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Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t- test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program. [ABSTRACT FROM AUTHOR]

Background: Smart nursing homes (SNHs) integrate advanced technologies, including IoT, digital health, big data, AI, and cloud computing to optimise remote clinical services, monitor abnormal events, enhance decision-making, and support daily activities for older residents, ensuring overall well-being in a safe and cost-effective environment. This study developed and validated a 24-item Expectation and Acceptability of Smart Nursing Homes Questionnaire (EASNH-Q), and examined the levels of expectations and acceptability of SNHs and associated factors among older adults in China. Methods : This was an exploratory sequential mixed methods study, where the qualitative case study was conducted in Hainan and Dalian, while the survey was conducted in Xi'an, Nanjing, Shenyang, and Xiamen. The validation of EASNH-Q also included exploratory and confirmatory factor analyses. Multinomial logistic regression analysis was used to estimate the determinants of expectations and acceptability of SNHs. Results: The newly developed EASNH-Q uses a Likert Scale ranging from 1 (strongly disagree) to 5 (strongly agree), and underwent validation and refinement from 49 items to the final 24 items. The content validity indices for relevance, comprehensibility, and comprehensiveness were all above 0.95. The expectations and acceptability of SNHs exhibited a strong correlation (r = 0.85, p < 0.01), and good test-retest reliability for expectation (0.90) and acceptability (0.81). The highest tertile of expectations (X2=28.89, p < 0.001) and acceptability (X2=25.64, p < 0.001) towards SNHs were significantly associated with the willingness to relocate to such facilities. Older adults with self-efficacy in applying smart technologies (OR: 28.0) and those expressing a willingness to move to a nursing home (OR: 3.0) were more likely to have the highest tertile of expectations compared to those in the lowest tertile. Similarly, older adults with self-efficacy in applying smart technologies were more likely to be in the highest tertile of acceptability of SNHs (OR: 13.8). Conclusions: EASNH-Q demonstrated commendable validity, reliability, and stability. The majority of Chinese older adults have high expectations for and accept SNHs. Self-efficacy in applying smart technologies and willingness to relocate to a nursing home associated with high expectations and acceptability of SNHs. [ABSTRACT FROM AUTHOR]

Composite time trade-off (cTTO) values for EQ-5D-Y-3L health states tend to be high, raising concerns about sensitivity particularly for mild or moderate health states. We conceptualized and pilot tested 2 alternative time trade-off (TTO) variants: the caregiver TTO (CGTTO) and lag-time TTO (LTTO). We collected CGTTO and LTTO data in China for 10 EQ-5D-Y-3L health states and compared the resulting values, respondent feedback, and task completion times with those from an EQ-5D-Y-3L valuation study using cTTO. We also examined how age and parental status of respondents could affect TTO values. A total of 304 participants were included in this study. Overall, cTTO showed statistically better results in all feedback questions. On a 5-point Likert scale where lower score means greater agreement, the mean (SD) feedback scores for cTTO, LTTO, and CGTTO were 1.18 (0.58), 1.45 (0.91), and 1.65 (1.02) for "easy to understand"; 1.45 (0.91), 1.94 (1.08), and 1.86 (1.24) for "easy to differentiate"; and 3.61 (1.29), 2.97 (1.33), and 3.02 (1.50) for "difficult to decide," respectively. The mean (SD) TTO values of all 10 states were 0.463 (0.494), 0.387 (0.555), and 0.123 (0.710) for cTTO, LTTO, and CGTTO, respectively. The effects of age and parental status on TTO values differed by the 3 methods. LTTO and CGTTO produce values with good characteristics and merit further investigation. Researchers need to be aware of the differences in design and values when using the TTO method to value children's health states. • Time trade-off (TTO) values of children's health states can be elicited by asking respondents to assume that the health states are experienced by their siblings, children, or grandchildren and to trade their own life-years for the health of the children. • TTO values of EQ-5D-Y-3L health states derived from lag-time TTO and composite TTO methods differ in values and distributions. • The issue of "unwillingness to trade" previously observed in TTO valuation of EQ-5D-Y-3L health states may be mitigated by using alternative designs such as lag-time TTO and caregiver TTO. [ABSTRACT FROM AUTHOR]

