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Background: With the emergence of numerous scientific outputs, growing attention is paid to research misconduct. This study aimed to investigate knowledge, attitudes and practices about research misconduct among medical residents in southwest China. Methods: A cross-sectional study was conducted in southwest China from November 2022 through March 2023. The links to the questionnaire were sent to the directors of the teaching management department in 17 tertiary hospitals. Answers were collected and analyzed. Logistic regression analysis was performed to explore the factors associated with research misconduct among residents. Results: 6200 residents were enrolled in the study, and 88.5% of participants attended a course on research integrity, but 53.7% of participants admitted to having committed at least one form of research misconduct. Having a postgraduate or above, publishing papers as the first author or corresponding author, attending a course on research integrity, lower self-reported knowledge on research integrity and lower perceived consequences for research misconduct were positively correlated to research misconduct. Serving as a primary investigator for a research project was negatively associated with research misconduct. Most residents (66.3%) agreed that the reason for research misconduct is that researchers lack research ability. Conclusions: The high self-reported rate of research misconduct among residents in southwest China underscores a universal necessity for enhancing research integrity courses in residency programs. The ineffectiveness of current training in China suggests a possible global need for reevaluating and improving educational approaches to foster research integrity. Addressing these challenges is imperative not only for the credibility of medical research and patient care in China but also for maintaining the highest ethical standards in medical education worldwide. Policymakers, educators, and healthcare leaders on a global scale should collaborate to establish comprehensive strategies that ensure the responsible conduct of research, ultimately safeguarding the integrity of medical advancements and promoting trust in scientific endeavors across borders. [ABSTRACT FROM AUTHOR]

Residents' environmental attitudes (EAs) towards ecological restoration programs are vital for evaluating program effectiveness and promoting environmental management. However, most local studies have neglected the indirect environmental contextual influences on residents' EAs, and have omitted the regional variations in the environmental contextual influences. To investigate the multilevel factors affecting residents' EAs, we conducted a transect survey that included the eastern, middle, and western regions in northern China's drylands, where have experienced ecological restoration. Multilevel linear models (MLMs) were applied to analyse the direct and indirect impacts of environmental contexts and individual characteristics on rural residents' EAs. The results showed the environmental context can indirectly impact EAs by amplifying the influence of individual characteristics such as family structure and income on EAs. The EAs are influenced by different local environmental contexts among the east, middle and west of China's drylands. The humidity attitude was influenced by precipitation only in the highly arid western and middle regions, while precipitation attitude is strongly influenced by land surface temperature and humidity in eastern China's drylands. These findings hold important implications for understanding the cross-scale impact of environmental contexts on EAs in drylands., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The rural B&B industry is a key component of rural tourism, local economic development, and the wider rural revitalization strategy. Despite the abundance of tourism resources in Yunnan, the B&B sector faces significant challenges. It is therefore imperative to accurately identify the most pressing issues within the current B&B industry and formulate appropriate solutions to advance Yunnan's rural revitalization efforts. This study uses recent reviews of rural B&Bs on Ctrip.com and employs machine learning techniques, including Bert, CNN, LSTM, and GRU, to identify the key management challenges currently facing Yunnan's rural B&B industry. An analysis is then conducted to identify the key stakeholders involved in the process of improving the management of Yunnan's B&Bs. To assess the willingness of each stakeholder to support the improvement of the rural B&B industry, this paper establishes a three-party evolutionary game model and examines the dynamic evolutionary process of management improvement within Yunnan's rural B&B industry. Two scenarios of evolutionarily stable strategies are analyzed, and parameters impacting stakeholders' strategy choices are simulated and evaluated. The results show that: i) Improving the "human factor" is the top priority for the current management improvement because tourists are most concerned about the emotional experience. Operators need to focus on improving service attitude and emotional experience; ii) The main stakeholders in the current management optimization process of Yunnan B&Bs are the local government, B&B operators, and tourists. Under appropriate conditions, the evolutionarily stable strategy of (1, 1, 1) is reachable. iii) variables such as additional costs, tourists' choice preferences, and government penalties significantly affect the strategy choices of stakeholders, especially B&B operators. This paper offers effective strategies for improving B&B management that can benefit the government, B&B operators, and tourists, and ultimately contribute to the promotion of quality rural revitalization. The paper not only identifies focal areas for improving B&B management in rural Yunnan, but also provides an in-depth understanding of stakeholder dynamics. As a result, it provides valuable insights to further the cause of quality rural revitalization., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Public electric bus (PEB) usage remains critical in reducing carbon emissions, traffic congestion, energy consumption, resource exhaustion, and environmental pollution. PEB usage revolves around consumer acceptance, and assessing the psychological factors accounting for using PEBs is essential in mitigating these challenges for a sustainable environment. The study extends the reasoned action theory (TRA) with environmental awareness, convenience, and personal norms in investigating residents' intention to use electric buses in Nanjing, China. 405 responses were gathered through an online survey and evaluated using Structural Equation Modeling (SEM). Statistical analysis showed that the structural model (66.4%) explained public electric bus use better than the original TRA model (20.7%). Attitude, subjective norms, personal norms, environmental awareness, and convenience directly influenced the intention to use PEBs. Personal norms related to attitude positively. Environmental awareness related to personal norms in PEB use. Subjective norms partially mediated the impact of personal norms on the intention to use PEBs. Convenience moderated the interaction between personal norms and intention to use PEBs. Respondents differed in income level, educational level, and employment but not gender in their inclinations to use PEBs. The current study recommends potent policy implications to enhance and ensure the maximum use of PEBs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The environmentally responsible behaviors of residents and tourists are great significance to the protection of natural resources and sustainable development of ecotourism. This paper takes China's Qilian Mountains National Park as the case place. By constructing a theoretical model of perceived value on environmentally responsible behavior and studying the relationship between residents' and tourists' perceived value, satisfaction and environmentally responsible behavior from both subject and object perspectives, the study shows that. Educational level and occupational distribution have significant effects on residents' and tourists' perceptions of ecotourism environmentally responsible behaviors, but age only has a significant effect on residents' perceptions of ecotourism environmentally responsible behaviors. Gender differences do not affect residents' and tourists' perceptions of ecotourism environmentally responsible behaviors. The theoretical model between residents' perceptions of environmentally responsible behaviors, environmentally responsible behaviors, and satisfaction was basically confirmed. Perceived environmentally responsible behaviors of tourists does not affect satisfaction. Satisfaction has a positive effect on tourists' environmentally responsible behaviors. Perceived environmental responsibility of tourists has a significant positive effect on tourists' environmentally responsible behaviors. The overall level of residents' perception of environmentally responsible behaviors in ecotourism is higher than tourists' perception. Residents and tourists have a poor perception of ecological and environmental protection policies. This paper expects to strengthen residents' and tourists' perceptions of ecologically responsible behaviors. Establishing the sentiment of satisfaction and commitment to environmental protection motivates residents and tourists to implement environmentally responsible behaviors and contribute to the sustainable development of ecotourism., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Research ethics provides the ethical standards for conducting sound and safe research. The field of medical research in China is rapidly growing and facing various ethical challenges. However, in China, little empirical research has been conducted on the knowledge and attitudes of medical postgraduates toward research ethics and RECs. It is critical for medical postgraduates to develop a proper knowledge of research ethics at the beginning of their careers. The purpose of this study was to assess the knowledge and attitudes of medical postgraduates toward research ethics and RECs. Methods: This cross-sectional study was conducted from May to July 2021 at a medical school and two affiliated hospitals in south-central China. The instrument of the study was an online survey that was distributed via WeChat. Results: We found that only 46.7% were familiar with the ethical guidelines for research with human subjects. In addition, 63.2% of participants were familiar with the RECs that reviewed their research, and 90.7% perceived RECs as helpful. However, only 36.8% were fully aware of the functions of RECs. In the meantime, 30.7% believed that review by an REC would delay research and make it more difficult for researchers. Furthermore, most participants (94.9%) believed that a course on research ethics should be mandatory for medical postgraduates. Finally, 27.4% of the respondents considered the fabrication of some data or results to be acceptable. Conclusion: This paper serves to suggest that research ethics education should be prioritized in medical ethics curriculum, and course syllabi or teaching methods should be revised to provide medical postgraduates with a deeper understanding of the principles, regulations, and specifics of research ethics. We also recommend that RECs provide diverse approaches in their review procedure to facilitate the understanding of medical postgraduates of the functions and processes of RECs and to enhance their awareness of research integrity. [ABSTRACT FROM AUTHOR]

