Search

Background: Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance. Objective: To estimate the prevalence of hypochondriac symptoms in Chinese health science students. Methods: A systematic literature search was conducted on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Data on July 1, 2018. Additionally, the references of the retrieved papers were searched. Cross-sectional studies published in either English or Chinese that reported the prevalence of hypochondriac symptoms in health science students were included. The selection process was executed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and study quality was assessed with the checklist recommended by the Agency for Healthcare Research and Quality for cross-sectional studies. A random-effects model according to the DerSimonian-Laird method was used to calculate the pooled prevalence. Results: Seven cross-sectional studies involving 6,217 Chinese health science students were included. The pooled prevalence of hypochondriac symptoms among health science students was 28.0% (95% CI = 19.0%–38.0%). The symptoms were a little more common in females (30.0%, 95% CI = 19.0%–42.0%) than in males (29.0%, 95% CI = 16.0%–42.0%), but the difference was not significant. No significant differences were found between participants grouped by study year. Only three studies explored the coping styles of students with hypochondriasis, and these revealed a high tendency toward help-seeking behaviors. Conclusion: Our systematic review and meta-analysis showed a high prevalence of hypochondriac symptoms among health science students, indicating that it is a noteworthy phenomenon. We suggest that counseling and other support services are necessary for health science students. [ABSTRACT FROM AUTHOR]

To balance the supply and demand in China's beef market, beef consumption must be scientifically and effectively forecasted. Beef consumption is affected by many factors and is characterized by gray uncertainty. Therefore, gray theory can be used to forecast the beef consumption, In this paper, the structural defects and unreasonable parameter design of the traditional gray model are analyzed. Then, a new gray model termed, EGM(1,1,r), is built, and the modeling conditions and error checking methods of EGM(1,1,r) are studied. Then, EGM(1,1,r) is used to simulate and forecast China’s beef consumption. The results show that both the simulation and prediction precisions of the new model are better than those of other gray models. Finally, the new model is used to forecast China’s beef consumption for the period from 2019–2025. The findings will serve as an important reference for the Chinese government in formulating policies to ensure the balance between the supply and demand for Chinese beef. [ABSTRACT FROM AUTHOR]

This paper aims to demonstrate the impact of coal enterprises’ vertical integration on the performance of innovation corporate social responsibility (ICSR) and to elaborate its specific transmission path through financing structure and market power. This paper takes the data of A-share listed coal company from 2008 to 2017 as samples, uses input-output table method to measure the degree of vertical integration, and explores the relationship between the four factors through multiple linear regression and Bootstrap method. We found that: (1) the vertical integration of coal enterprises has positive incentives for the promotion of ICSR. (2) Financing structure and market power play a chain intermediary role in this process of incentive. (3) In areas with high marketization process, vertical integration has more significant incentive effect on ICSR. The paper extends the research on the relationship between vertical integration and innovation, which provides a reference for the improvement of China’s supply-side reform and corporate social responsibility (CSR) fulfillment policy. It is helpful to promote the sustainable development of the coal industry, stimulate the innovation vitality of enterprises, and improve the fulfillment of CSR. [ABSTRACT FROM AUTHOR]

Lane change violations are a major cause of traffic conflicts and accidents at urban intersections and one of many road-safety issues in China. This study aims to explore the socio-psychological factors underlying drivers’ motivation for lane change violation behavior at urban intersections and examines how these factors predict this violation behavior. A self-reported questionnaire is designed by applying the construct of the theory of planned behavior (TPB) to collect data. Five hundred-six valid responses are received from the questionnaire survey conducted on the Internet in China. The data are then analyzed using structural equation modeling (SEM). The results of the analysis show that behavioral intention is the strongest predictor of self-reported lane change violation behavior at urban intersections. Perceived behavioral control has both direct and indirect effects on self-reported lane change violation behavior. Furthermore, attitude, subjective norms and perceived behavioral control are found to have significant correlations with drivers’ intention of lane change violations at urban intersections. The results of this study could provide a reference for designing more effective interventions to modify drivers’ lane change violation behavior at urban intersections. [ABSTRACT FROM AUTHOR]