This aim of this study was to investigate women's knowledge about HPV along with their experience and acceptability of self-sampling in Jiangsu province, China. A total of 862 women aged 25–63 years old from Jiangsu province who purchased an HPV self-sampling test kit were invited to complete a questionnaire designed by the authors. Participants had high acceptability for HPV self-sampling with a mean score of 4.2 (95% [CI], 4.1–4.22) out of 5 points. 27% of participants preferred clinician-sampling, 33% preferred self-sampling, other 40% expressed no preference. Women with good knowledge about HPV and with a good experience with HPV self-sampling were more acceptable for self-sampling (P < 0.05). The biggest concern about HPV self-sampling of the participants includes 'specimens' spoilage', 'incorrect sampling', 'can't get results in time', and so on. HPV self-sampling can be used to improve cervical cancer screening coverage and participation rates in China. Cancer screening and can be an alternative primary screening for cervical cancer. •What the results of this study add? This study adds new findings about Chinese women's experience and acceptability of HPV self-sampling. We found that most women had high acceptability for HPV self-sampling in Jiangsu province, China, and high knowledge about HPV as well as good •What is already known on this subject? HPV self-sampling testing was proven to be useful for improving the uptake rate of cervical experience of self-sampling can improve the acceptability for self-sampling in women. •What the implications are of these findings for clinical practice and/or further research? Further research should assess the acceptability of women with less education or who never screened. [ABSTRACT FROM AUTHOR]

Background: Diabetic retinopathy is a leading cause of preventable blindness in Canada. Clinical guidelines recommend annual diabetic retinopathy screening for people living with diabetes to reduce the risk and progression of vision loss. However, many Canadians with diabetes do not attend screening. Screening rates are even lower in immigrants to Canada including people from China, Africa, and the Caribbean, and these groups are also at higher risk of developing diabetes complications. We aim to assess the feasibility, acceptability, and fidelity of a co-developed, linguistically and culturally tailored tele-retinopathy screening intervention for Mandarin-speaking immigrants from China and French-speaking immigrants from African-Caribbean countries living with diabetes in Ottawa, Canada, and identify how many from each population group attend screening during the pilot period. Methods: We will work with our health system and patient partners to conduct a 6-month feasibility pilot of a tele-retinopathy screening intervention in a Community Health Centre in Ottawa. We anticipate recruiting 50–150 patients and 5–10 health care providers involved in delivering the intervention for the pilot. Acceptability will be assessed via a Theoretical Framework of Acceptability-informed survey with patients and health care providers. To assess feasibility, we will use a Theoretical Domains Framework-informed interview guide and to assess fidelity, and we will use a survey informed by the National Institutes of Health framework from the perspective of health care providers. We will also collect patient demographics (i.e., age, gender, ethnicity, health insurance status, and immigration information), screening outcomes (i.e., patients with retinopathy identified, patients requiring specialist care), patient costs, and other intervention-related variables such as preferred language. Survey data will be descriptively analyzed and qualitative data will undergo content analysis. Discussion: This feasibility pilot study will capture how many people living with diabetes from each group attend the diabetic retinopathy screening, costs, and implementation processes for the tele-retinopathy screening intervention. The study will indicate the practicability and suitability of the intervention in increasing screening attendance in the target population groups. The study results will inform a patient-randomized trial, provide evidence to conduct an economic evaluation of the intervention, and optimize the community-based intervention. [ABSTRACT FROM AUTHOR]

This aim of this study was to investigate women's knowledge about HPV along with their experience and acceptability of self-sampling in Jiangsu province, China. A total of 862 women aged 25–63 years old from Jiangsu province who purchased an HPV self-sampling test kit were invited to complete a questionnaire designed by the authors. Participants had high acceptability for HPV self-sampling with a mean score of 4.2 (95% [CI], 4.1–4.22) out of 5 points. 27% of participants preferred clinician-sampling, 33% preferred self-sampling, other 40% expressed no preference. Women with good knowledge about HPV and with a good experience with HPV self-sampling were more acceptable for self-sampling (P < 0.05). The biggest concern about HPV self-sampling of the participants includes 'specimens' spoilage', 'incorrect sampling', 'can't get results in time', and so on. HPV self-sampling can be used to improve cervical cancer screening coverage and participation rates in China. Cancer screening and can be an alternative primary screening for cervical cancer. •What the results of this study add? This study adds new findings about Chinese women's experience and acceptability of HPV self-sampling. We found that most women had high acceptability for HPV self-sampling in Jiangsu province, China, and high knowledge about HPV as well as good •What is already known on this subject? HPV self-sampling testing was proven to be useful for improving the uptake rate of cervical experience of self-sampling can improve the acceptability for self-sampling in women. •What the implications are of these findings for clinical practice and/or further research? Further research should assess the acceptability of women with less education or who never screened. [ABSTRACT FROM AUTHOR]

