressing disparities in service provision across different provinces. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that Chinese Clinicians and nurses have positive attitudes toward ACP, but no local tools exist to assess their need for ACP knowledge and skills training. resulting in their inability to initiate ACP conversations as well as poor end-of-life care for patients. Therefore, this study aims to assess the needs of Chinese Clinicians and nurses for ACP knowledge and skills training and assess the validity and reliability of a questionnaire on the Training Needs for Advance Care Planning (TNACP) scale. Methods: From October to November 2021, 170 clinicians and nurses were pre-surveyed using a preliminary draft of the questionnaire. The responses were screened using item analysis, Cronbach's alpha coefficient, and the intraclass correlation coefficient (ICC) to describe the internal consistency and stability of the questionnaire. The Content validity index (CVI), Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to test the validity of the questionnaire. Results: After independent samples t-test analysis, Except for the entry "A2", the critical ratio between the two groups of the remaining 23 items was statistically significant (p < 0.05). Based on the above screening methods, the "A2" item was deleted, and the final number of questionnaire items was 23. The I-CVI was 0.79–1.00, and the S-CVI/Ave was 0.90. Three common factors were extracted—the cumulative contribution rate was 69.969%, and the factor loading of all items was 0.506–0.843 (all > 0.40). The results of confirmatory factor analysis showed that the Training Needs for Advance Care Planning (TNACP) scale model fit well(X2/df = 2.504, RMSEA = 0.092, GFI = 0.809, AGFI = 0.745, CFI = 0.931, IFI = 0.932, TLI = 0.916); the Cronbach's α = 0.888 for the total questionnaire, and the three dimensions of Cronbach's α were 0.729 to 0.959; and the ICC for the overall scores between the test-retest evaluations was 0.884 (p < 0.001). Conclusions: The TNACP scale has good reliability and validity and can be used to assess Chinese Clinicians and nurses' training needs for implementing ACP. [ABSTRACT FROM AUTHOR]

Background: Conducting of clinical trials for rare diseases faces multiple challenges. Patients' cognition and attitude toward clinical trials are crucial, which may affect their participation and compliance, and affect the schedule of clinical trials eventually. Objective and Method: This study aims to explore the knowledge and attitudes of clinical trials of patients with rare diseases or patients' guardians. An anonymous cross-sectional survey was conducted from November 1, 2021, to November 30, 2021. A total of 1131 valid questionnaires were included. Among them, 417 were filled in by the patients themselves, and 714 were answered by the patients' guardians. Results: The average score of clinical trial knowledge of the patients (8.25) was lower than that of the guardians (8.85). The willingness of the patients to participate in clinical trials was high (4.28), and the willingness of the patients' guardians was also high for patients to participate in clinical trials (4.35). The main promoting factors of clinical trial participation were the possibility of curing the disease. The main hindering factors of participation in clinical trials were lack of access to clinical trial information and concern about the safety and effectiveness of the trial drug. Conclusions: In conclusion, most respondents had some basic knowledge of clinical trials and high willingness to participate in clinical trials. But there were some cognitive deficiencies about clinical trials and many hindering factors to participate in clinical trials. Clinical trials of rare diseases should be patient-centered and truly meet the unmet clinical, psychological, and social needs of patients with rare diseases. [ABSTRACT FROM AUTHOR]

Aims. To measure nursing clinical teachers' knowledge, attitudes, and practices about nursing students (NSs) suffering from workplace violence (WPV) in China. Background. The nursing clinical teacher is the most important person for NS during the clinical rotation. In contrast, there is a lack of investigation into the ability of nursing clinical teachers to manage NSs suffering from WPV. Method. A cross-sectional survey was conducted in Hubei province, China, between June and July 2022. Convenience sampling was employed to recruit clinical teachers in 9 tertiary hospitals who met the inclusion criteria. The survey was conducted using a self-designed questionnaire which has good reliability and validity. Questionnaires were collected through a web-based platform called Questionnaire Star in China. In July 2022, a total of 900 questionnaires were eventually distributed, and 869 valid questionnaires were returned. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses. Result. The mean ± SD knowledge, attitudes, and practices scores of the nursing clinical teachers were 69.51 ± 12.78, 29.11 ± 4.38, and 82.84 ± 13.60, respectively. Also, the average score rate was 77.24%, 83.17%, and 87.20%, respectively. There are still deficiencies in the knowledge, attitudes, and practices index, such as knowledge about the sources of violence, perceptions about influencing factors, and behavioural practices for prevention. Factors affecting the knowledge index scores included teachers' age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, whether they had experienced WPV, whether they had witnessed NSs suffering from WPV, and whether their NSs had suffered from WPV. Factors affecting scores on the attitude index included the age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Factors influencing the score for the practice index included the working department, highest academic degree obtained, professional title, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Conclusion. Nursing clinical teachers showed moderate levels of knowledge, attitudes, and practices about NSs suffering from WPV. The deficiencies mainly focused on the sources, manifestations, influencing factors, and preventive strategies of it. Also, nursing clinical teachers should be trained to better prevent and cope with WPV suffered by NSs. At the same time, in order to better protect and teach NSs, the selection criteria for nursing clinical teachers should be stricter, with requirements on age, education, years of working experience, and titles. Implications for Nursing Management. With nursing clinical teachers as the training target, health organizations and institutions should actively develop training related to preventing and coping with NSs suffering from WPV. Also, it should be incorporated into the preservice training system for nursing clinical teachers. The content of training could focus on the sources, manifestations, influencing factors, and prevention strategies of NSs suffering from WPV. The method could be online theoretical teaching combined with offline scenario simulation exercises. At the same time, strict admission criteria for nursing clinical teachers can be helpful in protecting the safety of NSs during the clinical rotation phase. For nursing managers, they should be kept abreast of organisational policies and adopt a zero-tolerance policy towards violence. It also can be recommended that nursing clinical teachers should be proactively involved in training to improve their own ability to protect NSs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [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: Currently, there is no instrument available to assess intensive care unit (ICU) nurses' knowledge, attitudes, and practices (KAP) of central line--associated bloodstream infection (CLABSI) prevention practices. Purpose: To develop and validate a CLABSI questionnaire to measure ICU nurses' KAP (CLABSI-KAP-Q). Methods: Data were collected from 255 nurses at 4 hospitals in Gansu Province, China. Questions on the CLABSI-KAP-Q were generated through a review of the literature, interviews with nurses, and multiple rounds of content validity evaluation by experts. The validity and reliability of the CLABSI-KAP-Q were assessed with exploratory factor analysis, confirmatory factor analysis, internal consistency, and correlation coefficients. Results: The final version of the CLABSI-KAP-Q consisted of 32 items. The reliability was represented by a Cronbach α of 0.946, while the test-retest reliability was 0.945. The overall content validity was 0.95. Conclusions: The CLABSI-KAP-Q is shown to be valid and reliable and recommended for use in clinical practice. [ABSTRACT FROM AUTHOR]

