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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]

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care. [ABSTRACT FROM AUTHOR]

Care-giving to older adults with disabilities could lead to relatively high levels of care-giving burden and low levels of life satisfaction among their family care-givers. However, there is a lack of research examining the role of care-giver wisdom in the above stress process model. This study examined the moderator role of wisdom in the relationship between care-giver burden and life satisfaction among family care-givers of disabled older adults in urban China. A multi-stage quota sampling method was used to recruit 789 disabled older adult–family care-giver dyads in Shanghai in 2013. The average age of older adults and their family care-givers was 84 and 63 years old, respectively. Multiple-group path analysis was conducted to examine the proposed hypotheses. The results showed that care-giver wisdom played a moderator role in the association between care-giver burden and life satisfaction. Care-giver burden was found to only negatively affect life satisfaction among care-givers with relatively low wisdom levels. The findings highlight the influences of care-giver wisdom on the relationship between burden and life satisfaction in Chinese contexts. The concept of wisdom should be used in needs assessment among family care-givers of older adults with disabilities. Future social interventions should focus on promoting care-givers' capacities of reflective thinking, their understandings of reality and their feelings of compassion. [ABSTRACT FROM AUTHOR]

Background: The Yi people are a sociolinguistic group living in Mile City, which is their typical settlement in southeastern Yunnan, China. Over the long history of using medicinal plants, the Yi people have accumulated and developed a wealth of traditional medicinal knowledge, which has played a vital role in their health care. However, only a few studies have been performed to systematically document the medicinal plants commonly used by the Yi people. This study provides fundamental data for the development and application of ethnomedicine as well as supports the conservation of the traditional medical knowledge of the Yi people. Methods: This study was conducted from May 2020 to August 2022 and involved five townships in Mile. Information regarding medicinal plants was obtained through semistructured interviews, key informant interviews, and participatory observation. The collected voucher specimens were identified using the botanical taxonomy method and deposited in the herbarium. Ethnobotanical data were analyzed using informant consensus factor, relative frequency of citation, and fidelity level. Results: In total, 114 informants distributed in five townships of Mile were interviewed. The Yi people used 267 medicinal plant species belonging to 232 genera and 104 families to treat various diseases. Asteraceae, Lamiaceae, and Fabaceae were the most commonly used plant families by the Yi people. In addition, herbs were most commonly used by the Yi people. Whole plants and roots were the preferred medicinal parts. Decoctions were the most common method of herbal medicine preparation. There are 49 different recorded diseases treated by Yi medicinal plants, and among them, respiratory diseases, rheumatism, traumatic injury, fractures, and digestive system diseases have the largest number of species used. A quantitative analysis demonstrated that plants such as Zingiber officinale, Lycopodium japonicum, Aconitum carmichaelii, Panax notoginseng, Cyathula officinalis, and Leonurus japonicus played crucial roles in disease prevention and treatment. Conclusion: Traditional knowledge of medicinal plants is closely associated with the social culture of the local Yi people. The medicinal plants used for health care in the study area were diverse. Local healers were skilled at using medicinal plants to treat various diseases. Their treatment methods were convenient and unique, exhibiting distinctive regional characteristics. However, the inheritance of their traditional medicinal knowledge and protection of wild medicinal plant resources are facing serious challenges, including the decreasing number of local healers, aging of healers, lack of successors, and excessive harvesting of medicinal plant resources. This ethnobotanical survey provides a useful reference for the sustainable utilization and protection of medicinal plant resources in Mile and the inheritance of traditional medicinal knowledge of the Yi people. [ABSTRACT FROM AUTHOR]

Aims. To measure nursing clinical teachers' knowledge, attitudes, and practices about nursing students (NSs) suffering from workplace violence (WPV) in China. Background. The nursing clinical teacher is the most important person for NS during the clinical rotation. In contrast, there is a lack of investigation into the ability of nursing clinical teachers to manage NSs suffering from WPV. Method. A cross-sectional survey was conducted in Hubei province, China, between June and July 2022. Convenience sampling was employed to recruit clinical teachers in 9 tertiary hospitals who met the inclusion criteria. The survey was conducted using a self-designed questionnaire which has good reliability and validity. Questionnaires were collected through a web-based platform called Questionnaire Star in China. In July 2022, a total of 900 questionnaires were eventually distributed, and 869 valid questionnaires were returned. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses. Result. The mean ± SD knowledge, attitudes, and practices scores of the nursing clinical teachers were 69.51 ± 12.78, 29.11 ± 4.38, and 82.84 ± 13.60, respectively. Also, the average score rate was 77.24%, 83.17%, and 87.20%, respectively. There are still deficiencies in the knowledge, attitudes, and practices index, such as knowledge about the sources of violence, perceptions about influencing factors, and behavioural practices for prevention. Factors affecting the knowledge index scores included teachers' age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, whether they had experienced WPV, whether they had witnessed NSs suffering from WPV, and whether their NSs had suffered from WPV. Factors affecting scores on the attitude index included the age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Factors influencing the score for the practice index included the working department, highest academic degree obtained, professional title, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Conclusion. Nursing clinical teachers showed moderate levels of knowledge, attitudes, and practices about NSs suffering from WPV. The deficiencies mainly focused on the sources, manifestations, influencing factors, and preventive strategies of it. Also, nursing clinical teachers should be trained to better prevent and cope with WPV suffered by NSs. At the same time, in order to better protect and teach NSs, the selection criteria for nursing clinical teachers should be stricter, with requirements on age, education, years of working experience, and titles. Implications for Nursing Management. With nursing clinical teachers as the training target, health organizations and institutions should actively develop training related to preventing and coping with NSs suffering from WPV. Also, it should be incorporated into the preservice training system for nursing clinical teachers. The content of training could focus on the sources, manifestations, influencing factors, and prevention strategies of NSs suffering from WPV. The method could be online theoretical teaching combined with offline scenario simulation exercises. At the same time, strict admission criteria for nursing clinical teachers can be helpful in protecting the safety of NSs during the clinical rotation phase. For nursing managers, they should be kept abreast of organisational policies and adopt a zero-tolerance policy towards violence. It also can be recommended that nursing clinical teachers should be proactively involved in training to improve their own ability to protect NSs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [ABSTRACT FROM AUTHOR]

Background: Considerable evidence suggests that students' achievement emotions are important contributors to their learning and success online. It is, therefore, essential to understand and support students' emotional experiences to enhance online education, especially under the COVID‐19 context. However, to date, very few studies have investigated how students' achievement emotions might be affected by teaching and learning factors in online learning environments. Objectives: Based on Pekrun's (2006) control‐value theory of achievement emotions, this study examined the influence of students' perceived online teaching quality and appraisals of control and value on their achievement emotions in an online second language (L2) learning context instigated by the COVID‐19. Methods: Data were collected using an online survey of 1503 undergraduates from ten universities across different regions of China. Confirmatory factor analyses (CFA) were performed to test the validity of the instruments and structural equation modelling were conducted to examine the relations between L2 teaching and learning variables. Results and Conclusions: Results revealed that perceived teacher internet and communication technology competence had positive effects on enjoyment, but negative effects on anxiety and boredom, and these effects were fully mediated by perceived control and/or value. Perceived chaotic teaching structure (CTS) had reverse effects for the three emotions. Perceived CTS effects on enjoyment and anxiety were fully and partially mediated by perceived control, respectively. Takeaways: Online teaching quality is critical for students' appraisals and emotions towards L2 learning. Teachers should strive to improve online teaching quality and design interventions targeting students' perceived control and value to temper their affective experiences associated with the crisis‐prompted online teaching practices. Lay Description: What is already known about this topic: Teachers' internet and communication technology (ICT) competence and pedagogical design can enhance students' e‐learning efficacy, motivation and interests.Students' perceived control and value can influence their achievement emotions in online learning.Teacher's ICT competence and pedagogical design can impact students' emotions in online learning. What this paper adds: Perceived teacher ICT competence and chaotic teaching structures can have differential impact on students' perceived control and value for e‐learning.Perceived control and intrinsic value differently mediated the effects of the two teaching factors on students' emotions for e‐learning.Perceived teacher ICT competence and chaotic teaching structures can have both direct and indirect effects on students' e‐learning emotions via perceived control and value. Implications for practice and/or policy: Teacher training and development programs should prepare teachers for varying teaching formats including unplanned online teaching due to a forced switch to remote teaching.Teachers should acquaint themselves with using various online platforms and software to communicate the goals, expectations, structures and requirements of their language lessons to students' in a clear manner.Online language teaching interventions aiming to increase or decrease a specific emotion could directly target specific combinations of teaching characteristics and appraisals. [ABSTRACT FROM AUTHOR]