Objective: To explore the acceptability and influencing factors of an Internet-based Tinnitus Multivariate Integrated Sound Therapy (iT-MIST). The individually tailored sound therapy used narrowband noise centered on the patient's tinnitus frequency in combination with natural sounds and relaxing music. Design: Patients with tinnitus were given a 1-week trial of iT-MIST. Semistructured interviews were then carried out and a thematic analysis used to analyze, identify, organize, and report factors discovered in the data. Study Sample: Semistructured interviews were carried out with 11 participants, 2 women and 9 men, mean age 39.82 years. Results: The first theme identified from patient interview analysis was their motivation to undertake and expectations of iT-MIST. Nearly half of the participants indicated that advice from the physician was considered very important and professional. Benefits acknowledged by most participants from their iT-MIST experience were accessibility, convenience, time- and cost-effectiveness, and emotional benefit. However, a few participants with poor understanding of tinnitus and iT-MIST showed a negative acceptability with doubtful thoughts and complaints about technical issues such as being easily interrupted by messages and phone calls. Conclusion: Patients with tinnitus in this study were not universally accepting of the iT-MIST therapy. Concerns about their tinnitus and ability to comply with doctor's recommendations were the main influencing factors. Attitude or willingness to explore new therapies facilitated its use. Emotional benefits, for example, relaxation and comfort, were seen to sustain motivation, while doubtful thoughts and technical problems negatively affected acceptability. [ABSTRACT FROM AUTHOR]

• This study serves as the first to examine the acceptability and preliminary impact of a school-based Social and Emotional Learning (SEL) intervention in rural Chinese elementary schools. • The SEL program showed a preliminary impact by strengthening rural Chinese children's self-awareness, social awareness, and relationship skills. In addition, it was highly acceptable to rural Chinese children. • Rural children of work-away parents and rural boys experienced greater gains in social-emotional competencies. While Social and Emotional Learning (SEL) as school-based mental health preventative interventions have been extensively examined in western contexts, they have not yet been studied much in China. Several SEL programs have been developed or adapted for Chinese contexts, but few studies have examined their intervention effects in resource constrained settings, especially rare in rural schools. This study serves as the first to examine the acceptability and preliminary impact of a school-based SEL intervention in rural Chinese elementary schools. A quasi-experimental pre- and post-intervention study with a two-level cluster design was adopted. The sample consisted of 1247 fifth graders nested within 28 classrooms in Southwest China. Students rated the SEL curriculum as highly satisfactory, interesting, helpful, and practical. Findings demonstrated significant SEL intervention effects on rural children's overall self-reported social and emotional competencies (ES = 0.213) and three subdomains including self-awareness (ES = 0.342), social awareness (ES = 0.25), and relationship skills (ES = 0.185). However, no intervention effects were found in the subdomains including self-management and responsive decision-making. Additionally, the subgroup analysis revealed that children of work-away parents, as well as boys, obtained greater benefits from the SEL intervention. These findings are interpreted in light of their practice, research, and policy implications to further strengthen school-based SEL efforts for improving rural children's wellbeing. [ABSTRACT FROM AUTHOR]

Background Portable systems using three-dimensional (3D) scan data to calculate young child anthropometry measurements in population-based surveys and surveillance systems lack acceptability data from field workers and caregivers. Objective The aim was to assess acceptability and experiences with 3D scans measuring child aged 0–59 mo anthropometry in population-based surveys and surveillance systems in Guatemala, Kenya, and China (0–23 mo only) among field teams and caregivers of young children as secondary objectives of an external effectiveness evaluation. Methods Manual data were collected twice and 12 images captured per child by anthropometrist/expert and assistant (AEA) field teams (individuals/country, n = 15/Guatemala, n = 8/Kenya, n = 6/China). Caregivers were interviewed after observing their child's manual and scan data collection. Mixed methods included an administered caregiver interview (Guatemala, n = 465; Kenya, n = 496; China, n = 297) and self-administered AEA questionnaire both with closed- and open-ended questions, and 6 field team focus group discussions (FGDs; Guatemala, n = 2; Kenya, n = 3; China, n = 1). Qualitative data were coded by 2 authors and quantitative data produced descriptive statistics. Mixed-method results were compared and triangulated. Results Most AEAs were female with secondary or higher education. Approximately 80–90% of caregivers were the child's mother. To collect all anthropometry data, 62.1% of the 29 AEAs preferred scan, while 31% preferred manual methods. In FGDs, a key barrier for manual and scan methods was lack of child cooperation. Across countries, approximately 30% to almost 50% of caregivers said their child was bothered by each manual and scan method, while ≥95% of caregivers were willing to have their child measured by scans in the future. Conclusions Use of 3D scans to calculate anthropometry measurements was generally at least as acceptable as manual anthropometry measurement among AEA field workers and caregivers of young children aged <60 mo, and in some cases preferred. [ABSTRACT FROM AUTHOR]