Background: Guangxi is one of the provinces having the highest notification rate of tuberculosis in China. However, spatial and temporal patterns and the association between environmental diversity and tuberculosis notification are still unclear. Objective: To detect the spatiotemporal pattern of tuberculosis notification rates from 2010 to 2016 and its potential association with ecological environmental factors in Guangxi Zhuang autonomous region, China. Methods: We performed a spatiotemporal analysis with prediction using time series analysis, Moran’s I global and local spatial autocorrelation statistics, and space-time scan statistics to detect temporal and spatial clusters of tuberculosis notifications in Guangxi between 2010 and 2016. Spatial panel models were employed to identify potential associating factors. Results: The number of reported cases peaked in spring and summer and decreased in autumn and winter. The predicted number of reported cases was 49,946 in 2017. Moran's I global statistics were greater than 0 (0.363–0.536) during the study period. The most significant hot spots were mainly located in the central area. The eastern area exhibited a low-low relation. By the space-time scanning, the clusters identified were similar to those of the local autocorrelation statistics, and were clustered toward the early part of 2016. Duration of sunshine, per capita gross domestic product, the treatment success rate of tuberculosis and participation rate of the new cooperative medical care insurance scheme in rural areas had a significant negative association with tuberculosis notification rates. Conclusion: The notification rate of tuberculosis in Guangxi remains high, with the highest notification cluster located in the central region. The notification rate is associated with economic level, treatment success rate and participation in the new cooperative medical care insurance scheme. [ABSTRACT FROM AUTHOR]

The changing population age structure has a significant influence on the economy, society, and numerous other aspects of a country. This paper has innovatively applied the method of compositional data forecasting for the prediction of population age changes of the young (aged 0–14), the middle-aged (aged 15–64), and the elderly (aged older than 65) in China, India, and Vietnam by 2030 based on data from 1960 to 2016. To select the best-suited forecasting model, an array of data transformation approaches and forecasting models have been extensively employed, and a large number of comparisons have been made between the aforementioned methods. The best-suited model for each country is identified considering the root mean squared error and mean absolute percent error values from the compositional data. As noted in this study, first and foremost, it is predicted that by the year 2030, China will witness the disappearance of population dividend and get mired in an aging problem far more severe than that of India or Vietnam. Second, Vietnam’s trend of change in population age structure resembles that of China, but the country will sustain its good health as a whole. Finally, the working population of India demonstrates a strong rising trend, indicating that the age structure of the Indian population still remains relatively “young”. Meanwhile, the continuous rise in the proportion of elderly population and the gradual leveling off growth of the young population have nevertheless become serious problems in the world. The present paper attempts to offer crucial insights into the Asian population size, labor market and urbanization, and, moreover, provides suggestions for a sustainable global demographic development. [ABSTRACT FROM AUTHOR]

The vehicle-pedestrian encounter at midblock crosswalks in urban centers is inevitable but the challenge to urban transportation planners is in achieving a balance between traffic flow efficiency and pedestrian safety. Vehicles are expected to yield to pedestrians who have a right of way at the midblock unsignalized crosswalks but, failure to yield causes conflicts that at times are fatal. This study investigated the effect of macroscopic factors on the vehicle yielding. Six environmental factors are considered: temporal gap size, number of traffic lanes, number of waiting pedestrians, position of pedestrian (whether on street kerb or median), traffic flow direction and presence (or absence) of monitoring ePolice. Video Data on six observed variables that influenced vehicle yielding was collected from 13 uncontrolled crosswalk locations in Shanghai city in the Peoples Republic of China. A Logit model with a 95.9% accuracy was developed to describe the vehicle yielding behavior. The results showed that gap size and number of traffic lanes had the highest influence on driver yielding decision and that drivers were more likely to yield if ePolice was present. The sensitivity analysis was conducted and appropriate recommendations on improving the pedestrians crossing safety were proposed accordingly. [ABSTRACT FROM AUTHOR]