Background Studies: Captioning and repetition are widely used multimedia instructional devices for non‐native students. Generally, studies in this area have tended to focus on second language literacy skills rather than on learning new content knowledge. Additionally, posttests were administered immediately after the treatments, while the delayed influences of captioning and repetition have never been investigated. Objectives: This paper addressed these research gaps in two separate studies. More specifically, this study attempted to examine the influences of captioning and repetition on non‐native students' immediate and relayed retention. Methods: In Study One, three captioning conditions; word‐by‐word captions, closed captions, and no‐captions; were compared to examine their efficacies in immediate and delayed content knowledge retention on 82 Chinese university students. To address the limitations in Study One as the multimedia lesson was short and played only once, Study Two incorporated captioning and two repetition types in its design. One hundred and eleven Chinese university students watch a video lesson in one of four captioning and repetition conditions. Results: The statistical analyses of Study One indicated that there were no significant differences in both immediate and delayed retention test scores across the three captioning condition. Similarly, in Study Two, there were no significant differences in retention tests scores across the four captioning and repetition conditions. Findings: Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention, which lent support to existing studies. Based on the research results, the limitations and future study possibilities are discussed. Lay Description: What Is Already Known About This TopicEmpirical studies on captioning have focused on immediate learning right after the treatment, so have studies on repetition.Empirical studies on multimedia lessons for non‐native students have focused on English language learning. What This Paper AddsThree types of captioning were compared to examine their efficacies in both immediate and delayed content retention of Chinese students.Two types of repetition were compared to examine their efficacies in both immediate and delayed content retention of Chinese students. Implications for Practice and/or Policy:Neither the availability of captions nor the repetition types had any impact on the Chinese students' immediate or delayed content knowledge retention.The availability of textual keywords adjacent to their corresponding graphics might have compromised the efficacy of captioning. [ABSTRACT FROM AUTHOR]

Backgrounds: Guangxi Fangcheng Golden Camellias national nature reserve, situated in Fangcheng City, Guangxi Province, China, is a coastal region renowned for its exceptional natural environment. Over time, the residents of this area have acquired extensive knowledge regarding medicinal plants, owing to their close association with the abundant flora. Our study aims to document the medicinal plants used by the local community near the Guangxi Fangcheng Golden Camellias national nature reserve. We seek to investigate the unique regional properties, cultural significance, and potential connections between medicinal plants used in surrounding villages and those sold in markets. Methods: During 2019–2021, 96 informants, including 36 key informants, were interviewed in the study area. The snowball sampling method was used to select respondents from medicinal markets and villages. Local therapists were defaulted as key informants. A panel discussion was held on the protection and threat of medicinal plants and traditional knowledge. In this study, two quantitative indicators, relative frequency citation (RFC) and informant consensus factor (ICF), were used to analyze the traditional medicinal plants in the study area. Results: According to the investigation, a total of 396 species of medicinal plants belonging to 295 genera and 116 families were recorded. From the perspective of Lifeform, herbs accounted for 38.9%, followed by shrubs. Most of the medicinal parts are whole plant (120 species, 25.59%), branches and leaves (116 species, 24.73%), and roots (101 species, 21.54%). Medicinal bath is the most commonly used therapeutic method. Among the 13 therapeutic targets recorded, rheumatic drugs accounted for the highest proportion, followed by muscular system diseases and skin-related diseases, which are closely related to local climate and livelihood. ICF shows that the use of local medicinal plants and related knowledge is very diverse, so local people have more options for treating diseases. Melicope pteleifolia, Clerodendrum cyrtophyllum, Lygodium flexuosum, Elephantopus scaber, Artemisia argyi, Plantago asiatica, Centella asiatica, Grangea maderaspatana, and Liquidambar formosana have high RFC, which are closely connected to local people's daily lives and are potentially vital to them. The wild vegetation, mostly around the nature reserve, is the primary source of medicinal materials sold in the urban medicinal market. Urban areas have fewer varieties of medicinal plants compared to villages near protected areas. However, there is consistency in their usage and application. Conclusion: The medicinal plants used in the villages near the Golden Camellia Nature Reserve are diverse, and the relevant traditional knowledge is relatively well preserved. The collection of medicinal materials by local people is sustainable. This study suggests that the local government should also protect relevant traditional knowledge in the decision-making process. [ABSTRACT FROM AUTHOR]

Background: Herbal tea drinks, different from classical Camellia beverages, are a wide variety of herbal drinks consumed for therapeutic purposes or health promotion. Herbal tea is widely consumed in Guangxi. However, the documentation on the plants for herbal tea and their related health benefits is still limited. Methods: An ethnobotanical survey was conducted in 52 villages and 21 traditional markets in Guangxi from 2016 to 2021. Semi-structured interviews, key informant interviews, and structured questionnaires were applied to obtain ethnobotanical information of herbal tea, in which 463 informants had participated. Relative frequency of citation (RFC) and cultural food significance index (CFSI) were used to evaluate the most culturally significant herbal tea plants, and informant consensus factor (ICF) was applied to assess the agreement among informants. Results: This study recorded 155 herbal tea species belonging to 49 families. The most commonly used parts included leaf (27.61%), whole plant (22.09%), branch and leaf (19.02%), and flower (13.50%). The most frequent preparation method of herbal tea was decoction. Herbal tea was very popular in Guangxi, attributing to its therapeutic value, special odor, and good taste. There are 41 health benefits classified into eight categories. Among them, clearing heat was the most medicinal effects. Local people had high consistency in tonic, removing cold and cough, improving blood circulation, and clearing heat away. Based on CFSI values of each species, the most culturally significant herbal tea species were Siraitia grosvenorii (Swingle) C. Jeffrey ex A. M. Lu & Zhi Y. Zhang, Plantago asiatica L., Gynostemma pentaphyllum (Thunb.) Makino, Zingiber officinale Roscoe, Pholidota chinensis Lindl., and Morus alba L. Conclusion: Herbal tea is a valuable heritage that carries the local people's traditional knowledge, like health care and religious belief. The recorded herbal tea species in this study possess tremendous potential for local economic development in the future. Further research on efficacy evaluation and product development of herbal tea species is necessary. [ABSTRACT FROM AUTHOR]

Purpose: Previous research has indicated the beneficial effects of musical training on speech perception in children. However, little has been known about whether musical training exerts transfer effects on fine-grained perception of linguistic pitch and time information. This study aimed to investigate the effects of different musical training programs and training duration on preschoolers’ categorical perception (CP) of lexical tones and voice onset time (VOT) in Mandarin Chinese, which utilize pitch and time changes, respectively, to convey phonemic contrasts. Method: Sixty-one Mandarin-speaking children aged 4 years were randomly assigned to pitch-based musical training (carillon group), rhythm-based musical training (drum group), or handcraft learning (control group). Children completed the tests designed to assess their musical abilities, CP of lexical tones and VOT, IQ, and working memory at three time-points. Repeated-measures analyses of variance were conducted to evaluate the training-related effects in various tasks. Correlation analyses were used to infer the relationships between musical abilities and CP performance of speech. Results: The carillon group demonstrated advantages over the drum and control groups in music pitch processing and CP of lexical tones; besides, the drum group performed better in the music time processing and CP of VOT than the control group. Moreover, positive correlations were found between musical gains and improvements on CP of speech. Conclusions: These results provide evidence that transfer effects occur in CP of lexical tones and VOT in preschoolers. Our findings highlight the selectivity of musical advantages driven by different components of training programs and suggest that long-term musical training could be a means of early speech rehabilitation in children with communication disorders. [ABSTRACT FROM AUTHOR]