Recent evidence shows that circumcision is associated with lower HIV prevalence among MSM. We assessed the acceptability of circumcision for preventing HIV and that of Shang Ring circumcision (SRC) among men who have sex with men (MSM) in China. 538 adult MSM were recruited from six cities in China between January and March 2019. Participants were surveyed by an online, self-administered questionnaire. The acceptability of circumcision was assessed before and after the potential protective effect of circumcision against HIV was informed, and subsequently men's willingness to undergo SRC was assessed. The level of circumcision was 16.4%. Of 450 uncircumcised MSM, their willingness to be circumcised in the following six months increased significantly from 32.2% to 55.6% after the information session. Three quarters of men who were willing to undergo circumcision accepted SRC. MSM who perceived that circumcision could maintain genital hygiene were more likely to accept circumcision after the information session, whereas those who regarded circumcision as an embarrassing surgery were disinclined to be circumcised. The low circumcision rate, along with its high acceptability in Chinese MSM, suggests a great potential benefit of circumcision intervention if proved effective. SRC might be a popular circumcision procedure in this population. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a promising HIV prevention method. However, the rollout of PrEP among men who have sex with men (MSM) is facing challenges. This study sought to understand PrEP acceptability and service use challenges among MSM in China. The study was conducted in 2018 in Guangdong Province using a mixed-methods approach. Among 489 HIV-negative MSM who completed an online survey, 374 (76.5%) had heard of PrEP before. The most common PrEP information sources were internet/social media (32.1%) and community-based organizations (30.4%). Two-thirds (n=328) of the MSM would accept PrEP even the protective efficacy is less than 100%, 60.1% (n=294) expressed willingness to use PrEP once it is approved in China, and 59.3% (n=290) were willing to pay out of pocket. Employment, disclosure of MSM status, and mental health issues were associated with PrEP acceptability. In-depth interviews with 30 MSM revealed that high cost, low accessibility, and stigma in clinic settings were barriers to PrEP using. Primary care-based PrEP services were acceptable, but patients' confidentiality was a concern. PrEP promotion efforts should address social and mental health challenges among MSM and mobilize primary care systems and community-based organizations to achieve the best result. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated whether the mini-clinical evaluation exercise (mini-CEX) has been successfully integrated into the Chinese context, following its introduction as part of the national general training programme. Materials and methods: Online questionnaires (N = 91) and interviews (N = 22) were conducted with Year 1 trainee doctors and clinical supervisors at a cancer hospital in China to explore users' experiences, attitudes and opinions of the mini-CEX. Results" Trainees were more likely than supervisors to report understanding the purpose of the mini-CEX and agree that it encouraged reflection and helped improve overall performance. Both trainees and supervisors felt that it provided a framework for learning, that it was useful in identifying underperformance, and that it informed learning progression. Groups were equally positive about the commitment of their counterpart in the process and valued the focus on detailed feedback. It was perceived as cultivating the learner–teacher relationship. Overall, both groups felt they 'bought in' to using the mini-CEX. However, concerns were raised about subjectivity of ratings and lack of benchmarking with expected standards of care. Conclusions: Chinese trainees and supervisors generally perceived the mini-CEX as an acceptable and valuable medical training tool, although both groups suggested enhancements to improve its efficacy. [ABSTRACT FROM AUTHOR]

Objectives: To explore the acceptability, consistency, and accuracy of eliciting health state utility values using discrete choice experiment (DCE) and DCE with life duration dimension (DCETTO) as compared with conventional time trade-off (TTO) by using the SF-6Dv2.Methods: During face-to-face interviews, a representative sample of the general population in Tianjin, China, completed 8 TTO tasks and 10 DCE/DCETTO tasks, with the order of TTO and DCE/DCETTO being randomized. The fixed-effect model and conditional logit models were used for TTO and DCEs data estimation, respectively. Acceptability was assessed by self-reported difficulties in understanding/answering. Consistency was observed by the monotonicity of model coefficients. Accuracy was evaluated by investigating differences between observed and predicted TTO values using intraclass correlation coefficient, mean absolute difference, and root mean square difference.Results: A total of 503 respondents (53.7% male; range, 18-86 years) were included, with comparable characteristics between respondents who completed DCE (N = 252) and DCETTO (N = 251). No significant difference was observed in self-reported difficulties among 3 approaches. The monotonicity of coefficients could not be achieved for 2 DCE approaches, even when combining the inconsistent levels. The health state utility values generated by DCE were generally higher than those generated by TTO, whereas DCETTO was lower than TTO. The TTO had a better prediction accuracy than the DCEs.Conclusions: Two DCE approaches are feasible for eliciting health state utility values; however, they are not considered to be easier to understand/answer than TTO. There are systematic differences in the health state utility values generated by 3 approaches. The issue of non-monotonicity from 2 DCE approaches remains a concern. [ABSTRACT FROM AUTHOR]

