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Objectives: This paper has two objectives. First, it assesses whether the existing informal care provided by adult children has an impact on older people's propensity to demand community care services. Second, it compares the different statuses of sons and daughters in the formal/informal support trade‐off. Methods: The paper is based on an analysis of data from the 2018 wave of the China Longitudinal Ageing Social Survey, within the framework of a revised version of Andersen's model, and applies multilevel models to analyse the effects of adult children's gender, numbers and the quality of their support, on older people's willingness to purchase community care services. Results: Older people who had sons as well as daughters demanded fewer services, while the number of sons increased service demand. Regarding sons, community care services compensated for economic support, daily life care and spiritual consolation, but did so only in respect of daily life care from daughters. Conclusions: Many families have only one son or one daughter as a result of the one‐child policy and therefore often require support from formal care services. Moreover, there is a distinct gender division and an influential filial culture governing the impact of services on the support provided by adult children. Because ageing in place depends on both informal family support and formal services, this key policy goal is at risk if the latter provides insufficient support to the former. [ABSTRACT FROM AUTHOR]

This study was aimed at comparing different formats of illustrations for children's books created by modern Chinese and Ukrainian artists. At the same time, it was not focused just on determining the leading format, but on identifying the attractiveness factors of each format. To this end, the study investigated children's illustration preferences drawing from the following three age groups: 5–6 years old (preschoolers), 7–8 years old (second‐graders), and 9–10 years old (fourth‐graders). According to the survey, children were most concerned with illustration colourfulness (this is true for paper and pop‐up books) and viewing convenience. There were no statistically significant differences found between Chinese and Ukrainian books in terms of these parameters. At the same time, Chinese e‐books appeared to outperform the Ukrainian texts in terms of feature management and illustration colourfulness. Publishers and artists of children's books can use these data for effective creative activity and making constructive decisions. At the same time, these findings may be of interest to parents, informing or guiding book selection for children. [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]

Background: Computational thinking (CT) has become a crucial skill for individuals in the 21st century, and while more educators are starting to recognize the importance of CT education, there is still a lack of research on how to teach young children CT, particularly outside of traditional school settings. Objectives: To fill the gap in knowledge, we aimed to investigate the effectiveness of a web‐based parent education program on improving children's CT skills. Additionally, we sought to determine if children's age, gender and family socioeconomic status had any impact on the development of CT skills. Methods: We selected 86 adult–child pairs in the K3 age group to participate in a 4‐week intervention program using a quasi‐experimental approach. Results: After 4 weeks, children in the intervention group had improved their CT skills more than their peers in the control group. This shows that the intervention was successful in enhancing children's CT skills. Age had a moderating effect on CT enhancement, with older children showing a more significant improvement than younger children. However, children's gender and family socioeconomic status did not have any moderating effects. Conclusions: These results demonstrate that CT education can be effectively implemented in the home setting through web‐mediated parent education. Encouraging the use of unplugged CT activities at home can aid children in acquiring CT skills. Lay Description: What is already known about this topic: Computational thinking (CT) education can be started at the early childhood stage.Both plugged‐in and unplugged activities can promote children's CT.Unplugged activities have many advantages and are suitable for young children. What this paper adds: Web‐mediated parent education is useful for equipping parents with the knowledge and skills to conduct CT activities at home.CT education has a positive effect on children in the home setting.Parents play an important leading role in children's CT education.Parent–child unplugged activities are beneficial to children's CT enhancement. Implications for practice and/or policy: A web‐mediated approach is an appropriate way to encourage parent participation in CT training.CT‐related parent education should be scaled up so that parents can play an active educational role at home.Unplugged CT activities should be designed more for the home settings in addition to school settings. [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]

This study tests the effect of age diversity on firm performance among international firms. Based on the resource-based view of the firm, it argues that age diversity among employees will influence firm performance. Moreover, it argues that two contextual variables-a firm's level of market diversification and its country of origin-influence the relationship between age diversity and firm performance. By testing relevant hypotheses in a major emerging economy, that is, the People's Republic of China, this study finds a significant and positive effect of age diversity and a significant interactive effect between age diversity and firm strategy on profitability. We also find a significant relationship between age diversity and firm profitability for firms from Western societies, but not for firms from East Asian societies. The paper concludes by discussing the implications of this study's findings. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether resilience mediates the connection between caregiver burden and hope among caregivers of patients with inflammatory bowel disease (IBD). Design: A cross‐sectional study. Methods: Two hundred patients with IBD were conveniently sampled from two tertiary hospitals in Jiangsu Province, China. The main instruments involved the Zarit Burden Interview, the 10‐item Connor‐Davidson resilience scale, and the Herth Hope Index. We conducted descriptive analysis and Pearson correlations using SPSS 25.0. The PROCESS v3.3 macro analysed the mediating effect. We report the results in line with the STROBE checklist. Results: Caregiver burden was significantly negatively connected with hope and resilience, whereas resilience positively correlated with hope. The mediation role of resilience was significant in the relationship between caregiver burden and hope, with mediating effects accounting for 47.86% of the overall effect. Conclusions: Resilience partially mediates the association between caregiver burden and hope among patients with IBD. This finding highlights the protective role of resilience in undermining caregiver burden and strengthening hope. Implications for Practice: In clinical practice, healthcare providers should perform routine psychological assessments for caregivers of patients with IBD. Furthermore, resilience training should be incorporated into interventions to alleviate caregiver burden and enhance hope. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to investigate the current status of the core competencies and self‐directed learning ability of diabetes specialist nurses and to explore the relationship between these core competencies and their self‐directed learning ability. Design: A cross‐sectional survey design was used. Methods: This cross‐sectional study was conducted via a web‐based questionnaire platform in China from January 14 to April 24, 2023. The survey included a general information questionnaire, a diabetes specialist nurses' core competencies self‐assessment scale, and a nursing staff's self‐directed learning ability evaluation scale. The data was collected online. Descriptive, correlation and multiple linear regression analyses were conducted using SPSS 26.0 software. Results: 118 diabetes specialist nurses from 11 cities participated in this study. A positive correlation was observed between the core competencies of diabetes specialist nurses and their self‐directed learning ability. The characteristics affecting the core competencies of diabetes specialist nurses included age, participation in external learning and communication and self‐directed learning. Conclusions: The training of diabetes specialist nurses can focus on core competencies, and the ability to self‐direct learning can be used as an entry point to customize feasible theoretical and practical courses. The training system can further improve diabetes specialist nurses' core competencies and self‐directed learning abilities. Relevance to Clinical Practice: A reference can be established that nursing managers and nursing educators can use to develop training programs for specialist nurses by validating the link between their core competencies and self‐directed learning skills. Patient or Public Contribution: Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation. [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]

Background: To identify independent factors of cognitive frailty (CF) and construct a nomogram to predict cognitive frailty risk in patients with lung cancer receiving drug therapy. Methods: In this cross‐sectional study, patients with lung cancer undergoing drug therapy from October 2022 to July 2023 were enrolled. The data collected includes general demographic characteristics, clinical data characteristics and assessment of tools for cognitive frailty and other factors. Logistic regression was harnessed to determine the influencing factors, R software was used to establish a nomogram model to predict the risk of cognitive frailty. The enhanced bootstrap method was employed for internal verification of the model. The performance of the nomogram was evaluated by using calibration curves, the area under the receiver operating characteristic curve, and decision curve analysis. Results: A total of 372 patients were recruited, with a cognitive frailty prevalence of 56.2%. Age, education background, diabetes mellitus, insomnia, sarcopenia, and nutrition status were identified as independent factors. Then, a nomogram model was constructed and patients were classified into high‐ and low‐risk groups with a cutoff value of 0.552. The internal validation results revealed good concordance, calibration and discrimination. The decision curve analysis presented prominent clinical utility. Conclusions: The prevalence of cognitive frailty was higher in lung cancer patients receiving drug therapy. The nomogram could identify the risk of cognitive frailty intuitively and simply in patients with lung cancer, so as to provide references for early screening and intervention for cognitive frailty at the early phases of drug treatment. [ABSTRACT FROM AUTHOR]

