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Background: Investigating emotion sequence patterns in the posts of discussion forums in massive open online courses (MOOCs) holds a vital role in shaping online interactions and impacting learning achievement. While the majority of research focuses on the relationship between emotions and interactions in MOOC forum discussions, research on identifying the crucial difference in emotion sequence patterns among different interaction groups remains in its infancy. Objectives: This research utilizes deep learning and sequential pattern mining to investigate whether there are differences in emotion sequence patterns across different groups of learners who exhibit various types of interactions in online discussion forums. Methods: Data from a comprehensive array of sources, including log files, discussion texts and scores from 498 learners in online discussion forums, were collected for this study. The agglomerative hierarchical algorithm is used to classify learners into groups with different levels of interactions. Additionally, we implement and evaluate multiple deep learning models for detecting different emotions from online discussions. Relevant emotion sequence patterns were identified using sequence pattern analysis and the identified emotion sequence patterns were compared across different groups with different levels of interactions. Results and Conclusions: Using an agglomerative hierarchical algorithm, we classified learners into three distinct groups characterized by different levels of interactions: high, average and low level. Leveraging the bi‐directional long short‐term memory model for emotion detection yielded the highest predictive performance, with an impressive F‐measure of 94.01%, a recall rate of 93.83% and an accuracy score of 95.01%. The results also revealed that learners in the low‐level interaction group experienced more emotion transition from boredom to frustration than the other two groups. Therefore, the aggregation of students into groups and the utilization of their MOOC log data offer educators the capability to provide adaptive emotional feedback, customize assessments and offer more personalized attention as needed. Lay Description: What is currently known about the subject matter: Emotions are dynamic over time when learners experience cognitive disequilibrium/equilibrium.Online interactions are critical components, which influence learners' emotional state, cognitive processes and learning achievement.It is not clear what are differences in emotion sequence patterns across the groups with different interaction types. What the paper adds: An agglomerative hierarchical algorithm was implemented to cluster learners into three groups by analysing behavioural data.We explore possibilities for automated classification of emotions using deep learning approaches.Learners in the low‐level interaction group experienced more emotion transition from boredom to frustration. Implications for practitioners: A considerable amount of effort should be expended to identify and respond to learners who experience boredom and frustration emotions.Designing interventions or scaffolding to facilitate learners' interaction and promote favourable emotions.Educators could provide more personalized support based on learners' online interaction cluster. [ABSTRACT FROM AUTHOR]

The principles of CBT emphasize the interactions among cognition, emotion, and behavior. CBT's origins lie in Stoicism philosophy and share similarities with the ideas of Confucianism, Taoism, and Traditional Chinese Medicine (TCM) in China. The idea of mind–body regulation in traditional Chinese culture has laid a cultural foundation for the promotion of CBT in China. This paper analyzes the applicability and challenges of CBT in China based on the current development of CBT in mainland China and the learning and practice of CBT therapists. It also explores the potential further development of CBT in China and the integration of CBT with the Chinese culture. [ABSTRACT FROM AUTHOR]

This paper explores the components of Chinese college counsellors' mental models in their daily work based on a rich content analysis of the story accounts of 152 exemplary college counsellors over the past 8 years. On the basis of a rigid three‐step coding procedure, this study reveals that Chinese college counsellors' mental models generally comprise four common constituents, namely a love‐filled faith system, a rule‐based thinking system, a professionalism‐based knowledge system and action‐based performance. These components jointly illustrate the general landscape of Chinese college counsellors' internal well‐being and fill a research gap regarding the sparse attention given to counsellors in the global literature on faculty professionalism. [ABSTRACT FROM AUTHOR]