• The intention of HPV vaccination was low among women aged 20 to 45 in rural China. • Insufficient knowledge and trust in vaccines were the main barriers to vaccination. • Interventions for spreading related information via multiple sources are needed. • HPV vaccines should be covered by health insurance to make access universal. This study aimed to examine the intentions of and barriers to vaccination against human papillomavirus (HPV) among women aged 20 to 45 in rural areas, and to determine the popular sources to getting information about HPV vaccine and vaccination. This cross-sectional study was conducted in 2018 with a sample of women aged 20 to 45 from rural areas of Hunan Province in China. Anonymous self-administered questionnaires were used to collect sociodemographic information and characteristics related to reproductive health of participants, and intentions of and barriers to HPV vaccination. All statistical analysis methods were performed with SPSS 18.0. A total of 2101 women participated in the study, with 58.55% intended to vaccinate against HPV. Increased intention of HPV vaccination was associated with higher age (adjusted odds ratio AOR = 1.35 and 1.50, respectively) and education level (AOR = 1.13 and 1.47, respectively). Women who have heard of HPV vaccine (AOR = 2.67, 95% confidence interval CI : 1.20–5.98) and have been aware of that cervical cancer could be prevented (AOR = 2.01, 95% CI : 1.44–2.82) were more willing to vaccinate. Having never heard of HPV vaccine and worry about efficacy and safety of vaccines were the most commonly cited reasons to refuse vaccination. The preferred source to get the knowledge was medical personnel (58.45%), followed by WeChat or Microblog, TV programs, and Internet. We found the intention of HPV vaccination among women aged 20 to 45 in rural China is low. Findings highlighted the importance of knowledge and trust in HPV vaccine, and suggested strengthening educational interventions on HPV vaccine and vaccination through multiple sources, including HPV vaccine coverage in health insurance to increase access. [ABSTRACT FROM AUTHOR]

Background: Using methadone maintenance therapy (MMT) clinics to deliver antiretroviral therapy (ART) has proven to be effective for promoting treatment initiation and adherence in drug users living with HIV. Objectives: The objective of this study was to investigate the HIV-positive client acceptability of integrated ART services and to identify the reasons for and factors associated with service acceptability. Methods: A total of 86 HIV-positive MMT clients were recruited from 12 MMT clinics in Sichuan Province, China. They participated in a cross-sectional survey that queried their willingness to receive seven different types of MMT-based ART services. The reasons for their willingness/unwillingness to accept these services were documented. The association between service acceptability and background characteristics was examined. Results: The most accepted integrated services were ART-related counseling (75.6%) and referral (73.2%). Concerns regarding the provider's lack of ART expertise and confidentiality issues were common barriers for the acceptance of MMT-based ART services. A trust relationship with MMT providers was a reason for service acceptance. Service acceptability was associated with a poorer perceived health status. Conclusions/Importance: ART-related services, based on the client perspective, can be delivered at MMT clinics. However, service provider training and the protection of confidentiality must be strengthened for the effective implementation of integrated service delivery. [ABSTRACT FROM AUTHOR]

Despite global efforts to increase HIV test uptake among men who have sex with men (MSM), social stigma and negative attitudes toward homosexuality hinder the effectiveness of traditional test promotion campaigns. Increasing HIV test uptake requires greater understanding of the conditions that facilitate decisions to get tested. We conducted an online survey hosted by two of the most highly frequented MSM web portals in China. A generalised ordered logistic regression analysis was conducted to determine factors associated with HIV testing behaviour. Compared to men who had never tested for HIV, men who had tested in the past year were more likely to have never engaged in sex with women, have multiple male sex partners in the past 3 months and have disclosed their sexual orientation to others. MSM found testing at local Chinese Centers for Disease Control and Prevention (80.7%), gay men's community-based organisations (80.2%) and public hospitals (70.9%) to be acceptable, while saunas (50.5%) and gay bars (41.8%) were found to be unacceptable testing venues. Our study shows that MSM in China prefer to test at venues that guarantee confidentiality, quality and quick results. Our study also suggests that self-testing may be a feasible approach to increase test uptake. [ABSTRACT FROM PUBLISHER]

Chinese character structure has often been described as representing a kind of grammar, but the notion of character grammar has hardly been explored. Patterns in character element reduplication are particularly grammar-like, displaying discrete combinatoriality, binarity, phonology-like final prominence, and potentially the need for symbolic rules (X→XX). To test knowledge of these patterns, Chinese readers were asked to judge the acceptability of fake characters varying both in grammaticality (obeying or violating reduplication constraints) and in lexicality (of the reduplicative configurations). While lexical knowledge was important (lexicality improved acceptability and grammatical configurations were accepted more quickly when also lexical), grammatical knowledge was important as well, with grammaticality improving acceptability equally for lexical and nonlexical configurations. Acceptability was also higher for more frequent reduplicative elements, suggesting that the reduplicative configurations were decomposed. Chinese characters present an as-yet untapped resource for exploring fundamental questions about the nature of the human capacity for grammar. [ABSTRACT FROM AUTHOR]