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

Purpose: Previous research has indicated the beneficial effects of musical training on speech perception in children. However, little has been known about whether musical training exerts transfer effects on fine-grained perception of linguistic pitch and time information. This study aimed to investigate the effects of different musical training programs and training duration on preschoolers’ categorical perception (CP) of lexical tones and voice onset time (VOT) in Mandarin Chinese, which utilize pitch and time changes, respectively, to convey phonemic contrasts. Method: Sixty-one Mandarin-speaking children aged 4 years were randomly assigned to pitch-based musical training (carillon group), rhythm-based musical training (drum group), or handcraft learning (control group). Children completed the tests designed to assess their musical abilities, CP of lexical tones and VOT, IQ, and working memory at three time-points. Repeated-measures analyses of variance were conducted to evaluate the training-related effects in various tasks. Correlation analyses were used to infer the relationships between musical abilities and CP performance of speech. Results: The carillon group demonstrated advantages over the drum and control groups in music pitch processing and CP of lexical tones; besides, the drum group performed better in the music time processing and CP of VOT than the control group. Moreover, positive correlations were found between musical gains and improvements on CP of speech. Conclusions: These results provide evidence that transfer effects occur in CP of lexical tones and VOT in preschoolers. Our findings highlight the selectivity of musical advantages driven by different components of training programs and suggest that long-term musical training could be a means of early speech rehabilitation in children with communication disorders. [ABSTRACT FROM AUTHOR]

With the increased popularity of mobile learning, there is a growing demand on the understanding of how the scalable technology, such as mobile devices, influences individual learning behaviours as well as their learning outcome. A theoretical model was built based on the adaptive structuration theory (AST) and the knowledge spiral theory. Using this model, we examined the relationship between structural sources, individuals' adaptive structural behaviours, and their perceived learning. A Structural Equation Modeling method was employed in our empirical study. Findings indicate that users' task adaptation had a positive influence on their perceived learning, In addition, their exploitive technology adaptation influenced the ultimate perceived learning, but the impact of users' exploratory technology adaptation on learning was mediated by their task adaptation. Contrary to expectations, the effect of computer self-efficacy on exploitive and exploratory technology adaptation was negative, and exploratory technology adaptation negatively affected exploitive task adaptation. A detailed discussion of the findings and implications are provided in this paper. [ABSTRACT FROM AUTHOR]

This study aims to understand the knowledge, attitudes and practices of COVID-19 in the Chinese context and to provide insights for developing targeted outbreak prevention and control measures among the general public. We conducted an online survey of urban and rural residents in Henan Province. A total of 517 valid questionnaires were collected via the online platform. The mean scores for knowledge and practice were 5.57/9 and 2.04/3, respectively. More than 90% of the participants believed COVID-19 was serious and preventable, were concerned about the disease process, and actively engaged in learning related knowledge. Our results showed that the COVID-19 knowledge level was significantly different among groups with different ages, genders, education levels and marital statuses; COVID-19 practice was significantly different among different regions. Multiple linear regression analysis showed that education level, female sex, unmarried status, and health care worker status had a significant impact on COVID-19 knowledge; urban area was associated with a higher practice score; COVID-19 knowledge was significantly associated with residents' attitude toward preventive measures that can prevent COVID-19 infection; urban area was significantly related to the willingness to go to a fever clinic to check for suspected infection. We found that Chinese urban and rural residents held a moderate level of COVID-19 knowledge and practice and showed a positive attitude toward the disease. It is necessary to develop relevant education programs targeting the general population in China to improve COVID-19-related knowledge, attitudes and practices, particularly for rural and undereducated residents. [ABSTRACT FROM AUTHOR]