The effective treatment of rural domestic waste is the key to solving rural environmental pollution and realizing rural ecological revitalization. Giving full play to the main role of farmers' domestic waste classification can improve the efficiency and effect of domestic waste treatment. To explore the key factors affecting the farmers' perception, attitude, and behavior of domestic waste classification, this study with 318 farmers in Sichuan Province as the research object, the research framework of domestic waste classification behavior was constructed based on the theory of planned behavior, and then, the logistic regression model was used for the empirical test. The results show that the farmers' education levels, subjective norms, relatives' and neighbors' views on waste classification, farmers' awareness regarding the negative environmental impacts caused by waste, farmers' private benefits, and farmers' views on the waste management ability of local governments are significantly positively correlated with the classification behavior of farmers' domestic waste. The distance between farmers' houses and waste collection points is significantly negatively correlated with the classification behavior of farmers' domestic waste. This paper provides a certain theoretical reference for realizing the reduction, resourcization, and positive development of rural domestic waste management in China.

With the continuous prominence of environmental problems, some online environmental platforms have been built in China. Such platforms provide an important carrier for public to learn environmental knowledge and participate in environmental protection. However, whether such platforms can play a substantive role in promoting users' green consumption behaviors is still unclear. Focusing on this question, the influence of online environmental platform services on public green consumption behaviors is explored. A model based on the theory of stimulus-organism-response is established to analyze the influential mechanism, using the online environmental platform services as the independent variable, users' green consumption behaviors as the dependent variable, environmental attitude as the mediator, and users' price sensitivity as the moderator. Survey data are used to test the model. The empirical results show that online environmental platform services have a significant positive impact on users' green consumption behaviors. Environmental attitude plays a partial mediating role and price sensitivity negatively moderates the mediating role of environmental attitude. Suggestions are given from the perspectives of platform operators and government. This paper provides both theoretical and practical implications for sustainable consumption.

Background: China is the country with the largest elderly population. To actively respond to this ageing population, China has proposed the Community Aged Care Service Centre (CACSC) network as the major elderly care development policy. However, many residents resisted the development of the CACSC network, which affected its smooth implementation. Based on the theory of "Not in My Backyard" (NIMBY), this paper proposes a model of the influencing factors of community residents on the opposition to the construction of CACSCs., Methods: Residents living in urban communities over the age of 20 in China are the target of this study. The questionnaires were collected in the form of electronic questionnaires created on a professional website, and hyperlinks to the questionnaires were distributed through social media. The descriptive statistical analysis, T-tests, ANOVA and structural equation modelling were performed on cross-sectional survey data from 509 questionnaires., Results: The research results show that superstition, the NIMBY attitude, and perceived risk have a significant positive impact on the opposition to the construction of CACSCs, while the negative impact of perceived benefit on the opposition intention is not significant. Moreover, perceived knowledge has a significant positive impact on perceived benefit and a significant negative impact on superstition and perceived risk., Conclusions: Strengthen policy advocacy on ageing, clarify the service content of CACSC and encourage young people to participate in public welfare activities for the elderly can reduce the opposition of community residents to the construction of a CACSC., (© 2022. The Author(s).)

There is a lack of quantitative studies on the acceptance of extramarital sex in China. Based on data from the Chinese General Social Survey 2013 (CGSS2013), this paper used a zero-inflated Poisson regression model to analyze the factors influencing the public's attitudes toward extramarital sex. When other variables were controlled, groups of younger ages, higher educational levels, and stronger tendencies toward "liberalization" and non-Islamic beliefs were more tolerant toward extramarital sex, whereas gender and Christian beliefs had no significant influence. In this regard, family and marriage counseling, and society's moral tolerance and social control of religion are discussed, and further research on cross-cultural verification is needed.

The impact of mandatory policies on residents' willingness to separate waste and how they respond to such measures is not clearly understood. To answer this question, based on deterrence theory, theories of belief change, the theory of rational behavior, and the theory of cognitive consistency, this paper established a mechanism model for the impact of mandatory policies on residents' willingness to separate waste, and analyzed the roles of attitude, subjective norms, and new ecological paradigms. Through a questionnaire survey of 442 ordinary residents in Shanghai, hierarchical regression and bootstrapping analysis were used to verify the above model. The results showed that:(1) mandatory policies positively affected residents' attitude and subjective norms toward waste separation; (2) through the mediation of attitude and subjective norms, mandatory policies positively affected residents' willingness to separate waste; and (3) the new ecological paradigm moderated the above effects. For residents with higher ecological paradigm, the positive influence of mandatory policies on attitudes and subjective norms was stronger, and the mediation effect of attitude and subjective norms was also stronger., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

With both cost and safety taken into account in the context of the life-threatening COVID-19 pandemic globally, rural tourism is expected to be the top choice for Chinese residents for relaxation and enhancing parent-child relationships. In this paper, a structural equation (SEM) model was proposed to compare risk knowledge, risk perception, risk aversion attitudes and behavioral intentions towards rural tourism. According to the empirical results, there was a large proportion of tourists showing preference for rural tourism recently. Potential participants in rural tourism paid most attention to the performance realization and time cost of scenic spots, while the psycho-social risk posed by COVID-19 had little impact. The inherent risk nature of risk aversion attitudes made knowledge of the pneumonia risk less effective in reducing tourists' intentions, while knowledge of the pneumonia risk was more effective in alleviating the risk perception that potential tourists have towards rural tourism. With regard to travel intention and recommendation intention of rural tourism, the negative impacts of risk aversion attitude were more considerable compared to risk perception. Meanwhile, the parallel mediating effect of risk perception and risk aversion attitude in rural tourism needed to be taken into consideration together.

Background: The household expired drugs disposal has been a huge public issue in many countries, including China, which may affect various side and toxic effects on human health and environment, water resources, and soil too. This paper explores the knowledge, attitude, and practice of Guangzhou city residents regarding household expired drugs and their effect on human health and provided the scientific pieces of evidence to carry out the long-term recovery mechanism for expired medicines. Methods: An observational, cross-sectional study was conducted using a self-structured questionnaire. Descriptive analysis, including univariate and unconditional logistic regression models, was carried out to analyze the data. Results: A total of 613 community residents with a 99.4% response rate enrolled for the study. More than half 60.2% of residents stated that expired drugs pollute the environment, soil, and water resources, where 81.2% of respondents knew that it would produce side effects or toxic effects. However, still, 71.6% of respondents disposed of directly into the trash bin or sink, and, only 24.8% had good practice that they use a designed recycling bin. Likewise, only 8.3% of respondents placed expired drugs into collection points nearly 3– 5 times in a year, while 65.1% of participants never disposed of in the collection point, which found a worse practice. Conclusion: Overall, the knowledge, attitude, and practice of Guangzhou residents regarding household expired drugs disposal were not ideal. To improve the resident's awareness about family expired drugs disposal, ensure the financial support for the recycling process, establish an accessible and acceptable recycling point, and introduce relevant laws and regulations for the long-term mechanism. [ABSTRACT FROM AUTHOR]

A growing body of research has shown that people's attitudes toward food safety is affected by their availability and accessibility to food risk information. In the digital era, the Internet has become the most important channel for information acquisition. However, empirical evidence related to the impact of Internet use on people's attitudes towards food safety is inadequate. In this study, by employing the Chinese Social Survey for 2013 and 2015, we have investigated the current situation of food safety perceptions and evaluations among Chinese residents and the association between Internet use and individuals' food safety evaluations. Empirical results indicate that there is a significant negative correlation between Internet use and people's food safety evaluation in China. Furthermore, heterogeneity analysis shows that Internet use has a stronger negative correlation with food safety evaluation for those lacking rational judgment regarding Internet information. Specifically, the negative correlation between Internet use and food safety evaluations is more obvious among rural residents, young people, and less educated residents. Finally, propensity score matching (PSM) is applied to conduct a robustness check. This paper provides new evidence for studies on the relationship between Internet use and an individuals' food safety cognition, as well as additional policy enlightenment for food safety risk management in the digital age.