Aim: Analysed clinical characteristics and influencing factors for hypoglycemia in hospitalized patients with type 2 diabetes mellitus (T2DM), and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM. Design: A cross‐sectional study. Methods: This study involved 378 hospitalized patients diagnosed with T2DM who have suffered hypoglycemia. Through questionnaires and electronic medical records to obtain the data concerning the general information, clinical symptoms, all recorded blood glucose information, and the diabetes knowledge and self‐management level of the patients. The clinical characteristics and influencing factors for hypoglycemia were analysed on the basis of the classification of hypoglycemia published by the American Diabetes Association in 2020. Results: Among 378 patients, 207 patients (54.76%) were experiencing Grade 1 hypoglycemia and 171 patients (45.24%) were experiencing Grade 2 hypoglycemia. Hypoglycemia and Grade 2 hypoglycemia in patients with T2DM occurred predominantly within the first 3 days of hospitalization. Hypoglycemia occurred most frequently after breakfast (74 cases, 19.6%), of which Grade 1 hypoglycemia and Grade 2 hypoglycemia accounted for 50%, respectively. Multivariable logistic regression identified risk factors for Grade 2 hypoglycemia in hospitalized patients with type 2 diabetes: older age, longer duration of diabetes, low body weight, diabetic nephropathy stages 4–5, diabetic autonomic neuropathy, inadequate self‐management ability and diabetes knowledge, and lower educational background. Conclusions: Hypoglycemia in type 2 diabetes occurs in the first 3 days during the hospitalization and most often after breakfast during the full day. Identifying high‐risk individuals and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM. [ABSTRACT FROM AUTHOR]

SummaryIntroduction1Definitions of ethnic groups and demographics of minority ethnic groups in the UK○ 1.1 Definitions of 'ethnic groups' and 'ethnicity'○ 1.2 Demographics and characteristics of minority ethnic groups in the UK– Countries of origin– Age/sex distribution and life expectancy– Geographical distribution and size of household– Religious beliefs– Education and employment patternsKey points2Overview of the health profile and dietary habits of minority ethnic groups in the UK○ 2.1 Available surveys○ 2.2 Overview of the health profiles among adults from minority ethnic groups– Overall health– Cardiovascular disease (CVD)– Coronary heart disease (CHD)– Stroke– Type 2 diabetes– Obesity○ 2.3 Possible causes of increased disease risk among minority ethnic groups○ 2.4 Smoking, drinking and physical activity habits○ 2.5 Dietary habits and nutritional status○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups– Overall health– Diet and health behaviour patterns○ 2.7 Gaps in data availabilityKey points3Factors affecting food choice– Income and socio‐economic status– Food availability and access– Awareness of healthy eating– Religious beliefs– Food beliefs– Time and cooking skills– Generation and genderKey points4Traditional diets of minority ethnic groups○ 4.1 Overview of traditional diets of minority ethic groups– South Asians– African‐Caribbeans– Chinese○ 4.2 Dietary acculturation○ 4.3 Nutritional composition of ethnic‐style cuisineKey points5Nutritional interventions and health promotion among minority ethnic groups○ 5.1 Effective nutritional interventions○ 5.2 Health promotion interventions to prevent problems associated with fasting○ 5.3 Priorities for nutritional interventions and health promotion○ 5.4 Using behaviour change models○ 5.5 Current community initiatives○ 5.6 Catering for institutionalised individuals○ 5.7 Recommendations for future research, policy and practiceKey points6Conclusion• Acknowledgements• References Summary: According to the latest census, non‐white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African‐Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well‐designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non‐white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to qualitatively explore the food choice determinants of both Chinese immigrants living in Australia and Chinese people living in mainland China. Methods: Eight Chinese Australian participants (female, n = 5; male, n = 3) and ten mainland Chinese participants (female, n = 5; male, n = 5) were recruited from Australia (primarily in Melbourne, Victoria) and China (predominantly in Zhengzhou, Henan province) between June 2021 and March 2022. Participants were diverse in age, socio‐economic background, occupation and health status. Semi‐structured in‐depth interviews were conducted in Mandarin either face‐to‐face or using online video/voice calls. Interviews were audio‐recorded and transcribed verbatim. Investigator triangulation was used to enhance scientific rigour. Results: Four themes were identified: (1) food choice determinants were shaped by traditional and modern nutrition perceptions and personal food philosophy; (2) physiological responses to food provide direct feedback that impacts future food choices; (3) consideration of convenience was a predominant influencer of food choice; and (4) the differences in food environments between China and Australia promoted distinctive food choice determinants for Chinese people. Conclusions: Chinese Australian and mainland Chinese participants' food choices are shaped by traditional Chinese nutrition philosophy, modern Western nutrition science and the contemporary food environment. There are clear cultural characteristics in their food choice determinants that should be considered by health educators, nutrition professionals and nutrition policymakers when developing culturally appropriate health interventions for Chinese people. Key points: This exploratory study identified various influencers of food choice in Chinese population, informing health educators to consider cultural aspects when planning interventions for Chinese communities. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of SUI and explore the factors that could influence the severity of SUI in adult females. Design: A cross‐sectional study. Methods: A total of 1178 subjects were assessed using a risk‐factor questionnaires and International Consultation on Incontinence Questionnaire Short Form (ICIQ‐SF) and then divided into no SUI group, mild SUI group and moderate‐to‐severe SUI group according to the ICIQ‐SF score. Univariate analysis between adjacent groups and ordered logistic regression models in three groups were then performed to analysis the possible associated factor with the progressive of SUI. Results: The prevalence of SUI among adult women was 22.2% of them; 16.2% and 6% had mild SUI and moderate‐to‐severe SUI, respectively. Moreover, logistic analysis revealed that age, BMI, smoking, position preference for urination, urinary tract infections, urinary leaks during pregnancy, gynaecological inflammation and poor sleep quality were independent risk for the severity of SUI. Conclusion: SUI symptoms were mostly mild among Chinese females, specific risk factors such as unhealthy living habits and urination behaviours increased the risk of SUI and the aggravation of symptoms. Therefore, targeted interventions should be formulated for women to delay disease progression. [ABSTRACT FROM AUTHOR]

Physical distancing and contact restrictions have been implemented in most countries and territories due to the rapid spread of SARS‐CoV‐2. This has caused physical, emotional, and psychological distress for adults living in the community. Diversified telehealth interventions have been widely applied in health care and have proven to be cost‐effective and well accepted by patients and health professionals. Currently, the effectiveness of telehealth interventions on psychological outcomes and quality of life among community adults during the COVID‐19 pandemic remains unclear. A literature search was conducted using PubMed, PsycINFO, CINAHL, EMBASE, MEDLINE, and the Cochrane Library from 2019 to October 2022. Twenty‐five randomized controlled trials with 3228 subjects were finally included in this review. Two independent reviewers performed the screening, extraction of key data points, and appraisal of the methodological quality. There were positive effects of telehealth interventions on anxiety, stress, loneliness, and well‐being among community adults. Participants who were women or older adults were more likely to recover from negative emotions, increase well‐being, and improve quality of life. The real‐time and interactive interventions and remote cognitive‐behavioural therapy (CBT) may be better choices during the COVID‐19 pandemic. Based on the findings of this review, health professionals have more options and alternatives for delivering telehealth interventions in the future. Rigorously designed randomized controlled trials (RCTs) with higher statistical power and long‐term follow‐up should be conducted in the future to strengthen the currently weak evidence. [ABSTRACT FROM AUTHOR]

Background: Meeting 24‐h movement guidelines for children and adolescents has been associated with improved health indicators. However, the literature examining adherence to 24‐h movement guidelines among Chinese children and adolescents with intellectual disability (ID) remains lacking. This study aims to investigate the prevalence of meeting the 24‐h movement guidelines and its socio‐demographic correlates for this population. Methods: The sample includes 319 Chinese students with ID. Accelerometers are used to measure moderate‐to‐vigorous physical activity time and sleep duration. Questionnaires are adopted to measure screen time (ST) and demographic factors. Associations among socio‐demographic factors, body mass index and 24‐h movement are analysed by using multivariable logistic regressions. Results: The proportions of participants who meet none, moderate‐to‐vigorous physical activity, ST, sleep duration and all three recommendations are 8.15%, 33.54%, 54.23%, 75.55% and 17.55%, respectively. In general, multivariable logistic regression analysis indicates that older participants are less likely to meet the ST guidelines [odds ratio (OR): 0.931; 95% confidence interval (CI): 0.869–0.998] and more likely to meet the sleep guidelines (OR: 1.106; 95% CI: 1.016–1.204) than younger individuals. Participants with moderate ID are less likely to meet the sleep guidelines (OR: 0.345; 95% CI: 0.140–0.850) than those with profound ID. Individuals from families with middle‐income (OR: 0.434; 95% CI: 0.226–0.836) and high‐income (OR: 0.219; 95% CI: 0.080–0.605) levels were less likely to meet the physical activity guidelines than those from low‐income families. Furthermore, participants from high‐income families were less likely to meet ST (OR: 0.426; 95% CI: 0.187–0.969) and all three movement guidelines (OR: 0.083; 95% CI: 0.010–0.659) than those in the low household income groups. Conclusions: Interventions that improve the health‐related behaviours of children and adolescents with ID are needed, particularly those that target their increased engagement in physical activity. [ABSTRACT FROM AUTHOR]

