Search

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

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

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]

Aim: This study aimed to develop a tool to measure paediatric specialist nurses' core competencies and examine the scale's validity and reliability. Design: An exploratory quantitative study. Methods: This study was performed in April 2022 with 302 paediatric specialist nurses in mainland China. Items were created through a literature review, a qualitative interview, and the Delphi method. The data were evaluated using descriptive statistics, independent sample t‐test, explanatory factor analysis, Pearson correlation coefficient, Cronbach's alpha coefficient and split‐half reliability. Results: The final scale consisted of five factors and 32 items. The factors were communication, coordination and judgement abilities; professional technology mastery ability; specialist knowledge mastery ability; medical‐related processes; and evidence‐based nursing competencies. The explained total variance of the five factors was 62.216%. The scale‐level and item‐level CVI of this scale was 1.00, and the mean CVR of the total scale was 0.788. The Pearson correlation coefficients of each dimension and the total dimension of the scale was 0.709–0.892, and within each dimension, it was 0.435–0.651. The Cronbach's α of this scale was 0.944, and its split‐half reliability was 0.883. [ABSTRACT FROM AUTHOR]

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

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

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

Both physical abuse and poor sleep quality are public health concerns among adolescents, particularly in mainland China, but examining any causal effect of physical abuse on adolescents' sleep quality using a randomized controlled trial is not possible for obvious ethical reasons. Researchers have proposed the use of propensity score matching with doses to minimize overt bias and estimate the effect of multidose treatments or varying degrees of risk exposure in observational studies. In this paper, we demonstrate the propensity score methods with a focus on matching with doses in an examination of the relationship between physical abuse levels (frequency and number of perpetrators) and self‐reported sleep quality among adolescents. Secondary analyses were conducted using data from the China Jintan Child Cohort. The sample comprised 707 adolescents (13.16 ± 0.90 years old) who had complete data on physical abuse, sleep, and covariates. Propensity scores were computed from eight covariates and used to carry out pair matching, matching with the frequency of abusive experience, and matching with the number of perpetrators. The standardized differences of covariates suggested an acceptable balance between groups after matching. The results derived from matching sets consistently indicated that adolescents being physically abused by parent(s) have worse sleep quality. Despite its inherent limitations, propensity score matching with doses provides a useful tool for nurse researchers analyzing observational data. [ABSTRACT FROM AUTHOR]

Malaysia is a multi-ethnic country with Malay, Chinese and Indian being the dominant ethnic groups. This paper investigates the three ethnic cultures in Malaysia by examining the individual-level values of managers and professionals. Based on 528 responses to a Schwartz Value Survey ( SVS) questionnaire, the paper identifies partial convergence of the value systems of Malay, Chinese and Indian people. It was found that the three ethnic groups do not differ significantly in the individualistic value dimensions of Self-enhancement and Openness-to-change. However, Malays are found to be more conservative and less self-transcendent than Chinese or Indians, while Chinese and Indians attribute the same importance to these two sets of values. [ABSTRACT FROM AUTHOR]

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]

Objective: Sarcopenia is a geriatric syndrome that occurs with age and is characterized by a gradual decline in muscle mass, power, and functionality. It serves as a prominent contributor to frailty, disability, and mortality among older individuals. Currently, no standardized global guidelines exist for the diagnosis of sarcopenia. This study aimed to establish the correlation between sarcopenia and the constitutions of traditional Chinese medicine (TCM), considering the connection between physical functioning and sarcopenia. Methods: A total of 1441 participants in this study were diagnosed with sarcopenia. The Asian Working Group for Sarcopenia (AWGS) proposed a sarcopenia definition algorithm. To determine the constitution of each participant, classification and determination standards were used in traditional Chinese medicine. This study evaluated the demographics, lifestyles, and self‐reported medical history of individuals diagnosed with sarcopenia through a self‐administered questionnaire. The constitution of the participants was determined using TCM classification and determination standards. Subsequently, we analyzed the results of univariate analysis and multivariate regression and constructed a receiver operating characteristic (ROC) curve. Results: Participants who were diagnosed with sarcopenia had substantially lower original Neutral constitution scores (P < 0.050). In comparison to those without sarcopenia, individuals with sarcopenia exhibited notably elevated original Qi‐deficiency, Yang‐deficiency, Yin‐deficiency, Blood‐stagnation, and Qi‐stagnation scores in contrast to those in the healthy group (P < 0.050). The identified risk factors associated with sarcopenia included the following: Neutral (OR = 0.903), Qi‐deficiency (in males, OR = 1.126), Yang‐deficiency (OR = 1.062), Phlegm‐dampness (in males, OR = 0.833), and Blood‐stagnation (in females, OR = 1.089). The highest area under the curve (AUC) was observed for the original neutral constitution score, followed by the Yang‐deficiency and blood‐stagnation scores (0.644, 0.613, and 0.611, respectively). Additionally, the AUC for the combined original scores of all nine constitutions among males reached 0.778. Conclusions: In this cross‐sectional study of older people with higher original Qi‐deficiency, Yin deficiency, Yang‐deficiency, Blood‐stagnation, and Qi‐stagnation were associated with sarcopenia. Notably, various TCM constitutions are significantly linked to sarcopenia. There was a significant occurrence of various body constitution types among individuals diagnosed with sarcopenia. The mixture of the nine original constitution scores exhibited good diagnostic performance for sarcopenia in males. [ABSTRACT FROM AUTHOR]

Aim: Moral courage among healthcare workers has been extensively studied. However, few studies have been conducted on oncology specialist nurses, who frequently encounter complex moral situations. This study aimed to describe the current situation regarding moral courage and explored its influence on oncology specialist nurses in China. Design: This was an exploratory, descriptive study. Methods: A convenience sample of 390 nurses was conducted from 15 hospitals in Sichuan Province, China, between March and May 2023. Participants were assessed using the Moral Distress Scale‐Revised, Nurses' Moral Courage Scale and the Moral Sensitivity Questionnaire. Results: The results demonstrated that moral courage was negatively associated with moral distress, and positively associated with moral sensitivity. Having a master's degree or above, an intermediate title or senior title, medical ethics training, moral distress or moral sensitivity contributed to explaining 54.1% of the variance in moral courage. Conclusions: Moral courage was associated with several factors. Developing clinical intervention strategies and effective teaching methods will be critical for improving moral courage. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