Background: Shexian Dryland Stone Terraced System (SDSTS) in the Taihang Mountains was formally recognized as Globally Important Agricultural Heritage Systems (GIAHS) by Food and Agriculture Organization on May 20, 2022. People there have been relying on the terraced fields for centuries, using various plants, including medicinal plants. However, little information was reported about the flora in SDSTS, nor medicinal plants. Thus, the present study aims to identify and document medicinal plants traditionally used by the local people living around the SDSTS and associated ethnobotanical knowledge. Methods: We conducted investigations in Shexian County, Hebei Province, North China, where SDSTS is distributed. Then, Wangjinzhuang, a community located in the core zone of SDSTS, was chosen as the case site. We selected the informants through purposive and snowball sampling. The data were collected through semi-structured interviews, participant observation, and key informant interviews. The medicinal plants traditionally used by the local people were documented and analyzed. We examined and confirmed the botanical identification based on voucher specimens and by cross-checking the descriptions with the series of books, scientific papers on medicinal plants, and the plant databases. Results: The local people have rich traditional knowledge to collect and use medicinal plants in SDSTS. Records of 123 medicinal plant species belonging to 51 families were obtained from SDSTS. Asteraceae was represented by 16 species, followed by Fabaceae, Lamiaceae and Ranunculaceae. (They all have 8 species.) The majority of the reported plant species were commonly processed into decoctions. And 180 diseases affecting humans were reported to be treated with traditional medicinal plants from SDSTS. Conclusion: It is the first ethnobotanical study on medicinal plants in China-Nationally Important Agricultural Heritage Systems, and in globally important agricultural heritage systems as well. Medicinal plants are crucial for people living in Shexian County. It is necessary to recognize and respect traditional knowledge peculiar to the mountainous region of northern China, especially for those involved in the human–nature interaction and the role of knowledge in agrobiodiversity conservation and rural development that local residents have persisted for centuries. [ABSTRACT FROM AUTHOR]

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In public health research, the health issues of irregular and vulnerable migrant populations remain under-explored. In particular, while mainland China has become a new and popular job-seeking destination for Filipino domestic workers (FDWs), the health status of FDWs and their access to healthcare have been invisible to public and academic concerns. This paper fills this lacuna by conducting a qualitative study that investigates FDWs' self-reported health status and their healthcare-seeking behaviors. The results show that: (1) respondents do not report significant abusive and exploitative experience because the scarcity of FDWs in China in relation to the high demand enables them a certain degree of agency in labour market; (2) while FDWs do report some health problems, they tend to resort to self-medication and food-healing; (3) the main factors influencing health-seeking behavior include the fear of deportation, language gaps, the lack of knowledge of the local healthcare system and dependence on co-ethnic networks which serves as a double-edged sword; (4) these factors also lead to hesitation in health-seeking choice between public and private hospitals, which sometimes result in delayed treatment. This paper contributes to revealing the health conditions of FDWs in mainland China and calls for more inclusive health policy to enroll foreign domestic workers into the local health system in China. [ABSTRACT FROM AUTHOR]

Background: Gongcheng Yao Autonomous County (Gongcheng) is typical for the Yao people in northeastern Guangxi, southern China. The Yao people have a long history of using medicinal plants. In this study, we used ethnobotanical methods to collect traditional knowledge regarding herbal medicines in Gongcheng. Our study provides fundamental data for developing and applying local ethnic medicines and their protection. Methods: Ethnobotanical data were collected from 103 villages in nine townships from 2014 to 2018 in Gongcheng. A total of 352 informants (279 male and 73 female) were interviewed through semi-structured interviews, key informant interviews, and guided field walks. All the informants were local inhabitants aged between 28 and 101 years of age, of which 40 key informants were selected based on the recommendations of knowledgeable elders and local medical institutions. The informant consensus factor (ICF) was used to evaluate the degree and importance of differences in medicinal plant species and calculated the relative frequencies of citation (RFC) for the recorded medicinal plants. Results: Data from 352 local healers were collected for the study. The Guanyin and Sanjiang townships had the highest distribution of per capita healers (Pch), while the Gongcheng, Lianhua, and Ping'an townships were relatively lower. Of the 352 local healers, more than half were older than 60 years of age and therefore faced the problem of suitable successors and potential loss of traditional medicinal knowledge. There are 12 types of diseases treated by local healers in the study area, and most of the types had a high ICF value. The highest ICF (0.80) was reported for digestive system disease, followed by urinary system disease (0.78) and nervous system disease (0.77). Traumatic injury and orthopedics, digestive system, and rheumatic disease are the most common ailments. The RFC value calculated in 33 medicinal plant species (with an FC of more than 5) ranged from 0.024 to 0.056. The higher RFC values included Kadsura longipedunculata, Schefflera heptaphylla, Plantago asiatica, etc. The most commonly used medicinal method was decoction; plasters, creams, and some form of moxibustion and cupping skills were locally practiced, but only rarely. The local healers used 306 medicinal plant species (116 families and 255 genera). Herbal plants were most commonly used among these, with whole plants and roots being favored. Conclusion: The Yao people are highly skilled at using medicinal plants to treat various diseases in Gongcheng. Their treatment methods are varied, convenient, and efficient. Due to the impact of urbanization and economic development, knowledge of traditional medicine is under threat, with declining numbers of local healers and a lack of suitable successors. In order to protect and inherit Yao's traditional medicinal knowledge, it is necessary to educate young healers and to protect biodiversity. [ABSTRACT FROM AUTHOR]

Background: Black-boned sheep is a precious genetic resource with black quality traits cultivated by the Pumi people in Tongdian Town, Lanping County, Nujiang Lisu Autonomous Prefecture, Northwest Yunnan, China. It has been included in the "National Breed List of Livestock and Poultry Genetic Resources." The local communities have a deep understanding of black-boned sheep. The traditional knowledge of black-boned sheep is essential to their conservation and sustainable development. In spite of this, there was no information on traditional knowledge associated with black-boned sheep so far. The aim of this study wasaimed to document traditional knowledge and culture, to elucidate information about forage plants, and to investigate the conservation strategy of black-boned sheep. Method: Four field surveys were conducted from July 2019 to May 2021. A total of seven villages and the Pumi Culture Museum in Lanping County are being investigated. A semi-structured interview method was used to interview 67 key informants. During the investigation, we also participated in the grazing activities of black-boned sheep, observed the appearance characteristics and the herd structure of the black-boned sheep, and demonstrated traditional knowledge regarding black-boned sheep, including grazing methods, forage plants, and related customs and habits. Results: We assumed that a majority of people in the current study sites were able to could distinguish black-boned sheep from their relatives by their black bones, blue-green gums, and blue-purple anus. The local people manage their black-boned sheep based on the number of sheep by sex, age, and role in a flock in the different breeding environments. Different grazing strategies have been adopted in different seasons. Through ethnobotanical investigations, 91 species of forage plants in 30 families were identified, including herbaceous, shrubs, lianas, and trees. Among all the plant species consumed by the black-boned sheep, Rosaceae species make up the greatest number, with 16, followed by Asteraceae, with 9, and 8 species of Fabaceae and Poaceae. Considering the abundance of forage plants and the preference for black-boned sheep, Prinsepia utilis and the plants of Rubus, Berberis, and Yushania occupy dominant positions. Plants used for foraging are divided into two categories: wild and cultivated. Due to the lack of forage plants in fall and winter, the local people mainly cultivate crops to feed their black-boned sheep. In addition, the black-boned sheep is an influential cultural species in the local community and plays a prominent role in the cultural identity of the Pumi people. Conclusion: Sheep play an essential role in the inheritance of the spiritual culture and material culture of the Pumi ethnic group. The formation of the black-boned sheep is inseparable from the worship of sheep by the Pumi people. With a long-term grazing process, the locals have developed a variety of traditional knowledge related to black-boned sheep. This is the experience that locals have accumulated when managing forests and grasslands. Therefore, both the government and individuals should learn from the local people when it comes to protecting black-boned sheep. No one knows black-boned sheep better than them. The foremost evidence of this is the rich traditional knowledge of breeding black-boned sheep presented by key informants. [ABSTRACT FROM AUTHOR]