The aim of this paper is to measure the knowledge and attitudes of primary care physicians toward antibiotic prescriptions and their impacts on antibiotic prescribing. A questionnaire survey was conducted on 625 physicians from 67 primary care facilities in Hubei, China. Structural equation modelling (SEM) was applied to test the theoretical framework derived from the Knowledge, Attitudes, and Practices (KAP) theory. Physicians' knowledge, five sub-types of attitudes, and three sub-types of behavioral intentions towards antibiotic use were measured. Physicians had limited knowledge about antibiotic prescriptions (average 54.55% correct answers to 11 questions). Although they were generally concerned about antibiotic resistance (mean = 1.28, SD = 0.43), and were reluctant to be submissive to pressures from consumer demands for antibiotics (mean = 1.29, SD = 0.65) and the requirements of defensive practice (mean = 1.11, SD = 0.63), there was a lack of motivation to change prescribing practices (mean = -0.29, SD = 0.70) and strong agreement that other stakeholders should take the responsibility (mean = -1.15, SD = 0.45). The SEM results showed that poor knowledge, unawareness of antibiotic resistance, and limited motivation to change contributed to physicians' high antibiotics prescriptions ( p < 0.001). To curb antibiotic over-prescriptions, improving knowledge itself is not enough. The lack of motivation of physicians to change needs to be addressed through a systematic approach.

This paper presents a descriptive analysis of data gathered by personal interviews from a multistage random sample of 1640 residents aged 18⁻34 years in Wuhan, China. First, alcohol drinkers and abstainers were compared based on demographic, attitude, and belief variables. Next, the drinkers from the sample were classified into four groups based on frequency-quantity of alcohol use, and the frequency-quantity groups were compared on the same variables. For Abstainers versus Drinkers, we found no difference by age or gender in this sample. Married people and people with children were more likely to be abstainers. University-educated, currently-employed individuals in mid-level jobs were more likely to abstain from alcohol. Vocational/Technical graduates, people who were currently attending college, currently unemployed and never-employed individuals were more likely to be drinkers. Abstainers also responded with less-positive attitudes and beliefs about drinking and attached more importance to reasons for not drinking compared to drinkers. When the drinking frequency-quantity groups were compared, gender differences became significant: more high-quantity drinkers were women; however the guideline for quantity for women was >1 drink at a time compared to >2 drinks at a time for men. Quantity and frequency of drinking was significantly associated with having children, educational level, employment status, and type of occupation. Age, marital status, and being in college did not relate significantly with quantity and frequency of drinking alcohol. Attitudes and beliefs about drinking tended to be more positive among high-frequency and high-quantity drinkers. Drinkers in all frequency-quantity groups attached greater importance to social reasons for drinking compared to personal/psychological reasons for drinking. Drinkers in the lowest frequency-quantity group attached the most importance to reasons for not drinking. These findings confirmed that in China drinking plays an important role in socializing and celebrating, and that there are important differences between alcohol drinkers and abstainers and between frequency/quantity groups of drinkers. Western models of individualized motivation of behaviors may not accurately explain alcohol use in China. We believe the findings from this study suggest the need for more detailed studies of alcohol drinking and abstaining.

Background: The administration of anesthesia during gastrointestinal endoscopy potentially contributes to post-anesthesia cognitive dysfunction (PACD), with detrimental impacts for cognitive function. This study aimed to assess the knowledge, attitudes, and practices (KAP) towards PACD among patients undergoing gastrointestinal endoscopy in Wenzhou region. Methods: This cross-sectional study was conducted between June and August 2023, and recruited individuals undergoing gastrointestinal endoscopy. Demographic data and KAP scores were collected through questionnaires. Pearson correlation analysis was applied to evaluate correlations between KAP scores, and logistic regression was utilized to identify influential factors. Results: We collected 405 valid questionnaires, with 54.57% being male and 29.88% aged 31–40 years. Mean KAP scores were 13.99 ± 4.80, 16.19 ± 2.35, and 15.61 ± 2.86, respectively (possible range: 0–16, 0–25, and 0–25). Pearson correlation analysis demonstrated significant positive correlations between knowledge and practice (r = 0.209, P < 0.001), attitude and practice (r = 0.233, P < 0.001), and knowledge and attitude (r = 0.328, P < 0.001). Multivariate logistic regression revealed negative associations of opting for standard gastrointestinal endoscopy (without anesthesia) with knowledge (OR = 0.227, 95%CI: 0.088–0.582, P = 0.002) and practice scores (OR = 0.336, 95%CI: 0.154–0.731, P = 0.006). Additionally, the presence of cognitive-related diseases or symptoms before undergoing gastrointestinal endoscopy was negatively associated with knowledge scores (OR = 0.429, 95%CI: 0.225–0.818, P = 0.010). Conclusion: Patients undergoing gastrointestinal endoscopy demonstrated good knowledge, neutral attitudes, and moderate practices regarding PACD. Educational interventions and behavior modification are recommended, particularly for individuals with lower monthly income, undergoing standard gastrointestinal endoscopy, or experiencing cognitive-related conditions. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the attitudes of Chinese college students toward using a blended learning approach to enhance their English speaking skills. Participants include 105 non-English major students from a regular university in western China. A quantitative analysis was conducted based on the data from a designed questionnaire. The findings identify the majority of students were satisfied with using the blended learning approach during the courses to improve their English-speaking skills. Furthermore, most students showed a preference for using blended learning in future English-speaking learning because of its user-friendliness, flexibility in terms of time and location, access to self-directed learning, and diverse teaching resources. The study further demonstrated the successful and effective implementation of blended learning in English-speaking instruction as part of an educational reform process in a regular university in Western China. The researcher attempted to provide some tips to enhance blended English-speaking learning including diversified instructional designs, increased teacher-student interaction, the active use of spoken English in the classroom, practice opportunities outside of class, and the dissemination of rich oral language learning resources. [ABSTRACT FROM AUTHOR]

INTRODUCTION Electronic cigarettes are increasingly popular worldwide, especially among youth. There is growing evidence of the negative health consequences of vaping. Our objective was to assess university students' knowledge and attitudes regarding electronic cigarettes (e-cigarettes), their use, as well as the associated influencing factors for their use. METHODS The study involved an online cross-sectional survey conducted between November 2019 and March 2020 in a university in Hangzhou, China. A total of 563 students completed the questionnaire. Descriptive statistics were used to assess characteristics, knowledge, and attitudes; t-tests, χ²-tests and logistic regression models were used to identify factors associated with ever e-cigarette use. RESULTS In all, 59.9% of respondents were female and the average age was 20.38 years (SD=1.32). Only 42.6% of the respondents thought that e-cigarettes contain nicotine, 31.1% thought e-cigarettes are tobacco products, and 8.2% of the students reported being ever e-cigarettes users. In regard to attitude, the average score of the students in the Safety dimension was 3.34 (SD=0.64), followed by the Restriction dimension (Mean=2.66, SD=0.83). Correlates of ever use included regions, friends' and roommates' ever e-cigarette use, and higher attitude score in the Supervision dimension. CONCLUSIONS The university students' level of knowledge regarding e-cigarettes was not high, and their attitudes regarding e-cigarettes were not that supportive. Students' ever use of e-cigarettes at a university in Hangzhou was higher than for university students in other cities in China, but lower than for those in foreign countries. [ABSTRACT FROM AUTHOR]