Aim: To explore the relationship between the serum sodium level on admission and all‐cause mortality in HF patients. Design: A single‐center retrospective cohort study. Methods: Patients hospitalized with HF at the Heart Failure Center, Fuwai Hospital, from November 2008 to November 2018 were enrolled. Results: A total of 3649 patients were included, and the mean sodium level was 137.19 ± 4.36 mmol/L, with a range from 115.6 to 160.9 mmol/L. During a median follow‐up of 1101 days, mortality occurred in 1413 (38.7%) hospital survivors. After adjustment for age, sex, and other potential confounders, patients with sodium levels <135 mmol/L (hazard ratio [HR]: 1.67; 95% confidence interval [CI]: 1.29–2.16) and 135–137 mmol/L (HR: 1.34; 95% CI: 1.01–1.78) had an increased risk of all‐cause mortality compared to those with sodium levels of 139–141 mmol/L. [ABSTRACT FROM AUTHOR]

Background: Most nursing interns have suffered some form of workplace violence in clinical settings, which has been linked to the jeopardizing of patient safety. Although previous research studies have examined the effect of workplace violence on patient safety, few studies have examined whether workplace violence is associated with patient safety through professional identity and professional burnout among nursing interns. Aims: To test whether professional identity and professional burnout play mediating roles in the relationship of workplace violence and patient safety among nursing interns. Design: Cross‐sectional study. Methods: The study included 466 nursing interns from three tertiary grade A hospitals. The Workplace Violence Scale, the Professional Identity Scale, the Maslach Burnout Inventory‐General Survey, and the Patient Safety Behaviour Scale were used to gather data. Associations among workplace violence, professional identity, professional burnout, and patient safety were assessed by correlation and the serial‐multiple mediation analysis. Results: Workplace violence, professional identity, professional burnout and patient safety were significantly correlated. Workplace violence can have a direct positive impact on patient safety of nursing interns, but also an indirect impact on patient safety through three paths: the independent mediating role of professional identity, the independent mediating role of professional burnout, and the chain mediating role of professional identity and professional burnout. Conclusions: Our findings suggest that workplace violence can affect patient safety through decreasing professional identity and increasing professional burnout among nursing interns. Interventions aimed at decreasing workplace violence among nursing interns would be beneficial for professional attitude and patient safety. [ABSTRACT FROM AUTHOR]

Using high‐precision zircon U‐Pb ID‐TIMS geochronology, tuffs from the Chang 9 shale and the Chang 7 shale were dated. The tuff in the Chang 9 shale is 241.47 ± 0.17 Ma, which falls between the top tuff age of 241.06 ± 0.12 Ma and the bottom tuff age of 241.558 ± 0.093 Ma in the Chang 7 shale. These reveal that the Chang 9 and Chang 7 shales are contemporaneous, belonging to the Ladinian stage of the Middle Triassic. This insight expands the region of the main source rock of Chang 7 to the northeast and will inform the search for the deep Chang 9 shale petroleum system, increasing the scope for exploring the Chang 7 shale system in northern Shaanxi. The research results clarify the relationship between the two sets of shale in the Yanchang Formation and redefine the distribution range of the Chang 7 shale in the Ordos Basin. At the same time, it shows that there is a cross‐layer problem in the stratigraphic division of the Yanchang Formation in different regions, the high‐precision U‐Pb dating technology providing a reference for the fine stratigraphic correlation of other continental basins in the world. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe critical thinking dispositions among newly graduated nurses with different educational background in China and to explore related factors. Design: A cross‐sectional questionnaire survey. Methods: The data were collected using the Chinese Version of Critical Thinking Dispositions Inventory (CTDI‐CV). Overall, 588 newly graduated nurses finally completed the survey. Spearman and Pearson's correlation coefficients were used to examine the correlation between the CDTI‐CV and nurses' general characteristics. Results: In terms of open‐mindedness, analysis and inquisitiveness subscales, significant differences were found among nurses based on three educational level. When dichotomizing total CTDI scores into high and low, nearly 80% of the respondents fell into low score group. Pressure from workplace was high for 68.4% of them. Significant correlation was found among the new graduated nurses' critical thinking ability and their age, education level, reading habit and attitude towards nursing profession. [ABSTRACT FROM AUTHOR]

Background: Erythrocyte parameter analysis is the important means for diagnosis and treatment of hematological diseases, which are essential for screening of thalassemia in southern China combined with hemoglobin electrophoresis analysis. But little is known regarding the reference intervals (RIs) in healthy pediatrics in these two areas. Methods: 95% RIs of erythrocyte parameters were calculated from 853 healthy preschoolers, aged from 1 days to <6 years, according to the C28‐A3C guidelines of the Institute of Clinical and Laboratory Standards. To express the magnitude of sex and age variation, standard deviation ratio (SDR) was calculated using ANOVA. Concurrently, we selected 3814 thalassemia carriers as carriers group and drew receiver operating characteristic (ROC) curves to establish the optimal cut‐off values of hemoglobin electrophoresis parameters, which were used as the upper/lower limits of RIs to efficiently screen thalassemia. Results: All parameters except red blood cell (RBC) required age partitioning, confirmed by SDRage above.4. There was no need for sex partitioning on all parameters, confirmed by SDRsex below.4. The optimal cut‐off value of Hemoglobin A2 (Hb A2) in the four subgroups was <7.8% (Hb A), 2.3%–3.2%, 2.5%–3.6% and 2.6%–3.6%, respectively. Conclusion: In this study, the establishment of RIs improved the diagnostic efficiency of hematological disease (especially thalassaemia) for children in Guangxi. It provides reliable hematological references for the identification and diagnosis, treatment monitoring, and health screening of children's clinical diseases. [ABSTRACT FROM AUTHOR]

The Neoproterozoic evolution of the Jiangnan Orogen is important for understanding the tectonic history of South China. As a volcanic‐sedimentary sequence developed in the Nanhua rift, the Banxi Group preserves the records of important magmatic and tectonic events linked to the assembly and breakup of the Rodinia supercontinent. In this study, we report the results from whole‐rock major‐ and trace‐element concentrations, with zircon LA‐(MC)‐ICP‐MS U‐Pb ages, trace elements and Lu‐Hf isotopic compositions of sandstones from the Banxi Group. The rocks are characterized by high SiO2 (65.88%–82.76%, with an average of 75.50%) contents, moderate (Fe2O3T + MgO) (1.81%–7.78%, mean: 3.79%) and TiO2 (0.39%–0.54%, mean: 0.48%), low K2O/Na2O (0.03–0.40, mean: 0.10) ratios and low Al2O3/SiO2 (0.11–0.24, mean: 0.15) ratios. The sandstones have high ΣREE contents (mean: 179.1 ppm), with chondrite‐normalized REE patterns similar to the upper crust and PAAS, showing enriched LREE ((La/Yb)N mean: 14.85), sub‐horizontal HREE curves and mild Eu (Eu/Eu*: 0.75–0.89, mean: 0.81) negative anomalies. Their geochemical characteristics resemble those of passive continental margin sandstones. Most of the zircons are magmatic in origin and yield a U‐Pb age distribution with three peaks: a major age peak at 805 Ma and two subordinate age peaks at 1990 Ma and 2470 Ma, implying three major magmatic sources. The Neoproterozoic zircons have ɛHf(t) values ranging from –47.4 to 12.4 (mostly –20 to 0), suggesting a mixture of some juvenile arc‐derived material and middle Paleoproterozoic heterogeneous crustal sources. The Hf model ages of middle Paleoproterozoic zircons (∼1990 Ma) with negative ɛHf(t) values (–12.65 to –6.21, Ave. = –9.8) concentrated around the Meso‐Paleoarchean (mean TDMC = 3.3–3.1 Ga). For late Neoarchean detrital zircons (∼2470 Ma), ɛHf(t) values are divided into two groups, one with negative values (–9.16 to –0.6) with model ages of 3.5–2.9 Ga, the other featuring positive values (1.0 to 3.9) with model ages of 2.9–2.7 Ga, recording a crustal growth event at ∼2.5 Ga. Neoproterozoic zircons show volcanic arc affinities with partly intraplate magmatic features. We propose that the Banxi Group formed in a rift basin within a passive continental margin setting, which derived detritus from felsic to intermediate rocks from the Yangtze Block and a small amount of arc volcanic rocks. The middle Paleoproterozoic detrital zircon data suggest Columbia‐aged basement lies beneath the western Jiangnan orogen. [ABSTRACT FROM AUTHOR]