This research conducted quasi-experiments in four middle schools to evaluate the long-term effects of an intelligent web-based English instruction system, Computer Simulation in Educational Communication ( CSIEC), on students' academic attainment. The analysis of regular examination scores and vocabulary test validates the positive impact of CSIEC, and in most cases, the positive impact is statistically significant. The reliability is ensured by the spectrum of the students from Grade 1 to Grade 3 in three junior high schools and from Grade 1 to Grade 2 in one senior high school, and of the teachers with or without blended learning experience, as well as by the various school locations from rural to urban areas in four provinces of China. The learning content-oriented design and the instant feedback feature of the web-based system, as well as its regular integration into the English class, contributed to its reliable positive effect on students' learning performance in ordinary examinations. This is the research's implication for instructional design. The conclusion of this paper could serve as a reference to the technical feasibility and pedagogical benefit of regular usage of appropriate Computer Assisted Learning system in the mainstream subject of middle schools. The multiple quasi-experiments in divergent school settings to ensure the results' reliability distinguish this research from previous ones that just implemented one single experiment in one school. [ABSTRACT FROM AUTHOR]

Aims This study examines the preliminary outcomes of an intervention targeting service providers in methadone maintenance therapy ( MMT) clinics in China. The intervention effects on both service providers and clients are reported. Design The MMT CARE intervention pilot was developed and implemented collaboratively with local health educators. After three group intervention sessions, trained providers in intervention clinics delivered two individual motivational interviewing sessions with their clients. Settings Six clinics in Sichuan, China, were randomized to either the MMT CARE intervention condition or a standard care condition. Participants A total of 41 providers and 179 clients were sampled from the six clinics. Measurements At baseline and three-, six-, and nine-month assessments, providers completed self-administrated paper/pencil questionnaires regarding provider-client interaction, MMT knowledge, perceived job-related stigma and clinic support. Clients completed a face-to-face survey about their concurrent drug use and drug avoidance self-efficacy. Mixed-effects regression models with clinic-level random effect were used to assess the intervention effects. Findings Significant intervention effects for providers were found in improved MMT knowledge, provider-client interaction and perceived clinic support. For clients, better improvements in drug avoidance self-efficacy and reduced concurrent drug use were observed for the intervention compared with the standard care group. Conclusions The MMT CARE intervention targeting providers in methadone maintenance clinics can improve providers' treatment knowledge and their interaction with clients. The intervention can also reduce clients' drug-using behavior through motivational interviewing sessions conducted by trained providers. [ABSTRACT FROM AUTHOR]

Aim: The aims of the present study are to describe the status of selfmanagement behaviors and illness perception, and explore the relationship between illness perception and self-management behaviors among Chinese diabetic foot patients. Methods: A cross-sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self-management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis. Results: Only 3.2% of participants maintained excellent self-management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self-management behaviors. Conclusions: Patient illness perception is an important factor influencing self-management behaviors. It may be helpful to improve self-management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions. [ABSTRACT FROM AUTHOR]

Background: Delirium is one of the most common complications in critically ill children. Once delirium occurs, it will cause physical and psychological distress in children and increase the length of their ICU stay and hospitalization costs. Understanding the risk factors for delirium in critically ill children can help develop targeted nursing interventions to reduce the incidence of delirium. Aims: To investigate the incidence and the risk factors of delirium in the paediatric intensive care unit (PICU). Study design: We performed a prospective observational study in critically ill patients in the PICU between February and July 2020. Delirium was diagnosed by the Cornell Assessment of Paediatric Delirium (CAPD) and the Richmond Agitation Sedation Scale and analysed via univariate analysis and multivariate logistic regression to determine the independent risk factors of delirium in critically ill children. Results: The study enrolled 315 patients ranging in age from 1–202 (65.3–54.3) months, with 56.2% (n = 177) being male. The incidence of delirium was 29.2% (n = 92) according to CAPD criteria. Among them, 33 cases (35.9%) were of hyperactive delirium, 16 cases (17.4%) were of hypoactive delirium, and 43 cases (46.7%) were of mixed delirium. By using stepwise logistic regression, the independent risk factors of delirium included mechanical ventilation (odds ratio [OR], 11.470; 95% confidence interval [CI], 4.283–30.721), nervous system disease (OR, 5.596; 95%CI, 2.445 to 12.809), developmental delay (OR, 5.157; 95% CI, 1.990–13.363), benzodiazepine (OR, 3.359; 95% CI 1.278–8.832), number of catheters (OR, 1.918; 95% CI, 1.425 to 2.582), and age (OR, 0.985; 95% confidence interval CI, 0.976–0.993). Conclusions: Delirium is a common complication in the PICU. The independent risk factors include mechanical ventilation, nervous system disease, developmental delay, benzodiazepines, higher number of catheters, and younger age. This study may help develop intervention strategies to reduce the incidence of delirium in critically ill children by targeting modifiable risk factors. Relevance to Clinical Practice: Recommendations for practice include paying attention to high‐risk children in the ICU who are prone to delirium, removing influencing factors as soon as possible, and providing targeted nursing interventions. [ABSTRACT FROM AUTHOR]