Aim: This study investigated the prevalence of circumcision among non-Muslim schoolboys in Urumqi, China, and how acceptable their parents found the practice.Methods: A convenient cluster sample of non-Muslim schoolboys (n = 3614) aged six to 15 years of age and 873 mothers and 927 fathers completed self-administered questionnaires. We compared the consistency of the circumcision status reported by students and their parents and analysed the factors that influenced the parents to have their child circumcised.Results: The mean age at circumcision was 8.3 years and the adjusted prevalence was 46.2%. Up to 45.4% of fathers and 66% of mothers with uncircumcised sons were willing to circumcise their sons after receiving further information on circumcision. Mothers were more likely to support circumcision if they had higher education levels and higher family income, were employed as government officials and had family members who had been circumcised, including their husband. Fathers were more likely to support circumcision if they were highly educated and had been circumcised themselves.Conclusion: The prevalence and acceptability of circumcision were higher than expected in this traditional schoolboy population in Urumqi, China. Factors that increased parental support for circumcision included high education and the father being circumcised. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine young women's perceptions and acceptability of human papillomavirus vaccination and factors influencing acceptability in mainland China. Background In the light of current concepts, human papillomavirus vaccines serve as new paradigms in cervical cancer prevention programme for young women. However, knowledge and acceptability of human papillomavirus vaccination and factors influencing acceptability among young Chinese women are not known. Design We implemented a cross-sectional descriptive study in the Hunan province of China. Methods One hundred and seventeen female undergraduate students completed confidential surveys in 2012. The questionnaire included five parts: background information, awareness and knowledge of human papillomavirus vaccine and cervical cancer, attitudes towards the vaccine and intentions to be vaccinated, psychosocial burden of human papillomavirus infection, and human papillomavirus-related sexual stigma. Results Only 44% of the participants were willing to be vaccinated in the future. Young women demonstrated low awareness and knowledge about human papillomavirus vaccine and cervical cancer. Their intention to receive future vaccination was associated with the high levels of knowledge about risk factors for cervical cancer and perceptions that infected women are responsible for their own infection of human papillomavirus. Conclusion The results of this study suggest low awareness and knowledge among young Chinese women about the preventive nature and value of human papillomavirus vaccination. Social and cultural factors including moral obligation and STD-related stigma may influence young women's intention to future vaccination. Relevance to clinical practice Educational interventions are necessary to promote public awareness and deliver information about human papillomavirus vaccination and cervical cancer prevention. Results of this study can help health care practitioners develop appropriate programmes for the promotion of human papillomavirus vaccination among this population. [ABSTRACT FROM AUTHOR]

Objective To determine the level of awareness on human papillomavirus (HPV) vaccine and acceptance of HPV vaccination among parents of junior middle school students. Methods A cross sectional survey employing cluster sampling was conducted in Jinan, Shandong Province of China in January of 2013. Results A total of 400 parents of junior middle school students participated in the questionnaire survey, among whom 360 (90%) completed valid questionnaires. About 88 (22.63%) parents had ever heard of HPV. Only one in ten (10.2%) knew about HPV vaccine. Parents willing to accept HPV vaccination for children accounted for 40.8%. Factors associated willing to accept HPV vaccination for children among parents were: female parent (AOR: 0.38, 95%CI: 0.21–0.67), having ever heard of HPV vaccine (AOR: 2.38, 95%CI: 1.01–5.61), thinking HPV vaccination should commence before sexual debut(AOR: 2.16, 95%CI: 1.21–3.85), thinking HPV vaccination should commence before 12 years old (AOR: 2.76, 95%CI: 1.02–7.46) or 13–15 years old (AOR: 4.75, 95%CI: 1.79–12.61), concern about suffering from cervical cancer and/or genital warts (AOR: 2.43, 95%CI: 1.31–4.50). About 60% of parents were in favor of future HPV vaccination promoting in China believing that HPV vaccine could efficiently prevent cervical cancer, anal cancer or genital warts, 37.4% of parents with expectation of governmental subsidy and price regulation. Conclusion Parental awareness level of HPV vaccine and willingness to accept HPV vaccination for children was low. However, the general attitude of many participants toward future promoting of HPV vaccination in China was encouraging, particularly if certain expectations were met. [ABSTRACT FROM AUTHOR]

We investigated the acceptability of early anti-retroviral therapy (ART) among HIV-infected people in Anhui Province, China. A cross-sectional study was conducted in 11 convenience selected cities of Anhui Province from September 2012 to December 2013. Study participants were convenience recruited from local Centers for Disease Control and Prevention when they attended for CD4+cell counts testing and HIV counselling. Answers to questionnaires were obtained through face-to-face structured interviews. Factors influencing the acceptability of early ART were identified by multiple logistic regression analysis. A total of 287 HIV-infected people met the criteria and completed the survey. The acceptability of early ART was 65.2%. The results of multiple logistic regression analysis indicated that the acceptability of early ART was associated with the following factors: CD4+T cell count (above 750 cells/µL vs. 350 cells/µL to 550 cells/µL: OR = 0.144,P< 0.001), years of HIV diagnosis confirmation (1 year to 5 years vs. <1 year: OR = 0.418,P= 0.005; above 5 years vs. <1 year: OR = 0.160,P< 0.001), whether had sexual behaviour after HIV diagnosis confirmation (yes vs. no: OR = 2.342,P= 0.005) and the awareness of two early ART-related questions (OR = 4.101,P= 0.015; OR = 3.294,P< 0.001). In summary, the present study showed that most HIV-infected people can accept early ART. Early ART interest in Anhui HIV-infected population was high. The awareness of early ART-related knowledge in HIV-infected population was low and should be improved to achieve higher acceptability and keep adherence to early ART for HIV prevention. [ABSTRACT FROM AUTHOR]