Background: Dulong (Drung people) are one of the ethnic minorities of China, consisting of a small population living in remote and mountainous regions with limited facilities. Over the years, the Dulong have maintained their livelihood by collecting wild medicinal and edible plants. Therefore, through their experience and understanding, they had accumulated sufficient traditional knowledge about local plant resources. Since ancient times, wild edible plants have been essential to the food security of the Dulong people. However, there is almost no comprehensive report available on WEPs consumed by the Dulong people. The objectives of this study were to: (1) make a systematic study of WEPs used by Dulong people, (2) record traditional knowledge related to WEPs, (3) analyze multiple uses of WEPs, and (4) evaluate species with significant cultural significance to Dulong people. Methods: Ethnobotanical survey including free listing, semi-structured interviews, key informant interviews and participatory observations was conducted in Dulongjiang Township, Gongshan County, Yunnan Province, Southwest China. A total of 127 informants were selected using the snowball method and information about WEPs, including vernacular name, food categories, parts used, mode of consumption, collection season, and other local uses were collected. The RFC and CFSI were calculated to identify the most culturally significant WEPs. One-way analysis of variance was performed to evaluate whether the four reference variables (gender, age, occupation, and education) significantly influenced the number of plant species mentioned by the respondents. Results and discussion: A total of 148 species of WEPs consumed by the Dulong people belonging to 58 families were collected, including wild vegetables (71), wild fruits (52), staple food substitutes (15), spices (7), nuts (4), tea substitute (2), liquor making materials (3) oils and fats (3), and culinary coagulants (1). WEPs are used in a number of different ways, including as fuelwood, feed, and medicine. Food substitute plants accounted for the majority of the top 27 wild food plants identified by RFC and CFSI. It was observed that farmers have more knowledge of WEPs, and moderate education level informants reported less WEPs used. Conclusion: The WEPs used by the Dulong people are diverse and abundant in the Dulongjiang region. In the future, WEPs such as Maianthemum atropurpureum, Caryota obtusa, Cardiocrinum giganteum, and Angiopteris esculenta with economic potential can be developed to provide a source of income for the residents. More studies of the nutritional value, chemical composition, and biological activities of WEPs are needed. The demands and development of local communities can be realized under the premise of protecting WEPs and the associated traditional knowledge. More attention should be paid to the value of WEP and underutilized plants during future rural development. [ABSTRACT FROM AUTHOR]

General cognitive and specific numerical abilities that underlay mathematical performance have been heavily investigated among hearing students; however, the inquiry has rarely been applied to students who are deaf or hard-of-hearing (d/Dhh). We examined whether general cognitive abilities (i.e. nonverbal IQ, processing speed, and spatial ability) and specific numerical abilities (i.e. symbolic and non-symbolic numerical magnitude processing) are related to mathematics achievement in 198 d/Dhh students in Grades 3 to 9. The results of our regression models indicated that, the three general cognitive abilities independently explained the variance in mathematics achievement when entered in one step; and spatial ability and processing speed had an independent contribution to mathematics achievement in the presence of the specific numerical abilities. The specific numerical abilities independently explained the variance in mathematics achievement when entered in one step; however, none of them had an independent contribution to mathematics achievement in the presence of the general cognitive abilities. These findings suggested that mathematics achievement in d/Dhh students depended more on general cognitive abilities, such as spatial ability and processing speed, than on specific numerical abilities. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess the effects of folic acid (FA) combined with a docosahexaenoic acid (DHA) intervention on the cognitive function and inflammatory cytokines in elderly subjects with mild cognitive impairment (MCI). Methods: This randomized, double-blind, placebo-controlled trial recruited 240 individuals with MCI in Tianjin, China, and randomly allocated into 4 groups: FA + DHA (FA 800 μg/d + DHA 800 mg/d), FA (FA 800 μg/d), DHA (DHA 800 mg/d), and placebo. Cognitive function, serum folate and homocysteine (Hcy), plasma DHA and inflammatory cytokines levels were measured at baseline and 6 months. Results: Daily oral FA, DHA and their combined use for 6 months significantly improved the full-scale intelligence quotient (FSIQ) and some subtests of Wechsler Adult Intelligence Scale compared to the placebo. The increases of FSIQ, arithmetic, picture completion scores in the FA group and picture completion, block design scores in the DHA group were significantly less than that in the FA combined DHA group (P < 0.05). Meanwhile, daily oral FA, DHA and their combined use for 6 months significantly decreased plasma inflammatory cytokines compared to the placebo. The changes of interleukin-1β levels in the FA group and interleukin-6 levels in the DHA group were significantly less than that in the FA + DHA group (P < 0.05). Conclusions: Daily oral FA, DHA and their combined use for 6 months can significantly improve cognitive function and decrease plasma inflammatory cytokines in MCI individuals. The combination of FA and DHA was more beneficial than each individual nutrient on their own. [ABSTRACT FROM AUTHOR]

The writing of Chinese is non-alphabetic, but children in China learn Pinyin, a Romanised alphabetic system, to facilitate literacy development. This research investigates how Mandarin phonological awareness (PA) develops, and how it interacts with Pinyin in school-aged Mandarin-speaking children in China. In Beijing, 182 students in grades two through four (ages ranged between 91 and 135 months) were tested for PA (syllable manipulation and onset-rime oddity tasks) and Pinyin knowledge (Pinyin symbol naming and syllable reading tasks). ANOVAs were used to examine their developmental trajectories. Partial correlations and linear regressions were used to examine the relationships between PA and Pinyin knowledge. Syllable awareness has already reached the ceiling level by grade two, while onset-rime awareness is still developing across grades. The ability to name Pinyin symbols decreases over time, while the ability to read syllables written in Pinyin stays invariant across grades. PA and Pinyin knowledge are significantly correlated, and the results of linear regression indicated that the relationship between PA and Pinyin syllable reading is bi-directional. This study suggests that Mandarin PA development shows features characteristic of a non-alphabetic language with Pinyin knowledge playing a crucial role. Implications for theory and practice of Mandarin-speaking children's literacy development are discussed. [ABSTRACT FROM AUTHOR]