Aims: To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. Background: Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. Study Design: A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. Results: Among nurses, the belief scale score was 2.87 ± 0.33 (range 2–4), and the attitude scale score was 5.53 ± 1.12 (range 2.33–7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96–4) and 6.18 ± 1.20 (range 1.67–7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. Conclusion: Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. Relevance to Clinical Practice: The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of enhanced recovery after surgery (ERAS)‐optimized management system with nurse‐led multidisciplinary cooperation. Design: A quasi‐experimental design. Methods: Nursing department cooperated with medical and clinical department to establish an ERAS‐optimized management system. After the system was developed, it was applied in surgical departments of the hospital. Using convenience sampling, 220 selective surgical patients, 82 nurses and 98 doctors from January 1st, 2021 to July 31st, 2021 were selected as the trial group. 220 selective surgical patients, 82 nurses and 98 doctors were selected as the control group from January 1st, 2020 to July 31st, 2020. ERAS observation indicators were compared between the two groups before and 6 months after implementation. The nurse professional identity scores and satisfaction of medical cooperation scores of the two groups at different time points were analysed by repeated analysis of variance. Results: After the implementation, ERAS observation indicators in the trial group were better than the control group (p < 0.05). There were significant differences in the group main effect, time main effect and interaction effect of nurse professional identity scores, satisfaction of medical cooperation scores and scores in all dimensions between the two groups (p < 0.05). The scores of the experimental group at 3 months and 6 months after implementation were better than those of the control group (p < 0.05). Conclusions: Enhanced recovery after surgery‐optimized management system with nurse‐led multidisciplinary cooperation was an effective working method. It could promote patients recovery and enhance nurse professional identity. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to assess the level of moral courage among nurses in China, and to explore related influential factors, to help nursing managers take measures to improve nurses' moral courage. Design: A cross‐sectional study. Methods: The data adopted a convenient sampling method. From September to December 2021, 583 nurses from five hospitals in Fujian Province completed the Chinese version of the Nurses' Moral Courage Scale (NMCS). Data were analysed using descriptive statistics, chi‐square test, T‐test, Pearson correlation analysis and multiple regression analysis. Results: The Chinese nurses perceived themselves, on average, as morally courageous. The mean NMCS score was 3.64 ± 0.692. The six factors showed statistically significant correlations (p < 0.05) with moral courage. Regression analysis showed that the main factors influencing nurses' moral courage were active learning of ethics knowledge and nursing was a career goal. Conclusion: This study provides the self‐evaluation level and related influencing factors of Chinese nurses' moral courage. There is no doubt that nurses still need strong moral courage to face unknown ethical problems and challenges in the future. Nursing managers should pay attention to the cultivation of nurses' moral courage, using various forms of educational activities to help nurses alleviate moral problems and improve their moral courage, to maintain patients' access to high‐quality nursing. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID‐19) pandemic has spread globally and caused a major worldwide health crisis. Patients who are affected more seriously by COVID‐19 usually deteriorate rapidly and need further intensive care. Aim: We aimed to assess the performance of the National Early Warning Score 2 (NEWS2) as a risk stratification tool to discriminate newly admitted patients with COVID‐19 at risk of serious events. Design: We conducted a retrospective single‐centre case‐control study on 200 unselected patients consecutively admitted in March 2020 in a public general hospital in Wuhan, China. Methods: The following serious events were considered: mortality, unplanned intensive care unit (ICU) admission, and non‐invasive ventilation treatment. Receiver operating characteristic (ROC) analysis and logistic regression analysis were used to quantify the association between outcomes and NEWS2. Results: There were 12 patients (6.0%) who had serious events, where 7 patients (3.5%) experienced unplanned ICU admissions. The area under the ROC curve (AUROC) and cut‐off of NEWS2 for the composite outcome were 0.83 and 3, respectively. For patients with NEWS2 ≥ 4, the odds of being at risk for serious events was 16.4 (AUROC = 0.74), while for patients with NEWS2 ≥ 7, the odds of being at risk for serious events was 18.2 (AUROC = 0.71). Conclusions: NEWS2 has an appropriate ability to triage newly admitted patients with COVID‐19 into three levels of risk: low risk (NEWS2 = 0‐3), medium risk (NEWS2 = 4‐6), and high risk (NEWS2 ≥ 7). Relevance to clinical practice: Using NEWS2 may help nurses in early identification of at‐risk COVID‐19 patients and clinical nursing decision‐making. Using NEWS2 to triage new patients with COVID‐19 may help nurses provide more appropriate level of care and medical resources allocation for patients safety. [ABSTRACT FROM AUTHOR]

Dry skin and pressure injuries in older persons have become global health care problems. This was a multicentre, prospective cross‐sectional study in 44 hospitals and 8 long term care institutions from 20 provinces, autonomous regions and municipalities in China and aimed to explore the relationship between the two skin problems in older patients. We mainly found 11 602 cases with dry skin and 1076 cases with pressure injuries in a total of 33 769 valid participants. The overall prevalence of dry skin and pressure injuries was 34.4% (95% confidence interval [CI] 33.9–34.9) and 3.1% (95% CI 2.9–3.3). Stage 2+ pressure injuries were the most (32.9%), followed by stage 1 (32.4%). The patients with dry skin had more pressure injuries than ones without dry skin (50.0% vs 33.9%). The patients with very severe and severe dry skin had more pressure injury risk (OR 2.22 and 1.90) and more stage 2+ pressure injury risk (OR 2.83 and 1.63). Other nine predictors associated with overall pressure injuries and stage 2+ pressure injuries. The area under receiver operating characteristic (ROC) curve of the predictive models of overall pressure injuries and stage 2+ pressure injuries were 0.89 (95% CI 0.88–0.90) and 0.91 (95% CI 0.90–0.92), respectively. [ABSTRACT FROM AUTHOR]

Aim: Attitudes toward older persons could affect services that are provided to them and change the value of the care they receive. The attitude of nursing students toward older persons is very important as it will affect their care of older patients in future. However, in China, the attitude of higher vocational nursing students toward older persons has not been widely studied. The purpose of this study is to explore the attitudes and factors toward older people among nursing students in higher vocational colleges in Heilongjiang Province. Design: A cross‐sectional study. Methods: A cross‐sectional study was conducted using cluster sampling. A total of 1106 nursing students from two higher vocational colleges in Heilongjiang Province participated. Multiple linear regression analysis was conducted to identify the factors influencing nursing students' attitudes toward older people. Conclusion: This study showed that the vocational college nursing students have a positive attitude towardolder persons. However, the proportion of respondents taking care of older persons as their first choice in their future career needs to be increased. Advanced vocational colleges should pay attention to the attitudes of nursing students toward older persons, and strengthen the education of career development planning, which has practical significance in meeting the diversified health needs of older persons and ensuring healthy aging. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of a professional identity promotion strategy (PIPS) on nursing students' professional identity and resilience. Methods: This study was a quasi‐experimental study with a random cluster sample of 103 sophomore undergraduate nursing students. One hundred students answered the questionnaires at both baseline and follow‐up (51 of 53 in the intervention group and 49 of 50 in the control group). Intervention and control groups underwent 5 months PIPS and standard professional education from May 2 to September 27, respectively. Participants completed the professional identity questionnaire for nursing students (PIQNS) and Connor–Davidson resilience scale (CD‐RISC). Data were collected at baseline (T0), after the intervention (T1) and 3 months after the intervention (T2), and analyzed using the Chi‐squared test, Fisher's exact test, and repeated‐measures analysis of variance. Results: There were no significant differences between the two groups (p >.05) regarding demographic questions, professional identity, or resilience at baseline (p >.05). Significant differences were found in professional identity between groups (p <.001), measurement times (p =.026), and in the interaction between groups and measurement times (p =.018) from T0 to T2. Significant differences were found in resilience between groups (p <.001), measurement times (p =.007), and in the interaction between groups and measurement times (p =.035) from T0 to T2. Conclusions: The PIPS program improved nursing students' professional identity and resilience. Further long‐term effectiveness of the program needs to be tested with implementation through various forms of mobile technology. [ABSTRACT FROM AUTHOR]