Teacher knowledge of Autism Spectrum Disorder (ASD) plays a key role in the successful inclusion of children with the disorder in public schools. It therefore becomes important to understand what impacts upon teachers' knowledge of ASD. As such, we aimed to investigate the role of experience and culture on teachers' knowledge of ASD. Public teachers working in the United Kingdom (UK; n = 51) and People's Republic of China (n = 59) completed questionnaires measuring the experience of teaching children with ASD and levels of knowledge about the disorder. Analysis was then conducted to examine how knowledge of ASD differed as a function of culture and experience. Results showed that teachers who had experience of working with children with ASD demonstrated a higher level of knowledge relating to the disorder. Further, teachers in the UK had significantly more knowledge of ASD than teachers in China. The results suggest cross-cultural differences in teachers' understanding of ASD. Training opportunities which allow teachers to work with children with ASD should be provided in both the UK and in China. [ABSTRACT FROM AUTHOR]

Smart manufacturing is a key element in Industry 4.0. However, studies on the relationship between manufacturers' network structure and their technology standardization capability are not available. As such, this paper develops a model to explore the relationships among enterprises' network structure, their knowledge acquisition capability and their technology standardization capability. A survey on manufacturers in China is conducted. Hypotheses are developed, and structural equation modelling is applied to analyse the model. The results indicate that the three dimensions of enterprises' network structure are positively related with their technology standardization capability. Enterprises' knowledge acquisition capability mediates the relationship between their network structure and their technology standardization capability. [ABSTRACT FROM AUTHOR]

This study aimed to examine the knowledge, attitude, and practice (KAP) of child sexual abuse (CSA) prevention among parents of children with hearing loss. The study involved 127 pairs of parents with deaf and hard of hearing children from three special education schools in Beijing and Hebei province, China. The findings revealed that the parents lacked knowledge about CSA prevention, such as the character of perpetrators and child victims. Parents were supportive about potential CSA prevention education in schools. Most parents told children much about personal safety, but topics on CSA prevention were still insufficient. The study also found that education level was significantly associated with knowledge and attitude. Elder parents knew more and talked more about CSA prevention. Mothers and girls' parents were more willing to communicate with children about CSA prevention. The conclusion of the study was that parents appeared to have gained a positive attitude, but poor knowledge and practice. Their knowledge and skills of effective communication should be strengthened to promote CSA prevention practice. [ABSTRACT FROM AUTHOR]

Objectives: Successful human papilloma virus (HPV) vaccine delivery depends heavily on parents’ attitudes, perceptions, and willingness to have their children vaccinated. In this study, we assessed parental knowledge, attitudes, and beliefs about the HPV vaccine, and examine factors associated with willingness to have eligible children receive HPV vaccination. Methods: From a community health center serving Chinese members in the Greater Philadelphia area, 110 Chinese- American parents with at least one child aged 11 to 18 who had not received HPV vaccine were recruited. Data were collected in face-to-face interviews. Results: Chinese-American parents generally lacked knowledge on HPV and the HPV vaccine, yet had a moderately high level of intention to vaccinate their children against HPV. Ordinal logistic regression results indicated that knowledge, whether or not to involve children, doctor influence, and time lived in the United States were significantly and independently related to parental intention to have their children vaccinated against HPV. Conclusion: Interventions should make efforts to raise awareness of HPV and promote vaccination in doctors’ offices. The lower level of parental intention among relatively recent immigrants indicated the necessity to target this population in public health campaigns and intervention efforts. [ABSTRACT FROM AUTHOR]

The academic underperformance of high school students with learning disabilities may reduce their access to higher education and decrease their employment opportunities. Based on stereotype threat hypothesis, the present study examined the role of stereotype threat in academic performance among adolescents with learning disabilities and the moderating role of psychological disengagement in this relation. In Study 1, 120 students with learning disabilities finished the measures of stereotype threat vulnerability and psychological disengagement, and their academic score at two time points were collected. Results showed that students who are more vulnerable to stereotype threat tend to have a lower academic score at Time 2 even after controlling for academic score at Time 1, and this relation was moderated by psychological disengagement. In Study 2, 62 sophomore students with learning disabilities finished measures of stereotype threat, academic persistence, and psychological disengagement. The results showed that the effect of stereotype threat on academic persistence was significant among students who were of low psychological disengagement, while this effect was not significant among students who were psychologically disengaged in academics. These results emphasize the individual differences of learning disabled students' response to stereotype threat and have significant implications for framing targeted interventions. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen's adaptability. Method: A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results: Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions: This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population. [ABSTRACT FROM AUTHOR]

