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This preliminary study investigates the current situation of school library support of K-12 health education in China. A survey of 42 school librarians and 115 K-12 teachers from selected schools was conducted to find out their views about school library's role in school health education and their current practice of library use in health teaching. Collection and circulation statistics were gathered from 29 schools where the Hua Xia 2000 school library automation system has been in operation. Research findings indicate that Chinese school libraries' involvement in and support of health education has been rather limited, both in student/teacher services and in collection development. (Contains 4 tables.)

Everyone would encounter the life issue of solving complicated problems generated by economic behaviors among all activities for making a living. Various life problems encountered therefore could be generalized by economic statistics. In other words, a lot of important events in daily life are related to economic statistics. For this reason, teaching students to understand the world, make reasonable decisions, and behave correctly on important personal or social issue has been the major objectives and directions of education. Taking universities in Fujian Province as the research subjects, including Xiamen University and Fuzhou University, the experimental design is applied to this study. The research results reveal that 1. creative problem solving teaching would affect attitudes toward learning, 2. creative problem solving teaching would influence learning achievements, 3. attitudes toward learning show significantly positive effects on learning effect in learning achievements, and 4. attitudes toward learning present notably positive effects on learning gain in learning achievements. According to the results, suggestions are eventually proposed in this study, expecting to train students' ability to make correct judgment and solve problems when facing the diverse and complicated information in the society or the critical choice of continuing study or looking for employment as well as to enhance the urgency.

In the official curriculum documents of many countries, statistical thinking have become part of the mainstream in school curriculum. We argue that teacher capacity is a key dimension in realizing essential goals for developing students' statistical literacy, reasoning and thinking in practical teaching. In this paper, a construct of Teacher Capacity was used to analyze how Australian and Chinese teachers understand and give effect to content in "Statistical thinking". The responses of the 82 teachers involved in the study to a questionnaire were analyzed qualitatively and quantitatively in terms of four criteria which form the basis of our construct of teacher capacity: Knowledge of Mathematics, Interpretation of the Intentions of the Official Mathematics Curriculum, Understanding of Students' Thinking, and Design of Teaching. These analyses gave rise to three classifications of Teacher Capacity: High, Medium and Low Capacity. Australian teachers performed slightly better on all four criteria than Chinese teachers, but there did not exist statistically significant difference. Among the four criteria, Design of Teaching appears to be the critical dimension for the implementation of curriculum reform.

It is clear that the teaching of medical statistics needs to be improved, yet areas for priority are unclear as medical students' learning and application of statistics at different levels is not well known. Our goal is to assess the attitudes of medical students toward the learning and application of medical statistics, and discover their learning needs. We conducted a cross-sectional survey of learning and application of medical statistics among graduates and undergraduates at a medical school in Chongqing. More than 70% of the medical students thought that the medical statistics course was as important as other medical courses. Among them, 62.58% of graduate students thought that it was very hard to learn medical statistics, whereas only 27.72% undergraduate students held the same opinion. Both graduates and undergraduates stated that the main difficulties involved in learning medical statistics were its abstract principles and the large quantity of concepts and formulas. In all, 70% of both graduates and undergraduates could conduct a basic statistical analysis of general medical data independently, although undergraduates demonstrated greater proficiency in applying basic statistical methods than did graduates (p<0.05). The most common mistake students made in solving statistical problems was the misuse of statistical methods. In conclusion, medical students do not perform well in learning and applying medical statistical methods despite a clear recognition of the importance of the course, and we should start to make the necessary reforms in the teaching of medical statistics.

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

Background: A positive work environment can enhance nursing safety and patient satisfaction while alleviating nurse stress. Conversely, a poor work environment can harm nurses' physical and mental health and compromise the quality of care, particularly in the high-intensity and shift-based setting of the ICU. Objectives: Based on the Job demands-resources (JD-R) model, this study examined the effects of job demands and job resources in the work environment, as well as personal resources, on the night-shift alertness of ICU shift nurses. Methods: This cross-sectional correlational exploratory study, conducted from July to September 2022, recruited 291 ICU shift nurses from a hospital in Beijing, China. The Copenhagen Psychosocial Questionnaire (COPSOQ), the Self-resilience scale, the General Self-Efficacy Scale (GSES), and the Psychomotor Vigilance Task (PVT) were used to subjectively and objectively measure the job demands, job resources, personal resources, and night-shift alertness. SPSS 26.0 and Mplus 8.3 were used to analyze the data and construct the structural equation model. Results: The night-shift reaction time was 251.0 ms (Median), indicating a relatively high level of alertness. Job demands were negatively correlated with both job resources (r=-0.570, P < 0.001) and personal resources (r=-0.462, P < 0.001), while a positive correlation existed between job resources and personal resources (r = 0.554, P < 0.001). The results show that increased job demands can lead to higher levels of nurse strain (β = 0.955, P < 0.001), whereas job resources were found that it can decrease strain (β=-0.477, P = 0.047). Adequate job resources can enhance motivation directly (β = 0.874, P < 0.001), subsequently reducing reaction time (β=-0.148, P = 0.044) and improving night-shift alertness among ICU shift nurses. Conclusion: Enhancing ICU shift nurses' work motivation through bolstering job resources can boost night-shift alertness. However, it is noteworthy that, in this study, neither strain nor individual resources significantly influenced nurses' night-shift alertness. This may be attributed to the complexity of the ICU environment and individual differences. Future research should explore the relationship between these factors and nurses' work alertness. [ABSTRACT FROM AUTHOR]

Background: Human papillomavirus (HPV) infection significantly contributes to the global cancer burden. Understanding the factors influencing male clinical interns' willingness to promote HPV vaccination is crucial for developing effective public health strategies in China. Methods: This study employed a stratified random sampling method to select 1,980 male clinical interns from five provinces in China between January and March 2024. Data were collected on participants' demographic characteristics, HPV-related clinical experience, and knowledge. The Theory of Planned Behavior framework, encompassing attitudes, subjective norms, and perceived behavioral control, was used to examine factors influencing the willingness to promote the HPV vaccine. Logistic regression analyses were conducted to identify factors associated with the willingness to promote the HPV vaccine. Results: Among the respondents, 72.29% were willing to encourage others to receive the HPV vaccine. Significant factors influencing this willingness included older age (OR = 3.065, P ≤ 0.001), higher monthly household income (OR = 1.449, P = 0.025), participation in the diagnosis and treatment of HPV-related diseases (OR = 3.458, P ≤ 0.001), positive attitude towards the vaccine (OR = 13.503, P = 0.004), and strong perceived behavioral control (OR = 2.364, P = 0.006). Conclusion: This study highlights the critical role of practical experience and targeted education in promoting HPV vaccination among male clinical interns in China. Enhancing the training and education of this group is essential for improving HPV vaccine advocacy and supporting public health efforts to reduce HPV-related diseases. [ABSTRACT FROM AUTHOR]

Objective: To investigate the current situation of innovative behavior and organizational structure authorization of ophthalmic specialty nurses in China, and analyze the influencing factors of innovative behavior. Methods: A cross-sectional survey was carried out among 301 ophthalmic specialty nurses in China, representing Representing 82 hospitals in 25 provinces, using a general data questionnaire, Innovative Behavior Scale(IBS), and conditions of work effectiveness questionnaire(CWEQ-II). Results: The mean total score for innovative behavior among Chinese ophthalmic specialty nurses was (4.73 ± 1.14), and the mean total score for organizational structure authorization was (61.65 ± 14.69). The logistic regression analysis revealed that organizational structure authorization, hospital grade, and ophthalmic specialty nurses primarily engaged in clinical care and clinical research had statistically significant impacts on the level of innovative behavior (P < 0.05). The higher the organizational structure authorization score, the higher the innovative behavior level of ophthalmic specialty nurses, the level of innovation behavior of grade-B tertiary hospitals is higher than that of grade-A tertiary hospitals. The main positions are low level of innovative behavior in clinical care and high level of innovative behavior in clinical research. Conclusions: The innovative behavior and organizational structure authorization of Chinese ophthalmic specialty nurses are at a medium level, the innovative behavior of ophthalmic specialty nurses is influenced by factors such as organizational structure empowerment level, hospital grade, and main job position. Nursing managers are advised to develop tailored training programs based on the influencing factors of innovative behavior among Chinese ophthalmic specialty nurses, in order to enhance their level of innovation and improve the quality of nursing services provided by Chinese ophthalmic specialty nurses. [ABSTRACT FROM AUTHOR]