People with diabetes frequently have elevated diabetes distress. Although mindfulness‐based stress reduction (MBSR) therapy has been shown effective in reducing diabetes distress, it has only been delivered by psychologists or a multidisciplinary team with an attrition rate of up to 39%, which limits its dissemination to a broader audience. This study was aimed to pilot evaluate the feasibility of a nurse‐led MBSR therapy and explore its potential efficacy amongst people with type 2 diabetes mellitus. A total of 100 participants were randomly allocated either to the intervention group (nurse‐led MBSR therapy + regular diabetes education) or the control group (regular diabetes education). Data on diabetes distress, diabetes self‐efficacy, and diabetes self‐management were collected at baseline, 8 and 12 weeks. Hemoglobin A1c (HbA1c) was collected at baseline and 12 weeks. A generalized estimating equation analysis for repeated measures was used to determine intervention and time effects. As predicted, the nurse‐led MBSR therapy had a significant time‐by‐group interaction effect on diabetes distress total score (95% confidence interval [CI]: 0.58–0.77, p < 0.001), diabetes self‐efficacy (95% CI: −0.93 to −0.74, p < 0.001), diabetes self‐management (95% CI: −10.80 to −7.83, p < 0.001), and HbA1c levels (95% CI: 0.04–1.14, p = 0.03) in the intervention group compared with the control group over 12 weeks. This is the first nurse‐led MBSR therapy in a hospital setting that is feasible and has the potential to improve health outcomes. This approach may offer an innovative model to deliver MBSR therapy. A randomized controlled trial comparing the nurse‐led MBSR plus usual diabetes education with usual diabetes education along with a mechanism to equalize intervention attention between the groups is indicated. [ABSTRACT FROM AUTHOR]

Aim: To explore the prevalence of nurse‐patient disputes and the influencing factors based on an analysis of patient characteristics. Design: A cross‐sectional study. Methods: This study used the convenience sampling method. Three self‐designed questionnaires based on clinical experience and literature review were used to collect the current status of nurse‐patient disputes and to assess patients' humanistic qualities and patients' recognition of nursing work. The Big Five personality questionnaire was used to assess the five personality traits of patients. Results: Of the patients, 9.6% reported having a dispute with nurses. The results of binary logistic regression analysis indicated that patients' humanistic quality, recognition of nursing work and agreeableness in personality traits had a negative predictive effect on nurse‐patient disputes, while family monthly income and neuroticism in personality traits positively predicted disputes. [ABSTRACT FROM AUTHOR]

Aim: To investigate the influencing factors in professional identity of undergraduate nursing students after the outbreak of COVID‐19. Design: Cross‐sectional study. Methods: The study covered 2,999 nursing students in six undergraduate nursing schools. Several self‐report questionnaires were used to collect the general information, psychological stress, coping styles and professional identity of the undergraduate nursing students. Results: The overall average score of the professional identity of nursing students (3.67 ± 0.51) has increased significantly after the outbreak of COVID‐19. The professional identity of the undergraduate nursing students was negatively correlated with psychological stress (r = −0.23, p <.001), expectation (r = −0.12, p <.001) and avoidance (r = −0.16, p <.001), but was positively correlated with solving problems (r = 0.18, p <.001) and seeking support (r = 0.12, p <.001). Academic performance, positions, grades, reasons for choosing a nursing profession, parents or relatives engaged in nursing work and the risk degree of residence were the factors influencing the professional identity score of undergraduate nursing students' (p <.001). [ABSTRACT FROM AUTHOR]

Background: In China, there is no unified standard for the responsibilities and authority of nurse anesthetists, resulting in different professional expectations from anesthesiologists and nursing managers, which may result in high levels of role stress and burnout in nurse anesthetists. Additional factors such as high occupational risk and heavy work may also contribute to role stress and burnout. Methods: In this multicenter cross-sectional study, an online questionnaire survey was conducted among 198 nurses from six tertiary hospitals in Shandong Province. The t test, analysis of variance, linear regression, and logistic regression were used to analyze the risk factors for role stress and professional burnout. Results: The scores of role conflict and role ambiguity in role stress were 30.61 ± 9.53 and 31.89 ± 9.56, respectively; satisfaction with income and the working environment, the hospital's attention, years of experience as a nurse, clarity concerning the nurse anesthetist's occupational scope, and attitude to career prospects were independent risk factors for role stress. The burnout data were non-normally distributed and were expressed as medians and quartiles. The scores of emotional exhaustion, depersonalization, and personal achievement in professional burnout were 30 (26-34), 11 (8-14), and 23 (20-26) respectively. The number of working hours per week, attitude to career prospects, satisfaction with the working environment and income, physical health, gender, and education were independent risk factors for burnout. Conclusions: Chinese nurse anesthetists were found to be in danger of high role stress and professional burnout, a situation requiring the attention of managers. [ABSTRACT FROM AUTHOR]

Objectives: To explore the correlations among social isolation and symptoms of anxiety and depression among patients with breast cancer in China and to further verify the mediating role of social support in social isolation and symptoms of depression or anxiety. Design: A cross‐sectional survey. Settings: The cluster sampling method was conducted for 456 female inpatients diagnosed with breast cancer at the Tumor Hospital Affiliated of Harbin Medical University from April 2019–September 2019. Methods: Pearson correlation analysis was used for identifying correlations among all the variables. Mediation effect analysis was used to examine the role of social support in social isolation and symptoms of depression or anxiety. Results: The results showed a prevalence of 73.26% and 70.44% for anxiety and depression symptoms in patients with breast cancer, respectively. Anxiety was significantly negatively correlated with social support (r = −.334, p <.01) and significantly positively correlated with social isolation (r =.369, p <.01). Similarly, depression was significantly negatively correlated with social support (r = −.289, p <.01) and significantly positively correlated with social isolation (r =.466, p <.01). Social support played a mediating role in social isolation and f symptoms of anxiety or depression among these patients. Conclusions: Social isolation was positively correlated with symptoms of anxiety and depression in patients with breast cancer, respectively. Social support for patients with breast cancer has a mediating effect on the patients' social isolation and symptoms of anxiety and depression. Therefore, the support of family, friends, hospitals, and organizations plays a positive role in reducing social isolation as well as symptoms of depression and anxiety in these patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to develop a cross‐cultural adaptation and to evaluate the validity and reliability of a Chinese version of the LiSat‐11 test. Methods: LiSat‐11 was translated into Chinese according to standardized procedures. A cross‐sectional descriptive study was conducted to examine its reliability and validity, in accordance to COnsensus‐based Standards for the election of health Measurements Instruments guidelines, among persons with stroke approximately 3 years after their discharge from rehabilitation. Participants completed the LiSat‐11, 36‐Item Short‐Form Health Survey (SF‐36), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI) and Hospital Anxiety and Depression Scale (HADS). To examine the test–retest reliability, thirty of these participants completed LiSat‐11 again after 2 weeks. Results: In total, 60 persons with stroke were recruited. The Chinese version of LiSat‐11 demonstrated good internal consistency with Cronbach's alphas at 0.82. Ceiling effects were found in five of the eleven items of LiSat‐11, and there was a floor effect in one item. LiSat‐11 had moderate to high correlations with SF‐36 with Spearman's correlation coefficient (rho) ranging from 0.44 to 0.73 (p < 0.01) in a concurrent validity test, and high correlations were also found between LiSat‐11 and HADS‐A/D in a convergent validity test with rho = −0.63/−0.67 (p < 0.01). Low correlations with NIHSS, BI and mRS were found in a divergent validity test, rho = −0.25, 0.17 and −0.26, respectively. Conclusion: The current study verified that the translated Chinese version of the Life Satisfaction Checklist‐11 is a reliable and valid tool for measuring the life satisfaction of persons with chronic stroke. [ABSTRACT FROM AUTHOR]