Abstract Parents play a crucial role as protectors and educators of their children, with whom they are in an ideal position to share prevention information. This study aimed to investigate whether Chinese parents' knowledge, attitude and practice regarding child sexual abuse (CSA) prevention could be explained by health behavior change theory and whether parental practice influenced children's CSA prevention skills. Data were collected from 452 families (comprising father, mother, and child) with self-administered questionnaires gathering information on demographics, parental knowledge, attitude, educational practice regarding CSA prevention, and children's CSA prevention knowledge and strategies. Data were analysed using structural equation modeling (SEM) to assess the relationships between variables. SEM analyses indicated that parents' knowledge had an indirect effect on their educational practice (β = 0.35), mediated by attitude. Parents' educational practice regarding CSA prevention directly influenced children's self-protection skills (β = 0.21, χ2[30] = 60.909, RMSEA = 0.053, IFI = 0.905, CFI = 0.901, TLI = 0.852). The study findings suggest that parents can be effective instructors by enhancing their children's capacities to protect themselves from CSA. Efforts are therefore needed to encourage parents to engage in CSA prevention education with their children and to provide parents with necessary knowledge, communicative techniques, and resources to do so. Highlights • Parental educational practice of CSA prevention directly influenced a child's self-protection skills. • Information about CSA prevention should be passed on to children from a young age and continue to be emphasized through every developmental phase. • Greater and more nuanced efforts are needed to provide parents with necessary knowledge and communicative techniques in interactive and engaging modes, so that parents can be effective protectors and instructors in child sexual abuse prevention. [ABSTRACT FROM AUTHOR]

We explored the association between maternal nutrition knowledge, attitude, and practice (KAP) and 25-hydroxyvitamin D (25(OH)D) values in children with rickets in Xinjiang, People’s Republic of China. We recruited 514 mothers with children (<2 years) from pediatric outpatient departments. We determined general status of families, maternal nutrition KAP, and 25(OH)D values in 212 children with rickets, with doctors using “Prevention and Treatment Program for Infant and Young Children Rickets” and “Application Guideline for Vitamin D and Bone Health in Adult Chinese (2014 Standard Edition)” to identify. We then assessed the associations between nutrition KAP and 25(OH)D values. The 25(OH)D values were positively correlated with maternal nutrition KAP scores. Factors influencing rickets included per-capita monthly dietary expenditure and spousal education level. Factors associated with nutrition practice included maternal education level, gestational vitamin D level, and nutrition knowledge. Augmented maternal nutrition KAP may improve 25(OH)D levels in children with rickets to a normal range. [ABSTRACT FROM AUTHOR]

The aim of this study was to derive a competency framework from the perspective of Chinese experts in social work, and to reveal the reasons for these particular choices. Working in reference to professional competencies that have been identified by the USA, England and Hong Kong, twenty Chinese academics, fourteen Directors/Deputy Directors and fifteen senior practitioners individually chose those competencies they perceived as important and a consensus was reached in accordance with the fuzzy Delphi method. It was discovered that the Chinese framework should be constituted of twenty-four competencies in the domains of 'Values & Ethics', 'Theoretical Knowledge' and 'Practical Skills'. Following further in-depth interviews with the experts, the rationale behind these choices can be described as 'pragmatic professionalism', which prefers pragmatic competencies with de-politicising techniques. This study can be seen not only as a pioneer attempt to identify the Chinese framework of competencies from the expert perceptions, but can also be used to reflect on the current Chinese method of professionalisation, with its characteristics of pragmatism, depoliticisation and technicism. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate community pharmacist's perception on the provision of over-thecounter (OTC) traditional Chinese medicine (TCM) pharmaceutical services; focusing on the areas of their attitude, general practice, perceived barriers and suggested improvements. Methods: Questionnaire survey targeting community pharmacists in Harbin of China was applied in this study. Questionnaires were distributed and collected at community pharmacies. Data was analyzed by combining descriptive analysis and Chi-test. Results: 280 valid questionnaires were collected, giving a response rate of 78%. Respondents generally showed positive attitude towards OTC TCM pharmaceutical services. However, they were uncertain about whether such pharmaceutical services should be considered as their primary responsibility. Respondents indicated that they acted proactively to find out all the medicines taken by their patients and to remind consumers of possible OTC TCM adverse reactions. However, they were less keen on recommending or re-directing consumers to suitable OTC TCM. The three main barriers hindering the provision of OTC TCM pharmaceutical service identified in this study were "insufficient professional knowledge" (54.6%), "ambiguity of the professional role of pharmacists" (54.6%) and "lack of scientific evidence of OTC TCM" (45.4%). The three main actions considered most relevant to improving pharmaceutical service of OTC TCM were "formulating or refining legislation to clarify the legal and professional role of pharmacists with respect to TCM" (60.7%), "strengthening training of pharmacists with respect to TCM" (57.9%), and "promoting public awareness of the pharmacist's role" (53.6%). According to the results of Chi-test, respondents' perceptions about the attitude, practice, perceived barriers, and improvement suggestions were significantly different depending on the education levels, certificate types and workloads of western medicine. Conclusions: The community pharmacists in Harbin, China were positive about the provision of OTC TCM pharmaceutical services. However, they were less certain about taking this duty as their primary responsibility. Insufficient knowledge and lack of role definition in the area of OTC TCM were found to be the major factors discouraging the provision of pharmaceutical service on OTC TCM by community pharmacists. [ABSTRACT FROM AUTHOR]