Background: Narrative nursing is a novel approach according with humanistic care, which has been shown to be effective in improving health outcomes for both patients and nurses. Nevertheless, few studies have investigated the status of narrative nursing practice among nurses, and a comprehensive understanding of factors influencing this practice remains elusive. Design: This was an observational, cross-sectional study using convenience sampling method. Methods: After obtaining the informed consent, a total of 931 registered nurses from three hospitals in China were investigated. Data were collected using the Social Support Rating Scale, the General Self-efficacy Scale, and the Knowledge-Attitude-Practice Survey of Clinical Nurses on Narrative Nursing. All the scales were validated in the Chinese population. The questionnaire results were verified by an independent investigator. Factors influencing narrative nursing practice were determined through a series of analyses, including independent sample t-tests, one-way ANOVA, and Pearson correlations. Subsequently, path analysis was performed and a structural equation model was established. Results: The score of narrative nursing practice in this study was 30.26 ± 5.32. The structural equation model showed a good fit, with a Root Mean Square Error of Approximation (RMSEA) of 0.007 (90%CI: 0.000, 0.047). Both social support and narrative nursing attitude could directly affect narrative nursing practice (βsocial support = 0.08, P < 0.001; βattitude = 0.54, P < 0.001) and indirectly influence it via self-efficacy (βsocial support = 0.04, P < 0.001; βattitude = 0.06, P < 0.001). In addition, narrative nursing knowledge (β = 0.08, P < 0.001) and the nurses' growth environment (β=-0.06, P < 0.001) also affected the practice of narrative nursing. Conclusion: Narrative nursing in China is at a medium level and could be influenced by several personal and environmental factors. This study highlighted the critical role of nursing management in the advancement of narrative nursing practices. Nurse managers should prioritize specialized training and cultivate supportive environments for nurses to improve their narrative nursing practices. [ABSTRACT FROM AUTHOR]

Objectives: Epidemiology showed that the falling incidences increased with advanced age, and recent findings found link between nutritional intake and risk of falls. Nevertheless, the relationship between different plant-based diets and the risk of falls in older adults remains unclear. Our investigation aimed to evaluate the correlation between various plant-based diet indices and the occurrence of falls. Design: This study is a cross-sectional and post-hoc analysis from a national cohort study. Setting and participants: We included individuals over 65 years from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) recruited in 2018 with information on falls and dietary assessments, finally 11,044 participants were eligible. Measurements: Using food frequency questionnaire (FFQ), we calculated plant-based index scores categorized as unhealthy plant-based index (uPDI) and healthy plant-based index (hPDI). The primary outcome was falls obtained from questionnaire. Statistical analysis was performed utilizing logistic regression model to investigate the relationship between the plant-based diet indices and falls. We also used the subgroup analysis to investigate the interaction of falls and plant-based diet index (PDI) among different status and used the restricted cubic spline (RCS) curves to investigate the connection between the PDI scores and falls risk. Results: Among 11,044 participants included in our study, a total of 2493 fall cases were observed. The logistic regression analysis revealed that the plant-based index related to falls. In the adjusted model, per 10-unit increment of hPDI has a significant decreased risk of falls (odd ratio [OR]: 0.85, 95% confidence interval [CI]: 0.79–0.91, P for trend < 0.001) and per 10-unit increment in uPDI increased the risk of falls (OR: 1.21, 95% CI: 1.13–1.30, P for trend < 0.001). We also revealed an interaction between smoking status and falls among the uPDI group (Pinteraction = 0.012). Finally, we found that with plant-based index scores increased, the odds of falls among hPDI decreased (P for overall < 0.001, P nonlinear = 0.0239), and the odds of falls among uPDI increased (P for overall < 0.001, P nonlinear = 0.0332). Conclusion and implications: We found significant association between the Plant-based diet index and the risk of falls, highlighting the key role of the consumption of nutritious plant-based foods on the risk of falls, which needed take into account in developing intervention and prevention strategies to decrease falls among older Chinese adults. [ABSTRACT FROM AUTHOR]

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

Although researchers have devoted great effort to explore the antecedents of altruistic behaviours (a type of organisational citizenship behaviours), the important role of technical factors (social media) remains unclear. Drawing on social comparison and organisational support theory, this study explored how social media affordances influence employees' altruistic behaviours from both positive and negative perspectives. In this study, 302 employees from organisations in China were surveyed. We found that social media affordances could facilitate employees' perceived organisational support and social comparison of ability. Perceived organisational support positively mediated the relationship between social media affordances and altruistic behaviours. Although the evidence did not support the notion that social comparison of ability could directly dampen altruistic behaviours, a post-hoc analysis found that it could dampen the positive impact of perceived organisational support on developing altruistic behaviours. This study expanded previous research focusing on only positive or negative effects of social media use in the workplace by investigating the dual effects and the interaction effect in between. Here, we discuss the results and provide practical guidance for managers and organisations. [ABSTRACT FROM AUTHOR]

Objectives: To determine the characteristics of lumbar foraminal stenosis (LFS) on magnetic resonance (MR) images and their association with back pain and radiating leg pain in a population-based sample of Chinese subjects. Methods: This study was an extension of the Hangzhou Lumbar Spine Study, a cross-sectional study focusing on back pain and lumbar spine MR imaging findings. Questionnaire data, including demographics, lifestyle, occupational exposures, back pain and radiating leg pain were included. On lumbar spine MR images, disc degeneration was assessed using Pfirrmann grade and Modic changes were evaluated. Using Lee's scale, the L3-S1 intervertebral foramina were evaluated, with grade 2–3 representing substantial LFS and grade 0–1 no LFS. Characteristics of LFS were noted, and associations of LFS with back pain and radiating leg pain were examined. Results: Among the 644 study subjects, 141 (21.9%) had at least one LFS, and its occurrence was associated with greater age (OR = 1.93 for each 10 years, p < 0.001). Substantial LFS was associated with the presence of back pain (OR = 1.92, p = 0.001) and the intensity of the worst back pain (Coef = 8.30, p < 0.001) over the past 12 months, and disabling back pain during their lifetime (OR = 2.25, p < 0.001). Substantial LFS was also associated with leg pain (OR = 14.27, p < 0.001), with a sensitivity of 75.7% for the presence of radiating leg pain and a specificity of 81.4%. Conclusion: Substantial LFS on MR images was a common age-related degenerative phenotype in adults, and appears to be an independent risk factor for back pain and leg pain. [ABSTRACT FROM AUTHOR]

While numerous studies have revealed the impact of different bullying behaviors, such as victimization and perpetration, on the psychological development of adolescents, the exploration of the correlates of positive/negative bystander behaviors and their potential underlying mechanisms remains scarce in China. The present study aims to compare the relationships between mental health and positive versus negative bystander behavior and to clarify whether self-efficacy and coping styles mediate the relationships between mental health and bullying dynamics. The current study was conducted on 11,734 students from 18 secondary schools in Suzhou, China (Meanage = 15.00, SDage = 1.47; 53.8% boys). The information on bullying victimization, perpetration, positive/negative bystander behaviors, as well as self-efficacy, coping styles and mental health variables (including depression, anxiety, sleep disturbance, suicide risk), were collected. Negative bystander behavior was positively associated with mental health problems, while positive bystander behavior was negatively associated with these factors. Also, further analysis showed that coping styles and self-efficacy mediated the relationship between different bullying behaviors and mental health outcomes. The results highlighted the comparison of the correlates of positive and negative bystander behaviors, which were comparably crucial to those of victims and perpetrators for prevention and intervention efforts. Promoting adaptive coping styles and self-efficacy to buffer the deleterious psychological consequences of bullying behavior in adolescents was also important. [ABSTRACT FROM AUTHOR]