Background: Due to historical perceptions of Liangshan Yi Autonomous Prefecture (Sichuan Province, China) as being a violent place, and due to its rugged terrain, cultural differences, and relative inaccessibility, few researchers have conducted in-depth ethnobotanical investigations in Liangshan. But wild edible plants (WEPs) are widely consumed by the Yi people of Liangshan, and their associated ethnobotanical knowledge remains relatively unknown, especially outside of China. This study aimed to (1) investigate the WEPs used by the Liangshan Yi, (2) document the traditional knowledge held about these plants, (3) analyze their special preparation methods and consumption habits, and (4) identify species with important cultural significance to the Liangshan Yi. Methods: During 2016-2017, 396 Yi individuals were interviewed in 1 county-level city and 6 counties across Liangshan. Prior informed consent was obtained, and multiple ethnographic methods were utilized, including direct observation, semi-structured interviews, key informant interviews, informal discussions, and field visits. Market surveys were conducted in April, July, and August 2017 by interviewing 38 Yi merchants selling WEPs in 6 Liangshan traditional markets. We collected information about the parts consumed, preparation methods, consumption habits, growth pattern of species, collection months, market prices, and other uses of WEPs. Use values (UVs) were calculated to analyze the relative cultural importance of each WEP. Results: In total, 105 plant species belonging to 97 genera and 62 families were recorded. Rosaceae was the family with the largest number of species (14), and herbs (58 species) were the dominant growth form reported. Fruits (34 species), roots (21 species), and tender shoots (20 species) were the primary plant parts used for snacking and cooking. There were 6 main preparation and consumption methods of WEPs reported, ranging from primary food, famine food, snack, spice, culinary coagulant, and medicine, among a few other uses. The Liangshan Yi mainly collect WEPs from March to October, seldom collecting from November to February. There were 35 species of WEPs sold in the markets we visited in Liangshan. The price of medicinal plants was much higher than the price of food and fruits. In total, we documented 49 species of edible medicinal plants in Liangshan, accounting for 44.7% of all WEPs. They can be used for treating 27 medical conditions, including cough, diarrhea, injury, and headaches. The plants with the highest UVs were Berberis jamesiana (1.92), Pyracantha fortuneana (1.87), and Artemisia capillaris (1.44) indicating that these species are the most commonly used and important to the Liangshan Yi's traditional life and culture. Conclusions: The traditional knowledge of WEPs from the accumulated experience of the Yi people's long period residing in Liangshan reflects the cultural richness of the Yi and the plant diversity of the region. Future research on the nutrition, chemical composition, and bioactivity of the WEPs are needed. Some species with high medicinal value but with sharp wild population decline should be surveyed for resource assessment, conservation, and domestication potential. [ABSTRACT FROM AUTHOR]

Background: Ecological migration serves as an important measure for poverty eradication as well as for the protection, inheritance, and utilization of traditional ecological knowledge. This study investigated and cataloged the traditional forage plant resources and recorded the associated traditional knowledge of immigrant villages in Hongsibu District of Ningxia, China. The diversity of traditional forage plant resources and the changes in associated traditional ecological knowledge were compared among ecological immigrant villages from different emigration areas, with a hope of providing a reference for forage development, the conservation of wild forage plant resources, and the development of regional animal husbandry. Methods: From March 2018 to May 2019, a field investigation was conducted in six villages in Ningxia. Through the snowball technique, a total of 315 immigrants were interviewed using various methods, including semistructured interviews and key person interviews, which included opportunities for free listing. The changes in the utilization of traditional forage plants were compared between the ecological migrants and the original inhabitants, and the causes underlying the changes were analyzed. In addition, the major forage plant species in the research area were investigated and evaluated. Results: (1) The six investigated villages reported 224 traditional forage plant species that belong to 42 families and 150 genera. Compared with their original living areas, the number of traditional forage plant species used in the immigrant villages decreased with the increase in the relocation distance. (2) The utilization of traditional forage plants varied among the immigrants who moved to Hongsibu District from forest areas, loess hilly areas, and semiarid desertified areas. The smaller the difference was in ecological environment between the immigration and emigration areas, the more the traditional forage plant knowledge had been retained. (3) The diversity and associated knowledge of traditional forage plants retained by ecological migrants are closely correlated to gender, age, education level, and occupation. Conclusion: This study revealed that the diversity of traditional forage plants and associated knowledge retained after migration vary among ecological immigrants from different areas; generally, the immigrants that relocated from a closer place retained more ecological knowledge. In the immigrant villages with significantly different natural resources and a long distance from the migrants' original locations, the diversity of traditional forage plants decreased, and the traditional knowledge about forage plants showed signs of being forgotten and abandoned by the younger generation. Therefore, measures are urgently needed to document and protect the forage plant resources and preserve the traditional knowledge of ecological immigrants. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the efficiency of a single-session character-strength-based cognitive intervention on enhancing freshmen's adaptability. Method: A randomized trial, pretest, posttest, follow-up intervention was employed using repeated-measures analyses to evaluate the effect. This 90-min intervention contained four activities with 52 undergraduate freshmen (age 17–20) randomly assigned to the intervention and control group, 38 of whom completed all the programs (19 of each group). Results: Compared with the control group, the intervention group showed a remarkable increase in well-being and a significant reduction in depression and anxiety at post and follow-up assessment. The stress level of the intervention group significantly decreased only at the follow-up test. Time effect and the interaction between time and group were significant in anxiety and stress. Conclusions: This intervention can quickly reduce negative affect and elevate well-being for freshmen. It expands the role of social worker in the prevention of mental illness among college population. [ABSTRACT FROM AUTHOR]

Background: Bai people in the Dali Prefecture of Northwest Yunnan, China, have a long history of using plant extracts to dye their traditional costumes and maintain this culture for posterity. However, the development of modern technology, while vastly improving the dyeing efficiency, is also replacing indigenous knowledge which threatens the indigenous practice, causing the latter disappearing gradually. This study sought to examine the indigenous knowledge of plants used for textile dyeing in Bai communities, so as to provide a foundation for their sustainable development. Methods: We conducted a semi-structured interview among 344 informants (above age 36) selected through a snowball sampling method. Free lists and participant observation were used as supplementary methods for the interviews. Three quantitative indicators (informant consensus factor [ICF], use frequency, and cultural importance index [CI]) were used to evaluate the indigenous knowledge of the dye-yielding plants. Results: Twenty-three species belonging to 19 plant taxonomic families were used for dye by Bai communities. We summarized them into four life forms, eight used parts, five colors, three processing methods, and four dyeing methods. Among them, Strobilanthes cusia (Nees) O. Kuntze was the most traditional dyeing plant and has an important cultural value. Location, age, and gender were found to have a significant effect on indigenous knowledge, and the dyeing knowledge was dynamic and influenced by social factors. Conclusions: Diverse plant resources and rich indigenous knowledge of textile dyeing persist at settlements of Bai communities in Dali Prefecture. However, high labor costs and thinning market of traditional products that use plant dye cause repulsion toward traditional practice. To that, a good income in other profession attracts indigenous people to shift from their tradition of making plant-based dye and associated cultural systems at risk of extinction. More research for market development for products that use plant-based dye is necessary for the conservation of this valuable knowledge and biodiversity protection in Bai communities. [ABSTRACT FROM AUTHOR]