Background: The article proposes a network public opinion risk assessment model for earthquake disasters, which can provide an effective support for emergency departments of China. Method: It uses the accelerated genetic algorithm (AGA) to improve BP neural network. The main contents: This article selects 10 indexes by using the methods of the principal component analysis (PCA) and cumulative contribution (CC) to assess the risk of the earthquake network public opinion. The article designs a BP algorithm to measure the risk degree of the earthquake network public opinion and uses AGA to improve the BP model for parameter optimization. Results: The experiment results of the improved BP model shows that its global error is 7.12×10, and the error is reduced to 22.35%, which showed the improving BP model has advantages in convergence speed and evaluation accuracy. Conclusion: The risk assessment method of network public opinion can be used in the practice of earthquake disaster decision. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of childhood maltreatment among college students in China by a systematic review and meta-analysis. Methods: A systematic search of relevant articles in Pubmed, Wanfang Data, Chinese Scientific Journals Fulltext Database (CQVIP), China National Knowledge Infrastructure (CNKI) and China Biology Medicine disc (CBMdisc) was conducted on September 1, 2017. A random-effects model was used to estimate the pooled prevalence and sources of heterogeneity were explored using subgroup analyses. Results: In total, 32 studies were included in our review. The pooled prevalence of childhood maltreatment among college students was 64.7% (CI: 52.3%-75.6%). For childhood physical abuse(CPA), childhood emotional abuse(CEA), childhood sexual abuse(CSA), childhood physical neglect(CPN)and childhood emotional neglect (CEN), the pooled estimates were 17.4% (13.8%-21.3%), 36.7%(25.1%-49.1%), 15.7%(11.6%-20.2%), 54.9%(41.2%-68.1%) and 60.0% (45.0%-74.0%), respectively. Use of the Childhood Trauma Questionnaire (CTQ) yielded a higher pooled estimate than any other measurement tools in the subgroup analyses of CPA, CEA, CSA, CPN and CEN. The Egger’s tests revealed no evidence of publication bias(P>0.05). Conclusions: Childhood maltreatment is common among college students in China. Prevention policies and programmes should be urgently developed to stop the occurrence of child maltreatment, and special attention should be paid to maltreated college students. [ABSTRACT FROM AUTHOR]

Based on carbon spot prices selected from seven carbon pilots, we assess the financial performances related to carbon volatility in China on the overall perspective. According to the results, the Chinese carbon market fluctuated severely at the beginning of carbon trading, but has stabilised in general, despite several dramatic changes related to ‘yearly compliance events’. Long-term memory exists in the volatility series. Moreover, asymmetry exists in the Chinese carbon market, and volatility reacts more severely to good news than to bad news. Finally, we discuss our empirical results, and make certain suggestions regarding firms’ awareness, international cooperation and individual investors not only for policy makers in China but also for other developing countries who are contemplating either commencing carbon trading or improving the current market. [ABSTRACT FROM AUTHOR]

Predicting and analyzing behaviors of investors is of great value to financial institutions. This paper uses survey data from about 9,000 individual investors across China to explore the predictability of decision behaviors by studying demographic characteristics that are relatively easy to obtain. After applying Pearson’s chi-squared test, Spearman rank correlation test, and several data mining methods, we verified that demographic characteristics are closely linked to decision behaviors, and it would be an economical and feasible solution for financial organizations to build initial behavioral prediction models especially when investors’ behavioral data are insufficient. [ABSTRACT FROM AUTHOR]

While numerous papers have illuminated the worthiness of research collaboration, relatively few have addressed its prerequisites. In our study, seven prerequisites for research collaboration were extracted from the existing literature, and 460 student researchers were surveyed for their perceptions of the prerequisites’ importance. Focusing on voluntary research collaborations rather than brokered ones, it was found that socially oriented prerequisites such as reciprocal interactions, accountability, trust, and equality are perceived of more importance than prerequisites of psychical proximity, networking channels, and funds and material supplies (substance- and entity-related prerequisites). With latent regression analyses, we also found that Chinese and older, more experienced researchers are inclined to stress the importance of equality. Researchers of different cohorts prioritise substance- and entity-related prerequisites disparately. Specifically, Chinese researchers emphasise the necessity of funds, while researchers from first-tier universities place more value on networking channels. Disciplinary differences for the prerequisite of proximity were also discovered. Based on these results, discussion and implications were referred. Further suggestions on research collaboration studies are rendered. [ABSTRACT FROM AUTHOR]