Background: The longitudinal associations of sleep timing and time in bed (TIB) with dementia and cognitive decline in older adults are unclear. Methods: This population‐based cohort study used data from 1982 participants who were aged ≥60 years, free of dementia, and living in rural communities in western Shandong, China. At the baseline (2014) and follow‐up (2018) examinations, sleep parameters were assessed using standard questionnaires. Cognitive function was measured using the Mini‐Mental State Examination (MMSE). Dementia was diagnosed following the DSM‐IV criteria, and the NIA‐AA criteria for Alzheimer disease (AD). Data were analyzed using restricted cubic splines, Cox proportional‐hazards models, and general linear models. Results: During the mean follow‐up of 3.7 years, dementia was diagnosed in 97 participants (68 with AD). Restricted cubic spline curves showed J‐shaped associations of sleep duration, TIB, and rise time with dementia risk, and a reverse J‐shaped association with mid‐sleep time. When sleep parameters were categorized into tertiles, the multivariable‐adjusted hazard ratio (HR) of incident dementia was 1.69 (95%CI 1.01–2.83) for baseline sleep duration >8 hours (vs. 7–8 h), 2.17 (1.22–3.87) for bedtime before 9 p.m. (vs. 10 p.m. or later), and 2.00 (1.23–3.24) for mid‐sleep time before 1 a.m. (vs. 1–1.5 a.m.). Early bedtime and mid‐sleep time were significantly associated with incident AD (HR range: 2.25–2.51; p < 0.05). Among individuals who were free of dementia at follow‐up, baseline long TIB, early bedtime and mid‐sleep time, early and late rise time, and prolonged TIB and advanced bedtime and mid‐sleep time from baseline to follow‐up were associated with a greater decline in MMSE score (p < 0.05). These associations with cognitive decline were statistically evident mainly among men or participants who were aged 60–74 years. Conclusions: Long TIB and early sleep timing are associated with an increased risk of dementia, and the associations with greater cognitive decline are evident only among older people aged 60–74 years and men. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between subjective/objective socioeconomic status (SES) and self/society‐oriented subjective well‐being (SWB) and the moderation effect of communication activity patterns in a nationally representative sample of Chinese citizens. We found that both subjective and objective SES were related to SWB, but the association varied by SES type and age group. Three kinds of communication activity patterns emerged across different age groups: balanced, mixed, and singular. A complex moderation effect of communication activity patterns also shaped the relationship between SES and SWB. The implications of these findings are discussed in the context of evolving Chinese culture and society. [ABSTRACT FROM AUTHOR]

Background: Post‐traumatic growth induced from cancer diagnosis and treatment could benefit the prognosis of cancer survivors, but intervention based on self‐disclosure in group is limited. Objective: Aimed to examine the effectiveness of a supportive‐expressive group intervention on post‐traumatic growth. The impact of the intervention on anxiety and depression were also explored. Design: This randomized clinical trial enrolled patients from June 2017 to September 2018 with a one‐month follow‐up. Data collectors were blinded to patient grouping. Setting: A single center study in Chengdu, China. Participants: One hundred sixty‐eight participants who met the eligibility criteria were randomly assigned to the intervention group (n = 84) or control group (n = 84); 46 were excluded and 122 patients finished the one‐month follow‐up. Methods: Participants in the intervention group received nurse‐led support intervention focusing on topics such as "Being a Patient", "Interpersonal Relationships", "Journey for Recovery", and "Planning the Future" while participants in the control group received health education, rehabilitation training etc. according to the nursing routine of breast cancer patients. The intervention was designed in accordance with the diagnosis and treatment process as well as patient needs. Participants in both groups were evaluated three times (T1‐baseline before the intervention, T2‐end of the intervention, and T3‐1 month follow up). Post‐traumatic growth, anxiety and depression were evaluated. Results: Participants in the intervention group reported higher level of post‐traumatic growth (p < 0.01 or 0.05) and reduced anxiety and depression (p < 0.01 or 0.05 and p < 0.01 or 0.05). The multilevel model indicated that the intervention significantly promoted post‐traumatic growth (βT3 = 7.87, p < 0.05) and dimensions of relating to others (βT3 = 4.26, p < 0.001), personal strength (βT3 = 4.27, p < 0.01), appreciation of life (βT3 = 8.69, p < 0.001), and new possibilities (βT3 = 1.91, p < 0.05), anxiety (βT3 = −3.63, p < 0.001), and depression (βT3 = −2.27, p < 0.001), but had no effect on the dimension of spiritual change. In addition, the multi‐level model showed that patients with younger ages (β = −0.05~−0.52, p < 0.05–0.001), with high school and above education levels (β = 1.53~9.29, p < 0.01) and accompanied by husbands(β = −1.48~−8.51, p < 0.05) had more effective intervention and patients with religious belief had a better spiritual change level (β = 1.86, p < 0.001). Conclusions: These findings provide evidence for the potential effectiveness of the nurse‐led intervention on positive benefits of post‐traumatic growth and relieved anxiety and depression for Chinese breast cancer survivors and will inform the design and development of a large randomized controlled trial. Clinical relevance: The supportive‐expression group intervention can be applied independently by nurses. The four themes of self‐disclosure can help patients grow after trauma, and this method can be used as a psychological support technique for breast cancer patients during hospitalization. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the influencing factors of frailty in elderly patients with multimorbidity and to develop a predictive risk model for frailty in elderly patients with multimorbidity. Methods: In total, 3836 elderly patients with multimorbidity who were admitted to the medical wards of five grade A tertiary hospitals in Sichuan Province from March 2020 to June 2021 were selected. Based on the general data of patients with multimorbidity, the independent risk factors for frailty were obtained using logistic analysis, and a risk prediction model of frailty was developed. Results: Independent risk factors for frailty in patients with multimorbidity were age, types of medication, and comorbidity with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) and chronic cerebrovascular disease (CCVD); and the protective factors for frailty were body mass index (BMI), exercise and education level. The expression of the model was Z = −2.054 + 0.016 × age − 0.029 × BMI − 0.153 × education level‐1.059 × exercise + 0.203 × types of medication + 0.788 × comorbidity with CHF + 0.950 × comorbidity with COPD + 0.363 × comorbidity with CCVD. Conclusion: Age, BMI, education level, exercise, types of medication, and comorbidity with CHF, COPD and CCVD can affect frailty risk in elderly patients with multimorbidity, which may be helpful to predict the frailty risk of elderly patients with multimorbidity. Geriatr Gerontol Int 2022; 22: 471–476. [ABSTRACT FROM AUTHOR]

Prior studies have shown that children can select and evaluate information based on the previous accuracy of an informant. The current study examines how 5‐ to 6‐year‐old kindergarteners (N = 46) and 7‐ to 8‐year‐old second‐graders (N = 48) in China judge scientific information provided by the internet or a teacher, and how a source's history of inaccuracy influences participants' judgments. When lacking explicit information about previous accuracy, neither younger children nor older children showed differential trust in the internet or a teacher. After observing the internet providing inaccurate information, children in both age groups decreased their trust in statements from the internet. When the teacher was consistently inaccurate, children in both age groups also showed reduced preference for the teacher's statements. These findings demonstrate that 5‐ to 8‐year‐old children take into account history of inaccuracy when deciding whether to request or endorse information from the internet or a teacher. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify coping difficulties after discharge and influencing factors of pregnant women with gestational diabetes mellitus. Design: A cross‐sectional descriptive survey was conducted with gestational diabetes mellitus women from four tertiary hospitals in the Shandong Peninsula in China. Methods: The study consists of 252 gestational diabetes mellitus women. Survey measures included demographic information, quality of discharge teaching scale, readiness for hospital discharge scale and postdischarge coping difficulty scale. Multiple linear regression analysis was used to explore the factors of coping difficulties after discharge. Results: The situation of coping difficulties in pregnant women with gestational diabetes mellitus after discharge is not optimistic. Age, education level, type of birth, parity, quality of discharge teaching and discharge readiness are six factors that significantly influence postdischarge coping difficulties. [ABSTRACT FROM AUTHOR]