Objective: To investigate the level of professional identity among psychiatric nurses and to explore what work‐related factors may affect their professional identity. Methods: Four hundred and twelve nurses were investigated. Two self‐report questionnaires were used: (a) Nursing Professional Identity Scale (NPIS, range: 30 ~ 150); and (b) Practice Environment Scale of Nursing Work (PESNW, range: 0 ~ 100) with six dimensions: nursing‐related hospital affairs, high‐quality nursing care, ability of nursing manager, manpower and material resources, cooperation between nurses and doctors, and salary and social status. Higher scores indicated higher professional identities and better work environments. Results: Three hundred and ninety‐one of the participants completed the questionnaires and were analyzed. The mean age of the participants was 32.53 years, and 93.3% of them were female. The mean score of NPIS was 100.03 (SD: 17.44). Multiple linear regression showed that professional identity was significantly and positively associated with two dimensions of PESNW: salary and social status and ability of nursing manager. Conclusions: Professional identity among psychiatric nurses was at a moderate level. Salary and social status and ability of nursing manager positively contributed to their professional identity. These results may indicate the directors to construct better work environments for psychiatric nursing to improve professional identity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the levels of illness perception and identify interrelations among the variables of illness perception, demographic, and health‐related characteristics in a sample of rural Chinese adults with hypertension (HTN). Design: This is a cross‐sectional descriptive study using descriptive and correlation analysis. Sample: It included 163 people diagnosed with HTN for at least 3 years who lived in two rural villages in Zhejiang Province of mainland China during 2014–2015. Measurements: Illness perception was measured by the Chinese Illness Perception Questionnaire‐Revised. Demographic and illness characteristics were collected by the researcher. Weight, height, and blood pressure (BP) were, respectively, measured by calibrated scale and digital sphygmomanometers. Results: The findings showed that the BP control rate was 28.80% in the village. The highest average item score found in timeline (3.98 ± 0.76) and control (3.29 ± 0.67) subscales indicated that rural Chinese adults believe in the chronicity and controllability of HTN. Negative illness representation presented the lowest mean item score (2.64) suggesting that the participants neither perceive symptom variation of the illness nor their illness as serious. Interrelations existed among the illness perception variables with variation from that in other previous study. The cause of HTN was attributed to balance factors, psychological factors, risk factors, and cultural factors in sequence. Age, education, body mass index, and household annual income were correlated with illness perception. Conclusion: These findings suggested that misconceptions about HTN perception existed among rural adults in the villages. Comprehensive health education program is needed to increase rural adults' knowledge and management of HTN. [ABSTRACT FROM AUTHOR]

The article presents analysis of left ventricular diastolic energy loss in patients with aortic stenosis with preserved ejection fraction by using vector flow mapping. Topic include vector flow mapping (VFM) has been proposed to visualize and quantify the blood flow in the ventricle and cardiovascular cavity.

The aim of this study was to examine the effect of a nurse‐led telephone‐based peer support program on health outcomes in patients after cardiac pacemaker implantation. Seventy six patients who received cardiac pacemaker implantation were recruited as participants and randomly assigned to either the peer support group or the usual care group. The usual care group received routine care and health education measures provided by nurses; the peer support group received telephone‐based peer support. Health‐related quality of life, self‐care knowledge–attitudes–practice, postoperative anxiety and depression, compliance with attending scheduled follow‐up visits, and the incidence of postoperative complications were evaluated at baseline and 6 months' postintervention for the two groups. The result showed that the interventions had a better effect on self‐care knowledge–attitudes–practice, postoperative anxiety and depression, and compliance with attending scheduled follow‐up visits in the peer support group than in the usual care group. This study confirms that telephone‐based peer support improves self‐care ability, compliance with attending scheduled follow‐up visits, and reduces postoperative anxiety and depression more effectively than conventional nurse care among patients with cardiac pacemaker implantation. [ABSTRACT FROM AUTHOR]

Aim: This investigation aimed to study the general self‐efficacy level and its influential factors of breast cancer screening for the female college students in Changchun city of China. Methods: A three‐part questionnaire was designed to investigate 220 female college students' general self‐efficacy for breast cancer screening and its associated factors and knowledge of breast cancer screening. The data were analyzed with spss 23.0 using descriptive statistics, independent sample t‐tests and multiple regression analysis. Results: The mean total score of general self‐efficacy for breast cancer screening was 22.2 ± 5.213 (average ± standard deviation [SD])). About 37.7% of participants had lower level of general self‐efficacy for breast cancer screening. The average score of knowledge about breast cancer and screening was 5.26 ± 3.974 (average ± SD). About half (48.6%) of the students had poor breast cancer screening knowledge. Multivariate logistic regression analysis demonstrated that the level of breast cancer knowledge (P = 0.011) and sleep satisfaction (P = 0.008) were two predictive factors of good general self‐efficacy for breast cancer screening in female college students. Conclusion: Female college students in Changchun did not have enough knowledge and self‐efficacy to cope with the breast cancer screening through this survey. Therefore, primary healthcare professionals have the responsibility to improve their awareness of breast cancer screening by delivering enough breast cancer knowledge and implementing effective health promotion strategies to keep better health status and have satisfied sleep. [ABSTRACT FROM AUTHOR]