Urban extent data play an important role in urban management and urban studies, such as monitoring the process of urbanization and changes in the spatial configuration of urban areas. Traditional methods of extracting urban-extent information are primarily based on manual investigations and classifications using remote sensing images, and these methods have such problems as large costs in labor and time and low precision. This study proposes an improved, simplified and flexible method for extracting urban extents over multiple scales and the construction of spatiotemporal models using DMSP/OLS nighttime light (NTL) for practical situations. This method eliminates the regional temporal and spatial inconsistency of thresholding NTL in large-scale and multi-temporal scenes. Using this method, we have extracted the urban extents and calculated the corresponding areas on the county, municipal and provincial scales in China from 2000 to 2012. In addition, validation with the data of reference data shows that the overall accuracy (OA), Kappa and F1 Scores were 0.996, 0.793, and 0.782, respectively. We increased the spatial resolution of the urban extent to 500 m (approximately four times finer than the results of previous studies). Based on the urban extent dataset proposed above, we analyzed changes in urban extents over time and observed that urban sprawl has grown in all of the counties of China. We also identified three patterns of urban sprawl: Early Urban Growth, Constant Urban Growth and Recent Urban Growth. In addition, these trends of urban sprawl are consistent with the western, eastern and central cities of China, respectively, in terms of their spatial distribution, socioeconomic characteristics and historical background. Additionally, the urban extents display the spatial configurations of urban areas intuitively. The proposed urban extent dataset is available for download and can provide reference data and support for future studies of urbanization and urban planning. [ABSTRACT FROM AUTHOR]

The energy-growth nexus has important policy implications for economic development. The results from many past studies that investigated the causality direction of this nexus can lead to misleading policy guidance. Using data on China from 1953 to 2013, this study shows that an application of causality test on the time series of energy consumption and national output has masked a lot of information. The Toda-Yamamoto test with bootstrapped critical values and the newly proposed non-linear causality test reveal no causal relationship. However, a further application of these tests using series in different time-frequency domain obtained from wavelet decomposition indicates that while energy consumption Granger causes economic growth in the short run, the reverse is true in the medium term. A bidirectional causal relationship is found for the long run. This approach has proven to be superior in unveiling information on the energy-growth nexus that are useful for policy planning over different time horizons. [ABSTRACT FROM AUTHOR]

The analysis of traffic collisions is essential for urban safety and the sustainable development of the urban environment. Reducing the road traffic injuries and the financial losses caused by collisions is the most important goal of traffic management. In addition, traffic collisions are a major cause of traffic congestion, which is a serious issue that affects everyone in the society. Therefore, traffic collision analysis is essential for all parties, including drivers, pedestrians, and traffic officers, to understand the road risks at a finer spatio-temporal scale. However, traffic collisions in the urban context are dynamic and complex. Thus, it is important to detect how the collision hotspots evolve over time through spatio-temporal clustering analysis. In addition, traffic collisions are not isolated events in space. The characteristics of the traffic collisions and their surrounding locations also present an influence of the clusters. This work tries to explore the spatio-temporal clustering patterns of traffic collisions by combining a set of network-constrained methods. These methods were tested using the traffic collision data in Jianghan District of Wuhan, China. The results demonstrated that these methods offer different perspectives of the spatio-temporal clustering patterns. The weighted network kernel density estimation provides an intuitive way to incorporate attribute information. The network cross K-function shows that there are varying clustering tendencies between traffic collisions and different types of POIs. The proposed network differential Local Moran’s I and network local indicators of mobility association provide straightforward and quantitative measures of the hotspot changes. This case study shows that these methods could help researchers, practitioners, and policy-makers to better understand the spatio-temporal clustering patterns of traffic collisions. [ABSTRACT FROM AUTHOR]

Background: Postpartum Family Visits (PFVs) have been advocated as a way to improve health outcomes for puerperal women and their newborns. This study aimed to identify individual factors associated with the utilization of PFVs in rural Jiangsu Province, China. Methods: We employed responses of the household survey in Jiangsu province, part of the National Health Service Survey (NHSS), a nationally representative survey in China. The data analysis framework was designed based on Andersen’s behavioral model. The outcome variables included nonuse and deficient use of PFVs, and the explanatory variables were organized into three hierarchical levels: predisposing, enabling and need factors. Univariate analysis and multivariate logistic regression analysis were conducted to examine the impact of the three hierarchical levels on PFVs utilization. Results: A total of 884 rural women who had a childbearing history in the prior five years answered PFVs questions. About 23.4% of them had never received any PFVs, and 40.4% received <3 visits. In the results of multivariate logistic regression, educational level (OR = 0.43, 95% CI: 0.24–0.77), income (OR = 0.62, 95% CI: 0.43–0.88), the distance from the nearest hospital (OR = 1.49, 95% CI: 1.07–2.07) and parity (OR = 2.17, 95% CI: 1.54–3.05) had significant relationship with nonuse. Factors significantly associated with deficient use of PFVs included employment (OR = 0.62, 95% CI: 0.39–0.98), the distance from the nearest hospital (OR = 1.73, 95% CI: 1.26–2.36), level of delivery institution (OR = 1.57, 95% CI: 1.14–2.17), and parity (OR = 1.45, 95% CI: 1.03–2.05). Conclusion: The study found lower Social Economic Status (SES), long distance with primary health institutions, and the increased need for services stemming from multi-parity reduced the likelihood of nonuse or deficient use of PFVs in rural areas. Multiparous, low SES women and those living far away from primary health institutions should be paid more attention to assure the coverage of postpartum care. [ABSTRACT FROM AUTHOR]