Background: To date, no national‐scale psychiatric epidemiological survey for children and adolescents has been conducted in China. In order to inform government officials and policymakers and to develop a comprehensive plan for service providers, there was a clear need to conduct an up‐to‐date systematic nationwide psychiatric epidemiological survey. Methods: We conducted a two‐stage large‐scale psychiatric point prevalence survey. Multistage cluster stratified random sampling was used as the sampling strategy. Five provinces were selected by comprehensively considering geographical partition, economic development, and rural/urban factors. In Stage 1, the Child Behavior Checklist was used as the screening tool. In Stage 2, Mini‐International Neuropsychiatric Interview for Children and Adolescents and a diagnostic process based on the Diagnostic and Statistical Manual were used to make the diagnoses. Sampling weights and poststratification weights were employed to match the population distributions. Exploratory analyses were also performed using socio‐demographic factors. Prevalence in socio‐demographic factor subgroups and overall were estimated. Rao‐Scott adjusted chi‐square tests were utilized to determine if between‐group differences were present. Factor interactions were checked by logistic regression analyses. Results: A total of 73,992 participants aged 6–16 years of age were selected in Stage 1. In Stage 2, 17,524 individuals were screened and diagnosed. The weighted prevalence of any disorder was 17.5% (95% CI: 17.2–18.0). Statistically significant differences in prevalence of any psychiatric disorder were observed between sexes [χ2(1, N = 71,929) = 223.0, p <.001], age groups [χ2(1, N = 71,929) = 18.6, p <.001] and developed vs. developing areas [χ2(1, N = 71,929) = 2,129.6, p <.001], while no difference was found between rural and urban areas [χ2(1, N = 71,929) = 1.4, p =.239]. Male, younger individuals, children, and adolescents from developed areas had higher prevalence of any psychiatric disorder. The prevalence of any psychiatric disorder was found to decrease with the age in the male group, while the female group increased with the age. Individuals diagnosed with attention‐deficit hyperactivity disorder, oppositional defiant disorder, a tic disorder, conduct disorder, and major depression disorder had the highest rates of comorbidity. Conclusions: The prevalence of any psychiatric disorder we found is the highest ever reported in China. These results urgently need to be addressed by public mental health service providers and policymakers in order to provide access to the necessary treatments and to reduce the long‐term negative impact of these conditions on families and the society as a whole. [ABSTRACT FROM AUTHOR]

Background: Reference intervals (RIs) are normal ranges of clinical indicators established from healthy subjects, and comparing test results with RIs is the first step for clinicians in differentiating between healthy and diseased subjects. Capillary blood is widely used in complete blood count (CBC) tests in children; however, capillary blood‐based RIs for the CBC parameters are still lacking for all pediatric populations. The aim of this study was to establish capillary blood‐based RIs for the CBC parameters in children aged 3 months to 18 years in Beijing. Methods: A total of 6799 capillary blood specimens from children were collected, including 3832 males and 2967 females aged 3 months to 18 years, and CBC parameters were analyzed. Data analysis, RI calculations, and 90% confidence interval (CI) calculations were performed according to CLSI C28‐A3 guidelines. Results: Capillary blood RIs for 22 CBC parameters were established in children aged 3 months to 18 years. The levels of most red blood cell‐related parameters increased with age and were generally higher in males than in females. White blood cell counts were relatively stable, with no obvious upward or downward trends from 3 months to 18 years of age. Platelet levels decreased within the first year and tended to be stable thereafter. Further validation with 458 healthy children illustrated that the verified results were within the established RIs with a 90%‐100% proportion. Conclusion: We established capillary blood RIs for 22 CBC parameters in children across a broad age range in Beijing. [ABSTRACT FROM AUTHOR]

Aim: The American Academy of Pediatrics and the European Centre for Pediatric and Adolescent Medicine guideline define fever as a temperature >38.0°C for all ages and recommend use of rectal thermometers in children <3 years. Based on new literature, this definition of fever using a fixed threshold of 38.0°C needs to be re‐examined. Design: A multi‐site diagnostic accuracy study was conducted to compare an "age‐based" threshold model with a "fixed" threshold over 38.0°C on a total of 894 patients of which 373 were ill. Methods: The "age‐based" and "fixed" threshold fever determinations were then compared to a clinical categorization ("well" or "ill") conducted by a clinician through a comprehensive examination. Results: The sensitivity and accuracy for the age‐based thresholds were found to be superior to the fixed thresholds in all ages and current ear thermometers were found equivalent to rectal thermometers in infants <6 months. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to prove that both rationality and emotion are indispensable for older people to maintain their ability to live independently during the twilight of their lives. The resilience of older people to dementia were investigated by considering the interactions between educational levels and marriage status. Design: A quantitative study was conducted using questionnaires. Methods: Four sociodemographic variables (age, sex, educational level and marital status) were collected from 1,177 older Chinese participants, whose mini‐mental state examination scores (MMSE scores) were measured. Results: A lower educational level coupled with being widowed caused a greater risk for severe cognitive impairment (relative risk [RR] 1.48; 95% confidence interval [CI] 1.20–1.82; p <.001) for high‐aged older participants (age range: ≥80) than for their low‐aged counterparts (age range: ≥60 and <80). In contrast, a higher educational level coupled with being married levelled this age‐related risk for cognitive loss (RR 0.91; 95% CI 0.65–1.27; p =.62). [ABSTRACT FROM AUTHOR]