Objective Empirical evidence has suggested that schizophrenia is associated with dysfunctions in the reward system and working memory. However, little is known about individuals at risk for schizophrenia. In particular, it is not known if those with schizotypal personality features will show similar deficits in these two domains. This study examined whether individuals with schizotypal personality disorder features will subjectively devalue potential rewards in the future and show changes in their decision-making behaviour, compared with healthy controls, and whether this devaluation is inversely associated with working memory performance. Method A total of 44 participants with schizotypal personality features and 22 healthy control participants without schizotypal personality features completed the Monetary- Choice Questionnaire, the Cambridge Gambling Task, and number and letter span tasks, which assessed delay-discounting rate, decision-making behaviour, and working memory, respectively. Results The results showed that participants with schizotypal personality features, especially those with negative features, valued delayed rewards in the future to a lesser extent than healthy control participants. However, there was no significant group difference in decision-making on the Cambridge Gambling Task. Moreover, the delay-discounting rate of individuals with schizotypal personality features correlated significantly with working memory performance. Conclusion The findings suggest that people with schizotypal personality features may be impaired in future reward perception and that this impairment is related to their working memory ability, although their capacity to make decisions is not affected. [ABSTRACT FROM AUTHOR]

Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre-posttest, repeated measures design, the current study explored the effectiveness of a nurse-led, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age = 61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar (p < 0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults. [Journal of Gerontological Nursing, 47(8), 17-21.] [ABSTRACT FROM AUTHOR]

Chinese immigrants in the Netherlands are less likely than other ethnic groups to utilize mainstream mental health care services. This study investigated the experiences of Chinese with mental health problems, to inform measures to make services more responsive to the needs of this group. Qualitative methods of analysis were applied to interview data in order to explore ways of finding help, barriers to accessing mainstream mental health care, experiences in care, factors jeopardizing the quality of care, and views on mental health services among Chinese migrants in the Netherlands. Rather than recruiting individuals with mental health problems, an indirect method was used in which ethnic Chinese participants were invited to tell us about one or more Chinese individuals in their social environment whom they regarded as having (had) mental health problems (). Although most Chinese regarded mainstream Dutch care as the appropriate resource for dealing with mental health problems, many barriers to access and threats to care quality were reported. In contrast to the widely accepted view that cultural differences in health beliefs underlie the low utilization of mental health services by Chinese in the West, the main obstacles identified in this study concerned practical issues such as communication problems and lack of knowledge of the health system. Respondents also described concerns about entitlement to care and discrimination (actual or anticipated). Measures suggested by respondents for improving care included increased use of interpreters and cultural mediators, encouraging migrants to increase their language proficiency, and better dissemination of information about the health system. The article concludes with a discussion of the policy implications of these findings. [ABSTRACT FROM PUBLISHER]

Background Placebo and sham acupuncture are common control strategies in acupuncture studies. However, the perception and practice of these approaches in acupuncturists are poorly documented. Objective To investigate knowledge of, attitude towards and practice of sham and/or placebo acupuncture among Chinese acupuncturists. Method A cross-sectional survey conducted in six different tertiary care hospitals of traditional Chinese medicine in Beijing, China. A total of 92 licensed acupuncturists were asked to complete a predesigned and structured questionnaire on-site. Results A response rate of 92.4% (n=85) was achieved. Almost all participants (99%, n=84) had moderate knowledge about sham and/or placebo acupuncture, but only a minority (27%, n=23) reported an excellent understanding. The general attitude towards sham and/or placebo acupuncture was positive. Most respondents (99%, n=84) thought such controls were necessary and the majority (81%, n=69) believed they were feasible in acupuncture research. More than two-thirds of participants (71%, n=60) had applied sham and/or placebo acupuncture, but only a few (8%, 5/60) used it as the most common control strategy in clinical trials. Conclusions The result of our survey suggests that Chinese acupuncturists have a moderate knowledge of, and a positive attitude towards, sham and/or placebo acupuncture. Research into sham and/or placebo acupuncture is limited in comparison with other control strategies. Therefore, an in-service education programme for acupuncturists and standardisation of sham and/or placebo acupuncture need to be developed. [ABSTRACT FROM AUTHOR]

Although many researchers found that drug use behaviors significantly increased HIV risk, few of them investigated the association between HIV risk and different drug use behaviors among female sex workers (FSWs) in China. The current study examines demographic and behavioral risk factors as well as the infections of HIV, syphilis, and among a subgroup of FSWs who are injection drug users (IDU) or noninjection drug users (NIDU) in comparison to Hepatitis C Virus (HCV) nondrug users (non-DU). We conducted secondary analysis of the 2010 National Sentinel Surveillance (NSS) data from Guangxi China. A self-administered, standard behavioral surveillance survey was completed by a total of 12,622 FSWs recruited from Guangxi, China. The Guangxi 2010 NSS sample included 2.6% NIDU and 0.5% IDU. Compared to non-DU, IDU were more likely to report no condom use in the last sex act (aOR = 3.25, 95%CI = 1.65, 6.40), inconsistent condom use in the past month (aOR = 4.88, 95%CI = 2.66, 8.96), having an HIV testing (aOR = 2.48, 95%CI = 1.34, 4.58), infections of HIV (aOR = 42.60, 95%CI = 9.45, 192.06), syphilis (aOR = 4.13, 95%CI = 1.86, 9.16), and HCV (aOR = 74.54, 95%CI = 30.26, 183.61). NIDU had 2.89 times higher than non-DU to report a history of sexually transmitted disease and 26% less likely to report inconsistent condom use in the past month (p< 0.05). We called for tailored, accessible, and nonjudgmental drug treatments coupled with effective sexual risk reduction interventions to help FSWs with various drug use problems to reduce their vulnerability and susceptibility of HIV risk in China as well as other cultural settings. [ABSTRACT FROM PUBLISHER]