Lane-changing (LC) behavior is investigated on Chinese freeways, where the driving circumstances are relatively aggressive. Three data sets were collected from urban expressways and an intercity highway in the form of traffic videos. Different aspects of LC behaviors are analyzed, i.e., the LC rate, motivation, target lane choice and impact on traffic. The results suggest that LC is a transient behavior that randomly occurs with high frequency, which is the main feature of aggressive driving. Several LC patterns and the combination effect of ramps, fast lanes and various vehicle types are presented. The influence of LC on local traffic endures for approximately 15 to 30 s, which rapidly increases and slowly declines. LC behavior will increase the risk of high-speed car-following. All results are obtained from the empirical data; they will be useful for traffic management and traffic modeling. [ABSTRACT FROM AUTHOR]

Background: Offering free glasses can be important to increase children’s wear. We sought to assess whether “Upgrade glasses” could avoid reduced glasses sales when offering free glasses to children in China. Methods: In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA)< = 6/12 in either eye correctable to >6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of $30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization. Results: Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0%) at 27 schools to Free Glasses +$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3%, multiple regression relative risk (RR) 0.90 (0.56–1.43), P = 0.65; Free + $30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69. Conclusions: Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income. Trial registration: ClinicalTrials.gov Identifier: . Registered on 31 August 2014. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before and after institutional and policy interventions. After institutional interventions were introduced, the overall CDMR rate increased from 15.76% to 16.34% (p = 0.053), but the average annual growth rate (AAGR) of the overall CDMR rate quickly declined from 20.11% to -4.30%. After policy interventions were introduced, the overall CDMR rate, the AAGR of the overall CDMR rate, and the probability of performing CDMR declined. Further, the overall probability of a woman undergoing CDMR decreased in all three age groups (group one: <24; group two: 24–34; group three: >34) after institutional and policy interventions. These results show that institutional and policy interventions can reduce the CDMR rate. Additionally, the CDMR rate should be included in hospitals’ performance assessment matrix to reduce the CDMR rate further. [ABSTRACT FROM AUTHOR]