The vulnerable children refer to the special group of children with deviation in the process of children's psychological development and personality formation due to growth dilemmas. This may incur a series of serious social and family problems. The vulnerable children mainly cover the children suffering from children's psychological problems, such as childhood autism, autism, social anxiety and hypersensitivity, fear, depression, and PTSD arising from other factors. At present, the research results at home and abroad mainly focus on the psychological dynamic correlation investigation and solution discussion of a certain kind of difficult factor in the children's psychological development based on statistical data by the experimental methods, such as scale and model, and there is a blind spot in the humanistic orientation theory construction of psychological treatment for vulnerable children, causing the social reflection on children's psychological predicament from the humanistic perspective cannot be performed in related researches and going against searching for universal and integral theoretical paradigm for solving related problems. Sophisticated technologies for the observations have emerged increasingly for enabling the psychological features of vulnerable children through developmental cognitive neuroscience experiments. This paper introduces humanistic art therapy theory, focuses on the construction of a theoretical paradigm, and verifies its effectiveness based on the experimental results on the psychological development of vulnerable children, with an efficient performance. This study mainly refers to children with difficulty in social inclusion and psychological development. The results showed that two kinds of art therapy can obviously improve the psychological disorders of vulnerable children. The goal was to enhance self-cognition, strengthen emotional interaction, and implement positive motivation. [ABSTRACT FROM AUTHOR]

As a healthcare ICT4D solution, mobile health (mHealth) can potentially improve users' well‐being during pandemics, especially in developing countries with limited healthcare resources. Recent ICT4D research reveals that providing end‐users with access to ICT is insufficient for improving well‐being and, thus, understanding how mHealth empowers end‐users to enhance well‐being against stressful events is important. However, prior research has rarely discussed the issue of empowerment in the domain of mHealth or the context of major disruptive events. This paper contributes to the literature by conceptualizing the psychological empowerment of mHealth users (PEMU) and investigating its nomological network during pandemics. Drawing upon theories of psychological empowerment and event characteristics, we developed a research model and tested it through a mixed‐methods investigation, containing a quantitative study with 602 Chinese mHealth users during COVID‐19 and a follow‐up qualitative study of 326 online articles and reviews. We found that PEMU, driven by three technological characteristics (perceived response efficacy, ease of use, and mHealth quality), affects well‐being through both (a) a stress‐buffering effect, which counterbalances the detrimental, stress‐increasing effects of event criticality and disruption, and (b) a vitality‐stimulating effect, which is intensified by event criticality. These findings have important implications for ICT4D research and practice. [ABSTRACT FROM AUTHOR]

With the rise of the transportation mode of shared electric bikes (shared e-bikes) in China, shared e-bike related accidents have gradually increased. To facilitate the design of safety policies, it is important to understand the factors that influence shared e-bike riders' traffic accidents to facilitate intervention strategies. For this purpose, the structural equation model (SEM) with mediation analysis was applied by incorporating seven latent factors: traffic accidents, traffic violation behaviors, attitude toward safety responsibility, and attitude toward rule violations, risk perception, perceptive-motor skills, and safety skills. A questionnaire survey of a sample of 406 shared e-bike riders in China was conducted to obtain self-reported survey data. The results reveal that traffic violation behaviors and attitude toward safety responsibility had a statistically significant consequence on traffic accidents. Attitude toward rule violations, perceptive-motor skills, and safety skills can predict shared e-bike riders' traffic accidents when the traffic violation behaviors are used as a mediator. Moreover, risk perception could also be used to predict shared e-bike riders' traffic accidents when using attitudes toward safety responsibility or rule violations and traffic violation behaviors as a mediator. This paper lays a foundation for policymakers and traffic managers to develop effective intervention strategies and improve shared e-bike safety. [ABSTRACT FROM AUTHOR]