Background: Suboptimal care for people with dementia in hospital settings has been reported and is attributed to the lack of knowledge and inadequate attitudes in dementia care among health professionals. Educational interventions have been widely used to improve care outcomes; however, Chinese-language instruments used in dementia educational interventions for health professionals are lacking. Objectives: The aims of this study were to select, translate and evaluate instruments used in dementia educational interventions for Chinese health professionals in acute-care hospitals. Design: A cross-sectional study design was used. Participants and setting: A modified stratified random sampling was used to recruit 442 participants from different levels of hospitals in Changsha, China. Methods: Dementia care competence was used as a framework for the selection and evaluation of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale for health professionals in the study. These two scales were translated into Chinese using forward and back translation method. Content validity, test-retest reliability and internal consistency were assessed. Construct validity was tested using exploratory factor analysis. Known-group validity was established by comparing scores of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale in two sub-groups. A person-centred care scale was utilised as a gold standard to establish concurrent validity of these two scales. Results: Results demonstrated acceptable content validity, internal consistency, test- retest reliability and concurrent validity. Exploratory factor analysis presented a single-factor structure of the Chinese Alzheimer's Disease Knowledge Scale and a two-factor structure of the Chinese Dementia Care Attitudes Scale, supporting the conceptual dimensions of the original scales. The Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale demonstrated known-group validity evidenced by significantly higher scores identified from the sub-group with a longer work experience compared to those in the sub-group with less work experience. Conclusions: The use of dementia care competence as a framework to inform the selection and evaluation of instruments used in dementia educational interventions for health professionals has wide applicability in other areas. The results support that Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale are reliable and valid instruments for health professionals to use in acute-care settings. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. Background No previous study has demonstrated whether there are differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. If there are differences, the health education regarding the stroke knowledge should be conducted separately and differently for the two groups. Methods and design We consecutively recruited 355 transient ischaemic attack patients with/without subsequent stroke from our hospital from 1 December 2008-31 December 2011. There were 304 patients receiving health education both upon hospital discharge and 90 days after discharge. Through telephone interviews, six months after discharge, only 180 patients completed the survey to determine in detail their general knowledge and compliance with secondary prevention of stroke. Results The transient ischaemic attack patients with subsequent stroke exhibited a higher identification rate of speech disorder, weakness and decreased sensation or inability to feel things, compared with those without subsequent stroke (76·1 vs. 66·3%, p < 0·05; 91·5 vs. 73·5%, p < 0·05; 62·2 vs. 46·9%, p < 0·05). The compliance rates to antiplatelet agents and statins therapy were higher in transient ischaemic attack patients with subsequent stroke compared with those without subsequent stroke (80·5 vs. 65·3%, p < 0·05; 53·7 vs. 35·7%, p < 0·05). Conclusions The transient ischaemic attack patients with subsequent stroke exhibit a higher identification rate of most of the warning signs of stroke and a better compliance with antiplatelet agents and statins therapy of stroke compared with those without subsequent stroke. Thus, we suggest that transient ischaemic attack patients should receive additional health education to increase their awareness of the harms of stroke. Relevance to clinical practice Clinicians should be aware of conducting different health education to patients with transient ischaemic attack and stroke. Also, it is important to give health education to individualised patients based on their actual risk of stroke. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To describe the level of knowledge, attitudes, and self-reported quality of practice in pain assessment among nurses of Mainland China and explore links with current hospital pain policy and continuing education. Background. Knowledge is necessary for skilled pain assessment among nurses. Little is currently known regarding knowledge, attitude toward, and self reported pain assessment by nurses from Mainland China. Methods. Quantitative research and cross-sectional convenience sampling assessed nursing knowledge, attitude, and practice among 101 nurses working in high-level hospitals in Mainland China. Results. 81.2% of nurses participating in the survey were from high-level (level three) hospitals in Mainland China. 24.8% of the nurses attended continuing education in pain assessment. No nurses from the 76 hospital staffs surveyed were able to recall any hospital policy regarding pain assessment. Knowledge regarding pain assessment was rated at 1.9 ( SD = 1.6) on a (0-7) scale. 27.7% of nurses possessed a positive attitude toward pain assessment. Pain assessment was not routine in most of the hospitals surveyed. Nurses who attended continuing education showed greater knowledge and more positive attitudes regarding pain assessment but did not show improvement in their quality of practice. Conclusions. This study identified inadequate knowledge and low level of self-reported pain assessment practice among nurses working in high-level hospitals in Mainland China. Current education did not influence nursing self-reported pain assessment practice. Knowledge of pain evaluation should be improved through newer approaches to education. A better policy framework for pain evaluation may also contribute to improvement. [ABSTRACT FROM AUTHOR]