Background: Continuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) engage playing pivotal roles in administering CRRT, but there is paucity of evidence-based research on joint training and management strategies. This study armed to evaluate the knowledge, attitude, and practice (KAP) of ICU staff toward CRRT, and to identify education pathways, needs, and the current status of CRRT implementation. Methods: This study was performed from February 6 to March 20, 2023. A self-made structured questionnaire was used for data collection. Descriptive statistics, T-tests, Analysis of variance (ANOVA), multiple linear regression, and Pearson correlation coefficient tests (α = 0.05) were employed. Results: A total of 405 ICU staff from 66 hospitals in Central and South China participated in this study, yielding 395 valid questionnaires. The mean knowledge score was 51.46 ± 5.96 (61.8% scored highly). The mean attitude score was 58.71 ± 2.19 (73.9% scored highly). The mean practice score was 18.15 ± 0.98 (85.1% scored highly). Multiple linear regression analysis indicated that gender, age, years of CRRT practice, ICU category, and CRRT specialist panel membership independently affected the knowledge score; Educational level, years of CRRT practice, and CRRT specialist panel membership independently affected the attitude score; Education level and teaching hospital employment independently affected the practice score. The most effective method for ICU staff to undergo training and daily work experience is within the department. Conclusion: ICU staff exhibit good knowledge, a positive attitude and appropriately practiced CRRT. Extended CRRT practice time in CRRT, further training in a general ICU or teaching hospital, joining a CRRT specialist panel, and upgraded education can improve CRRT professional level. Considering the convenience of training programs will enhance ICU staff participation. Training should focus on basic CRRT principles, liquid management, and alarm handling. [ABSTRACT FROM AUTHOR]

Purpose: Controversy exists on whether or not elective oocyte cryopreservation (eOC) can be conducted in public hospitals in China. Policymakers should take into account the benefits and risks in the Chinese population. This study explored basic data concerning the awareness, attitudes of eOC, and fertility desire of eOC in China to offer evidence for policy making. Methods: A total of 442 people in four areas of China responded to a survey. The questionnaire was divided into three parts: awareness, attitude, and fertility desire of eOC. Descriptive analysis and multivariable regression analysis were used in the study. Results: Generally, the respondents had a positive or neutral attitude towards eOC. However, about 90% of respondents did not know the cost of eOC. In general, a more positive attitude was found towards eOC among participants who had heard of the procedure compared with those who had not. Most women did not desire to reproduce by eOC. After adjusting for access to information, we found that female, older age groups, and singles were more likely to have increased awareness than their counterparts. The awareness of participants who accessed information from any source had a higher relative probability of having good awareness levels compared to participants who had not accessed the information. Undergraduates exhibited significantly higher levels of cognitive understanding, as indicated by their increased familiarity and comprehension, compared to high school students (relative risk ratio = 1.44, confidence interval = 0.48,4.29). Conclusion: Continued discussion is needed regarding the ethical, legal, and social aspects of performing eOC in public hospitals. Furthermore, policies are needed to regulate eOC to protect the reproductive freedom of healthy women. [ABSTRACT FROM AUTHOR]

Purpose: KAP studies serve to enhance health consciousness and furnish foundational data for appraising, strategizing, and enacting disease management and prejudice eradication initiatives. There remains a dearth of published studies elucidating the dimensions of knowledge, attitudes, and practices among psoriasis patients in China. To investigate the knowledge, attitudes and practices (KAP) towards psoriasis among patients and their family members in Northern China. Methods: This web-based, cross-sectional study was conducted among psoriasis patients and their family members through a self-administered questionnaire. Results: Among patients (n=260), their mean KAP scores were 9.76± 5.69 (range: 0– 19), 35.64± 11.48 (range: 14– 70), and 56.73± 10.98 (range: 16– 80), respectively. Among family members (n=237), their mean KAP scores were 11.93± 5.34 (range: 0– 19), 35.80± 4.34 (range: 8– 40), and 37.04± 4.38 (range: 8– 40), respectively. Structural equation modeling (SEM) analysis for patients indicated significant and negative path relations between knowledge and attitudes (β=− 2.271, P< 0.001), and between knowledge and practice (β=− 0.398, P< 0.001). Extended SEM analysis, which divides knowledge into K1, K2, and K3 parts, showed negative path relations between K3 and attitude (β=− 1.300, P=0.002), between attitude and practice (β=− 0.634, P< 0.001). Moreover, SEM for family members showed positive path relations between knowledge and attitude (β=1.536, P< 0.001), between attitude and practice (β=0.682, P< 0.001). Conclusion: Patients in Northern China demonstrated insufficient knowledge, negative attitude, and proactive practice, while their family members had insufficient knowledge, positive attitude, and proactive practice toward psoriasis. It is recommended to implement educational interventions addressing knowledge gaps among patients and families. [ABSTRACT FROM AUTHOR]

Purpose: The knowledge, attitude, and practices (KAP) concerning antibiotics by healthcare students have the potential impact on controlling antibiotic abuse and antimicrobial resistance (AMR) growth. This study aims to evaluate the levels and explore the associated factors with KAP on antibiotic use and AMR in Chinese nursing students. Methods: A cross-sectional survey using a self-administered questionnaire consisting of demographics and selected features and KAP on antibiotic use and AMR was conducted to measure KAP levels among nursing students at various universities in Hubei Province, China. The logistic regression analyses were performed to analyze the potential factors associated with the KAP. Results: The survey eventually included a total of 1959 nursing students. The mean scores for KAP were 57.89 ± 26.32, 55.00 ± 12.50, and 71.88 ± 15.63, respectively. Regarding knowledge, 54.3% of participants were unaware that antibiotic was ineffective against viral infections. Regarding attitude, 36% of participants agreed that current antibiotic abuse existed; 96.2% of participants thought it necessary to set up a special course on antibiotics. Regarding practice, only 48.4% of participants usually purchased antibiotics with a prescription. Multivariable analyses indicated that lack of discussion on AMR in school courses was an independent risk factor against KAP, respectively. The main knowledge sources of antibiotic being outside the classroom was an independent risk factor related to knowledge and practice. The average score > 80 points was an independent protective factor related to knowledge and practice. Conclusion: The KAP level on antibiotic use and AMR among Hubei nursing students was general and required further strengthening. Nursing students with risk factors should be prioritized in educational interventions. The findings of our study pointed out some directions for tailored interventions to improve the training on antibiotics. [ABSTRACT FROM AUTHOR]

Once an asset owned exclusively by native English speakers (NESs) in inner circle, the native English speaking norms, specifically the standard varieties of British and American English, have been taken for granted as models for non-native English speakers (NNESs) in outer and expanding circles to imitate and approximate to. But this paradigm is under severe attack given the fact that people who use English as a lingua franca (ELF) have far outnumbered NESs. This paper aims to show how Chinese tertiary-level second language (L2) learners perceive different English accents and how their perceptions were related to their identities within the framework of ELF. By means of an online questionnaire survey, data from 574 English major students were retrieved and analysed with the assistance of SPSS 20.0 and Nvivo 11.0. The current study focuses on ambivalence in respondents' attitudes toward different English accents. On the one hand, there was an obvious bias towards NES norms and accents and a strong bias against Chinese-accented English and other NNES accents; on the other hand, there was an emergence of linguistic rights and learner identity experienced by some respondents, which demonstrated itself in highlighting pragmaticity in communication, endorsing L1-accented Chinese identity, and questioning benchmark roles accorded to NES accent standards. The implication of the current study is to acknowledge an urgency of addressing the controversies between the linguistic reality and the prescriptive standards, and between the respondents' hidden appeals for projecting their identity via L1-accented English and highly-acclaimed NES accent models. [ABSTRACT FROM AUTHOR]

Aims: The aims of this paper were to determine the level of knowledge of and attitude to nuclear power among residents around Tianwan Nuclear power plant in Jiangsu of China., Design: A descriptive, cross-sectional design was adopted., Participants: 1,616 eligible participants who lived around the Tianwan nuclear power plant within a radius of 30km and at least 18 years old were recruited into our study and accepted epidemiological survey., Methods: Data were collected through self-administered questionnaires consisting of a socio-demographic sheet. Inferential statistics, t-test, ANOVA test and multivariate regression analysis were used to compare the differences between each subgroup and correlation analysis was conducted to understand the relationship between different factors and dependent variables., Results: Our investigation found that the level of awareness and acceptance of nuclear power was generally not high. Respondents' gender, age, marital status, residence, educational level, family income and the distance away from the nuclear power plant are important effect factors to the knowledge of and attitude to nuclear power., Conclusions: The public concerns about nuclear energy's impact are widespread. The level of awareness and acceptance of nuclear power needs to be improved urgently.