Based on cohort data obtained from 13,085 college freshmen’s (2005 to 2011) SCL-90 (the Symptom Check-List-90) reports and their subsequent 4-year psychological counseling help-seeking records, this study examined the association between college students’ mental health problems and help-seeking behaviors across four college years. Female students’ mental health problems and help-seeking behaviors increased from the 2005 to the 2011 cohorts and no changes emerged for male students across cohorts. Overall, male students reported higher levels of mental health problems than did female students in the first college year, whereas female students reported more help-seeking behaviors than did male students in the following four college years. College students’ mental health problems was associated positively with help-seeking behaviors. College students were more likely to seek help from the college psychological counselling center when they experienced relatively few or quite a lot of mental health issues (i.e., an inversed U shape). Implications for future studies and practices are discussed. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common form of violence against women worldwide. IPV during pregnancy is an important risk factor for adverse health outcomes for women and their offspring. However, the prevalence of IPV during pregnancy is not well understood in China. The objective of this study was to estimate the pooled prevalence of IPV during pregnancy in China using a systematic review and meta-analysis. Methods: Systematic literature searches were conducted in PubMed, Web of Science, CNKI, Wanfang, Weipu and CBM databases to identify relevant articles published from the inception of each database to January 31, 2016 that reported data on the prevalence of IPV during pregnancy in China. The Risk of Bias Tool for prevalence studies was used to assess the risk of bias in individual studies. Owing to significant between-study heterogeneity, a random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval, and then univariate meta-regression analyses were performed to investigate the sources of heterogeneity. Subgroup analysis was conducted to explore the risk factors associated with IPV during pregnancy. Results: Thirteen studies with a total of 30,665 individuals were included in this study. The overall pooled prevalence of IPV during pregnancy was 7.7% (95% CI: 5.6–10.1%) with significant heterogeneity (I2 = 97.8%, p < 0.001). The results of the univariate meta-regression analyses showed that only the variable “sample source” explained part of the heterogeneity in this study (p < 0.05). The characteristics “number of children” and “unplanned pregnancy” were determined as risk factors for experiencing violence during pregnancy. Conclusions: The prevalence of IPV during pregnancy in China is considerable and one of the highest reported in Asia, which suggests that issues of violence against women during pregnancy should be included in efforts to improve the health of pregnant women and their offspring. In addition, a nationwide epidemiological study is needed to confirm the prevalence estimates and identify more risk factors for IPV during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Numerous school-based interventions for childhood obesity have been emerging in mainland China in recent decades, but little is known about the effectiveness of such interventions. This study aims to assess the effectiveness of school-based interventions for childhood obesity conducted in mainland China. Methods: A systematic search was undertaken in eight databases to identify both randomized and non-randomized controlled trials from January 1990 to December 2015 examining the effectiveness of school-based obesity interventions. A random effects meta-analysis was conducted assessing the impact of included interventions on (body mass index) BMI. The quality of each included studies were assessed using Effective Public Health Practice Project Quality Assessment Tool. A P value <0.05 (two-sided) was considered statistically significant. Result: Of the seventy-six included studies, we found physical activity and health education were the two most common components of interventions. More treatment studies were effective compared with prevention studies (85.0% vs. 58.3%). Comprehensive interventions involving physical activity and health education appeared more effective than the physical activity only interventions in both obesity treatment and prevention studies. The meta-analyses showed comprehensive interventions involving physical activity and health education had larger effect on the change of BMI than physical activity only interventions (treatment studies: -1.80 kg/m2 (95% CI: -2.15,-1.44) vs. -0.91 kg/m2 (95% CI: -1.15,-0.67); prevention studies: -0.19 kg/m2 (95% CI: -0.27, -0.11) vs. +0.05 kg/m2 (95% CI: -0.04, +0.15)). Conclusions: Comprehensive school-based interventions may assist in tackling the rising prevalence of childhood obesity in mainland China. [ABSTRACT FROM AUTHOR]

In China, the number of college students using mobile phone based messaging and social networking applications like WeChat is increasing rapidly. However, there has been minimal research into the addictive nature of these applications and the psychological characteristics associate with their excessive use. There is also no published scale available for assessing excessive use of WeChat and similar applications. In the current study, we collected data from 1,245 college students in China (715 females) and developed the WeChat Excessive Use Scale (WEUS). We then assessed the relationship between excessive use of WeChat and excessive use of a social networking application-Weibo, problematic use of mobile phones, external locus of control, and social interaction skills. Our 10-item scale featured three factors, namely- “mood modification,” “salience” and ‘‘conflict”- critical factors in assessing different forms of addiction. The WEUS was found to be a reliable instrument in assessing excessive use of WeChat as it showed good internal consistency and correlated with other measures of problematic use social networking and mobile phone addiction. Our results showed that excessive users of WeChat are more likely to excessively use Weibo than they are to problematically use mobile phones. Our study also showed that greater excessive use of WeChat is associated with higher external locus of control and greater online social interaction skills. These results reveal that WeChat has unique and strong appeal among college students in China. Further, practitioners should consider dealing with malleable factors like locus of control and real life social skills in treating people with problematic messaging and social networking. [ABSTRACT FROM AUTHOR]

Municipal infrastructure is a fundamental facility for the normal operation and development of an urban city and is of significance for the stable progress of sustainable urbanization around the world, especially in developing countries. Based on the municipal infrastructure data of the prefecture-level cities in China, municipal infrastructure development is assessed comprehensively using a FA (factor analysis) model, and then the stochastic model STIRPAT (stochastic impacts by regression on population, affluence and technology) is examined to investigate key factors that influence municipal infrastructure of cities in various stages of urbanization and economy. This study indicates that the municipal infrastructure development in urban China demonstrates typical characteristics of regional differentiation, in line with the economic development pattern. Municipal infrastructure development in cities is primarily influenced by income, industrialization and investment. For China and similar developing countries under transformation, national public investment remains the primary driving force of economy as well as the key influencing factor of municipal infrastructure. Contribution from urbanization and the relative consumption level, and the tertiary industry is still scanty, which is a crux issue for many developing countries under transformation. With economic growth and the transformation requirements, the influence of the conventional factors such as public investment and industrialization on municipal infrastructure development would be expected to decline, meanwhile, other factors like the consumption and tertiary industry driven model and the innovation society can become key contributors to municipal infrastructure sustainability. [ABSTRACT FROM AUTHOR]