Background: Nurses represent China's largest healthcare workforce. Nurse practitioners (NPs) play an essential role in providing cost-effective quality healthcare and bridging the healthcare gaps. However, NPs are relatively new in China, and limited evidence exists on senior nurses' knowledge of and attitudes toward NPs. Aims: This study aimed to describe senior nurses' knowledge, attitudes, and perceived facilitators and barriers of NPs in China using a self-designed, culturally adaptive questionnaire. Methods: A cross-sectional online survey was conducted among 412 senior nurses in Hunan Province from December 2021 to January 2022. The Knowledge and Attitudes towards Nurse Practitioners Questionnaire (KANPQ) was developed based on the Delphi method, which included 30 items under three dimensions: knowledge (22 items), attitude (2 items), and perceived facilitators and barriers (6 items). Multivariate linear regression was conducted to explore factors associated with senior nurses' attitudes toward NPs. Results: The average KANPQ knowledge score was 68.56 ± 22.69, with 55.09%,10.20%, and 34.71% of participants showing good, moderate, and poor levels of knowledge, respectively. The average KANPQ attitude score was 7.79 ± 1.72, with 65.3% thinking NPs were necessary and 69.9% expressing willingness to become NPs. Nurses with higher professional titles and better knowledge of NPs had more positive attitudes toward NPs. The three most frequently mentioned barriers to NP implementation were patient trust, laws, and education. Conclusions: Approximately one-third of senior nurses have poor knowledge and negative attitudes toward NPs, indicating much room for improvement. Strengthening the education and training of NPs, especially among those with lower professional titles and lower knowledge of NPs, may help improve their knowledge and attitudes toward NPs. In addition, continuous political, social, economic, and individual efforts are needed to facilitate the successful development of NPs in China. [ABSTRACT FROM AUTHOR]

Objective: To explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures. Methods: A cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children. Results: Univariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father's education level (χ2 = 4.207, p < 0.001), mother's education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434–6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354) were risk factors for dental caries. Higher father's educational level (OR = 0.724, 95% CI: 0.564–0.891), higher mother's educational level (OR = 0.641, 95% CI: 0.601–0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643–0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352–0.747) were protective factors against dental caries (all p < 0.05). Conclusion: Multiple factors result in early dental caries in preschool children aged 3–6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption. [ABSTRACT FROM AUTHOR]

Background: Oral aripiprazole exhibits favorable clinical efficacy and safety in the suppression of tics in children and adolescents with tic disorders. This study aims to evaluate and compare the cost-effectiveness of high-dose and low-dose aripiprazole in children and adolescents with tic disorders from the perspective of the Chinese healthcare system. Methods: A questionnaire survey was conducted on 146 patients with tic disorders, of whom 144 completed EQ-5D-Y and YGTSS. Four models were built to convert YGTSS onto EQ-5D-Y utility using two mapping algorithms. We constructed a decision tree model containing efficacy and safety to compare the cost-effectiveness of high-dose and low-dose aripiprazole based on our mapping function. Results: The GLM with model 1 (YGTSS total tic scores) was selected as the preferred function in our decision tree model. The base case cost-effectiveness analysis showed that compared to low-dose aripiprazole, high-dose aripiprazole improves effectiveness by 0.001QALYs and increases the overall cost by $197.99, resulting in an ICER of $174339.22 per QALY, which exceeds three times the gross domestic product per capita. Hence, high-dose aripiprazole is not likely to be a cost-effective option for child patients with tic disorders. One-way sensitivity analysis and probabilistic sensitivity analysis showed that these results is robust. Conclusion: On the basis of currently available data, low-dose aripiprazole may be a safe, effective, and economical dosage for children and adolescents with tic disorders. Limitations: The main limitation of our study is the lack of utility directly used for cost-effectiveness analysis. We obtained the utility of patients with tic disorders indirectly by the mapping function. This may introduce some bias and uncertainty. And it is a limitation to use the direct medical costs of Germany in our model. Although we converted it to the equivalent value of China using purchasing power parities, caution should be exercised when interpreting the results of this study. [ABSTRACT FROM AUTHOR]

With considerable debate concerning the impact of culture on the expression of callous–unemotional (CU) traits, it is unclear whether the core features of CU traits generalize to youth across cultures. This study aimed to examine whether cultural differences are reflected in the core features of CU traits and the associations among these features. Network analysis was employed to identify the core features and to examine the network structure of CU traits operationalized by the Inventory of Callous Unemotional traits (ICU) in four community youth samples from different nations (Australia, N = 190; the UK, N = 437; the USA, N = 330; China, N = 503). The item "Apologizes to people" was identified as a cross-cultural core feature in the ICU network with a greater centrality of this item compared to others in all four samples. In addition, some items were identified as culture-specific core features in the network, differing in their centrality across samples. The network structures of the youth self-report ICU items were moderately similar across samples, while the structures of parent-report items showed substantial differences. These findings have important implications for cross-cultural research on CU traits as well as practical implications for screening and treatment. The core features of ICU appear to be generalizable in youth across cultures, although cultural-specific manifestations should be noted. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the factors associated with suicidal ideation in schizophrenia patients in China using decision tree and logistic regression models. From October 2020 to March 2022, patients with schizophrenia were chosen from Chifeng Anding Hospital and Daqing Third Hospital in Heilongjiang Province. A total of 300 patients with schizophrenia who met the inclusion criteria were investigated by questionnaire. The questionnaire covered general data, suicidal ideation, childhood trauma, social support, depressive symptoms and psychological resilience. Logistic regression analysis revealed that childhood trauma and depressive symptoms were risk factors for suicidal ideation in schizophrenia (OR = 2.330, 95%CI: 1.177 ~ 4.614; OR = 10.619, 95%CI: 5.199 ~ 21.688), while psychological resilience was a protective factor for suicidal ideation in schizophrenia (OR = 0.173, 95%CI: 0.073 ~ 0.409). The results of the decision tree model analysis demonstrated that depressive symptoms, psychological resilience and childhood trauma were influential factors for suicidal ideation in patients with schizophrenia (p < 0.05). The area under the ROC for the logistic regression model and the decision tree model were 0.868 (95% CI: 0.821 ~ 0.916) and 0.863 (95% CI: 0.814 ~ 0.912) respectively, indicating excellent accuracy of the models. Meanwhile, the logistic regression model had a sensitivity of 0.834 and a specificity of 0.743 when the Youden index was at its maximum. The decision tree model had a sensitivity of 0.768 and a specificity of 0.8. Decision trees in combination with logistic regression models are of high value in the study of factors influencing suicidal ideation in schizophrenia patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: In the postoperative period, patients mainly rely on caregivers, who experience their own physical and mental fatigue. Caregiver fatigue may affect patient outcomes. OBJECTIVES: This study explored the fatigue status and influencing factors of primary caregivers of patients after liver cancer surgery. METHODS: A baseline information questionnaire, the Fatigue Scale-14, and the Barthel Index were used to investigate the self-care ability and fatigue status of 191 primary caregivers of patients with hepatic carcinoma who had had surgery. FINDINGS: The postoperative hospitalization time and self-care level of patients, whether the primary caregiver had health insurance, subjective feelings of fatigue, the perception that health was affected, and the patients' desired level of postoperative care were correlated with the occurrence of primary caregiver fatigue. [ABSTRACT FROM AUTHOR]

Bereavement of one or both parents is known to cause many kinds of internalizing and externalizing problems in adolescents. However, less is known about factors that are protective of the mental health of orphaned adolescents and differences by their gender and orphanhood type. To fill these gaps, the current study used a sample from southwestern China to test the association between types of orphans, life satisfaction, adolescents' psychological distress and problem behaviours. The results showed that orphan girls were prone to have lower levels of problem behaviours but higher levels of psychological distress than orphan boys. Female paternal orphans tended to have the highest psychological distress, while male paternal orphans tended to have the lowest psychological distress. In addition, school satisfaction had a stronger association with problem behaviour, and self‐satisfaction had a stronger association with psychological distress. Interventions and preventive measures aimed at reducing the psychological distress of orphans could benefit from the findings regarding the correlates of psychological distress and the most vulnerable group among orphans. [ABSTRACT FROM AUTHOR]