Premastication is thought to be an adaptive behavior in the introduction of complementary plant-bassed food to infants. It arouses controversy, however, because of the potential for transmitting saliva-born infectious diseases. The aim of this study was to explore whether premastication by healthy caregivers was associated with children's health and behavior. The data were collected as part of the Maternal and Infant Nutrition and Growth study. From 8 cities in China, 1341 pairs of infants/toddlers and their caregivers were recruited. An interviewer-administrated questionnaire collected data on sociodemographic characteristics, feeding behaviors, and self-reported health status. Anthropometric measurements were taken and blood samples were collected for analysis of hemoglobin levels. The overall prevalence of premastication was 26.9% and varies from 14-43% among the 8 cities. Premastication was not associated with occurrences of illness or with the nutritional indicators of height-for-age Z score, weight-for-age Z score, weight-for-height Z score, head circumference Z score and hemoglobin ( P all >.05). Premastication occurred more often among infants who were raised by their parents ( P = .005), whose mothers' education was lower ( P < .001), who were subject to more concern from their parents ( P = .022), and whose parents thought their children had an obesity problem ( P = .001). Presmastication was not associated with food picky behaviors. Premastication is still a common feeding practice in China. More studies are needed to determine the biological, economic, and cultural benefits or harm from premastication. [ABSTRACT FROM AUTHOR]

Objectives To compare differences in oral health-related quality of life ( OHRQoL) between halitosis and non-halitosis patients and to explore relationships between halitosis and OHRQoL. Methods Patients who visited the halitosis clinic at the Ninth People's Hospital and were diagnosed with halitosis were included in the halitosis group. The control group consisted of patients without halitosis. All participants were assessed for halitosis (volatile sulphur compound measurements with a portable sulphide monitor, Oral Chroma and organoleptic tests), underwent a clinical oral examination (dental caries status and periodontal condition) and completed a questionnaire. Oral health-related quality of life was measured using the Oral Health Impact Profile ( OHIP-14, Chinese version). Results A total of 204 patients (102 halitosis and 102 controls) were included. The halitosis group had significantly higher OHIP-14 scores (severity) than the control group (15.7 versus 7.9, P < 0.001). The mean number of items with negative impact (extent) was significantly different between the halitosis and control groups (1.8 versus 0.3, P < 0.001). Around 56% of participants in the halitosis group reported at least one item with 'fairly often' or 'very often' (prevalence), while 21% did so in the control group ( P < 0.001). In halitosis patients, the most commonly reported negative impacts were within the domains of 'psychological discomfort' and 'psychological disability'. Conclusions Oral health-related quality of life status was significantly poorer in halitosis patients than in non-halitosis patients. Halitosis patients may experience some degree of psychological discomfort and disability. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Family Therapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Our aim is to evaluate the expression of SATB1 in human oral squamous cell carcinomas ( OSCC) and its role in the invasiveness and metastasis of OSCC. Subjects and methods A human OSCC tissue microarray was used to evaluate the expression pattern of SATB1. SATB1 mRNA knockdown was performed in human OSCC cell lines SCC25 and Cal27 to assess the function of SATB1 in the invasiveness and metastasis of OSCC. Results SATB1 is highly expressed in human OSCC determined by immunohistochemistry, and its nuclear/cytoplasmic ratio of histoscore is significantly correlated with patients' prognosis. Reduced cell motility, invasiveness, expression of epithelial to mesenchymal transition ( EMT) markers (N-cadherin and β-catenin), and elevated expression of epithelial markers were observed in SATB1-knockdown cells in in vitro studies. Depletion of SATB1 also restored a cobblestone-like morphology in TGF-β1-treated cells. Conclusions These findings suggest SATB1 may play an important role in OSCC invasiveness and metastasis. [ABSTRACT FROM AUTHOR]

Accurate and precise wound measurements are a critical component of wound detection and assessment. Digital cameras are convenient and objective tools that are being increasingly used worldwide to assist with wound measurements and assessments. However, heterogeneous wounds and poor lighting conditions continue to be obstacles to wound area recognition. This study, therefore, provides an improved automated type-based wound area assessment method that is robust to lighting conditions and can distinguish between different wound tissues based on wound colors. The results of both laboratory and clinical applications of the proposed method show excellent consistency of manual area measurements. This proposed technology is expected to provide wound care specialists with more clinical information about heterogeneous wounds, thereby enabling prospective cost savings for therapy and treatment. [ABSTRACT FROM AUTHOR]

We explored the effects of acupressure training on older adults’ sleep quality and cognitive function. Ninety older adults with impaired sleep quality were selected from screened volunteers and randomly divided into equal control and experimental groups; 82 completed the 1‐year follow‐up. Participants in the control group were given instructions on sleep health, while those in the experimental group received sleep health instructions plus individual and small group acupressure training sessions and support to practice the intervention on their own each day. All participants were assessed by trained assistants blind to study group allocation using Chinese versions of the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Mini‐Mental State Examination, and four subscales from the revised Chinese version of the Wechsler Memory Scale, at baseline and at 3, 6, and 12 months. Repeated measures analysis of variance showed that acupressure training improved older adults’ sleep quality and cognitive function, but the mediating effect of sleep on the relationship between acupressure training and cognitive function was not supported. Given the ease, simplicity, and safety of acupressure training observed with community‐dwelling older adults in China, attempts should be made to replicate these preliminary positive findings with larger samples. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

The purpose of the study is to examine the safety and effectiveness of topical autologous platelet-rich gel (APG) application on facilitating the healing of diabetic chronic refractory cutaneous ulcers. The study was designed as a prospective, randomized controlled trial between January 1, 2007 and December 31, 2011. Eligible inpatients at the Diabetic Foot Care Center of West China Hospital, Sichuan University (China) were randomly prescribed with a 12-week standard treatment of ulcers (the control group) or standard treatment plus topical application APG (the APG group). The wound healing grades (primary endpoint), time to complete healing, and healing velocity within 12 weeks were monitored as short-term effectiveness measurements, while side effects were documented safety endpoints. The rates of survival and recurrence within the follow up were recorded as long-term effectiveness endpoints. Analysis on total diabetic ulcers (DUs) ( n = 117) and subgroup analysis on diabetic foot ulcers (DFUs) ( n = 103) were both conducted. Standard treatment plus APG treatment was statistically more effective than standard treatment ( p < 0.05 in both total DUs and subgroup of DFUs). The subjects defined as healing grade 1 were 50/59 (84.8%) in total DUs and 41/48 (85.4%) in DFUs in the APG group compared with 40/58 (69.0%) and 37/55 (67.3%) in the control group from intent to treat population. The Kaplan-Meier time-to-healing were significantly different between the two groups ( p < 0.05 in both total DUs and subgroup of DFUs). No side effects were identified after topical APG application. The long-term survival and recurrence rates were comparative between groups ( p > 0.05). This study shows that topical APG application plus standard treatment is safe and quite effective on diabetic chronic refractory cutaneous ulcers, compared with standard treatment. [ABSTRACT FROM AUTHOR]