Although speculation of the curvilinear relations between job insecurity and job-related behaviors is theoretically appealing, the empirical evidence has been sparse. The purpose of this study was to contribute to the literature on job insecurity and work withdrawal behaviors by reexamining their curvilinear relation, and the effects of achievement orientation and propensity for risk aversion on this U-shaped relationship. Using samples with both secure and insecure job situations, we hypothesized that job insecurity could have both positive and negative effects on work withdrawal simultaneously; however, one of these effects could dominate the other at different levels of job insecurity. That is, a U shape would best describe such a relationship, since a moderate level of job insecurity would result in the lowest level of work withdrawal. Furthermore, we hypothesized that achievement orientation and propensity for risk aversion moderates this relationship in such a way that the curvilinear relationship is weaker (flattened curve) when the individual's achievement orientation is high, and that the curvilinear relationship is stronger (steep curve) when the individual's propensity for risk aversion is high. Results show that these hypotheses were supported; implications and limitations of the study are discussed. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension is a growing health concern in people living with HIV (PLWH). However, association between HIV infection and hypertension is equivocal. Methods: In all, 1472 PLWH and 2944 HIV‐negative individuals frequency‐matched by age and sex were derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China. Prehypertension was defined as systolic blood pressure (BP) of 120–139 mmHg and/or diastolic blood pressure of 80–89 mmHg. Results: Despite the fact that prevalence of hypertension was overall lower among PLWH than among HIV‐negative people (21.1% vs. 29.1%, P < 0.001), it was similar at ages 18–29 (7.6% vs. 8.5%) and 30–44 years (17.1% vs. 18.5%) but significantly lower in PLWH at ages 45–59 (26.1% vs. 40.7%) and 60–75 years (37.1% vs. 57.3%). Prehypertension prevalence was consistently higher in PLWH across all age groups. In the model adjusting for traditional risk factors, HIV infection was associated with hypertension (adjusted odds ratio [aOR] = 1.27, 95% confidence interval: 1.04–1.55) and prehypertension (aOR = 1.77, 95% CI: 1.51–2.08), and attenuated after additional adjustment for abdominal obesity. Age‐stratified analysis showed that these associations of HIV with hypertension were observed at ages 18–29 and 30–44 years and associations with prehypertension were observed at ages 18–29, 30–44 and 45–59 years only. Years since HIV diagnosis and stavudine use were the HIV‐specific factors independently associated with hypertension or/and prehypertension. Conclusions: HIV infection is independently associated with prehypertension and hypertension especially at younger ages, and this risk may increase as treatment becomes prolonged. Our findings reinforce the urgent necessity for active BP screening and control strategies be adopted for PLWH in China. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to measure socioeconomic‐related inequality and horizontal inequity in the use of oral health services and decompose this inequality among adults of different age groups in China. Methods: In total, 10 973 adults (3669 aged 35‐44 years, 3767 aged 55‐64 years and 3537 aged 65‐74 years) who participated in the 4th National Oral Health Survey (2015‐2016) in China were included. Concentration curves and the Erreygers‐corrected concentration index (EI) were employed to measure socioeconomic‐related inequality in the use of oral health services. Then, inequity in this utilization was measured by the horizontal inequity index (HI). Furthermore, decomposition analyses were conducted for the three groups to explain the contributions of income level, need factors (ie self‐assessed oral health and evaluated oral health status), other factors (ie sex, residential location, educational attainment level and type of basic insurance) and a residual term to overall inequality in oral health service utilization. Results: The significant positive EI and HI values indicated that pro‐rich inequality and inequity in oral health service utilization exist among Chinese adults. Income and type of basic medical insurance contributed the most to socioeconomic‐related inequality in the use of oral health services among adults aged 55‐64 and 65‐74 years. However, the main driving factors of socioeconomic inequality among adults aged 35‐44 years in dental care use included income, educational achievement, type of basic medical insurance and residential location. The need variables accounted for a very small proportion of overall socioeconomic‐related inequality in oral health service use in all three groups. Conclusions: Oral healthcare service utilization was disproportionately concentrated among better‐off Chinese adults. The primary determinants of inequality in dental care use in different age groups provide information for policymakers to create more targeted policies to achieve equity in the oral healthcare system in China. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) has emerged as a major public health concern. However, little is known about the burden attributable to specific risk factors. The present study aimed to estimate the temporal trends and geographical variation of CRC burden attributable to a diet low in milk in China. Methods: Following the general analytic strategy used in the 2017 Global Burden of Disease study, we assessed the age‐, sex‐, and province‐specific mortality and disability‐adjusted life‐years (DALYs) of CRC caused by a diet low in milk in China from 1990 to 2017. Results: In 2017, a diet low in milk contributed 32 032 [95% uncertainty interval (UI) = 11 350–53 806] deaths and 726 710 (95% UI = 256 651–1 218 153) DALYs for CRC with a population attributable fraction of 17.1%. The age‐standardised mortality and DALY rates per 100 000 were 1.7 (95% UI = 0.6–2.9) and 36.8 (95% UI = 13.0–61.7), respectively. An upward trend with age in rates of mortality and DALYs was observed. Males had higher age‐standardised rates than females. The number of deaths and DALYs increased significantly from 1990 to 2017, whereas the corresponding age‐standardised rates showed relatively stable trends. In 2017, Hunan and Liaoning were ranked as the top two provinces in terms of disease burden. Socio‐demographic index had a weak correlation with the age‐standardised mortality (r = 0.348, P = 0.047). Conclusions: The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less‐developed provinces. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the indicators for severity of coronavirus disease 2019 (COVID-19) in young patients between the ages of 18 and 40 years.Methods: This retrospective cohort study included 65 consecutively admitted patients with COVID-19 who were between 18 and 40 years old in Zhongnan Hospital of Wuhan University in Wuhan, China. Among them, 53 were moderate cases, and 12 were severe or critical cases. Epidemiological, clinical, and laboratory characteristics and treatment data were collected. A multivariate logistic regression analysis was implemented to explore risk factors.Results: The patients with severe/critical cases had obviously higher BMI (average 29.23 vs. 22.79 kg/m2 ) and lower liver computed tomography value (average 50.00 vs. 65.00 mU) than the group of moderate cases. The patients with severe/critical cases had higher fasting glucose, alanine aminotransferase, aspartate aminotransferase, and creatinine compared with patients with moderate cases (all P < 0.01). More severe/critical cases (58.33% vs. 1.92%) had positive urine protein levels. The severe/critical cases also experienced a significant process of serum albumin decline. Logistic regression analysis showed that male sex, high BMI (especially obesity), elevated fasting blood glucose, and urinary protein positivity were all risk factors for young patients with severe COVID-19.Conclusions: Obesity is an important predictor of COVID-19 severity in young patients. The main mechanism is related to damage of the liver and kidney. [ABSTRACT FROM AUTHOR]

Summary: Background: The intake of sugar‐sweetened beverages (SSBs) has been linked to an increased risk of cardiometabolic diseases. Objectives: This study aims to examine associations between SSB intake and cardiometabolic risks among Chinese children and adolescences. Methods: Data from 3958 participants aged 6‐17 years old were obtained in Shanghai, China, from September to October 2015. A 3‐day dietary record and a food‐frequency questionnaire (FFQ) were applied to assess SSB consumption and frequency. Anthropometric and laboratory measurements were conducted to measure cardiometabolic indicators. Results: After adjusting for age, sex, daily energy intake, pubertal stage, sedentary time, maternal education, and household income, SSB consumption was positively associated with serum total cholesterol and low‐density lipoprotein‐cholesterol (LDL‐C), while it was inversely associated with systolic blood pressure (P <.05). The participants in the highest intake category (≥201.7 mL/day) of SSB consumption had 0.10 (95%CI, 0.02‐0.18) mmol/L higher total cholesterol and 0.09 (95%CI, 0.03‐0.16) mmol/L higher LDL‐C levels than the nonconsumption group (0 mL/day). There was a quasi‐U‐shaped trend in LDL‐C across the categories of >0 mL/day SSB consumption. SSB frequency was positively associated with BMI (P =.04). Conclusions: SSB intake was positively associated with serum cholesterol and was weakly associated with BMI in Chinese children and adolescents, independent of energy intake. [ABSTRACT FROM AUTHOR]

China is a sexually conservative country compared with Western countries. To evaluate the psychological characteristics of Chinese erectile dysfunction (ED) patients, we conducted a cross‐sectional study of 153 ED outpatients. Patients were interviewed with the Structured Interview on Erectile Dysfunction (SIEDY) for pathogenic quantification. ED was measured by International Index of Erectile Function (IIEF). Depression and anxiety were evaluated with 9‐item Patient Health Questionnaire (PHQ‐9) and 7‐item Generalised Anxiety Disorder Scale (GAD‐7) respectively. Most patients (74.5%) were <40 years old. IIEF‐5 were significantly correlated with SIEDY scale 3 (r =.16, p =.040) and GAD‐7 (p =.15, p =.033). The SIEDY scale 1 increased with age, but the IIEF‐5, SIEDY scale 3, PHQ‐9 and GAD‐7 decreased with age. A negative correlation was observed between ED and psychological stress, which conflicts with many Western‐country studies. Younger patients were characterised by milder ED but more psychological stress, while older patients were characterised by worse ED but less psychological stress. Which may be responsible for the conflicting result. Meanwhile, the much younger age distribution among Chinese ED outpatients may indicate that quite a few older ED patients (≥40 years) in China do not seek outpatient service which should merit more attention. [ABSTRACT FROM AUTHOR]

Tectonic affinity between the Qaidam‐Qilian Block and the Western Qinling Block is an outstanding issue that has not been fully understood. Detrital zircon U–Pb dating and Hf isotope data for the Precambrian and Permian–Triassic strata around the Gonghe Basin area in both the Western Qinling and Qaidam‐Qilian blocks were studied. Detrital zircons from Precambrian strata range in age from Archean to Late Neoproterozoic, with age peaks at ~2.7–2.5, ~1.8–1.6, and ~0.95–0.75 Ga. Except for Precambrian age groups, Early Palaeozoic (550–500 Ma and ~450 Ma) and Late Palaeozoic–Triassic (~250 Ma) age peaks were also detected in the Triassic strata. The juvenile accreted crustal materials were detected at 1.85–1.5 Ga and over ~2.5 Ga based on zircon Hf isotope studies. Different Precambrian and Triassic strata in both the Western Qinling Block and the Qaidam‐Qilian Block show parallel age distribution patterns and Hf isotopes. A Qaidam‐Qilian source contributed to the majority of detritus in Precambrian strata. Besides sources from the Qaidam‐Qilian Block, Late Permian intrusions around the Gonghe Basin area also provided inputs for the Triassic strata. Detrital zircon studies show a strong connection of the Qaidam‐Qilian Block and the majority of detritus in the Gonghe Basin area of the Western Qinling Block. Tectonomagmatic and provenances comparison of the Western Qinling and Qaidam‐Qilian blocks are supportive of their tectonic continuity at least in three stages, that is, in the Precambrian, Middle Palaeozoic, and Permian to Early Triassic. [ABSTRACT FROM AUTHOR]