Aims: To explore the association between nurse managers' paternalistic leadership and nurses' perceived workplace bullying (WPB), as well as to examine the mediating role of organizational climate in this association. Background: There is a lack of empirical evidence regarding the relationship between nurse managers' paternalistic leadership, organizational climate and nurses' perceived WPB. Clarifying this relationship is crucial to understand how paternalistic leadership influences WPB and for nursing managers to seek organizational‐level solutions to prevent it. Methods: A cross‐sectional survey was performed from 4 January to 10 February 2022, in six tertiary hospitals in mainland China. Demographic information, Paternalistic Leadership Scale, Organizational Climate Scale and Negative Acts Questionnaire‐Revised were used in the survey. Descriptive statistics, Spearman correlation analyses and a structural equation model were used for data analysis. Results: A total of 5093 valid questionnaires were collected. Moral leadership and authoritarian leadership have both direct and indirect effects on WPB through the mediating effect of organizational climate. The former is negatively related to WPB and the latter is positively related to WPB. Benevolent leadership was only negatively associated with WPB via the mediating effect of organizational climate. Conclusion: The three components of paternalistic leadership have different effects on WPB through the mediating effect of organizational climate. Nurse managers are recommended to strengthen moral leadership, balance benevolent leadership, reduce authoritarian leadership and strive to create a positive organizational climate in their efforts to mitigate WPB among nurses. Impact: This study enhanced our comprehension of the relationship between different leadership styles and WPB. Greater emphasis should be placed on moral leadership in the promotion of nursing managers and nursing leadership training programs. Additionally, nursing managers should focus on establishing a positive organizational climate that helps to reduce WPB. Patient or Public Contribution: No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public. [ABSTRACT FROM AUTHOR]

Aims: To describe the changes in moderate‐to‐late preterm infants' (MLPIs) growth during 12 months of corrected age (CA) and to examine the predictive role of NICU‐related stress, postpartum depression trajectory and family coping ability on the physical developmental trajectory of MLPIs. Design: A prospective longitudinal study. Methods: There were 237 mother–infant dyads with at least two follow‐up data records included. General characteristics and NICU‐related stress were recorded from medical records at baseline. Infants' physical growth was measured at 40 weeks, 1, 3, 6, 9 and 12 months CA during outpatient follow‐up. Maternal postpartum depressive symptoms and family coping ability were assessed by questionnaires at 1, 3, 6, 9 and 12 months CA and 1 month CA respectively. We investigated the modifiable factors inside and outside of NICU on the trajectories of physical growth in the first year in MLPIs, mainly by using latent growth curve models with time‐varying covariates. Results: The curved trajectories of weight, length and head circumference in the first year in MLPIs demonstrated gradually slowed growth rates and these infants were above the WHO growth standards for the same age and sex. The latent growth curve models indicated that more NICU‐related stress was negatively associated with the weight and length at 40 weeks CA, and family coping ability (parent–child relationship) at 1 month CA was associated with the growth rate of weight. Besides, more NICU‐related stress predicted faster length growth rate. The infants of mothers who were in the group of high‐level postpartum depression trajectory had a slower growth rate of head circumference. Conclusions: Our study identified the modifiable factors along the care continuum influencing the trajectory of MLPIs' physical growth. Nurses should receive more training about infant stress measurement and family‐centred care to work in partnership with parents so that MLPIs can reach their full developmental potential. Also, multidisciplinary interventions including stress reduction strategies, close psychological monitoring and education improving parent–infant relationships should be further developed to achieve optimizing growth in the first year of MLPIs. Implications for the Profession and/or Patient Care: It is recommended that nurses pay attention to the long‐term physical growth status of MLPIs, and closely support their families. Quantifying NICU‐related stress and developing reduction strategies should be the priority for clinical staff during hospitalization. After discharge, persistent screening of depressive symptoms, psychological intervention and education about the parent–child relationship need to be included in the follow‐up visits. Patient or Public Contribution: No patient or public contribution. The study only included patients who were research participants. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationships between dietary patterns and perceived stress with memory deficits in 291 patients with heart failure aged 45–85 years. A total of 142 (48.8%) patients reported memory deficit. Three dietary patterns were identified by K-means clustering: nut-fruit-dairy, meat-processed, and traditional (high intake of cereals) diets. Compared to the traditional diet, the nut-fruit-dairy diet and meat-processed diet were associated with lower levels of deficits in short-term memory, delayed memory, and overall memory. What's more, perceived stress was positively associated with deficits in short-term memory and overall memory, but the association was only found in patients adhering to the traditional diet using stratified analyses. Our findings suggest that adhering to a healthy diet may be conducive to improving deficits in short-term memory, delayed memory, and overall memory, while also buffering the adverse association between perceived stress and deficits in short-term memory and overall memory. [ABSTRACT FROM AUTHOR]

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

Background: Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied. Objective: The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively. Methods: The Symptom Checklist 90 (SCL‐90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age‐ and gender‐matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons. Results: 100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001). Conclusions: Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment. [ABSTRACT FROM AUTHOR]

Objectives: To explore the influencing factors of family doctors agreement performance rate in Dongguan City, Guangdong Province. Methods: The multi-stage sampling method was used to randomly select family doctors in Dongguan City, Guangdong Province, to investigate the status quo of family doctors performance. Logistic regression analysis was used to investigate the influencing factors of family doctors performance, and decision trees and associations were used to further identify the influencing factors. Results: 389 family doctors participated in the survey, and 75.07% of them were generally able to perform their duties. Logistic regression analysis shows that whether a family doctor contracted residents is the influencing factor of family doctor performance behavior. The results of decision tree analysis showed that the biggest influence factor of family doctors performance behavior is whether the family doctors contracted residents or not. The most influential factor in decreasing the average Gini index of random forest also proved this result. Conclusions: The performance rate of family doctors in Dongguan City is relatively high. Whether family doctors sign contracts with residents is the influencing factor of family doctors performance. Improving the contract rate of family doctors is the key to improve the performance rate of family doctors. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate personal preparedness among patients on haemodialysis (HD) and to examine the relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours during natural disaster incidents. Design: A cross‐sectional survey was conducted. Methods: A convenience sampling method was used. A total of 446 participants from six areas of Sichuan province completed the online questionnaire study from February 27 to March 13, 2022. Sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were measured. Descriptive statistics were used to analyse sociodemographic characteristics and attitudes toward disaster preparedness. The relationship among sociodemographic characteristics, attitudes toward disaster preparedness and personal preparedness behaviours were assessed using ordinal regression. Statistical significance was defined as p < 0.05. Results: A total of 446 participants completed the survey. Of these, 42.15% (N = 188) were poorly prepared, 26.23% (N = 117) were moderately prepared and 31.61% (N = 141) were highly prepared. Ordinal regression showed that knowing about disaster preparedness (Odds Ratio (OR) = 1.691, 95% Confidence Interval (CI) = 1.081–2.644, p = 0.021), participating in disaster evacuation exercises (OR = 2.519, 95% CI = 1.595–3.977, p < 0.001) and learning about disaster preparedness (OR = 2.421, 95% CI = 1.542–3.802, p < 0.001) were associated with high preparedness. Compared to patients with a university degree or higher, patients with a junior high school education or lower (OR = 3.491, 95% CI = 1.760–6.925, p < 0.001) and senior high school degree (OR = 2.052, 95% CI = 1.038–4.057, p = 0.039) were associated with high preparedness. Patients who felt very confident and could deal with all their needs (OR = 3.878, 95% CI = 2.904–7.181, p < 0.001) or patients who felt confident and could meet some of their needs (OR = 1.949, 95% CI = 1.124–3.379, p = 0.017) had higher preparedness than those who felt less confident and were not well prepared to take care of their needs. Patient or Public Contribution: After obtaining each participant's consent, they filled out the online questionnaire using their own or a relative's cell phone while undergoing HD. Implication for Practice: It is essential that patients should be educated not only on medical specialty topics, but also on general disaster preparedness. Medical institutions should improve and reinforce preparation training among targeted populations. The low level of preparedness is partly due to the lack of participation of patients in disaster preparedness programs. Dialysis center managers should be urged to implement such programs at their centers. [ABSTRACT FROM AUTHOR]

Background: Validated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care. Methodology: The translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach's alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity. Results: The mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ2/df = 1.741; root mean square error of approximation (RMSEA) = 0.038; standardized root mean square residual (SRMR) = 0.058; comparative fit index (CFI) = 0.911; Tucker-Lewis Index (TLI) = 0.903). All standardized factor loadings were 0.30 or above. Significant positive correlations between the latent factors were found for all factor pairs (correlation coefficient < 0.8). Conclusions: The Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained. [ABSTRACT FROM AUTHOR]