Introduction: In recent years, the pursuit of a master's degree has become a social phenomenon of wide concern. It is essential to understand why large number of students choose to pursue master's degree. This study aims to empirically analyze the factors that influence the intent to pursue a master's degree. Method: Based on the extended theory of planned behavior, this study conducts a questionnaire survey of university students in Shandong Province, which has had the highest number of people taking the postgraduate entrance examination in China for several years. A total of 440 questionnaires were finally collected, including 417 valid questionnaires. And then ordinary least squares (OLS) regression was used to analyze the factors that influence the intent to pursue a master's degree. Results: In general, the intent to pursue a master's degree is positively influenced by attitude (β = 0.161, p < 0.01) and subjective norms (β = 0.208, p < 0.01), and negatively influenced by risk perception (β = -0.084, p < 0.05). Compared with male students, female students' intent is more likely to be influenced by risk perception (β = -0.144, p < 0.05) and social factors (β = 0.140, p < 0.05). The intent of upperclass students tends to be positively influenced by perceived behavioral control (β = 0.125, p < 0.05), whereas the negative impact of risk perception (β = -0.219, p < 0.05) on the intent is significant for underclass students. The intent of students in rural areas are more sensitive to risk perception (β = -0.194, p < 0.01) than those of students in cities. In private universities, social factors (β = 0.445, p < 0.05) significantly affect the intent to pursue a master's degree. In ordinary public universities, the intent of students is more likely to be influenced by risk perception (β = -0.082, p < 0.05). Conclusion: The study is helpful to strengthen the understanding of the influencing factors of the intent to pursue a master's degree. In general, the intent to pursue a master's degree is mainly influenced by attitude, subjective norms and risk perception. Moreover, the influencing factors vary among different groups (e.g., female vs. male, rural areas vs. cities). Furthermore, attitude, subjective norms, perceived behavioral control, risk perception, and social factors have greater impacts on the intent of students from low-income households than those from high-income households. This study can provide policy implications for universities to take targeted educational measures to encourage students to make a choice that suits their own development after graduation. [ABSTRACT FROM AUTHOR]

Purpose: Medical insurance fraud has caused huge losses to countries around the world, and public reporting has become an important means to combat medical insurance fraud. The attitude of medical insurance fraud whistleblowers affects people's reporting behavior, and understanding people's attitude toward medical insurance fraud whistleblowers provides a basis for further improving the system and policy of public participation in medical insurance fund supervision. Methods: We adopted the questionnaire method to conduct a national cross-sectional survey of the Chinese public and analyzed the data using Chi-square tests, Fisher's exact tests, and binary logistic regression models. Results: A total of 837 respondents were included, and 81.8% of the population had a supportive attitude toward medical insurance fraud whistleblowers, with gender, whether they had used medical insurance reimbursement, and present life satisfaction being statistically significant (P < 0.05). Conclusion: The public is generally supportive of medical insurance fraud whistleblowers, and women, those who have used medical insurance for reimbursement, and those who are satisfied with their lives are more likely to be supportive of medical insurance fraud whistleblowers. [ABSTRACT FROM AUTHOR]

Aim: This study is to investigate the current status of knowledge, attitude and self‐reported practice in hospice care among nurses in Hainan, China, and then to analyse its influencing factors and mediating effects. This provides a basis for formulating scientific and standardized hospice care training programmes for nurses. Methods: This cross‐sectional study investigated knowledge, attitude and self‐reported practice in hospice care among 1819 nurses in Hainan, China. Convenience sampling was used to select participants from 45 hospitals and nursing homes in 14 cities and counties from October to December 2021. A scale of knowledge, attitude and self‐reported practice of healthcare providers in hospice care (Chinese version) was administered to collect data during the study period. Statistical analyses, including t‐tests, one‐way ANOVA, post‐hoc analysis and multiple linear regression, assessed the status of knowledge, attitude and self‐reported practice of hospice care in nurses and identified influencing factors. The PROCESS macro program model 4.0 was employed to explore the mediating effect of attitude on knowledge and self‐reported practice in hospice care. Results: Nurses in Hainan displayed low knowledge (mean = 7.68, SD = 3.53), moderate attitudes (mean = 88.13, SD = 12.10) and self‐reported practice (mean = 51.81, SD = 9.82) in hospice care. Current employment and willingness to engage in hospice care were significant factors influencing knowledge, attitude and self‐reported practice in hospice care. Attitude partially mediated the relationship between knowledge and self‐reported practice. Patient or Public Contribution: This study focuses on nurses' knowledge, attitude and self‐reported practice in hospice care and does not directly involve patients or the public. However, the findings enhance hospice care provided to patients and the broader community by improving nurses' knowledge and skills. This study informs evidence‐based training programmes and interventions, benefiting those in need of hospice care services. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of myopia in young generations has dramatically increased over the years, especially in China. This study aims to understand Chinese parents' perspectives on myopia for further improvement of treatment compliance and informing future health planning and policy. Methods: This was a prospective cross-sectional survey study. A self-administrated, internet-based questionnaire was distributed to 2545 parents in China. Detailed information about the demographics, the awareness of myopia, related complications, and practices of myopia prevention and control of the respondents were collected. The distribution of answers was compared among different groups of children's age, children's refractions, and parents' residential locations. Relationships between parental cognition and behavior were also analyzed. Results: Eligible responses were returned by 2500 parents. A total of 55.1% of the respondents considered myopia as a disease and more than 70% of respondents did not realize pathological changes related to myopia. Most parents thought myopia could be prevented (82.0%) and controlled (75.2%), and these parents were more likely to take measures than the parents who did not think so (P < 0.001). The most common myopia control modality was spectacles (87.0%), among which single-vision spectacles are the most used (63.7%). Conclusions: Knowledge about health risks related to myopia was lacking in Chinese parents and their practices of myopia control mainly involved single-vision glasses. Nationwide education for parents about myopia is needed to further advance outcomes of myopia prevention and control. [ABSTRACT FROM AUTHOR]

Objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes. Methods: This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA). Results: Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores. Conclusion: There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention. [ABSTRACT FROM AUTHOR]

Background: Older adults with chronic diseases require long-term medication. However, due to lack of drug knowledge and hypomnesia, older adults with chronic diseases are prone to adverse drug events and increased medical costs. This study aimed to explore the status and influencing factors of home-based medication safety among community-dwelling older adults with chronic diseases in China to provide a basis for follow-up to conduct targeted health education. Methods: Overall, 427 community-dwelling older adults with chronic diseases participated in this study. The Knowledge, Attitude, and Behaviour of Medication Safety among Older Adults with Chronic Diseases Questionnaire was used to assess their home-based medication safety. Multivariate linear regression was used to identify the factors influencing knowledge, attitude, and behaviour regarding medication safety. Results: The average score of home-based medication safety among older adults with chronic diseases was 68.26 ± 8.96, indicating that they had a moderate grasp of medication safety. The scoring rate of each subscale was ranked from high to low as follows: behaviour (84.51%), knowledge (63.33%), and attitude (47.39%). Stepwise linear regression analysis showed that medication safety knowledge, attitudes, and behaviours were significantly associated with higher monthly income, adverse drug events, and taking medicine several times a day (p < 0.05). Additional influencing factors included having fewer chronic diseases, being female, higher educational attainment, taking medicines multiple kinds a day, better self-care ability, and non-hospitalisation for chronic illnesses (p < 0.05). Conclusion: Medical staff and community workers should pay attention to the drug safety of older adults with different characteristics and mobilise their enthusiasm for participation to improve their medication self-management ability. Trial registration: Chinese Clinical Trial Register: ChiCTR2200060987; reg. date: 15/06/2022. [ABSTRACT FROM AUTHOR]