Aims and objectives To prospectively evaluate the effects of a nurse-led educational intervention on the management of hyperphosphataemia as well as knowledge of phosphate among patients with end-stage renal disease. Background Haemodialysis and phosphate binder therapy are the major methods used to reduce the phosphate level in dialysis patients. However, patient education related to hyperphosphataemia, diet and phosphate binders may be another important factor associated with the success of the control of the hyperphosphataemia. Design This prospective randomised controlled trial was conducted during the period from June 2009-March 2011 at the HD units of two hospitals in Tianjin, China. Methods A total of 80 participants were randomly assigned to experimental group ( n = 40) and control group ( n = 40). Participants in the experimental group received the nurse-led intensive educational programme, including individualised education and educational session about diet and medicine regimes, etc., while participants in the control group received the routine guidance. Results There were statistically significant differences between the study groups in decline in serum phosphorus and calcium-phosphorus product levels and improvement in patients' general knowledge three months postintervention, and these differences sustained until the end of the study. Increased serum calcium level was observed both in the experimental group and in the control group, but there was no significant difference between groups. No statistical significance was found regarding serum albumin level between the groups. No significant difference in the serum parathyroid hormone level was found between the groups by month 6. Conclusions Nurse-led intensive educational programme plays an important role in the control of hyperphosphataemia among patients with end-stage renal disease. Relevance to clinical practice Chronic kidney failure patients with hyperphosphataemia are more likely to benefit from nurse-led intensive educational programmes. [ABSTRACT FROM AUTHOR]

Background: Locally harvested wild edible plants (WEPs) provide food as well as cash income for indigenous people and are of great importance in ensuring global food security. Some also play a significant role in maintaining the productivity and stability of traditional agro-ecosystems. Shangri-la region of Yunnan Province, SW China, is regarded as a biodiversity hotspot. People living there have accumulated traditional knowledge about plants. However, with economic development, WEPs are threatened and the associated traditional knowledge is in danger of being lost. Therefore, ethnobotanical surveys were conducted throughout this area to investigate and document the wild edible plants traditionally used by local Tibetan people. Methods: Twenty-nine villages were selected to carry out the field investigations. Information was collected using direct observation, semi-structured interviews, individual discussions, key informant interviews, focus group discussions, questionnaires and participatory rural appraisal (PRA). Results: Information about 168 wild edible plant species in 116 genera of 62 families was recorded and specimens were collected. Most species were edible greens (80 species) or fruits (78). These WEPs are sources for local people, especially those living in remote rural areas, to obtain mineral elements and vitamins. More than half of the species (70%) have multiple use(s) besides food value. Some are crop wild relatives that could be used for crop improvement. Several also have potential values for further commercial exploitation. However, the utilization of WEPs and related knowledge are eroding rapidly, especially in the areas with convenient transportation and booming tourism. Conclusion: Wild food plants species are abundant and diverse in Shangri-la region. They provide food and nutrients to local people and could also be a source of cash income. However, both WEPs and their associated indigenous knowledge are facing various threats. Thus, conservation and sustainable utilization of these plants in this area are of the utmost importance. Documentation of these species may provide basic information for conservation, possibly further exploitation, and will preserve local traditional knowledge. [ABSTRACT FROM AUTHOR]

Parent-child acculturation discrepancy has been considered a risk factor for child maladjustment. The current study examined parent-child acculturation discrepancy as an ongoing risk factor for delinquency, through the mediating pathway of parental knowledge of the child's daily experiences relating to contact with deviant peers. Participants were drawn from a longitudinal project with 4 years between data collection waves: 201 Chinese immigrant families participated at Wave 1 (123 girls and 78 boys) and 183 families (110 girls and 73 boys) participated at Wave 2. Based on the absolute difference in acculturation levels (tested separately for Chinese and American orientations) between adolescents and parents, one parent in each family was assigned to the 'more discrepant' group of parent-child dyads, and the other parent was assigned to the 'less discrepant' group of parent-child dyads. To explore possible within-family variations, the mediating pathways were tested separately among the more and less discrepant groups. Structural equation modeling showed that the proposed mediating pathways were significant only among the more discrepant parent-adolescent dyads in American orientation. Among these dyads, a high level of parent-child acculturation discrepancy is related to adolescent perceptions of less parental knowledge, which is related to adolescents having more contact with deviant peers, which in turn leads to more adolescent delinquency. This mediating pathway is significant concurrently, within early and middle adolescence, and longitudinally, from early to middle adolescence. These findings illuminate some of the dynamics in the more culturally discrepant parent-child dyad in a family and highlight the importance of examining parent-child acculturation discrepancy within family systems. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to broadly assess the level of knowledge, attitude and behaviors related to sexual and reproductive health (SRH) among unmarried female migrants in China. Material and Methods: This cross-sectional study was conducted and a self-administered questionnaire was designed for collecting information on SRH including 15 items for knowledge, 8 items for attitude and some items for contraception and abortion related behaviors. Results: A total of 1690 unmarried female migrants were interviewed. Most of the respondents had less knowledge of SRH. Only one-third of respondents was aware of emergency contraceptives and could freely talk about SRH with their friends. Over one-third of respondents were not willing to come into contact with someone with AIDS or STDs. In this study, 10.4% participants had an unwanted pregnancy and 95% of them had an abortion. Multivariate analysis showed that having a boyfriend, duration of employment in city, knowledge on SRH and freely discussing SRH with peer were associated with having premarital sex among these unmarried female migrants. Conclusion: This study revealed that the unmarried female migrant was one of the most vulnerable groups concerning SRH. In some policy reforms, appropriate and cost-effective SRH services should be provided for these migrants. [ABSTRACT FROM AUTHOR]