This study aimed to understand the acceptability of short message service (SMS) as a reminder for improving antiretroviral therapy (ART) adherence and determine the factors associated with willingness to accept SMS among people living HIV (PLH) in China. A total of 801 adult patients were recruited in a cross-sectional survey. Factors associated with willingness in unadjusted analyses (α= 0.10) were included in a logistic regression model; 88.4% of the participants owned mobile phones, 49.6% read every short message and 16.2% read only if the phone number was familiar, 79.5% reported daily SMS to remind taking medicine would be helpful, and 68.9% were willing to receive them. In the final model, willingness to accept was positively associated with being young (odds ratio [OR] = 0.32; 95% confidence interval [CI]: 0.11–0.99;p= 0.048), living in the middle or north region (OR = 2.36; 95% CI: 1.24–4.50;p= 0.009, OR = 71.79; 95% CI: 21.53–239.37;p< 0.001, respectively), having primary or “junior or higher” education (OR = 5.80; 95% CI: 2.13–15.86;p= 0.001, OR = 3.20; 95% CI: 1.20–8.58;p= 0.021, respectively), having serious disease condition of stage (OR = 10.01; 95% CI: 2.12–47.30;p= 0.004), being a rural resident (OR = 2.96; 95% CI: 1.72–5.10;p< 0.001), having side effect (OR = 4.74; 95% CI: 1.24–18.03;p= 0.023), and taking a dose two or more hours late in the last 30 days (OR = 2.45; 95% CI: 1.26–4.78;p= 0.009). SMS as a reminder for improving ART adherence is acceptable. The survey results indicate that to be effective, messages need to be more acceptable to elderly patients, urban residents, individuals with earlier stage of HIV disease, and individuals not experiencing side effects. Nonetheless, these results suggest that for a high proportion of PLH in China, reminder messages through mobile phones would be useful for increasing compliance with HIV regimens. [ABSTRACT FROM AUTHOR]

Highlights: [•] We conducted a nation-wide survey on the perceptions and acceptability of HPV vaccination. [•] We found low acceptability of HPV vaccine among parents of young adolescents. [•] Mothers and well educated parents were less likely to accept HPV vaccination. [•] Knowledge of HPV and HPV vaccine was a positive correlate with vaccination acceptability. [•] Local CDC was selected as the most appropriate venue for HPV vaccination. [ABSTRACT FROM AUTHOR]

Abstract: This paper measures the company''s awareness and acceptability of market-based instruments (MBIs) for energy saving, and identifies their relationships with pre-classified determinants. The data were collected from 121 respondents in Taicang, China, with almost all of them being small and medium-sized enterprises (SMEs). The surveyed companies indicate moderate awareness of MBIs at present. Market competition is confirmed to function as a driver for the companies to collect strategic information and thus enhance their policy awareness. The samples with higher education level of employees indicate higher awareness of MBIs. In contrast to the regulative polices, MBIs and voluntary approaches are more appreciated by the companies. The companies in the survey area prefer to make internal efforts in response to energy cost increases due to the implementation of carbon pricing policies and are reluctant to simply transfer the policy burden to their customers. Empirical evidences on the conditions for policy success from this study are meaningful for supporting further progress of industrial energy saving policies in China. [Copyright &y& Elsevier]

Conclusive evidence-based research has shown that circumcision reduces the risk of HIV transmission via heterosexual intercourse, whilst ongoing studies are investigating similar effects via homosexual transmissions and the results are equivocal. Few acceptability studies regarding circumcision were conducted among men who have sex with men (MSM). In this cross-sectional study, a total of 307 MSM were recruited by snowball sampling and were interviewed anonymously by some peer field workers in Yangzhou, China. Amongst all uncircumcised participants (93.4% of all participants were uncircumcised), the willingness to be circumcised increased from 8.1% to 30.7%, before and after the participants were briefed about a hypothetical potential benefit of a 50% risk reduction of circumcision in preventing HIV transmission among MSM. In the multivariate analysis, perception of overly long foreskin (odds ratio [OR] = 6.04), unprotected sexual intercourse with male regular sex partners in the last six months (OR = 2.04), and seeing no chance for contracting HIV in the next 12 months (OR = 0.54) were significantly associated with conditional willingness for circumcision. Adjusting for these variables, other significant factors were identified by multiple logistic regression analysis, including number of perceived disadvantages for having overly long foreskin (adjusted OR = 2.60), variables that were derived from the Theory of Planned Behaviors (TPB), and having some circumcised MSM peers (adjusted OR = 0.45–4.38). Some risk compensation behaviors however, may be practiced by 15.9% of the MSM who were willing to undergo circumcision. The acceptability would increase slightly with the effect size of circumcision in protecting MSM from HIV transmission via homosexual intercourse. However, it was only around 30%, even if circumcision could result in a large (50%) risk reduction in HIV transmission among MSM. If future studies can establish efficacy of circumcision, relevant promotion programs need to guard against risk compensation, though the magnitude of risk compensation may be moderate. [ABSTRACT FROM PUBLISHER]