Objective: With consumers’ concerns about food safety and the environment growing, the interest in organic food has increased. However, due to the late start of the organic food market in China, the market size of the Chinese organic food industry is still relatively small. This study aims to examine whether organic food credence attributes have an impact on consumers’ attitudes and willingness to pay a premium (WTPP), in order to provide valuable information to facilitate the development of the organic food market in China. Methods: A questionnaire survey was conducted with 647 respondents in China. Structural equation modeling (SEM) was utilized to verify the model and test the relationships among the constructs. Results: SEM analyses showed that credence attributes stimulate consumers’ attitudes and increase consumers’ WTPP. Utilitarian attitudes and hedonistic attitudes play a partially mediating role in the relationship between credence attributes and WTPP. Uncertainty negatively moderates the role between utilitarian attitudes and WTPP, while it positively moderates the role between hedonistic attitudes and WTPP. Discussion: The findings reveal the motivations and barriers for Chinese consumers to purchase organic food at a premium, providing a theoretical basis for companies to gain a deeper understanding of consumer groups and develop organic food marketing strategies. [ABSTRACT FROM AUTHOR]

Pressure injury is a serious and preventable problem in intensive care units. Translating guidelines into clinical practice can reduce the incidence of pressure injury. Identifying clinical status, barriers and facilitators contribute to guideline implementation. To identify the knowledge, attitudes, and practices of pressure injury prevention in Chinese critical care nurses. Secondary data were extracted from a multicentric clinical trial. Knowledge and attitudes toward pressure injury prevention were assessed by a fourteen‐item questionnaire. The observed practices were recorded using a case report form. The report complies with the STROBE statement. A total of 950 critical care nurses in 15 hospitals from six provinces of China were investigated. A total of 53.1% of nurses received a median score of 6 points or less. Knowledge regarding the repositioning procedure, risk assessment, and heel pressure injury prevention was insufficient. Over 99% of nurses strongly or somewhat agreed that pressure injury prevention was very important and that they were willing to take measures to prevent pressure injury. A total of 27 781 patient days of pressure injury prevention practice were recorded. Repositioning was the most commonly used prevention measure, followed by support surfaces and prophylactic dressings. A combination of repositioning, support surface, and prophylactic dressing was lacking. Chinese critical nurses showed a low level of knowledge and a positive attitude toward pressure injury prevention. Practices of pressure injury prevention were unsatisfactory. There is a clear gap between the guidelines and clinical practices. The barrier (low‐level knowledge) and facilitator (positive attitude) were identified in this study. According to these findings, strategies need to be developed to promote guideline implementation. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate a questionnaire on knowledge, attitude, behaviour and care preference of family members of Chinese older adults related to palliative care. Design: A descriptive study design and STROBE checklist were applied in this research. Methods: The theoretical framework of the questionnaire was knowledge–attitude–behaviour model. An additional dimension of palliative care preference of family members was set up in the questionnaire. Items were generated from a rapid review of international literature and interviews with 61 family members of the older adults living either in an aged care service organization or the community. The content validity was examined by five experts. A preliminary questionnaire with 69 items was then set up, and its psychometric property was assessed. Results: A final version of questionnaire with 42 items under four dimensions was constructed. The content validity index of the overall questionnaire was 0.93 and of each item ranged 0.80–1.00. The factor loading of all items was higher than 0.50 as per exploratory and confirmatory factor analysis; the average variance extracted for each dimension was higher than 0.50; the composite reliability was higher than 0.90; and the absolute value of the correlation coefficient of each dimension was <0.50 and less than the square root of the average variance extracted. The Cronbach's alpha value and the split‐half reliability value of the overall questionnaire were 0.93 and 0.97, respectively. Conclusions: This questionnaire has good validity and reliability, but needs further testing in multi‐centered settings. [ABSTRACT FROM AUTHOR]

To carry out the translation and cultural adaptation of the attitude towards pressure ulcer prevention instrument for use in Chinese and to analyse the validity and reliability of the adapted version of the questionnaire. In this quantitative, descriptive, cross‐sectional study, after translation of the questionnaire from English to Chinese, back‐translation, and assessment of equivalence between the original and back‐translated version by an expert panel, the Chinese version instrument was assessed by a convenience sample of registered nurses in several hospitals in cities of China. The internal consistency and content validity of the instrument was tested, and a confirmatory factor analysis was also performed. Confirmatory factor analysis showed that the goodness of fit of the five‐factor model after the scale localization was not ideal. Therefore, confirmatory factor analysis is performed to obtain the three‐factor solution of comparative fit index, goodness‐of‐fit index, and adjusted goodness‐of‐fit index reaching the acceptable standard. The instrument score of nurses with wound care certification was significantly higher than that of nurses without wound care special certification. The adapted version of the instrument for Chinese nurses can be used as a tool to measure attitudes towards pressure injury prevention. [ABSTRACT FROM AUTHOR]

Background: Pressure injury is a common problem in intensive care units. Critical care nurses play an important role in multidisciplinary teams performing pressure injury treatment. Identifying the clinical status of pressure injury treatment may contribute to improving care quality. Aim: To identify the knowledge, attitudes, and practices regarding pressure injury treatment in critical care nurses. Design: A cross-sectional survey. Methods: Secondary data were extracted from a multicenter clinical trial. Knowledge and attitudes toward pressure injury treatment were assessed through a self-administered eight-item questionnaire. The observed practices were recorded using a case report form. The report was in accordance with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. Results: A total of 950 critical care nurses in 15 hospitals from six provinces/municipalities of China were investigated. The mean knowledge score was 2.89 ± 1.16 (95% confidence interval: 2.82– 2.97) out of a possible total of 5 points. The correct rates of selecting wound dressings and pain management were 34.4% and 45.6%, respectively. The mean attitude score was 9.07 ± 1.09 (95% confidence interval: 9.00– 9.13) out of a possible total of 12 points. A total of 2092 patient days of pressure injury treatment practices were observed and recorded. Repositioning was the most commonly employed treatment measure (98.8%). Foam dressing was the common dressing for stage I (53.6%), stage II (47.5%), and more severe pressure injury (67.9%), including stage III, IV, unstageable, and suspected deep tissue injury. Conclusion: Critical care nurses exhibited a generally low level of knowledge and moderate attitudes regarding pressure injury treatment. Practices of pressure injury treatment were generally acceptable. [ABSTRACT FROM AUTHOR]

(1) Background: Uptake of pharmacogenomic testing in routine clinical practices is currently slow in China. Pharmacists might play an important role in leveraging care through applying pharmacogenomics, therefore, it is important to better understand clinical pharmacists' knowledge of and attitudes toward pharmacogenomic testing, which has not been well-studied. (2) Methods: A self-administered survey was developed based on previous knowledge of pharmacogenomic testing and its uptake in China. Participants were recruited through the Committee of Pharmaceutical Affairs Management under the Chinese Hospital Association. (3) Results: A total of 1005 clinical pharmacists completed the questionnaire, among whom 996 (99.10%) had heard of pharmacogenomic testing before participation. More than half of respondents (60.0%, n = 597) rated their knowledge of pharmacogenomic testing as "average", while 25% rated it "good" or "excellent". "Guidelines, consensus and treatment paths for disease diagnosis and treatment" (78.7%) were the most preferred sources of information about pharmacogenomic testing. Most respondents (77.0%) believed that pharmacogenomics could "help to improve efficacy and reduce the incidence of adverse reactions". Our participants also believed that patients would benefit most from pharmacogenomic testing through better prediction of individual drug responses and thus informed treatment decisions. The top challenge for the uptake of pharmacogenomic testing was its high cost or lack of insurance coverage (76.7%). (4) Conclusions: Most Chinese clinical pharmacists who participated in our study had a positive attitude toward pharmacogenomic testing, while the knowledge of pharmacogenomic testing was generally self-assessed as average. [ABSTRACT FROM AUTHOR]

In China, food has become safer over the past five years, especially commonly consumed foods. Food supervision sampling has played an important role in improving food safety. However, consumer acceptance of the results of food safety supervision have not kept pace. Communicating actual food safety risks to consumers and improving the public trust in food safety supervision sampling inspection has become an important issue. This study focused on food safety surveillance sampling of commonly consumed foods. In total, 4408 adult consumers were surveyed between August and October 2021. Structural equation modeling was performed for data analysis. This study found significant differences along gender lines and across different cities and levels of education with respect to evaluating competence trust and care trust on food supervision sampling inspection. This study identified the public's competence trust, care trust, and perception of food safety as factors that significantly affect one's attitude toward supervision sampling inspection. Care trust showed a more pronounced effect on trust enhancement than competence trust. The present study also provides some practical measures for food safety supervisors to improve public trust in the national food inspection. Specifically, the sampling process should be open and transparent. [ABSTRACT FROM AUTHOR]