Aim To explore general practitioners ( GPs)knowledge of ageing, attitudes towards older people and factors affecting their knowledge and attitudes in a Chinese context. Methods Four hundred GPs were surveyed using the Chinese version of the Aging Semantic Differential ( CASD) and the Chinese version of the Facts on Aging Quiz ( CFAQ1) scale. Results The CASD scores indicated that GPs had a neutral attitude towards older people. The CFAQ1 scores indicated a low level of knowledge about ageing. GPs' awareness of the mental and social facts of ageing was poorer compared to that of physical facts. Male GPs had a significantly higher negative bias score than female GPs. No other variables had a statistically significant influence on knowledge and attitudes. Conclusions The findings suggest the need for education interventions for GPs regarding knowledge of ageing and also provide evidence to guide future development of continuing medical programs for this group of medical doctors. [ABSTRACT FROM AUTHOR]

It has been consistently demonstrated that initial exertion of self-control had negative influence on people's performance on subsequent self-control tasks. This phenomenon is referred to as the ego depletion effect. Based on action control theory, the current research investigated whether the ego depletion effect could be moderated by individuals' action versus state orientation. Our results showed that only state-oriented individuals exhibited ego depletion. For individuals with action orientation, however, their performance was not influenced by initial exertion of self-control. The beneficial effect of action orientation against ego depletion in our experiment results from its facilitation for adapting to the depleting task. [ABSTRACT FROM AUTHOR]

ABSTRACT To determine the annual incidence and clinically relevant risk factors for foot ulceration in a large cohort study of diabetic foot ulcer (DFU) patients and diabetes mellitus (DM) patients in China. To investigate a cohort of 1,333 patients comprising 452 DFU patients and 881 DM patients, who underwent foot screening, physical examination, and laboratory tests in eight hospitals. The patients were assessed at baseline in terms of their demographic information, medical and social history, peripheral neuropathy disease (PND) screening, periphery artery disease (PAD) screening, assessment of nutritional status, and diabetic control. One year later, the patients were followed up to determine the incidence of new foot ulcers, amputation, and mortality. By univariate analysis, statistically significant differences were found in age, location, gender, living alone (yes/no), occupation, smoking, hypertension, PND, PAD, nephropathy, retinopathy, cataracts, duration of diabetes, Glycosylated hemoglobin A (HbA1c), fasting plasma glucose level, postprandial blood glucose level, insulin level, blood urea nitrogen, creatinine, cholesterol, triglyeride, high density lipoprotein (HDL), serum albumin, white blood cell, and body mass index. A binary logistic regression model was used to examine which of these risk factors were independent risk factors for foot ulceration. A total of 687 (51.5%) of the 1,333 patients were followed up for an average of 12 months; there were 458 DM patients and 229 DFU patients. A total of 46 patients died during the follow-up period; 13 were DM patients, and 33 were DFU patients. Of the 641 patients, 445 (69.4%) patients were DM patients, and 196 (30.6%) were DFU patients. At follow-up, 36/445 DM patients (8.1%), and 62/196 DFU patients (31.6%), developed new ulcers; 10/196 DFU patients underwent an amputation. The annual incidence of ulceration for DM patients and amputation for DFU patients were 8.1 and 5.1%, respectively. The annual mortality of the DM patients and DMF patients were 2.8 and 14.4%, respectively. A binary logistic regression model was used to examine which risk factors were independent risk factors for foot ulceration during the follow-up period, and the final results showed that nephropathy (odds ratio 2.32), insulin level (odds ratio 3.136, 2.629), and decreased HDL (odds ratio 0.427) were associated with increased risks for foot ulceration. Complications of diabetes affecting the feet represent a serious problem in China. The incidence of foot ulcers and amputation are much higher than that of Western countries. More intensive surveillance and aggressive care following a diagnosis of DFU and earlier referral to specialty care might improve the patient outcome. [ABSTRACT FROM AUTHOR]

Chewing-side preference ( CSP) may be associated with temporomandibular disorders. However, little information exists regarding whether CSP will lead to osseous changes of temporomandibular joint ( TMJ) in asymptomatic participants. The aim of this study was to investigate the relationship between osseous morphology of TMJ in asymptomatic participants with CSP and without CSP. Of the 121 healthy dentate participants, 35 participants with left CSP, 38 with right CSP and other 48 without CSP were scanned by cone-beam computed tomography. The dimensions of the reconstructed images of opposing TMJs were compared. Statistical analyses were performed using spss 16.0 software. The results showed that there were no significant differences between the dimensions of bilateral structures of the TMJ ( P1 > 0·05) in participants without CSP. However, the posterior-superior, posterior and lateral joint space of the preferred side were smaller than that of the unpreferred side in participants with CSP ( P2 < 0·01) and bilateral TMJ in participants without CSP ( P3 < 0·01). In addition, width of condylar neck of the unpreferred side both in sagittal and perpendicular to the long axis of condyle views was greater than that of the preferred side in participants with CSP ( P2 < 0·01) and bilateral TMJ of participants without CSP ( P4 < 0·01). Also, the inclination of articular eminence of the preferred side in view perpendicular to the long axis of condyle was less than that of the unpreferred side ( P2 < 0·05). These findings suggest CSP affects osseous morphology of TMJ in asymptomatic participants. [ABSTRACT FROM AUTHOR]

Background 'Ageing in place' is widely promoted as a response to global ageing and increased demand for services, but little evidence is available about what older people think they need in terms of services and supports to remain at home. Aim To investigate older people's needs when ageing in place in order to provide evidence to inform policies and strategies promoting the option of ageing in place. Methods A total of 568 elderly persons in Hangzhou, China, were surveyed in 2009-2011 using a modified questionnaire validated in the USA and China. Results Overall, 88.9% of older adults were satisfied with the community in which they live; 97.2% were satisfied with life quality. Health problems and healthcare access difficulty increased with age. House repairs and housework were the most troubling. Respondents identified high need for social and health promotion services and this varied across age groups. Limitations Cultural adaptation and validation of the questionnaire could have been influenced by differences in socioeconomic and cultural factors. The sample excluded older adults with disabilities, bed-ridden and/or unable to communicate thus limiting the scope of relevance. Conclusion A majority of older adult respondents ageing at home lived a relatively healthy life; however, they required more comprehensive health insurance to cover costs of long-term health problems and access to home care support. Implications for nursing and health policy The needs of community-dwelling older Chinese people in the Xiacheng District are not being fully met and much remains be done to increase community and regional capacity before ageing in place can be promoted as a policy strategy. More generally, nursing and health policies geared to enhance the self-sufficiency of older people residing in their communities must draw upon evidence of assessed needs and client perspectives of their requirements before services can be designed and delivered. [ABSTRACT FROM AUTHOR]