Using 5-minute high frequency data from the Chinese stock market, we employ a non-parametric method to estimate Fama-French portfolio realized jumps and investigate whether the estimated positive, negative and sign realized jumps could forecast or explain the cross-sectional stock returns. The Fama-MacBeth regression results show that not only have the realized jump components and the continuous volatility been compensated with risk premium, but also that the negative jump risk, the positive jump risk and the sign jump risk, to some extent, could explain the return of the stock portfolios. Therefore, we should pay high attention to the downside tail risk and the upside tail risk. [ABSTRACT FROM AUTHOR]

Background: Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China. Methods: Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined. Results: 76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were acceptable. Conclusions: The instrument was shown to be both valid and reliable for measuring clinical physicians’ competency in China. The results of the competency-based instrument can be used by ministry of health and administrators of hospitals to assess physicians’ competencies, encourage and guide them to modify their behaviors according to the evaluation criteria, and also cultivate physicians with strong clinical practice, innovation and independent scientific research ability. Through these measurements and understandings, the overall level of clinical physicians will be increased in China. [ABSTRACT FROM AUTHOR]

We examine the different effects of monetary policy actions and central bank communication on China’s stock market bubbles with a Time-varying Parameter SVAR model. We find that with negative responses of fundamental component and positive responses of bubble component of asset prices, contractionary monetary policy induces the observed stock prices to rise during periods of large bubbles. By contrast, central bank communication acts on the market through expectation guidance and has more significant effects on stock prices in the long run, which implies that central bank communication be used as an effective long-term instrument for the central bank’s policymaking. [ABSTRACT FROM AUTHOR]

In this study, university-industry collaborations in China and the USA are analyzed in terms of co-authored publications indexed in the Web of Science (WoS). Results show a wide gap between China and the USA: Chinese universities are much less active in collaborations with industry in terms of either publication productivity or collaboration intensity. In selecting local and foreign industrial partners, however, more variation exists among Chinese universities than among US universities. The US system is domestically oriented more than that of China. In the USA, the intensity of university-industry collaboration is determined by research quality, whereas in China this is not the case. In both China and the USA, distance is not critical for the establishment of domestic university-industry collaboration. A high correlation is found between productivity indicators including total publications and university-industry co-authored publications. However, the productivity indicators are less correlated with the intensity of university-industry collaboration. Large research universities with strong ties to domestic industry play critical roles in both national publication systems. [ABSTRACT FROM AUTHOR]

Objective: To estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China. Methods: The Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. Results: The model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. Conclusion: Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM. [ABSTRACT FROM AUTHOR]

Although studies have increasingly linked air pollution to specific health outcomes, less well understood is how public perceptions of air quality respond to changing pollutant levels. The growing availability of air pollution measurements and the proliferation of social media provide an opportunity to gauge public discussion of air quality conditions. In this paper, we consider particulate matter (PM) measurements from four Chinese megacities (Beijing, Shanghai, Guangzhou, and Chengdu) together with 112 million posts on Weibo (a popular Chinese microblogging system) from corresponding days in 2011–2013 to identify terms whose frequency was most correlated with PM levels. These correlations are used to construct an Air Discussion Index (ADI) for estimating daily PM based on the content of Weibo posts. In Beijing, the Chinese city with the most PM as measured by U.S. Embassy monitor stations, we found a strong correlation (R = 0.88) between the ADI and measured PM. In other Chinese cities with lower pollution levels, the correlation was weaker. Nonetheless, our results show that social media may be a useful proxy measurement for pollution, particularly when traditional measurement stations are unavailable, censored or misreported. [ABSTRACT FROM AUTHOR]