Objective: This study examined the effects of WeChat-assisted perioperative instructions for parents whose children were to undergo herniorrhaphy.Method: A randomized controlled trial was conducted in a day surgery center in China. Participants were randomly assigned to the intervention (WeChat) group (n = 209) and the control (Leaflet) group (n = 209). The primary outcomes of this study were parents' knowledge regarding hernia and rate of cancellation of children's surgery. The secondary outcomes were the rate of lost-to-follow-up and the rate of complications and adverse events during the seventh postoperative follow-up day.Results: There was a significant difference in the rate of cancelling the surgery and the mean knowledge score between the WeChat group and leaflet groups. The lost-to-follow-up rate was significantly lower in the WeChat group (0.54%) than in the leaflet group (3.66%). The incidence of postoperative complications were higher in the control group.Conclusions: WeChat-assisted perioperative care instructions enhanced parents' knowledge on perioperative instructions and promoted the preparation of their children for day surgery resulting in lower rate of cancelling the surgery.Practice Implications: WeChat has the ability to expand health services outside the hospital confines and could be used as an important low-cost health educational medium in China. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate community pharmacist's perception on the provision of over-thecounter (OTC) traditional Chinese medicine (TCM) pharmaceutical services; focusing on the areas of their attitude, general practice, perceived barriers and suggested improvements. Methods: Questionnaire survey targeting community pharmacists in Harbin of China was applied in this study. Questionnaires were distributed and collected at community pharmacies. Data was analyzed by combining descriptive analysis and Chi-test. Results: 280 valid questionnaires were collected, giving a response rate of 78%. Respondents generally showed positive attitude towards OTC TCM pharmaceutical services. However, they were uncertain about whether such pharmaceutical services should be considered as their primary responsibility. Respondents indicated that they acted proactively to find out all the medicines taken by their patients and to remind consumers of possible OTC TCM adverse reactions. However, they were less keen on recommending or re-directing consumers to suitable OTC TCM. The three main barriers hindering the provision of OTC TCM pharmaceutical service identified in this study were "insufficient professional knowledge" (54.6%), "ambiguity of the professional role of pharmacists" (54.6%) and "lack of scientific evidence of OTC TCM" (45.4%). The three main actions considered most relevant to improving pharmaceutical service of OTC TCM were "formulating or refining legislation to clarify the legal and professional role of pharmacists with respect to TCM" (60.7%), "strengthening training of pharmacists with respect to TCM" (57.9%), and "promoting public awareness of the pharmacist's role" (53.6%). According to the results of Chi-test, respondents' perceptions about the attitude, practice, perceived barriers, and improvement suggestions were significantly different depending on the education levels, certificate types and workloads of western medicine. Conclusions: The community pharmacists in Harbin, China were positive about the provision of OTC TCM pharmaceutical services. However, they were less certain about taking this duty as their primary responsibility. Insufficient knowledge and lack of role definition in the area of OTC TCM were found to be the major factors discouraging the provision of pharmaceutical service on OTC TCM by community pharmacists. [ABSTRACT FROM AUTHOR]

Many men who have sex with men (MSM) do not use condoms with their main partners, especially if both parties are of the same HIV status. However, significant proportions of MSM have never tested or recently tested and are unaware of their main partners' HIV status. A cross-sectional survey was conducted among 524 MSM in Jiangsu, China in 2013-2014. Time-location sampling and online convenience sampling were used to recruit participants. We compared awareness of HIV status and recent HIV testing between participants who had main partners versus those who did not, and identified factors associated with recent HIV testing among men in main partnerships. Participants in main partnerships were significantly more likely to report recent HIV testing and being HIV-negative instead of HIV-unknown compared to participants in casual partnerships only. Overall, 74.5 % of participants were aware of their main partners' HIV status. Among participants in main partnerships, those who had 2-5 male anal sex partners in the past 6 months and those who reported that their partners were HIV-negative had 2.36 (95 % CI 1.12, 4.97) and 4.20 (95 % CI 2.03, 8.70) fold greater odds of being tested in the past year compared to those who had main partners only and those whose partners were HIV-positive/unknown, respectively. Chinese MSM in main partnerships might be practicing serosorting and may be at lower risk for HIV infection due to increased awareness of main partners' HIV status and higher uptake of recent testing. [ABSTRACT FROM AUTHOR]

This pilot study tested the effects of health education on knowledge of Alzheimer's disease ( AD) and health-promotion lifestyles among older Chinese adults residing in a nursing home in Wuhan. A convenience sample of 35 elders without AD was recruited from a nursing home in Wuhan and provided with a 5 week health education intervention. Participants had little knowledge about AD and had an intermediate level of health promotion. After receiving the intervention, there were significant increases in scores on AD knowledge ( F = 29.69, df = 1.23, P < 0.01) and health-promotion lifestyle ( F = 4.39, df = 2, P < 0.05). These results suggest that the intervention on AD knowledge and health promotion was effective for elders in this study. Nurses should therefore provide education for elders in nursing homes to improve their AD knowledge and health-promotion lifestyles, and to prevent or ameliorate AD. [ABSTRACT FROM AUTHOR]

Ethnic minority groups are less engaged than Caucasian American adults in advance care planning (ACP). Knowledge deficits, language, and culture are barriers to ACP. Limited research exists on ACP and advance directives in the Chinese American adult population. Using a pre-posttest, repeated measures design, the current study explored the effectiveness of a nurse-led, culturally sensitive ACP seminar for Chinese American adults on (a) knowledge, completion, and discussion of advance directives; and (b) the relationship between demographic variables, advance directive completion, and ACP discussions. A convenience sample of 72 urban, community-dwelling Chinese American adults (mean age = 61 years) was included. Knowledge, advance directive completion, and ACP discussions increased significantly after attending the nurse-led seminar (p < 0.01). Increased age correlated with advance directive completion and ACP discussions; female gender correlated with ACP discussions. Nursing education in a community setting increased advance directive knowledge and ACP engagement in Chinese American adults. [Journal of Gerontological Nursing, 47(8), 17-21.] [ABSTRACT FROM AUTHOR]

Chinese immigrants in the Netherlands are less likely than other ethnic groups to utilize mainstream mental health care services. This study investigated the experiences of Chinese with mental health problems, to inform measures to make services more responsive to the needs of this group. Qualitative methods of analysis were applied to interview data in order to explore ways of finding help, barriers to accessing mainstream mental health care, experiences in care, factors jeopardizing the quality of care, and views on mental health services among Chinese migrants in the Netherlands. Rather than recruiting individuals with mental health problems, an indirect method was used in which ethnic Chinese participants were invited to tell us about one or more Chinese individuals in their social environment whom they regarded as having (had) mental health problems (). Although most Chinese regarded mainstream Dutch care as the appropriate resource for dealing with mental health problems, many barriers to access and threats to care quality were reported. In contrast to the widely accepted view that cultural differences in health beliefs underlie the low utilization of mental health services by Chinese in the West, the main obstacles identified in this study concerned practical issues such as communication problems and lack of knowledge of the health system. Respondents also described concerns about entitlement to care and discrimination (actual or anticipated). Measures suggested by respondents for improving care included increased use of interpreters and cultural mediators, encouraging migrants to increase their language proficiency, and better dissemination of information about the health system. The article concludes with a discussion of the policy implications of these findings. [ABSTRACT FROM PUBLISHER]