The objective of the present study is to test the validity of the integrated cognitive model of depression proposed by Kwon and Oei (1994) with a Chinese adolescent sample. A two-wave panel design was used. We hypothesized that the interaction between dysfunctional attitudes measured at time 1 and adolescents' negative life events experienced between times 1 and 2 would predict changes in the frequency of automatic thoughts between times 1 and 2. We further hypothesized that changes in the frequency of automatic thoughts would, in turn, predict changes in the severity of depressive symptoms. Participants were 329 Chinese adolescents. As a comparison, we tested three other competing models: linear mediation, alternative aetiologies and symptom models. All participants completed the Adolescent Self-Rating Life Events Checklist, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire and Center for Epidemiological Studies Depression Scale on two occasions-5 months apart. Path analysis was used to test all models. Results of the path analysis indicated that the integrated cognitive model showed an adequate fit for the Chinese adolescent data. During phases of increased depression, dysfunctional attitudes were common cognitive moderators of depression, whereas automatic thoughts were specific cognitive mediators of depression. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Backgroud and Objective Genetic factors may influence the colonization of pathogenic bacteria, therefore increasing the risk for the initiation and development of periodontal disease. The present study was carried out to investigate the association of CD14-260 polymorphisms, subgingival microbiota, and gingival crevicular fluid ( GCF) cytokine levels with cyclosporine A ( Cs A)-induced gingival overgrowth ( GO) in renal transplant patients. Material and Methods A total of 204 patients were dichotomized into two groups: 124 with GO and 80 without GO. The CD14-260 polymorphisms were measured using an allele-specific PCR method. The levels of periodontal pathogens were determined by real-time PCR of subgingival samples. GCF levels of IL-1 β and s CD14 were detected by ELISA. Results The frequency of CD14-260 genotype CT + TT was found to be similar in both groups. Patients with GO presented increased prevalence of Pg, Td, and Tf (red complex) and significantly higher levels of interleukin -1 β than those without GO. Patients with GO carrying CT + TT genotypes were found to have higher frequencies of Pg, Td, and Tf than those carrying the CC genotype. Furthermore, in the presence of red complex, CT + TT genotypes were associated with higher interleukin -1 β levels and severe GO. Multiple logistic regression analysis demonstrated that the severity of GO is not dependent on age, gender and pharmacological variables, being only associated with CD14-260 genotype and red complex periodontopathogens. Conclusion No association between CD14-260 polymorphisms and the prevalence of GO was revealed in renal transplant patients administered Cs A. However, CD14-260 CT + TT genotypes are associated with the prevalence of red complex periodontopathogens in patients with GO, and may thus play some role in the development of severe Cs A-induced GO. [ABSTRACT FROM AUTHOR]

Inappropriate complementary feeding practices have led to, in part, significant disparities in growth and nutritional status between rural and urban children in China. A cluster-randomised, controlled trial was implemented in Laishui, China to assess the effectiveness of an educational intervention on caregivers' feeding practices and children's growth. Eight townships were randomly assigned to the intervention or control. Five hundred ninety-nine healthy infants were enrolled at 2-4 months old, and were followed up at ages 6, 9, 12, 15 and 18 months. The intervention group received information on enhanced home-prepared recipes and food preparation and hygiene through group training, counselling and home visit. Key outcomes were children's physical growth, caregivers' knowledge and behaviours on complementary feeding, and the infant and child feeding index ( ICFI). Analysis was by intention to treat. The intervention group achieved better knowledge and practices related to complementary feeding, and significantly higher ICFI scores at each follow-up point. Children in the intervention group achieved higher z-scores for weight-for-age ( WAZ) and weight-for-height ( WHZ) than the control (0.18 vs. 0.01 and 0.49 vs. 0.19, respectively) at 18 months old, and were less likely to have stunted growth (odds ratio = 0.71, 95% confidence interval: 0.53-0.94). Mixed model showed that the intervention group achieved significantly better linear growth over time, including WAZ ( P = 0.016), WHZ ( P = 0.030) and HAZ ( P = 0.078). These results indicated that an educational intervention delivered through local health services can enhance caregivers' knowledge and practices of complementary feeding and ultimately improve children's growth. [ABSTRACT FROM AUTHOR]

Background Women choosing breast cancer surgery encounter treatment decision-making (TDM) difficulties, which can cause psychological distress. Decision Aids (DAs) may facilitate TDM, but there are no DAs designed for Chinese populations. We developed a DA for Chinese women newly diagnosed with breast cancer, for use during the initial surgical consultation. Aims Conduct a pilot study to assess the DA acceptability and utility among Chinese women diagnosed with breast cancer. Methods Women preferred the DA in booklet format. A booklet was developed and revised and evaluated in two consecutive pilot studies (P1 and P2). On concluding their initial diagnostic consultation, 95 and 38 Chinese women newly diagnosed with breast cancer received the draft and revised draft DA booklet, respectively. Four-day post-consultation, women had questionnaires read out to them and to which they responded assessing attitudes towards the DA and their understanding of treatment options. Results The original DA was read/partially read by 66/22% ( n = 84) of women, whilst the revised version was read/partially read by 74/16% ( n = 35), including subliterate women (χ2 = 0.76, P = 0.679). Knowledge scores varied with the extent the booklet was read (P1: F = 12.68, d.f. 2, P < 0.001; P2: F = 3.744, d.f. 2, P = 0.034). The revised, shorter version was graphically rich and resulted in improved perceived utility, [except for the 'treatment options' (χ2 = 5.50, P = 0.019) and 'TDM guidance' (χ2 = 8.19, P = 0.004) sections] without increasing anxiety ( F = 0.689, P = 0.408; F = 3.45, P = 0.073). Conclusion The DA was perceived as acceptable and useful for most women. The DA effectiveness is currently being evaluated using a randomized controlled trial. [ABSTRACT FROM AUTHOR]