BACKGROUND: In a previous study, more attention has been given to the psychological state of doctors than to that of nurses although the workload, working hours, and patient contact time are generally higher for nurses than doctors. The current status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the Coronavirus disease 2019 (COVID-19) pandemic and how their perceived stress affects the other two variables are topics that merit research attention. OBJECTIVE: In this study, the status of nurses' perceived stress, work engagement, and perceived professional benefit during the routine management of the COVID-19 pandemic was investigated to explore whether their perceived stress level has any effect on the other two variables. METHODS: The convenience sampling method was adopted, and 669 nurses from the First People's Hospital of Jingzhou were selected to participate in this study. Questionnaires on perceived stress, work engagement, and perceived professional benefit were used in the survey, and the data were processed using the SPSS 20.0 program for the descriptive statistics, independent sample t-test, analysis of variance. RESULTS: The total score of the nurses' perceived stress was 18.58±4.37 points. The total scores of their work engagement (43.32±14.01) and perceived professional benefit (140.23±17.75). CONCLUSION: The nurses' total perceived stress score was at an upper-middle level, and their total work engagement and perceived professional benefit scores were relatively high. Overall, perceived stress has a negative effect on nurses' work engagement and perceived professional benefit. That is, the higher the pressure perception of nurses, the lower the degree of work engagement and perceived professional benefit. [ABSTRACT FROM AUTHOR]

Background: Healthcare-associated infections (HAIs) are important indicators of healthcare quality. The aseptic non touch technique (ANTT), a standardised aseptic technique, is a crucial preventative measure against HAIs. However, there is insufficient evidence currently available regarding ANTT awareness and proficiency among nurses. This study aimed to investigate the status of ANTT proficiency in a cohort of nurses and analyse the associated risk factors, with the ultimate goal of providing a reference for promoting the application of ANTT in clinical practice. Methods: The study population was sampled from nurses working in a tertiary hospital in Zhejiang Province, China, in January 2024. A cross-sectional survey was conducted using a self-designed questionnaire to assess ANTT knowledge. Multivariate linear regression analysis was used to analyse the risk factors influencing ANTT knowledge in nurses. Results: A total of 458 nurses were included in this study. The cohort had an overall score of 49.7% correct responses on the ANTT knowledge questionnaire, with a mean score of 12.4 ± 2.4 out of 25, and 30.1% of the nurses felt that they did not need training related to ANTT. Multivariate linear regression analysis indicated that professional title, educational level, and the need for ANTT training were independently associated with ANTT knowledge in nurses. Nurses with Master's degrees and associated chief nurses were observed to have higher levels of ANTT knowledge compared to the rest. Conclusions: ANTT knowledge is insufficient among nurses in China, and its importance is not widely recognised. Continuous efforts are required to strengthen this knowledge. Constructing sustained, multiform, and stratified training programmes may represent an effective method to strengthen ANTT knowledge among nurses and promote its clinical use. [ABSTRACT FROM AUTHOR]

Background: The aims of the present study were to investigate the incidence of nurses who suffered anxiety during the COVID-19 pandemic and to explore how expressive suppression influences the relationship between family function and anxiety. Methods: This study used cross-sectional research and simple random sampling. A total of 300 questionnaires were distributed and 254 questionnaires were qualified after invalid questionnaires were proposed, thus a total of 254 female nurses from a tertiary hospital were included in this study. The measurement included General demographic questionnaires, the Self-Scale Anxiety, Scale (SAS), Emotion Regulation Strategies Questionnaire (ERQ), and Family Function Assessment (FAD). T-test, nonparametric Wilcoxon or Kruskal-Wallis test, χ2 test, Pearson or Spearman correlation analysis, multiple stepwise regression and bootstrap methods was performed to analyze the data. Results: In this study, 22.4% of the nurses exhibited anxiety symptoms, with 17.7% eliciting mild anxiety symptoms, 4.3% showing moderate anxiety symptoms and 0.4% with severe anxiety symptoms. Family function and expressive suppression were positively associated with anxiety severity. And family function influenced anxiety among nurses via direct and indirect (Expressive suppression -mediated) pathways. Conclusions: Expressive suppression partially mediated the influence of family function on anxiety symptom. To this end, nurse administrators should establish a robust mental health support system encompassing psychological counseling and emotional support groups. Furthermore, nurse administrators should consistently inquire about nurses' family situations, encourage nurses to articulate their emotions and needs candidly, both within the domestic sphere and the workplace, while refraining from excessive self-repression. [ABSTRACT FROM AUTHOR]

Background: Female sex workers (FSW) are particularly vulnerable to unintended pregnancy. Research examining the experience of unintended pregnancy due to commercial sex among Chinese FSW, however, is limited. This study aimed to examine the prevalence and correlates of unintended pregnancy due to commercial sex among FSW in China. Methods: In 2021, a cross-sectional study was conducted among 1257 FSW in five cities from Guangdong provinces in South China. Data were collected on social-demographic characteristics, sexual behaviors, experience of unintended pregnancy due to commercial sex and its pregnancy outcome, as well as experience of abortion in lifetime. Multivariable logistic regression analysis was employed to identify factors associated with unintended pregnancy. Results: Among the 1257 FSW, 19.3% reported having at least one unintended pregnancy due to commercial sex. Of those, 96.7% chose to terminate the pregnancy through induced abortion, and 40.5% reported undergoing multiple induced abortions in their lifetime. Multivariable logistic regression indicated that FSW working in current location over one year (adjusted Odds Ratio (aOR): 2.82, 95% CI 1.71–4.64) and having more than seven clients in the past week (aOR: 4.53, 95% CI 2.74–7.51) were more likely to have had unintended pregnancy due to commercial sex. Working in high tier (aOR: 0.21, 95% CI 0.14–0.30) and consistent condom use with clients in the past month (aOR: 0.16, 95% CI 0.10–0.23) were associated with a lower proportion of FSW having ever had unintended pregnancy. Conclusions: Unintended pregnancy are prevalent among FSW in South China. Interventions aimed at reducing the prevalence of unintended pregnancy and enhancing post-abortion care could be necessary among Chinese FSW. Plain English summary: Female sex workers (FSW) are particularly vulnerable to unintended pregnancies. Research on the experience of unintended pregnancy resulting from commercial sex among Chinese FSW is, however, limited. To address this knowledge gap, we investigated the prevalence and correlates of unintended pregnancies due to commercial sex among FSW in China. We conducted a cross-sectional study among 1257 FSW in five cities across Guangdong Province in South China in 2021. Multivariable logistic regression analysis was used to identify factors associated with unintended pregnancy. Among 1257 FSW, 19.3% reported having experienced at least one unintended pregnancy due to commercial sex. The factors significantly associated with unintended pregnancy in the multivariate analysis included participants working in high tier, working in current location over one year, using condom with clients inconsistently in the past month, and having more clients in the past week. The findings from this study could provide valuable insights for the development of policies aimed at reducing unintended pregnancies, improving abortion care, and enhancing family planning programs targeted at FSW. [ABSTRACT FROM AUTHOR]

Background: Missed or delayed child healthcare caused by the COVID-19 lockdown has threatened young children's health and has had an unpredictable influence on caregivers' child healthcare preferences. This study investigated caregivers' child healthcare preferences and the factors that influence them among families with young children (0–3 years) during the lockdown in Shanghai. Methods: Participants in this cross-sectional study were enrolled through random encounter sampling. Questionnaires were distributed online from June 1 to November 10, 2022, in Shanghai. A total of 477 valid questionnaires were received. The demographics of caregivers and their families, children's characteristics, COVID-19-related information, and caregivers' healthcare preferences were analyzed. The statistical analyses included frequency and percentage, chi-square tests, and multinomial logistic regression. Results: Caregivers preferred child healthcare professionals in the community health service system (CHS; 47.6%) followed by hospital pediatricians (40.0%) during lockdown. Caregivers with the following characteristics preferred CHS: those with an annual household income of CNY 200,000–300,000, those whose youngest children were aged 8–12 months, and those who experienced early childhood physical development issues. Caregivers preferred hospitals if they had experienced healthcare-seeking-related difficulties in accessing professional guidance from hospital pediatricians. Conclusions: During pandemic lockdowns, policymakers should allocate more resources to CHS to meet caregivers' childcare demands. Moreover, special attention should be given to the healthcare needs for CHS among families with specific demographics. Trial registration: Approval was obtained from the Ethics Committee of Shanghai Jiao Tong University School of Medicine School of Public Health (SJUPN-202,109; June 1, 2022). [ABSTRACT FROM AUTHOR]