Background: The critical aspects of risk management for students are providing knowledge, building positive attitudes, and readiness to practice. Our study aimed to assess Chinese health-care university students' knowledge (K), attitude (A), and readiness to practice (rP) regarding disaster medicine and preparedness. Materials and Methods: A survey was carried out using a self-administered disaster medicine and preparedness questionnaire. Three main outcome measures were K (22 items), A (16 items), and rP (11 items). Responses were scored and classified as high, moderate, and low. Descriptive and inferential statistics were performed for data analysis. Results: A total of 769 valid questionnaires were collected. The associations between K, A, and rP scores was significant, i.e., K–A scores (r = 0.449, P = 0.000), K–rP scores (r = 0.312, P = 0.000), and A–rP scores (r = 0.656, P = 0.000). Multiple linear regression analysis indicated direct low-to-moderate effects of gender, age, attitude, and knowledge on readiness to practice (R2 = 0.198; P < 0.001). Conclusions: The study discovered that most of the students had a moderate level of knowledge, moderate level of attitude, high level of readiness to practice, and a moderate level of total KArP. K, A, and rP were significantly correlated, and K and A were predictors for rP among the health-care students. The findings indicate the importance of health-care colleges for building students' knowledge, attitudes, and readiness to practice disaster medicine and preparedness before joining the profession. [ABSTRACT FROM AUTHOR]

Background: The persistence of threatened and protected wildlife depends not only on habitat suitability but also remarkably on local communities' acceptance. The black-necked crane (Grus nigricollis) is a flagship species for conservation on the plateau in western China. However, the human dimension has been completely ignored in the decision-making process for conservation. Methods: In this study, a questionnaire survey aiming to assess knowledge of and conservation attitude toward this bird was carried out among 1042 students of 7th and 9th grade from 12 schools in Weining county, Guizhou province, which has a large wintering population in an urban wetland. Logistic regression was used in the generalized linear model to identify the determinants that significantly affect students' knowledge of and conservation attitude toward this species. Results: Most students have positive attitudes toward conservation, which is significantly affected by awareness, knowledge of this bird and grade. However, they have somewhat limited knowledge of this bird's biology and ecosystem services (nature's contributions to people). Knowledge was found to link with observation of the bird and grade, while observation related to the experience of visiting the wetland. Social media is the most cited resource to obtain knowledge on this bird. Conclusion: It is suggested that local conservation experts could help introduce more information on the black-necked crane in the schools and help conduct outdoor education activities in and around the wetland. Traditional knowledge and culture could also be incorporated into the conservation awareness enhancing program. This study focuses on the human dimension for conserving the black-necked crane in China, showing significant implications in the design and application of effective measurements to improve students' perception and attitude toward its conservation. Future assessments should include other local populations, such as farmers, fishers, and urban citizens. [ABSTRACT FROM AUTHOR]

Background: Travel for health reasons is booming around the world and in China. As a huge source and destination of health tourism, little is understood about the volume, characteristics, motivations, and preferences of health travelers in China. This study provides details of China's health tourism reality and consumer demand of Chinese residents who did or will travel for health. Methods: We established a questionnaire through literature analysis and a focus group, then collected 695 responses based on an online random sampling design. Finally, 629 questionnaires (effective recovery rate was 90%) were analyzed with statistical description, binary logistic regression, and word frequency analysis to draw the reality of health tourism, explore the influential factors, and sort out suggestions. Results: In this study, 387 respondents knew of health tourism (61.53%), 446 reported interest (70.9%), and 234 had traveled for health reasons before (37.2%), with 329 occurring within China (91.4%). The top three reasons for health tourism were decompression and relaxation (116, 20%), physical examination (82, 14.1%), and health care (73, 12.6%). High costs (372, 16.3%), little disposable time (309, 13.5%), and lack of reliable professional institutions (289, 12.6%) were the main potential barriers for consumers. Professional level and quality of the institution, personal privacy, and service personnel's attitude were the most important concerns for consumers when arranging health travel. Marital status (OR = 0.209, 95% CI = 0.085–0.514, P = 0.001) and attitude to health tourism (OR = 2.259, 95%CI = 1.553–3.287, P < 0.001) were factors for consumers' willingness to perform health tourism. "Propaganda" was proposed most frequently by participants, followed by "service" and "price". Conclusion: The popularity of health tourists is low although there is a huge market in China. There are also differences between willingness of previous and prospective customers with varying socio-demographic characteristics in this investigation. Overall, more diverse propaganda measures should be taken, and government policies or legal documents ought to keep pace with it. Health tourism products' promotion, as well as supporting measures and brand, need to be emphasized. [ABSTRACT FROM AUTHOR]

Background: Most nurses in China have not been trained to take care of end-of-life patients appropriately due to lack of educational resources and insufficient training. A palliative care program was launched by the Jiangsu Nursing Association (JNA training program) and to identify gaps in palliative care training. The main aim of this study was to evaluate the training effects of the JNA training program on nurses' knowledge and attitudes to palliative care. Methods: A cross-sectional study was conducted with 10 048 registered nurses in all regions of Jiangsu. All participants completed an online questionnaire using the Chinese version of The Palliative Care Quiz for Nursing (PCQN-C) and the Frommelt Attitude Toward Care of the Dying scale (FATCOD-B-C). A propensity score matched analysis was performed between the nurses who had attended the JNA training program and whose who hadn't. Results: The average score of PCQN-C among all nurses was 8.79, while the mean score of the FATCOD-B-C was 103.62. Those participants who attended the JNA training program had significantly better scores than those who did not. Propensity score matching analysis showed that the palliative care training program failed to improve nurses' knowledge in psychosocial and spiritual care or their attitudes towards the necessity of family support although there was positive impact on other aspects of palliative care. Conclusions: Knowledge of palliative care among Chinese nurses remains low. Training programs may improve general knowledge and attitudes to palliative care. However, important aspects of knowledge such as communication skills, family support, and psychosocial aspects of care, are missing. These gaps should be filled in future palliative care training programs targeting nurses with oriental culture background. [ABSTRACT FROM AUTHOR]

Abstract: Conflicts between human and wildlife, especially the wild boar (Sus scrofa), have been reported from all over the world in recent years, and contradiction between wildlife conservation and local people''s interests are more and more serious. The attitudes of local people to wildlife are thus an increasing important element of conservation work. Attitudinal studies have increasingly been adopted as a tool for evaluating public understanding, acceptance and impact of conservation interventions. However, attitudes may vary within a community and be influenced by many factors. In this study, data were collected from November 2009 to January 2010 by questionnaire and informal interviews with local people in Taohongling National Nature Reserve of Jiangxi province to assess how their attitudes towards wild boar were shaped by a series of socio-demographic and physical factors. The results showed that 92.8% of the interviewees considered wild boar had no value while 7.2% chose having value; 29.7% chose “extirpate”, 70.3% chose “control” and nobody chose “protect” when asked about how they would expect the wild boar population changes; 86.6% chose “no” and 13.4% chose “yes” when inquired about whether they would kill wild boars when their interests were threatened by wild boars. In a binary logistic regression analysis, gender, residence status, types of fuel sources, frequency of encountering wild boar, area of farmland converted from rice-planting to cotton-planting, level of awareness of wildlife protection and level of wild boar damage to local people''s interests were important in shaping people''s attitudes. The paper discusses the implications of these results and puts forwards suggestion for alleviating human-wild boar conflicts. [Copyright &y& Elsevier]