Background: Initial knowledge of professionalism among medical students is particularly important for designing effective professionalism curricula and for studying the change in the knowledge of professionalism. Aim: The study examined first-semester medical students' initial knowledge of important attributes of good doctors. Methods: Mixed methods were used to examine initial knowledge among first-semester students from a Chinese medical college. We used an open-ended survey to identify attributes of good doctors and grounded theory analysis to find emergent themes. We also used a close-ended survey to solicit students' responses to 50 attributes of good doctors and explorative and confirmatory factor analysis to examine underlying factors. Results: 973 students completed the open-ended survey while 1730 students completed the close-ended survey. Through grounded theory analysis, 24 subthemes and three themes that include Ethics, Skill, and Person, emerged from the data. Explorative and confirmatory factor analysis showed convergent results: 24 valid items and three factors that include Ethics, Skill, and Person were identified. Conclusion: The initial knowledge of medical professionalism among first-semester students involves approximately 24 important attributes within three major dimensions of Ethics, Skill, and Person, with an overwhelming emphasis on Ethics. It is neither sophisticated nor comprehensive, compared with specialists' professional knowledge. [ABSTRACT FROM AUTHOR]

Background: Historically, indigo-yielding plant species were important cash crops from Central Asia to the southern United States and Central America. Indigo-dyed textiles were widely traded along the legendary Silk Road that linked China to Europe. Today, due to the labor-intensive nature of indigo extraction at the household level, lifestyle changes and the widespread availability of commercially produced indigo paste, traditional indigo extraction methods have declined in villages. Yet Li textile weavers on Hainan Island are internationally recognized as producers of indigo-dyed textile using warp ikat techniques. In contrast, Hainan Miao weavers produce indigo-dyed textiles using batik (wax resist) techniques. The aim of this study was to document the indigenous knowledge on indigo-yielding plant species used by both Hainan Miao and Li people on Hainan Island, China. Method: Ethnic uses were documented during three field surveys, through a questionnaire survey of 193 respondents, comprising 144 Hainan Miao and 49 Li traditional dyers. Mention index (QI), Availability index (AI), and Preference ranking (PR) of each indigo-yielding plant species were calculated to screen out plant resources with potential development value. Results: Five indigo-yielding plant species (from four plant families and four genera) were historically used by Hainan Miao and Li dyers. However, just four species are still in use. Strobilanthes cusia was the main indigo source for Hainan Miao dyers. Li dyers also commonly use Indigofera species (I. tinctoria and I. suffruticosa) for indigo extraction. Wrightia laevis is less commonly used as a contemporary indigo source. Indigo extraction by steeping in water to which lime is added to increase the pH is sharing by the five indigo-yielding plant species. Strobilanthes cusia had the highest QI, AI and PR values in Hainan Miao villages. Indigofera tinctoria had the highest QI and AI values, but Indigofera suffruticosa was preferred by Li dyers. Conclusion: In the process of modernization and urbanization, some Hainan Miao and Li dyers retain the traditional indigo extraction methods. We found that Strobilanthes cusia and Indigofera tinctoria have the most potential for sustainable indigo production in the future. Furthermore, this study documents the details of extraction method from Wrightia laevis for the first time and the use of Ricinus communis seeds in that process. As one of the last places globally where Wrightia laevis is still used for indigo production, the may also be a nice market among textile collectors and museums that keeps the tradition of Wrightia laevis production and use for indigo extraction alive. [ABSTRACT FROM AUTHOR]

Background: Visual impairment is an important disability affecting a substantial proportion of people globally. The aim of this study was to assess the oral health status of visually impaired schoolchildren in northeast China, and to investigate the influencing factors. Methods: The study was performed in 2015, according to the criteria and methods used in the Third National Oral Health Epidemiological Survey in China. One hundred and three visually impaired schoolchildren from the only special school for the blind in northeast China were included in the study. Oral examinations were performed to assess the caries of deciduous and permanent teeth, periodontal disease, malocclusion. A questionnaire-based survey was conducted to investigate oral health-related behaviors, knowledge and attitude about oral care. Results: The overall prevalence of caries was 78.64%, and mean number of caries was 2.43 ± 2.75. The prevalence of caries in deciduous and permanent teeth was 65.22 and 71.84%, respectively. The rates of gingival bleeding and dental calculus were 44.66 and 67.96%, respectively. Malocclusion was observed in 49.51% of the children with visual impairment. The prevalence of caries was significantly higher in girls than boys (P < 0.05). The logistic regression analysis identified the knowledge level of parents and the toothache experience as risk factors for oral health, while the daily use of fluoride toothpaste could reduce the caries incidence. Conclusions: This group of visually impaired schoolchildren exhibited a high prevalence of dental caries, poor periodontal health, and severe malocclusion. Oral health status is relatively poor among visually impaired schoolchildren in northeast China. Factors that significantly affected the prevalence of dental caries included education level of the mother, experience of toothache, and use of fluoride toothpaste. [ABSTRACT FROM AUTHOR]