Economic growth has brought improvements in many areas of child health, but its effects on anaemia among school‐aged children remain unknown. However, this is important because iron deficiency anaemia is common and is the main cause of disability‐adjusted life years for school‐aged children. In this study, we included 429,222 Chinese children aged 7–17 years from five consecutive national cross‐sectional surveys during 1995–2014. Using altitude‐adjusted haemoglobin concentration measured from capillary blood samples, we defined anaemia status according to World Health Organization's recommendation. We used logistic regressions weighted by provincial population to examine the association between provincial gross domestic product (GDP) per capita and anaemia, adjusting for sex, age, urban–rural location, regional socio‐economic status (SES), fixed effect of province, and clustering of schools. We used generalised additive mixed models to evaluate a potentially non‐linear relationship. For each 100% growth in GDP per capita, there was a 40% (odds ratio [OR] = 0.60; 95% confidence interval [CI; 0.56, 0.65]) reduction in anaemia. However, the association was weaker for girls and in cities with a lower SES. The association was weaker across 2005–2014 (OR = 0.75, 95% CI [0.62, 0.90]) compared with 1995–2005 (OR = 0.52; 95% CI [0.44, 0.61]), reflecting a weaker association when GDP per capita reaches around $2,000. The results were similar for moderate‐to‐severe anaemia. We concluded that economic growth has been associated with reductions in anaemia among school‐aged children in China but with fewer benefits for girls and those in poorer settings. Further economic development in China is unlikely to bring similar reductions in anaemia, suggesting that additional population level and targeted interventions will be needed. [ABSTRACT FROM AUTHOR]

Objectives: To explore the factors associated with utilization of oral health services among Chinese adults and older adults according to the Andersen Behavior Model. Methods: Data from the 4th National Oral Health Survey (2015‐2016) in China were used. A total of 7206 people (3669 adults aged 35‐44 years and 3537 older adults aged 65‐74 years) were included in our analysis. Oral health service utilization in the past 12 months was the outcome variable. Explanatory variables were selected according to the Andersen Behavior Model. Descriptive statistics and bivariate associations (chi‐square tests) were analysed, followed by hierarchical Poisson regression models, which were conducted to determine the factors associated with oral health service utilization. Results: In total, 21.4% (95% CI: 19.4%‐23.7%) of adults (35‐44 years old) and 20.7% (95% CI: 18.6%‐22.9%) of older adults (65‐74 years old) utilized oral health services in the past 12 months. Nearly 80% of adults (78.7%, 95% CI: 74.0%‐82.7%) and more than 90% of older adults (93.7%, 95% CI: 91.0%‐95.6%) visited a dentist for treatment. Adults aged 35‐44 years old who were female (IRR: 1.15, 95% CI: 1.00‐1.33, P =.047), had good oral health knowledge and attitudes (IRR: 1.30, 95% CI: 1.06‐1.59, P =.011), perceived their oral health status as fair (IRR:1.51, 95% CI:1.24‐1.85, P <.001) or poor/very poor (IRR:2.52, 95% CI:2.01‐3.18, P <.001) and had a decayed, missing and filled teeth (DMFT) index >0 (IRR: 1.52, 95% CI: 1.11‐2.09, P =.009) were more likely to report dental visits in the past 12 months. Older adults who utilized oral health services tended to be female (IRR: 1.32, 95% CI: 1.09‐1.59, P =.004); to be covered by Urban Resident Basic Medical Insurance (URBMI) (IRR: 1.56, 95% CI: 1.18‐2.05, P =.002), Urban Employee Basic Medical Insurance (UEBMI) (IRR: 1.69, 95% CI: 1.32‐2.16, P <.001) or government medical insurance (GMI) (IRR: 1.03, 95% CI:1.01‐2.16, P =.044); to have a high education level (IRR: 1.37, 95% CI: 1.08‐1.74, P =.010); to have an income level in the 2nd tertile (IRR: 1.44, 95% CI: 1.13‐1.84, P =.003) or 3rd tertile (IRR:1.52, 95% CI:1.18‐1.95, P =.001); and to perceive their oral health status as poor or very poor (IRR: 1.53, 95% CI: 1.21‐1.95, P =.001). Conclusions: Sex and self‐perceived oral health status were associated with oral health utilization among Chinese population. Additionally, for older adults, education level, household income and insurance coverage were determinants of dental service use. These findings can aid in creating more targeted policies to increase the use of dental services by Chinese adults. [ABSTRACT FROM AUTHOR]

Background: Previous data, although scant, indicated that the incidence of HIV in China has increased over the past decade. There is a growing concern about the impact of the HIV epidemic on blood safety.Methods and Materials: We used donation data from five geographically-disperse blood centers in 2013-2016 participating in the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) China program to estimate HIV prevalence and incidence among blood donors. Multivariable logistic regression model was used to examine factors associated with HIV infection in Chinese blood donors.Results: The overall HIV prevalence among first-time donors from 2013 through 2016 was 68.04 per 100,000 donors (95% CI 61.68-74.40). The HIV incidence rate was estimated to be 37.93 per 100,000 person-years (95% CI 30.62-46.97) among first-time donors and 20.55 per 100,000 person-years (95% CI 16.95-24.91) among repeat donors. There was substantial variation in HIV prevalence and incidence rates across blood centers. Multivariable logistic regression results showed that among first-time donors, being male, older than 25 years, minority ethnicity, less than college education, and certain occupations (commercial services, factory workers, retired, unemployed, or self-employed) were associated with positive HIV confirmatory testing results.Conclusion: HIV prevalence and incidence among blood donors remain low in the selected five regions in China; however, an increasing trend is observed at some blood centers. It is important to monitor HIV epidemiology in Chinese blood donors on a continuous basis, especially among populations and regions of higher risk. [ABSTRACT FROM AUTHOR]

Objectives: To observe changes in the complete blood count (CBC) venous blood parameters of healthy children and establish appropriate reference intervals (RIs). Methods: Overall, 4066 healthy children were selected and divided into four groups: infants, toddlers, preschool‐age children and school‐age children. Venous blood was analysed for 17 parameters. Outlier data for each parameter were eliminated and RIs were established based on the Clinical and Laboratory Standards Institute C28‐A3c guideline. Results: The RIs for certain parameters differed among the different age groups. The white blood cell (WBC) count differed among the four age groups. The variation trends for absolute neutrophil count in all age groups were opposite to those for WBC and absolute lymphocyte count. The mean absolute eosinophil count values were significantly higher in the infant group than in the other groups. The RIs for red blood cell were identical across all age groups except in infants. The mean Hb level for infants was significantly lower than that for the other age groups. The mean and RI for platelet count were significantly higher in the infant group than in the other groups. Conclusions: There are dynamic variations in the values reported for measurements of most CBC parameters in children. Hence, such results should always be interpreted according to the child's age. Thus establishing appropriate RIs for different age groups in paediatrics is essential. [ABSTRACT FROM AUTHOR]

Aim: To describe changed epidemiological features of advanced maternal age (AMA) and to examine the effect of AMA on the risk for Cesarean section (CS) in a Chinese pregnant population. Methods: This retrospective single‐center cohort study investigated the changes of epidemiological features of AMA parturients with respect to the revised reproductive policy in China in 43 702 singleton deliveries with live birth at ≥28 weeks managed from January 2005 to December 2016. We also evaluated the pregnancy outcomes in different age groups and risk factors of CS with multivariate analysis. Results: In this 12‐year study period, the average maternal age increased from 28.5 to 30.2 years, and the proportion of AMA raised from 6.5% to 17.2%. AMA was significantly associated with increased risk of adverse pregnancy outcomes, and after adjustment for confounding factors, AMA remained a significant independent risk factor for CS. Furthermore, the effect of AMA in nulliparous women on the risk of CS was more significant than in multiparous women, while the history of previous CS (adjusted odds ratio 39.85) and interdelivery interval ≥10 years (adjusted odds ratio 1.52) also increased the risk of CS in multiparous women. Conclusion: AMA increased the risk of a number of adverse pregnancy outcomes, and was independently associated with increased risk for CS. The increasing number of AMA parturients with risk factors is likely to increase CS rate in China in the near future, thus it is imperative to reduce the rate of primary CS as a matter of policy. [ABSTRACT FROM AUTHOR]