As the impacts of climate change become increasingly visible across the globe, awareness of the need for cleaner energy and demand reduction is growing. Energy literacy offers a strong potential for explaining and predicting energy-related behaviours, yet research and policies focused on this topic remain limited. In this study, energy literacy was measured in a sample of 2806 university students in the United Kingdom and China, in addition to their wider environmental attitudes using the New Ecological Paradigm scale. Findings indicate that energy literacy was relatively high overall, but there were significant differences between the knowledge, attitudes and behavioural intentions of participants in the two countries. Whilst the UK respondents rated themselves significantly more highly on perceived knowledge of energy issues, Chinese respondents provided significantly more correct answers in a knowledge test. UK respondents demonstrated more positive attitudes towards energy conservation than those from China, and were more likely to report energy-saving behaviours. However, Chinese respondents exhibited higher levels of trust in government and businesses to take action on energy issues. This paper provides a novel insight into cultural differences which may be crucial to policy and practice, and evidences the potential benefits of utilising a combination of educational and structural change to support transition to a cleaner, low-energy society. Image 1 • Significant differences in energy literacy arose in 1806 students in UK and China. • Chinese respondents demonstrated more knowledge about energy than UK respondents. • UK respondents demonstrated more positive attitudes and energy saving behaviours. • Cultural context, including trust in government impacts on energy-saving behaviours. • Combining educational and structural change will aid transition to a cleaner world. [ABSTRACT FROM AUTHOR]

Objective: Cervical cancer screening participation in China remains insufficient, possibly because of embarrassment or discomfort. We assessed knowledge of HPV and its link to cervical cancer, and whether HPV self-sampling might be an acceptable alternative to clinician-based screening, among Sichuan women. Methods: A sample of healthy women undergoing routine physical examinations in 2017 at the West China Hospital, Sichuan University, completed a questionnaire. Results: From 3000 questionnaires distributed, 1810 were completed and analyzed. Only 29.94% of respondents (n = 542) had heard of HPV, among whom 65.75% knew that it caused cervical cancer. Among the 766 (42.32%) who considered that HPV self-sampling for cervical cancer screening was an acceptable option, over 90% thought it would be convenient, private, not embarrassing, and not painful. However, 1044 women (57.68%) did not consider self-sampling acceptable, mainly because the result might not be accurate (85.63%), specimens may have gone bad (83.05%), and they may not perform the test correctly (79.98%). Respondents who believed HPV self-sampling was acceptable were more likely than other respondents to be young, and to have completed at least secondary education. Of the 1810 respondents, 1312 (72.49%) reported that they would be willing to be vaccinated against HPV. Conclusion: Most women in Chengdu lack basic knowledge about HPV. Over 40% of women believed HPV self-sampling for cervical cancer screening was an acceptable option. To increase screening coverage, public health efforts to educate the public about HPV and HPV self-sampling for cervical cancer screening should be strengthened and expanded. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease (COVID-19) has become a pandemic. The knowledge, attitudes, and practices (KAP) of the public play a major role in the prevention and control of infectious diseases. The objective of the present study was to evaluate the KAP of the Chinese public and to assess potential influencing factors related to practices.Methods: A cross-sectional online survey was conducted in China in February 2020 via a self-designed questionnaire comprising 33 questions assessing KAP.Results: For the 2136 respondents from 30 provinces or municipalities in China, the accurate response rate for the knowledge section ranged from 72.7 to 99.5%, and the average was 91.2%. Regarding attitude section, the percentage of positive attitudes ("strongly agree" and "agree") ranged from 94.7 to 99.7%, and the average value was 98.0%. The good practices ("always" and "often") results ranged from 76.1 to 99.5%, and the average value was 96.8%. The independent samples t-test revealed that gender and ethnic differences had no effect on knowledge, attitude or behaviour (P > 0.05). However, knowledge was associated with age (t = 4.842, p < 0.001), marital status (t = - 5.323, p < 0.001), education level (t = 8.441, p < 0.001), occupation (t = - 10.858, p < 0.001), and place of residence (t = 7.929, p < 0.001). Similarly, attitude was associated with marital status (t = - 2.383, p = 0.017), education level (t = 2.106, p = 0.035), occupation (t = - 4.834, p < 0.001), and place of residence (t = 4.242, p < 0.001). The multiple linear regression analysis results showed that the factors influencing practices were knowledge (t = - 3.281, p = 0.001), attitude (t = 18.756, p < 0.001), occupation (t = - 3.860, p < 0.001), education level (t = 3.136, p = 0.002), and place of residence (t = 3.257, p = 0.001).Conclusions: The Chinese public exhibited a good level of knowledge of COVID-19, a positive attitude, and high adherence to good practices. COVID-19-related knowledge, attitudes and practices were affected by age, marital status, education level, occupation, and place of residence to varying degrees. In addition, practices were affected by knowledge and attitudes towards COVID-19. [ABSTRACT FROM AUTHOR]

Background: Fishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People's Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China. Methods: A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR. Results: Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population. Conclusions: Fishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify Chinese parents' knowledge and attitudes toward transthoracic device closure of ventricular septal defect (VSD).Methods: This cross-sectional study collected data on a total of 203 Chinese parents of patients with VSD were included, and an author-designed three-page questionnaire was used.Results: A total of 73.9% of the parents had heard of transthoracic device closure of VSD; however, they lacked detailed knowledge. 88.2% parents expressed their willingness to undergo this procedure. Although there was no significant correlation between knowledge about the occluder material and acceptance of the method, knowledge of other information was significantly related to willingness to undergo the procedure. Some parents expressed some concerns and high expectations, but the postoperative risk reduced their desire for accepting the procedure. This study also found that most parents did not have a detailed understanding of such procedure.Conclusion: Parents of patients with VSD in China need continued education regarding transthoracic device closure of VSD, especially in terms of its benefits and limited postoperative complications. In addition, it is essential to reduce the cost of this procedure to promote its development and application. [ABSTRACT FROM AUTHOR]

Background: To assess the knowledge of and attitudes towards erosive tooth wear among dental, medical, and non-medical university students of two Chinese universities. Methods: A questionnaire containing 15 questions on knowledge of erosive tooth wear and 10 questions on attitudes towards erosive tooth wear was designed, and its psychometric properties (reliability and validity) were analysed in a pilot study (n = 120 students). The following 3 groups of university students (n = 635) were recruited based on a convenience sampling technique and were distributed the questionnaire via an online survey system: dental students (DSs), medical students (MSs), and non-medical students (NSs). Differences in the scores between groups and genders were analysed by one-way analysis of variance (ANOVA). The Pearson correlation coefficient was used to determine the association between the knowledge and attitude scores (P < 0.05). Results: The questionnaire was found to be reliable, valid and reproducible. A total of 435 students participated in this study (response rate: 69.6%). The knowledge score of the DSs (11.5 ± 3.4) was significantly higher than those of the NSs (5.5 ± 4.0) and MSs (6.1 ± 4.0) (P < 0.001). The attitude score of the DSs (45.2 ± 6.5) was significantly higher than those of the NSs (41.1 ± 6.9) and MSs (41.8 ± 6.4) (P < 0.001). The majority of DSs expressed attitudes that were more accurate and positive than those expressed by the other 2 groups. The attitude score was positively correlated with the knowledge score (r = 0.237, P < 0.001). Conclusions: Dental students had more accurate knowledge of and more positive attitudes towards erosive tooth wear than medical and non-medical students. In this population, a positive correlation was established between knowledge of and attitudes towards erosive tooth wear. [ABSTRACT FROM AUTHOR]

Almost after investing 25 years in research and development, China has reached to the decisional stage to either continue or discontinue or at least reduce the introductory speed of the genetically modified (GM) food production. The current study integrates the Benefit-Risk Analysis (BRA) framework and trust to study the consumer willingness to consume GM food. A structured survey conducted in nine major cities of China among 345 qualified samples analyzed through structural equational modeling-smart partial least square (SEM-Smart PLS). The statistical results lead to the following conclusions: The proposed psychological-persuasive model highlights the "trust in institutions" holds the least explanatory power while communicating about GM food-related risks in society. In the case of mapping perceived benefits, the trust in technology should be improved; as in the overall view of BRA, the perceived benefits hold less explanatory abilities in contrast to perceived risks. In other words, a secure communication strategy can change the public acceptance trend of GM food in China. [ABSTRACT FROM AUTHOR]