Background: The mental health inequality between migrants and non-migrants was exacerbated by the COVID-19 pandemic. Identifying key determinants of this inequality is essential in promoting health equity. Methods: This cross-sectional study recruited Shanghai residents by purposive sampling during the city-wide lockdown (from April 29 to June 1, 2022) using an online questionnaire. Migration statuses (non-migrants, permanent migrants, and temporary migrants) were identified by migration experience and by household registration in Shanghai. Mental health symptoms (depression, anxiety, loneliness, and problematic anger) were assessed by self-report scales. The nonlinear Blinder-Oaxaca decomposition was used to quantify mental health inequality (i.e., differences in predicted probabilities between migration groups) and the contribution of expected correlates (i.e., change in predicted probability associated with variation in the correlate divided by the group difference). Results: The study included 2738 participants (771 [28.2%] non-migrants; 389 [14.2%] permanent migrants; 1578 [57.6%] temporary migrants). We found inequalities in depression (7.1%) and problematic anger (7.8%) between permanent migrants and non-migrants, and inequalities in anxiety (7.3%) and loneliness (11.3%) between temporary migrants and non-migrants. When comparing permanent migrants and non-migrants, age and social capital explained 12.7% and 17.1% of the inequality in depression, and 13.3% and 21.4% of the inequality in problematic anger. Between temporary migrants and non-migrants, age and social capital also significantly contributed to anxiety inequality (23.0% and 18.2%) and loneliness inequality (26.5% and 16.3%), while monthly household income (20.4%) and loss of monthly household income (34.0%) contributed the most to anxiety inequality. Conclusions: Significant inequalities in depression and problematic anger among permanent migrants and inequalities in anxiety and loneliness among temporary migrants were observed. Strengthening social capital and economic security can aid in public health emergency preparedness and promote mental health equity among migrant populations. [ABSTRACT FROM AUTHOR]

Background: Moral distress seriously affects professional nurses, and a number of instruments have been developed to measure the level of moral distress. The moral distress thermometer (MDT) is one of the commonly used instruments that can rapidly measure real-time moral distress; however, it remains unclear whether it is still useful in the Chinese cultural context. Aim: This study aimed to adapt and validate the MDT among Chinese registered nurses. Research design: An online, cross-sectional, survey study of adapting and validating Chinese version of MDT. Participants and research context: A total of 182 registered nurses effectively finished this survey. The correlation between MDT score and the score of the moral distress scale-revised version (MDS-R) was used for evaluating convergent validity, and MDT scores of registered nurses who working in different departments and who made different actions to the final question of the MDS-R were compared by using one-way ANOVA to evaluate construct validity. Ethical considerations: The Ethics Committee of Chongqing Traditional Chinese Medicine Hospital approved this study. Results: The Chinese version of MDT was described as relevant to measure moral distress, with a reported item-level content validity index (I-CVI) and scale-level CVI (S-CVI) of 1. The mean MDT score and mean MDS-R score were 2.54 and 38.66, respectively, and the correlation between these two scores was significantly moderate (r = 0.41). Nurses working different departments reported different levels of moral distress, and those working in intensive care unit reported the highest level of moral distress than those working in other departments (p = 0.04). The MDT scores between nurses who presented different actions to their position were also significantly different, and those who had ever left and those who had considered leaving but did not leave reported significantly higher moral distress. Conclusion: The MDT is a reliable, valid, and easy-to-use instrument to rapidly measure the real-time moral distress of registered nurses in China. [ABSTRACT FROM AUTHOR]

Background: Dietary assessment methods have limitations in capturing real-time eating behaviour accurately. Equipped with automated dietary-data-collection capabilities, the "intelligent ordering system" (IOS) has potential applicability in obtaining long-term consecutive, relatively detailed on-campus dietary records among university students with little resource consumption. We investigated (1) the relative validity of IOS-derived nutrient/food intakes compared to those from the 7-day food diary (7DFD); (2) whether including a supplemental food frequency questionnaire (SFFQ) improves IOS accuracy; and (3) sex differences in IOS dietary intake estimation. Methods: Medical students (n = 221; age = 22.2 ± 2.4 years; 38.5% male and 61.5% female) completed the 7DFD and SFFQ. During the consecutive 7-day survey period, students weighed and photographed each meal before and after consumption. Then, students reviewed their 3-month diet and completed the SFFQ, which includes eight underprovided school-canteen food items (e.g., dairy, fruits, nuts). Meanwhile, 9385 IOS dietary data entries were collected. We used Spearman coefficients and linear regression models to estimate the associations among the different dietary intake assessment methods. Individual- and group-level agreement was assessed using the Wilcoxon signed-rank test, cross-classification, and Bland‒Altman analysis. Results: IOS mean daily energy, protein, fat, and carbohydrate intake estimations were significantly lower (-15-20%) than those of the 7DFD. The correlation coefficients varied from 0.52 (for added sugar) to 0.88 (for soybeans and nuts), with fruits (0.37) and dairy products (0.29) showing weaker correlations. Sixty-two (milk and dairy products) to 97% (soybeans and nuts) of participants were classified into the same or adjacent dietary intake distribution quartile using both methods. The energy and macronutrient intake differences between the IOS + SFFQ and 7DFD groups decreased substantially. The separate fruit intake measurements from each assessment method did not significantly differ from each other (p > 0.05). IOS and IOS + SFFQ regression models generally yielded higher R2 values for males than for females. Conclusion: Despite estimation differences, the IOS can be reliable for medical student dietary habit assessment. The SFFQ is useful for measuring consumption of foods that are typically unavailable in school cafeterias, improving the overall dietary evaluation accuracy. The IOS assessment was more accurate for males than for females. [ABSTRACT FROM AUTHOR]

Aim: Extending working life is considered as an important initiative to respond to the population aging and pension payment dilemma. This study aimed to investigate whether work after retirement is related to improved health‐related quality of life. Methods: We used two waves of data from the China Health and Retirement Longitudinal Study in 2011 and 2018. Work after retirement was ascertained based on self‐reported retirement and work status, and health‐related quality of life (HRQOL) was measured with the three‐level EuroQol five‐dimensions. The impact of work after retirement on HRQOL was analyzed using the propensity score matching with difference‐in‐difference approach. Results: A total of 1043 retirees were included. The results showed that work after retirement was associated with significant improvement in HRQOL among retirees (β = 0.072, P < 0.001). Heterogeneity analyses did not show specificity on sex (P for sex interaction >0.05), but older‐aged retirees seemed more sensitive to the benefits of work after retirement on HRQOL than their younger‐aged counterparts (≥65 years: β = 0.167, P < 0.001 vs <65 years: β = −0.047, P > 0.05; P for age interaction = 0.010). Conclusions: Work after retirement shows a positive impact on HRQOL among community‐dwelling adults in China. Policy‐makers should take the health of retirees into account when implementing policies related to delayed retirement, and reduce health inequity. Geriatr Gerontol Int 2024; 24: 722–729. [ABSTRACT FROM AUTHOR]