Early Cretaceous sedimentary rocks in the Sulu Orogen (SO) have been a popular topic in recent years. The provenances of sedimentary rocks can help elucidate the tectonic history of the SO, China. The Dingzi Bay and Taolin areas in the SO have always been poorly known. Thus, we date detrital zircons from four sedimentary rock samples including sandstone, siltstone, and greywacke collected in both areas. Age distributions from Dingzi Bay exhibit three major age populations including Palaeoproterozoic (1900–1800 Ma), Neoproterozoic (800–700 Ma), and Early Cretaceous (136–106 Ma) ages and small age populations including early Mesozoic, Palaeozoic, and Palaeoproterozoic–Archean ages, while age distributions in the Taolin area show the largest age population of Early Cretaceous (132–102 Ma) with minor early Mesozoic, Palaeozoic, and Neoproterozoic populations. The youngest detrital zircon populations yield weighted mean ages of ca. 116 Ma in Dingzi Bay and ca. 120 Ma in the Taolin area as the maximum depositional ages, which correspond to the Early Cretaceous Lower Qingshan Group. Age distributions in both areas indicate that the local SO served as the primary source area, whereas the Yangtze Block might have been a lesser source of detrital zircons. The comparison of geochronological, geochemical, and sedimentary data among Dingzi Bay, Taolin, Laoshan, and Lingshan Island suggests an Early Cretaceous marine basin formed over the SO. Further, considering previous regional tectonic history, we propose a two‐stage (Laiyang and Qingshan stages) evolutionary model for this marine basin. We suggest that transpression between the Laiyang and Qingshan stages due to subduction of the Pacific Plate might have caused rapid uplift of the south‐eastern SO and closing of the marine basin. Correspondingly, this process influenced the input of the source material from the Yangtze Block to the marine basin during the Qingshan stage. [ABSTRACT FROM AUTHOR]

Introduction: Reference intervals for pediatric laboratory tests need to be interpreted in the context of age‐ and sex‐dependent dynamics. However, few reference intervals for healthy ethnic Han Chinese children have previously attempted to establish using large sample sizes. As such, there are no national hematological standards in China for pediatric reference intervals. Methods: We used a direct method to enroll a total of 2164 healthy 1‐ to 7‐year‐old children from Henan province. Hematological reference intervals were established by analyzing venous blood sample data on 17 hematologic analytes. The reference values for different ages and sexes were estimated using both parametric methods (mean ± 2 SD) and nonparametric methods (2.5‐97.5th percentiles). Results: We provided reference intervals for 17 hematologic analytes including red blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width, white blood count and differential count as well as platelet count and related parameters. Conclusion: We established age‐ and sex‐specific reference intervals that can provide more evidence‐based guidance for the diagnosis and treatment for pediatric diseases. Our findings provide the basis for the next step in establishing national blood testing standards. [ABSTRACT FROM AUTHOR]

Background: Multidrug‐resistant tuberculosis (MDR‐TB) brings major challenges to the health care workers (HCWs). This study is to determine the risk factors for MDR‐TB, latent tuberculosis infection (LTBI), and tuberculosis (TB) disease among HCWs in China. Methods: A meta‐analysis was conducted to evaluate the risk factors for MDR‐TB, LTBI, and TB disease among HCWs using a random‐effects model, and the pooled odds ratios (ORs) with 95% confidence interval (CI) were used as effect indicators. Results: We identified 46 eligible studies and found eight factors were associated with MDR. The ORs with 95% CI are migrant population 1.96 (95% CI, 1.50–2.57), low family income 2.23 (95% CI, 1.74–2.85), retreatment 7.22 (95% CI, 5.63–9.26), anti‐TB treatment history 5.65 (95% CI, 4.80–6.65), multiple episodes of treatment 3.28 (95% CI, 2.60–4.13), adverse reactions 3.48 (95% CI, 2.54–4.76), interrupted treatment 3.18 (95% CI, 2.60–3.89), and lung cavities 1.42 (95% CI, 1.14–1.77). Work duration as a HCW for 5 years and above increased the risk of LTBI and TB. HCWs aged 30 years and above were more susceptible to TB (OR = 1.70, 95% CI: 1.37–2.09). Conclusion: The risk factors for MDR‐TB in China are possibly migrant population, low family income, retreatment, anti‐TB treatment history, adverse reactions, interrupted treatment, and lung cavities. Longer work duration and greater age are risk factors for LTBI and TB among HCWs. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the prevalence, incidence, and the associated factors of pressure injuries (PIs) among immobile hospitalised patients in China. Being immobile during hospitalisation put these patients at a higher risk of PIs. There is little literature about pressure injury (PI) prevalence or PI incidence in immobile hospitalised patients in hospitals in China. This was a multicentre, cross‐sectional, exploratory descriptive study. A total of 23 985 immobile patients were recruited from 25 general hospitals in six provinces of China from November 1, 2015 to March 18, 2016. Information was collected on demographic characteristics, physical assessment information, and treatment and nursing care measures. The PI period prevalence was 3.38%, and the PI cumulative incidence was 1.23%. Most PIs (84.03%) were Stage 1 or Stage 2. A total of 48.22% of PIs occurred in the sacrum or heel region. In the multivariate analysis, the following factors were associated with higher PI prevalence: age, gender, length of immobility, type of hospital, modified Braden Scale score, urinary incontinence, faecal incontinence, low serum albumin, the usage of fixation or restraint devices, and patient's discharge diagnosis (lower limb fracture, malnutrition, and spinal cord injury). PI prevalence for immobile hospitalised patients in the study was lower than those reported in literature. However, because of the large population in China, the number of patients who suffer with PIs can be very high. The relating factors of higher PI prevalence identified in this study were consistent with current literature. Patients with a higher number of these associated factors should be monitored more closely, and preventative measures should be taken to prevent PI occurrence in high‐risk populations. [ABSTRACT FROM AUTHOR]

Abstract: Background: Rate of progression of periodontitis has been used to inform the design of classifications of periodontal diseases. However, the evidence underpinning this topic is unclear and no systematic review has yet been conducted. Objectives: The focused question for this systematic review was: in adults, what is the progression of periodontitis in terms of clinical attachment loss, radiographic bone loss, and tooth loss? Data sources: Highly sensitive electronic search was conducted for published data in MEDLINE, EMBASE, LILACS, and unpublished grey literature in OpenGrey up to February 2016. Reference lists of retrieved studies for full‐text screening and reviews were hand‐searched for potentially eligible studies. Study eligibility criteria and participants: Prospective, longitudinal observational studies with follow‐up of at least 12 months and presenting data on the primary outcome, change in clinical attachment level, in adults (age ≥18 years). Secondary outcomes, tooth loss and bone level change, were only assessed in studies reporting the primary outcome. Studies investigating specific disease populations or only on treated periodontitis patients were excluded. Study appraisal and synthesis methods: Risk of bias and methodology were assessed using the Newcastle‐Ottawa Scale with two additional questions on security of outcome assessment. Studies were pooled by abstracting or estimating mean annual attachment or bone level change and annual tooth loss. Random effects meta‐analysis was conducted with investigation of effect of potential modifiers where possible. Results: A total 11,482 records were screened for eligibility; 33 publications of 16 original studies reporting on more than 8,600 participants were finally included as eligible for the review. The studies represented populations from both developing and developed economies. Mean annual attachment loss was 0.1 mm per year (95% CI 0.068, 0.132; I2 = 99%) and mean annual tooth loss was 0.2 teeth per year (95% CI 0.10, 0.33; I2 = 94%). Observational analysis of highest and lowest mean attachment change quintiles suggested substantial differences between groups with minimal annual change in the lowest quintile and an average deterioration of 0.45 mm mean attachment loss per year in the highest group. This value increased to 0.6 mm per year with periodontitis alone. There was surprisingly little effect of age or gender on attachment level change. Geographic location, however, was associated with more than three times higher mean annual attachment loss in Sri Lanka and China (0.20 mm, 95% CI 0.15, 0.27; I2 = 83%) vs North America and Europe (0.056 mm, 95% CI 0.025, 0.087; I2 = 99%) P < 0.001. Limitations: There were a limited number of studies (N = 16), high variability of design in key study components (sampling frames, included ages, data analyses), and high statistical heterogeneity that could not be explained. Conclusions: Within the limitations of the research, the data show that mean annual attachment level change varies considerably both within and between populations. Overall, the evidence does not support or refute the differentiation between forms of periodontal diseases based upon progression of attachment level change. [ABSTRACT FROM AUTHOR]