Background: Suboptimal care for people with dementia in hospital settings has been reported and is attributed to the lack of knowledge and inadequate attitudes in dementia care among health professionals. Educational interventions have been widely used to improve care outcomes; however, Chinese-language instruments used in dementia educational interventions for health professionals are lacking. Objectives: The aims of this study were to select, translate and evaluate instruments used in dementia educational interventions for Chinese health professionals in acute-care hospitals. Design: A cross-sectional study design was used. Participants and setting: A modified stratified random sampling was used to recruit 442 participants from different levels of hospitals in Changsha, China. Methods: Dementia care competence was used as a framework for the selection and evaluation of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale for health professionals in the study. These two scales were translated into Chinese using forward and back translation method. Content validity, test-retest reliability and internal consistency were assessed. Construct validity was tested using exploratory factor analysis. Known-group validity was established by comparing scores of Alzheimer's Disease Knowledge Scale and Dementia Care Attitudes Scale in two sub-groups. A person-centred care scale was utilised as a gold standard to establish concurrent validity of these two scales. Results: Results demonstrated acceptable content validity, internal consistency, test- retest reliability and concurrent validity. Exploratory factor analysis presented a single-factor structure of the Chinese Alzheimer's Disease Knowledge Scale and a two-factor structure of the Chinese Dementia Care Attitudes Scale, supporting the conceptual dimensions of the original scales. The Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale demonstrated known-group validity evidenced by significantly higher scores identified from the sub-group with a longer work experience compared to those in the sub-group with less work experience. Conclusions: The use of dementia care competence as a framework to inform the selection and evaluation of instruments used in dementia educational interventions for health professionals has wide applicability in other areas. The results support that Chinese Alzheimer's Disease Knowledge Scale and Chinese Dementia Care Attitudes Scale are reliable and valid instruments for health professionals to use in acute-care settings. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. Background No previous study has demonstrated whether there are differences in the knowledge and compliance with secondary prevention of stroke between transient ischaemic attack patients with and without subsequent stroke. If there are differences, the health education regarding the stroke knowledge should be conducted separately and differently for the two groups. Methods and design We consecutively recruited 355 transient ischaemic attack patients with/without subsequent stroke from our hospital from 1 December 2008-31 December 2011. There were 304 patients receiving health education both upon hospital discharge and 90 days after discharge. Through telephone interviews, six months after discharge, only 180 patients completed the survey to determine in detail their general knowledge and compliance with secondary prevention of stroke. Results The transient ischaemic attack patients with subsequent stroke exhibited a higher identification rate of speech disorder, weakness and decreased sensation or inability to feel things, compared with those without subsequent stroke (76·1 vs. 66·3%, p < 0·05; 91·5 vs. 73·5%, p < 0·05; 62·2 vs. 46·9%, p < 0·05). The compliance rates to antiplatelet agents and statins therapy were higher in transient ischaemic attack patients with subsequent stroke compared with those without subsequent stroke (80·5 vs. 65·3%, p < 0·05; 53·7 vs. 35·7%, p < 0·05). Conclusions The transient ischaemic attack patients with subsequent stroke exhibit a higher identification rate of most of the warning signs of stroke and a better compliance with antiplatelet agents and statins therapy of stroke compared with those without subsequent stroke. Thus, we suggest that transient ischaemic attack patients should receive additional health education to increase their awareness of the harms of stroke. Relevance to clinical practice Clinicians should be aware of conducting different health education to patients with transient ischaemic attack and stroke. Also, it is important to give health education to individualised patients based on their actual risk of stroke. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To describe the level of knowledge, attitudes, and self-reported quality of practice in pain assessment among nurses of Mainland China and explore links with current hospital pain policy and continuing education. Background. Knowledge is necessary for skilled pain assessment among nurses. Little is currently known regarding knowledge, attitude toward, and self reported pain assessment by nurses from Mainland China. Methods. Quantitative research and cross-sectional convenience sampling assessed nursing knowledge, attitude, and practice among 101 nurses working in high-level hospitals in Mainland China. Results. 81.2% of nurses participating in the survey were from high-level (level three) hospitals in Mainland China. 24.8% of the nurses attended continuing education in pain assessment. No nurses from the 76 hospital staffs surveyed were able to recall any hospital policy regarding pain assessment. Knowledge regarding pain assessment was rated at 1.9 ( SD = 1.6) on a (0-7) scale. 27.7% of nurses possessed a positive attitude toward pain assessment. Pain assessment was not routine in most of the hospitals surveyed. Nurses who attended continuing education showed greater knowledge and more positive attitudes regarding pain assessment but did not show improvement in their quality of practice. Conclusions. This study identified inadequate knowledge and low level of self-reported pain assessment practice among nurses working in high-level hospitals in Mainland China. Current education did not influence nursing self-reported pain assessment practice. Knowledge of pain evaluation should be improved through newer approaches to education. A better policy framework for pain evaluation may also contribute to improvement. [ABSTRACT FROM AUTHOR]

Background: Ethnobotanical studies on the use of plants amongst migrant populations are of great relevance to public health. Traditional health strategies, which incorporate plants as medicines, foods, or both - can play an important role in individual well-being. However, at the same time, migrant populations' traditional knowledge of such practices may be under a state of greater threat of decline due to factors such as limited access to the plant materials and physical isolation from the homeland, which serves as the primary living reservoir for this knowledge. Methods: In this study, we conducted a medical ethnobotanical survey focusing on a comparison of local medicinal food and health strategies with members of two Asian immigrant populations in metro-Atlanta: Chinese and Taiwanese. Snowball sampling techniques were employed to recruit 83 study participants, 57 of which were included in the final analysis. Semi-structured interview techniques were used to question participants about their beliefs and usage of the yin yang system, usage of Chinese herbs and medicinal foods, preference and usage of Eastern and Western medicines, and gardening for medicinal foods. Results and conclusion: Comparison of the two groups demonstrated a remarkable difference in health strategies concerning medicinal plant use, including statistically significant differences in beliefs concerning yin and yang, uses of Eastern versus Western medicine, and gardening for medicinal foods. Domestic health strategies in the form of medicinal foods play an important role in local health practices, especially among the Taiwanese participants. The collective desire for the use of both Eastern and Western medicine by both groups highlights the important role that cultural competency training will play in preparing allopathic health practitioners to serve increasingly diverse patient populations in the US. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to broadly assess the level of knowledge, attitude and behaviors related to sexual and reproductive health (SRH) among unmarried female migrants in China. Material and Methods: This cross-sectional study was conducted and a self-administered questionnaire was designed for collecting information on SRH including 15 items for knowledge, 8 items for attitude and some items for contraception and abortion related behaviors. Results: A total of 1690 unmarried female migrants were interviewed. Most of the respondents had less knowledge of SRH. Only one-third of respondents was aware of emergency contraceptives and could freely talk about SRH with their friends. Over one-third of respondents were not willing to come into contact with someone with AIDS or STDs. In this study, 10.4% participants had an unwanted pregnancy and 95% of them had an abortion. Multivariate analysis showed that having a boyfriend, duration of employment in city, knowledge on SRH and freely discussing SRH with peer were associated with having premarital sex among these unmarried female migrants. Conclusion: This study revealed that the unmarried female migrant was one of the most vulnerable groups concerning SRH. In some policy reforms, appropriate and cost-effective SRH services should be provided for these migrants. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the development and psychometric testing of the Clinical Nursing Faculty Competence Inventory. Background. Clinical faculty plays a vital role in nursing education. Highly competent clinical faculty is a prerequisite for graduating competent future nurses. Many studies have examined the effectiveness of clinical nursing teaching. Yet, translating this body of knowledge into accurate and comprehensive assessment tools for measuring the competence of nursing faculty remains a challenge. Method. Thirty-one indicators of core competence of clinical nursing faculty were identified thorough literature review, expert consultation and a small sample pilot test. A total of 237 nursing faculty members, students and administrators from six advanced medical colleges in China were surveyed during 2007-2008. Using a five-point Likert-type scale, the respondents identified their level of agreement with statements addressing the components of clinical nursing faculty competence. Exploratory factor analysis was used to determine the factor structure of the inventory. Results. Students and faculty members valued aspects of clinical nursing faculty competence differently. Exploratory factor analysis using varimax rotation determined construct validity of the inventory and 26 items were retained. Five important categories of clinical nursing faculty competence were revealed: leadership ability, problem solving ability, educational intelligence, general teaching ability and clinical nursing skills. The Cronbach's alpha level of the inventory was 0.91, with each domain ranging from 0.61 to 0.85. Conclusion. The inventory has good psychometric properties and can be used in training and evaluation of clinical nursing faculty. [ABSTRACT FROM AUTHOR]

Background: This study describes road traffic injuries among school-aged children in Guangzhou, China, and examines the effect of road safety knowledge and risk behaviours on road traffic injuries. Methods: A stratified cluster sample of 3747 children from six primary schools and six middle schools in Guangzhou, China, was surveyed. Data were collected on sociodemographic factors and road traffic injuries during the past year. Knowledge about road safety rules was assessed using a 14-item road safety knowledge index, and risky road safety behaviours were measured using a 25-item road safety behaviour index. Results: A total of 403 (10.8%) students reported having at least one road traffic injury during the past 12 months. A high proportion of injuries was found among children who were boys, in primary school and from the suburbs. Bicycle-related injuries were the most common (46.0% of all injuries). Motor vehicle-related injuries had higher hospitalisation rates and worse psychological impact than bicycle or pedestrian injuries. Children with low and medium road safety knowledge had 1.5 to 3 times the odds of injury compared with students with high road safety knowledge. Students with high scores on the risky road behaviour index had twice the odds of injury (OR 2.04, 95% CI 1.47 to 2.84) compared with students with low scores. Conclusion: Better road safety knowledge and the avoidance of walking or cycling-related risk behaviours are protective factors for road traffic injuries among Chinese school children. More injury prevention programmes are needed to improve road safety knowledge and reduce risk behaviours. [ABSTRACT FROM AUTHOR]