We investigated the inter-day effects of price limits policies that are employed in agent-based simulations. To isolate the impact of price limits from the impact of other factors, we built an artificial stock market with higher frequency price limits hitting. The trading mechanisms in this market are the same as the trading mechanisms in China’s stock market. Then, we designed a series of simulations with and without price limits policy. The results of these simulations demonstrate that both upper and lower price limits can cause a volatility spillover effect and a trading interference effect. The process of price discovery will be delayed if upper price limits are imposed on a stock market; however, this phenomenon does not occur when lower price limits are imposed. [ABSTRACT FROM AUTHOR]

Objectives: Road traffic crashes that involve very high numbers of fatalities and injuries arouse public concern wherever they occur. In China, there are two categories of such crashes: a crash that results in 10–30 fatalities, 50–100 serious injuries or a total cost of 50–100 million RMB ($US8-16m) is a “serious road traffic crash” (SRTC), while a crash that is even more severe or costly is a “particularly serious road traffic crash” (PSRTC). The aim of this study is to identify the main factors affecting different types of these crashes (single-vehicle, head-on, rear-end and side impact) with the ultimate goal of informing prevention activities and policies. Methods: Detailed descriptions of the SRTCs and PSRTCs that occurred from 2007 to 2014 were collected from the database “In-depth Investigation and Analysis System for Major Road Traffic Crashes” (IIASMRTC), which is maintained by the Traffic Management Research Institute of the Ministry of Public Security of China (TMRI). 18 main risk factors, which were categorized into four areas (participant, vehicle, road and environment-related) were chosen as potential independent variables for the multinomial logistic regression analysis. Comparisons were made among the single-vehicle, head-on, rear-end and side impact crashes in terms of factors affecting crash occurrence. Findings: Five risk factors were significant for the six multinomial logistic regression models, which were location, vertical alignment, roadside safety rating, driver distraction and overloading of cargo. It was indicated that intersections were more likely to have side impact SRTCs and PSRTCs, especially with poor visibility at night. Overloaded freight vehicles were more likely to be involved in a rear-end crash than other freight vehicles. Driver distraction is an important risk factor for head-on crashes, while vertical alignment and roadside safety rating are positively associated with single-vehicle crashes. Conclusion: Based on the findings, promising measures were proposed to prevent each type of SRTC and PSRTC, which governmental or regulatory agencies could employ to plan strategies to reduce SRTCs and PSRTCs and support lifesaving policies. [ABSTRACT FROM AUTHOR]

This study used the dynamic conditional correlations (DCC) method to identify the linkage effects of Chinese stock market, and further detected the influence of network linkage effects on magnitude of security returns across different industries. Applying two physics-derived techniques, the minimum spanning tree and the hierarchical tree, we analyzed the stock interdependence within the network of the China Securities Index (CSI) industry index basket. We observed that that obvious linkage effects existed among stock networks. CII and CCE, CAG and ITH as well as COU, CHA and REI were confirmed as the core nodes in the three different networks respectively. We also investigated the stability of linkage effects by estimating the mean correlations and mean distances, as well as the normalized tree length of these indices. In addition, using the GMM model approach, we found inter-node influence within the stock network had a pronounced effect on stock returns. Our results generally suggested that there appeared to be greater clustering effect among the indexes belonging to related industrial sectors than those of diverse sectors, and network comovement was significantly affected by impactive financial events in the reality. Besides, stocks that were more central within the network of stock market usually had higher returns for compensation because they endured greater exposure to correlation risk. [ABSTRACT FROM AUTHOR]

The purpose of this study was to construct and validate a “Perceived Physical Literacy Instrument” (PPLI) for physical education teachers. Based on literature review and focus group interviews, an 18-item instrument was developed for the initial tests. This self-report measure, using a 5-point Likert scale, formed the PPLI and was administered to 336 physical education teachers in Hong Kong. The sample was randomly split, and exploratory and confirmatory factor analyses resulted in a 9-item, 3-factor scale. Exploratory factor analysis (EFA) item loadings ranged from 0.69 to 0.87, and Cronbach’s alpha ranged from 0.73 to 0.76. Confirmatory factor analysis (CFA) showed that the construct demonstrated good fit to the model. The PPLI thus appeared to be reliable and valid to measure the perceived physical literacy of physical education teachers. It is argued that the instrument can be used for both research and applied purposes and potential uses for the instrument in physical education, medical and health settings are discussed. [ABSTRACT FROM AUTHOR]

Objective: Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL. Methods: Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship. Results: In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students. Conclusion: The application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population. [ABSTRACT FROM AUTHOR]