Objective: To compare the performance and acceptability of 2 types of female condoms (FCs) among female sex workers (FSWs) in China. Methods: The present crossover survey trial was conducted in Enping City between September and December 2007. Results: There were no significant differences between the 2 types of condoms in cumulative rates of episodes of misdirection; participants experiencing discomfort or feeling the outer or inner ring of an FC; or the clinical breakage or turning inside out of an FC. The rates of total clinical failures were similar for both FC types. Moreover, 59.5% of the survey participants reported that either type was acceptable to them. Conclusion: There were no statistically significantly differences in performance between the 2 types of FCs tested, and most participants would accept using either in the future. [ABSTRACT FROM AUTHOR]

The article presents a study which determined the microbicide acceptability rate of female sex workers (FSW) and male clients in Yunnan, China. It says that a large percentage of FSW are willing to accept changes. It also mentions that the efficacy, safety, and affordability of microbicides are among the major factors that influence acceptability among FSW and their clients. Thus, it suggests that development of microbicides can possibly contribute to control HIV epidemic transmission in China.

Abstract: Infection with the human papillomavirus (HPV) is one of the most common sexually transmitted infections and causes virtually all cervical cancer globally. The recent development of two safe and clinically effective vaccines against HPV is a promising step towards lowering cervical cancer rates in the future. What Chinese women think about HPV and the vaccines remains unknown. We undertook a population-based survey, which was embedded in a cervical cancer screening project and was designed to assess women''s knowledge about HPV and their acceptability to the vaccines. We found that only 15.0% of women in our study reported to have ever heard of HPV, and this knowledge differs by rural (9.3%) and metropolitan areas (21.6%) and also by education. Most (84.6%) participants were willing to be vaccinated if HPV vaccine became available to them. The present study documents ways in which women learn about HPV and indicates the potential barriers and success of introducing HPV vaccine to China. [Copyright &y& Elsevier]

Abstract: Purpose: An acceptability study of an injectable preparation of the synthetic steroid testosterone undecanoate as a once-a-month male contraceptive method was carried out concurrently with, but independently from, a clinical safety and efficacy trial of this preparation in China, from 1997 to 1999. Method: Three hundred eight men, the entire group of volunteers enrolled in the clinical trial, were interviewed using a structured questionnaire. In addition, 24 sessions of focus group discussions and 54 in-depth interviews were conducted with a broad range of stakeholders, including men enrolled in the trial and their wives, potential users, service providers, principal investigators of the six participating clinical trial centers, provincial and national policy makers, and experts engaged in research and development of male methods of contraception. Results: Overall, men found the regimen to be acceptable, and most reported no change or an improvement in their well-being as a result of participating in the clinical study. The frequency of the injections, monthly semen analyses and the need to use another contraceptive method during the period of sperm suppression were reported inconveniences of the trial. Conclusion: Further research is needed to assess the long-term safety, continuation rates, satisfaction among users and issues related to service delivery. [Copyright &y& Elsevier]

The acceptability and value of patch testing in Hong Kong was studied in 56 cases of suspected dermatitis (CD), 26 cases of endogenous (EE) and 30 cases of unclassified eczema (DE), selected systematically: all those suspected of having CD and 1 in 3 of the others, 81.3% of the 112 patients selected accepted the test. The main reasons for refusal were inconvenience and lack of time for the readings. Of the 91 tested, in 88 they were successfully completed. In 39 patients, the results were negative, while 49 patients reacted to 1 or more allergens. The 2 commonest sensitizers were fragrance-mix (15 patients) and nickel sulphate (14 patients). The "usefulness" of patch testing was defined as it causing the initial clinical diagnosis to be changed. The test was found to be "useful" in 10 cases (21.3%) of those diagnosed as CD in 2 respects: (a) changing the diagnosis from irritant to allergic CD (6 cases) and (b) changing the diagnosis from CD to a suspected substance, to CD to another unsuspected substance (4 cases). For EE and UE, the initial diagnosis was changed to allergic CD in 3 (18.7%) and 7 (28.0%) cases, respectively. [ABSTRACT FROM AUTHOR]