Background: Initial knowledge of professionalism among medical students is particularly important for designing effective professionalism curricula and for studying the change in the knowledge of professionalism. Aim: The study examined first-semester medical students' initial knowledge of important attributes of good doctors. Methods: Mixed methods were used to examine initial knowledge among first-semester students from a Chinese medical college. We used an open-ended survey to identify attributes of good doctors and grounded theory analysis to find emergent themes. We also used a close-ended survey to solicit students' responses to 50 attributes of good doctors and explorative and confirmatory factor analysis to examine underlying factors. Results: 973 students completed the open-ended survey while 1730 students completed the close-ended survey. Through grounded theory analysis, 24 subthemes and three themes that include Ethics, Skill, and Person, emerged from the data. Explorative and confirmatory factor analysis showed convergent results: 24 valid items and three factors that include Ethics, Skill, and Person were identified. Conclusion: The initial knowledge of medical professionalism among first-semester students involves approximately 24 important attributes within three major dimensions of Ethics, Skill, and Person, with an overwhelming emphasis on Ethics. It is neither sophisticated nor comprehensive, compared with specialists' professional knowledge. [ABSTRACT FROM AUTHOR]

As the majority of out-of-hospital cardiac arrest occur at patients' homes, implementing high-quality cardiopulmonary resuscitation by family members is critical in improving patient outcomes. However, the survival rate remains low due to low bystander cardiopulmonary resuscitation rate and rapid skill deterioration in individuals who complete the training. To evaluate the effectiveness of audio-visual review model and audio-visual-practice review model on cardiopulmonary resuscitation skill retention 12 months after training. A randomized, double-blind, placebo controlled, and three-arm parallel study. A total of 641 family members of patients at high risk of out-of-hospital cardiac arrest enrolled in the study and 448 participants completed the follow-up. Family members from Beijing, China were recruited. All families underwent initial cardiopulmonary resuscitation training. Their cardiopulmonary resuscitation skill and knowledge were assessed immediately after training. Trainees who were rated "adequate skill and knowledge" were assigned randomly into one of three groups. The control group was given a cardiopulmonary resuscitation instruction booklet and a placebo-DVD without any reminders. Both audio-visual and audio-visual-practice groups were reinforced by a telephone reminder every 3 months. The audio-visual-practice group was also asked to simultaneously practice the skills while watching the instructional-DVD. The trainees' cardiopulmonary resuscitation skills and knowledge were re-assessed 12 months after training. The retention rates of cardiopulmonary resuscitation skills in both audio-visual-practice (N = 177) and audio-visual (N = 157) groups were higher than that in control group (N = 114) 12 months after training (all P- values < 0.001). The cardiopulmonary resuscitation skill retention rate in audio-visual-practice group was higher than that in audio-visual group (49.7% vs 36.9%, P = 0.019), but no difference was found in intention-to-treat analysis (32.1% vs 27.1%, P = 0.230). Both audio-visual-practice and audio-visual groups had higher correct rates on all skill elements than that in control group (all P- values < 0.05). The cardiopulmonary resuscitation knowledge scores in both audio-visual-practice and audio-visual groups were higher than that in control group (all P -values < 0.001). However, no significant difference was found between audio-visual-practice and audio-visual groups (P = 0.243). Both audio-visual-practice and audio-visual review models demonstrated better long-term retention of cardiopulmonary resuscitation skills for families of people at higher risk of out-of-hospital cardiac arrest. (Registration number: chiCTR-TRC-12002149) [ABSTRACT FROM AUTHOR]

Background: Historically, indigo-yielding plant species were important cash crops from Central Asia to the southern United States and Central America. Indigo-dyed textiles were widely traded along the legendary Silk Road that linked China to Europe. Today, due to the labor-intensive nature of indigo extraction at the household level, lifestyle changes and the widespread availability of commercially produced indigo paste, traditional indigo extraction methods have declined in villages. Yet Li textile weavers on Hainan Island are internationally recognized as producers of indigo-dyed textile using warp ikat techniques. In contrast, Hainan Miao weavers produce indigo-dyed textiles using batik (wax resist) techniques. The aim of this study was to document the indigenous knowledge on indigo-yielding plant species used by both Hainan Miao and Li people on Hainan Island, China. Method: Ethnic uses were documented during three field surveys, through a questionnaire survey of 193 respondents, comprising 144 Hainan Miao and 49 Li traditional dyers. Mention index (QI), Availability index (AI), and Preference ranking (PR) of each indigo-yielding plant species were calculated to screen out plant resources with potential development value. Results: Five indigo-yielding plant species (from four plant families and four genera) were historically used by Hainan Miao and Li dyers. However, just four species are still in use. Strobilanthes cusia was the main indigo source for Hainan Miao dyers. Li dyers also commonly use Indigofera species (I. tinctoria and I. suffruticosa) for indigo extraction. Wrightia laevis is less commonly used as a contemporary indigo source. Indigo extraction by steeping in water to which lime is added to increase the pH is sharing by the five indigo-yielding plant species. Strobilanthes cusia had the highest QI, AI and PR values in Hainan Miao villages. Indigofera tinctoria had the highest QI and AI values, but Indigofera suffruticosa was preferred by Li dyers. Conclusion: In the process of modernization and urbanization, some Hainan Miao and Li dyers retain the traditional indigo extraction methods. We found that Strobilanthes cusia and Indigofera tinctoria have the most potential for sustainable indigo production in the future. Furthermore, this study documents the details of extraction method from Wrightia laevis for the first time and the use of Ricinus communis seeds in that process. As one of the last places globally where Wrightia laevis is still used for indigo production, the may also be a nice market among textile collectors and museums that keeps the tradition of Wrightia laevis production and use for indigo extraction alive. [ABSTRACT FROM AUTHOR]

Objective To explore the determinants of smoking behaviour in recreational venues and to provide scientific bases for establishing smoke-free measures applying to these locations. Methods The International Tobacco Control (ITC) China Survey—a face-to-face cross-sectional survey of representative adult smokers from six cities (Shenyang, Beijing, Shanghai, Guangzhou, Changsha and Yinchuan) was conducted between April and August 2006. A total of 4815 smokers were selected using multistage sampling methods, and final analyses were conducted on 2875 smokers who reported patronising recreational venues at least once in the last six months. Multivariate logistic regression models were used to identify factors influencing the smoking behaviour within recreational settings. Outcome measure Whether a smoker reported smoking in recreational venues during the last 6 months. Results 84% subjects reported smoking in recreational venues. Analyses showed that smoke-free laws had been exempted, 32.0% of the patrons reporting bans on smoking in these locations. The following factors were significant predictors of smoking in recreational venues: absence of bans on smoking, support for non-bans, being aged 18–24 years, positive smoking-related attitudes, low number of health effects reported and not living in Beijing. Conclusions The findings point to the importance of informing Chinese smokers about the active smoking and passive smoking harmfulness in both building support for smoke-free laws and in reducing smokers’ desire to smoke within recreational venues. They also point to the importance of good enforcement of smoke-free laws when implemented. Such strategies could also serve to de-normalise smoking in China, a key strategy for reducing smoking in general. [ABSTRACT FROM PUBLISHER]