• The dietary intake of patients with type 2 diabetes mellitus (T2DM) is imbalanced. • The insufficient fruit intake was associated with a higher risk of T2DM. • Indicators of Dietary Balance Index-16 may predict the risk of T2DM. The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (OR Vegetable = 0.77, 95% CI = 0.60-0.97; OR Dairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (OR fruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (OR Q2 = 1.40, 95% CI = 1.03-1.90, P =.033; OR Q3 = 1.52, 95% CI = 1.11-2.08, P <.01) or DQD (OR Q2 = 1.45, 95% CI = 1.06-1.99, P =.021; OR Q3 = 1.64, 95% CI = 1.20-2.24, P <.01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese. Dietary quality was assessed by DBI-16, based on the Chinese Food Guide Pagoda and Chinese dietary guidelines. Individuals with higher DQD, especially higher LBS, are at an increased risk of developing diabetes. Among this, fruit, vegetables, and dairy significantly contribute to the overall dietary insufficiency associated with the risk of T2DM, especially insufficient fruit intake. Abbreviations: Chinese Diet Balance Index 2016, DBI-16; Diet Quality Distance, DQD; Low Bound Score, LBS. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: To analyze the mode of school physical activity, the relationship with obesity, and participation willingness and behavior in the relationship between modes of school physical activity and BMI in students with overweight or obesity. Design: Cross‐sectional study. Sample: Data from the 2014 Physical Fitness and Health Surveillance of Chinese School Students was used, wherein physical measurements and questionnaires of 3476 middle school students were collected. Measurements: Physical measurements and questionnaires were completed. Latent profile analysis and mediated effects analysis were conducted using Mplus 8.3 and IBM SPSS 26.0 for data description and statistical analysis. Result: After latent profile analysis divided into poor (9.35%), medium (65.16%), and good (25.49%) groups of school physical activity, among junior middle school students, medium (OR = 0.428, 95% CI = 0.259–0.707, p =.001) and good (OR = 0.448, 95% CI = 0.255–0.718, p =.002) groups were positive for controlling overweight. Among students with overweight or obesity, participation willingness mediated the relationship between the mode of school physical activity and BMI, with effect coefficients of −0.120 (95% CI = −0.264 to −0.016) and −0.240 (95% CI = −0.426 to −0.099). Conclusions: School physical activity modes have a positive effect only on preventing and controlling overweight in junior middle school students. For middle school students with obesity, weight‐specific measures should be considered for their prevention and control. [ABSTRACT FROM AUTHOR]

Parent-child separation due to internal migration is prevalent in China. However, few studies have focused on the associations between different characteristics of parent-child separation and children's involvement in bullying. We conducted a cross-sectional study among 2,355 fifth-to eighth-grade students in China, using self-reported questionnaires to investigate the associations between children's bullying involvement (i.e., bullies, victims, bully-victims) and different characteristics of parent-child separation resulting from parental migration. Bivariate and multivariate analyses were conducted to explore these associations. Among all respondents, 17.3% reported being victims of bullying, 3.8% reported being bullies, and 2.7% reported being bully-victims. Compared to children with no left-behind experiences, those with current left-behind experiences were more likely to be victims and bully-victims. Children left behind by parent(s) at the age of three years or younger were more likely to be victims (aOR = 1.66, 95% CI [1.22, 2.25], p =.001), bullies (aOR = 1.88, 95% CI [1.02, 3.52]), and bully-victims (aOR = 2.17, 95% CI [1.04, 4.71]). Children left behind for seven years or longer were more likely to be victims (aOR = 1.49, 95% CI [1.12, 2.00], p =.007), bullies (aOR = 2.03, 95% CI [1.15, 3.69]), and bully-victims (aOR = 2.13, 95% CI [1.06, 4.50]). The identified characteristics of parent-child separation associated with bullying involvement hold implications for parental decisions regarding internal migration, interventions, and policymaking for preventing bullying among left-behind children. [ABSTRACT FROM AUTHOR]

Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self‐determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother–infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self‐efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p < 0.001), 6 weeks post‐partum (MD: 5.06; 95% CI: 3.80 to 6.31; p < 0.001) and 3 months post‐partum (MD: 5.24; 95% CI: 4.12 to 6.35; p < 0.001). Similarly, the intervention group reported significantly higher connection and mother's self‐perception scores at discharge (MD: 4.31; 95% CI: 3.07 to 5.56; p < 0.001), 6 weeks post‐partum (MD: 4.69; 95% CI: 3.71 to 5.68; p < 0.001) and 3 months post‐partum (MD: 4.93; 95% CI: 4.14 to 5.72; p < 0.001), compared to the control group. In contrast, the pressure from significant others scores were higher in the control group relative to the intervention group at discharge (MD: −2.09; 95% CI: −2.88 to −1.31; p < 0.001), 6 weeks post‐partum (MD: −4.35; 95% CI: −5.20 to −3.49; p < 0.001) and 3 months (MD: −4.89; 95% CI: −5.70 to −4.08; p < 0.001). Finally, the intervention group also reported higher Instrumental Needs scores at all three time points: at discharge (MD: 1.96; 95% CI: 1.35 to 2.58; p < 0.001), 6 weeks post‐partum (MD: 3.58; 95% CI: 3.05 to 4.11; p < 0.001) and 3 months post‐partum (MD: 1.18; 95% CI: 0.68 to 1.69; p < 0.001). BSE scores were significantly higher in the intervention group compared to the control group at discharge (MD: 14.29; 95% CI: 10.38 to 18.21; p < 0.001), 6 weeks post‐partum (MD: 14.04; 95% CI: 11.05 to 17.02; p < 0.001) and 3 months post‐partum (MD: 6.80; 95% CI: 4.66 to 8.94; p < 0.001). The rates of exclusive breastfeeding were higher in the intervention group than in the control group at each stage of the intervention (p < 0.01). At 6 weeks post‐partum, the intervention group's infants showed slower weight (t = −0.90, p = 0.371) and length (t = −0.69, p = 0.495) growth compared to the control group, though not significantly. By 3 months post‐partum, there was a significant difference in both weight (t = −3.46, p = 0.001) and length (t = −2.95, p = 0.004) between the groups. The findings in this study suggest that the RBF intervention programme based on SDT may be effective in improving mothers' motivation to breastfeed, building breastfeeding self‐confidence and increasing the rate of exclusive breastfeeding. The effects of the intervention on infant physical development will need to be verified with longer follow‐up in future research. Key messages: This study validated the application of responsive breastfeeding (RBF) intervention during the exclusive breastfeeding phase of Chinese infants.The RBF intervention may help to increase mothers' level of autonomous motivation for breastfeeding, enhance breastfeeding self‐efficacy and increase exclusive breastfeedingrates. The intervention had no significant effect on the weight and length of 6 week old infants but significantly impacted 3monthold infants, with slower growth observed in the intervention group compared to the control group.Future intervention programmes shouldinclude extended follow‐up periods to investigate the long‐term effects of RBF on infant growth and development. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate challenges in speech-in-noise (SiN) processing faced by school-age children with autism spectrum conditions (ASCs) and their impact on listening effort. Method: Participants, including 23 Mandarin-speaking children with ASCs and 19 age-matched neurotypical (NT) peers, underwent sentence recognition tests in both quiet and noisy conditions, with a speech-shaped steady-state noise masker presented at 0-dB signal-to-noise ratio in the noisy condition. Recognition accuracy rates and task-evoked pupil responses were compared to assess behavioral performance and listening effort during auditory tasks. Results: No main effect of group was found on accuracy rates. Instead, significant effects emerged for autistic trait scores, listening conditions, and their interaction, indicating that higher trait scores were associated with poorer performance in noise. Pupillometric data revealed significantly larger and earlier peak dilations, along with more varied pupillary dynamics in the ASC group relative to the NT group, especially under noisy conditions. Importantly, the ASC group’s peak dilation in quiet mirrored that of the NT group in noise. However, the ASC group consistently exhibited reduced mean dilations than the NT group. Conclusions: Pupillary responses suggest a different resource allocation pattern in ASCs: An initial sharper and larger dilation may signal an intense, narrowed resource allocation, likely linked to heightened arousal, engagement, and cognitive load, whereas a subsequent faster tail-off may indicate a greater decrease in resource availability and engagement, or a quicker release of arousal and cognitive load. The presence of noise further accentuates this pattern. This highlights the unique SiN processing challenges children with ASCs may face, underscoring the importance of a nuanced, individual-centric approach for interventions and support. [ABSTRACT FROM AUTHOR]

Background and Objectives: Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system. Methods: A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction. Results: Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01). Conclusions: The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures. [ABSTRACT FROM AUTHOR]

Background: Postintensive care syndrome (PICS) has adverse multidimensional effects on nearly half of the patients discharged from ICU. Mental disorders such as anxiety, depression and post-traumatic stress disorder (PTSD) are the most common psychological problems for patients with PICS with harmful complications. However, developing prediction models for mental disorders in post-ICU patients is an understudied problem. Aims: To explore the risk factors of PICS mental disorders, establish the prediction model and verify its prediction efficiency. Study Design: In this cohort study, data were collected from 393 patients hospitalized in the ICU of a tertiary hospital from April to September 2022. Participants were randomly assigned to modelling and validation groups using a 7:3 ratio. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis was performed to select the predictors, multiple logistic regression analysis was used to establish the risk prediction model, and a dynamic nomogram was developed. The Hosmer-Lemeshow (HL) test was performed to determine the model's goodness of fit. The area under the receiver operating characteristic (ROC) curve was used to evaluate the model's prediction efficiency. Results: The risk factors of mental disorders were Sepsis-related organ failure assessment (SOFA) score, Charlson comorbidity index (CCI), delirium duration, ICU depression score and ICU sleep score. The HL test revealed that p = .249, the area under the ROC curve = 0.860, and the corresponding sensitivity and specificity were 84.8% and 71.0%, respectively. The area under the ROC curve of the verification group was 0.848. A mental disorders dynamic nomogram for post-ICU patients was developed based on the regression model. Conclusions: The prediction model provides a reference for clinically screening patients at high risk of developing post-ICU mental disorders, to enable the implementation of timely preventive management measures. Relevance to Clinical Practice: The dynamic nomogram can be used to systematically monitor various factors associated with mental disorders. Furthermore, nurses need to develop and apply accurate nursing interventions that consider all relevant variables. [ABSTRACT FROM AUTHOR]

Aim: To analyse the risk factors and incidence of falls in geriatric outpatients in a university hospital ward in Hangzhou, China. Methods: From May 2020 to August 2022, 1712 geriatric outpatients in a university hospital ward in Hangzhou, China, were screened using a socio‐demographic questionnaire (e.g. gender, age, living arrangement, etc.) and assessment scales. The correlation between each factor and falls was preliminarily analysed by chi‐squared tests. Finally, binary logistic regression analysis was conducted to further analyse the risk factors of falls. The STROBE checklist was used in reporting this study. Results: Of the 1712 geriatric outpatients recruited, 1626 participants (60–79 and ≥ 80 years old) with complete questionnaire and assessment data were included. The occurrence of falls for those in the 60–79 age group was 8.4%, and for those in the ≥80 age group it was 13.4%. Age (p =.007), use of a walking assistance device (p <.001), the Stay Independent Brochure Questionnaire (SIB) (OR = 7.751, 95% CI = 5.089–11.806, p <.001), living arrangement (p =.004), timed up and go test (TUGT) (p =.007) and three diseases or above (OR = 2.496, 95% CI = 1.358–11.4.586, p =.003) reached statistical significance. Conclusions: Older people have a high incidence of falls. In this study, age, disease history, SIB scores (≥4 points), living arrangement, TUGT and walking assistance device increased the probability of falls in older Chinese adults. Personalised interventions should be carried out according to the specific situation of older people to effectively reduce their incidence of falls and improve their quality of life. Relevance to Clinical Practice: The basic characteristics and fall risk factors of the older can help nurses identify fall risk, and early intervention by caregivers can reduce fall‐related injuries, which has practical significance for promoting healthy aging. Patient or Public Contribution: The subjects of this study were older patients ≥60 years old, and the demographic characteristics and fall‐related information of patients were obtained by questionnaire. The team worked closely with a team of experts in the field of health care. Some researchers collect data and rewrite them, while other researchers analyse the information and write a paper. All authors read and approved the final manuscript. [ABSTRACT FROM AUTHOR]

Background: Neonatal nurses should provide timely and high-quality palliative care whenever necessary. It's necessary to investigate the knowledge, attitude and behavior of palliative care among neonatal nurses, to provide references and evidences for clinical palliative care. Methods: Neonatal intensive care unit (NICU) nurses in a tertiary hospital of China were selected from December 1 to 16, 2022. The palliative care knowledge, attitude and behavior questionnaire was used to evaluate the current situation of palliative nursing knowledge, attitude and behavior of NICU nurses. Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors. Results: 122 nurses were finally included. The average score of knowledge in neonatal nurses was 7.68 ± 2.93, the average score of attitude was 26.24 ± 7.11, the score of behavior was 40.55 ± 8.98, the average total score was 74.03 ± 10.17. Spearman correlation indicated that score of knowledge, attitude and behavior of palliative care in neonatal nurses were correlated with the age(r = 0.541), year of work experience(r = 0.622) and professional ranks and titles(r = 0.576) (all P < 0.05). Age (OR = 1.515, 95%CI: 1.204 ~ 1.796), year of work experience (OR = 2.488, 95%CI: 2.003 ~ 2.865) and professional ranks and titles (OR = 2.801, 95%CI: 2.434 ~ 3.155) were the influencing factors of score of knowledge, attitude and behavior of palliative care (all P < 0.05). Public contribution: NICU nurses have a positive attitude towards palliative care, but the practical behavior of palliative care is less and lack of relevant knowledge. Targeted training should be carried out combined with the current situation of knowledge, attitude and practice of NICU nurses to improve the palliative care ability and quality of NICU nurses. [ABSTRACT FROM AUTHOR]

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

Background: The lack of professional identity can impede the transition from nursing students to qualified nurses and exacerbate the shortage of health care professionals. Personality is important to resilience-building and professional identity development in nursing students. However, the associations among personality, resilience, and professional identity are less explored. The study aims to identify latent subtypes of personality, to evaluate the mediating role of resilience between personality and professional identity in nursing students, and to provide practical guidance for educators' subsequent interventions with nursing students' professional identity. Methods: 1397 nursing students were recruited from Be Resilient to Nursing Career (BRNC) between October 2020 and April 2022 by cluster sampling from 4 universities in China. NEO Five-Factor Inventory, 10-item Connor-Davidson Resilience Scale, and Professional Identity Questionnaire for Undergraduate Students were administered. Analyses of latent profiles and mediations were performed. Results: Three latent personality types were identified: Over-sensitivity (35.4%), Ordinary (53.8%), and Flexibility (10.8%). Nursing role model was found to be a significant indicator of personality (Ordinary as ref, Over-sensitivity: OR = 0.73, 95% CI: 0.57–0.93, P = 0.010; Flexibility: OR = 1.85, 95% CI: 1.29–2.65, P = 0.001). The association between personality portraits and professional identity were significantly mediated by resilience (P < 0.05). Conclusions: There exists heterogeneity in nursing students' personality. Resilience plays a significant role in mediating the relationship between personality and professional identity. [ABSTRACT FROM AUTHOR]

Background: Hearing loss and tinnitus have been linked to mild cognitive impairment (MCI); however, the evidence is constrained by ethical and temporal constraints, and few prospective studies have definitively established causation. This study aims to utilize Mendelian randomization (MR) and cross-sectional studies to validate and analyze this association. Methods: This study employs a two-step approach. Initially, the genetic data of the European population from the Genome-wide association studies (GWAS) database is utilized to establish the causal relationship between hearing loss and cognitive impairment through Mendelian randomization using the inverse variance weighted (IVW) method. This is achieved by identifying strongly correlated single nucleotide polymorphisms (SNPs), eliminating linkage disequilibrium, and excluding weak instrumental variables. In the second step, 363 elderly individuals from 10 communities in Qingdao, China are assessed and examined using methods questionnaire survey and pure tone audiology (PTA). Logistic regression and multiple linear regression were used to analyze the risk factors of MCI in the elderly and to calculate the cutoff values. Results: Mendelian randomization studies have shown that hearing loss is a risk factor for MCI in European populations, with a risk ratio of hearing loss to MCI loss of 1. 23. The findings of this cross-sectional study indicate that age, tinnitus, and hearing loss emerged as significant risk factors for MCI in univariate logistic regression analysis. Furthermore, multivariate logistic regression analysis identified hearing loss and tinnitus as potential risk factors for MCI. Consistent results were observed in multiple linear regression analysis, revealing that hearing loss and age significantly influenced the development of MCI. Additionally, a notable finding was that the likelihood of MCI occurrence increased by 9% when the hearing threshold exceeded 20 decibels. Conclusion: This study provides evidence from genomic and epidemiological investigations indicating that hearing loss may serve as a risk factor for cognitive impairment. While our epidemiological study has found both hearing loss and tinnitus as potential risk factors for cognitive decline, additional research is required to establish a causal relationship, particularly given that tinnitus can manifest as a symptom of various underlying medical conditions. [ABSTRACT FROM AUTHOR]