Cyber dating abuse victimization (CDAV) among female adolescents is common and harmful; however, little is known regarding how CDAV relates to victims' experiential avoidance in the Chinese context. Drawing from general strain theory, this cross-sectional study investigated possible differences in the relationships among CDAV, experiential avoidance, and self-compassion according to female adolescents' levels of interpersonal flexibility (low vs. high). A sample of 420 female adolescents aged 13 to 17 years (mean age = 15.78 years) who had been in intimate relationships during the past year participated in a voluntary and anonymous paper-and-pencil survey. Participants completed four self-reported measures on CDAV experience, self-compassion, experiential avoidance, and interpersonal flexibility. The findings indicated that nearly 49% of participants had experienced CDAV in the last year; CDAV exposure was directly linked with experiential avoidance and indirectly related to experiential avoidance through self-compassion. Moderation analyses showed that the negative associations between CDAV and experiential avoidance and self-compassion were only significant among participants with low interpersonal flexibility. These findings deepen the understanding of CDAV as a risk factor for reduced self-compassion and increased experiential avoidance in female adolescents. However, high interpersonal flexibility is a potential protector. This study has implications for the prevention of experiential avoidance among female adolescents exposed to CDAV and supports incorporating self-compassion and interpersonal flexibility skills to combat the negative outcomes of CDAV. [ABSTRACT FROM AUTHOR]

Highlights • China's MI field has undergone significant development. • Few authors have high-quality articles and high output. • The collaboration intent of authors is growing stronger. • The field of research is relatively stable. • Current advanced technologies continue to emerge in MI research. Abstract Background As the world's second largest economy, China makes unique contributions to the world in many fields, including sociology, the economy, technology and defense. Medical informatics (MI) is an important cross-disciplinary field that, along with its applications, has received massive funding from the Chinese government. However, the question of how to evaluate China's input and output in MI remains important and complex issue of great significance for China and the rest of the world. Objective This paper analyzed, for the first time, the quality and quantity of research by Chinese academics in MI based on their articles published in international specialty journals in recent years and examined MI research hotspots in China. Our purpose is to summarize the experiences and lessons learned by China and the rest of the world as they develop MI. Method We targeted 18 MI journals listed in the JCR 2016 report and searched for papers published by Chinese academics in these 18 journals in the WOS and PUBMED databases and on journal sites. We also performed data cleansing and categorized the obtained information. We used Excel, SPSS, Ucinet and NetDraw to conduct quantitative analyses on the research papers. Results A total of 1340 articles satisfied the inclusion criteria of this study. We observed a significant upward trend in the number of articles published over time, particularly after 2011. Lei Jianbo, Huang Zhengxing and Li Jin-song are active Chinese authors in the MI discipline who have written many high-quality publications. Meanwhile, universities remain the primary breeding grounds for scientific research: 93.36% of the articles came from universities. Zhejiang University published the most first-author articles, whereas Zhejiang University, Shanghai Jiao Tong University and Tsinghua University produced 17.76% of the total articles. According to the lists of authors, 24% of the papers were co-authored with foreign researchers. This rate of cooperation is increasing each year, from 5.88% to the current rate of 39.04%. An analysis of keywords showed that “EMR”, “SVM”, “Authentication”, “Telecare medical information system”, “EEG”, “ECG” and “RFID” were the most frequently searched terms in popular technological fields, including artificial intelligence and image processing. In recent years, there has been a significant increase in the number of high-frequency keywords and a broadening range of research fields, which has led to the emergence of several research hotspots, including MI systems, mobile health care, telecare, data mining and machine learning. Conclusions Through the quantitative analysis of publications, we discovered the emergence of three stages – infancy, slow growth and rapid growth – in China's MI research in recent years as academics make achievements in their research works. The global influence of Chinese academics is growing, and they are making increasingly conscious efforts to enter into research collaborations with foreign researchers. The findings of Chinese academics’ publications are gaining international recognition. [ABSTRACT FROM AUTHOR]

In the face of COVID-19, many schools have to educate their students using online activities. During this time, whether and how parents are involved may be of particular importance for young children—who are less able to learn independently via the Internet due to their developmental immaturity. Therefore, this study examined the cross-sectional association of maternal involvement in child online learning with child adjustment during the COVID-19 pandemic and tested maternal mindfulness as a moderator. Data were collected from 236 mothers of kindergarten-aged children (mean age = 55.91 months; 75% of them were girls) during the fourth wave of COVID-19 outbreak in Hong Kong, China. Using paper-and-pencil questionnaires, mothers rated their involvement and mindfulness and their children's pre-academic ability and internalizing and externalizing behaviors and provide demographic information. Regression models revealed that maternal involvement was associated positively with child pre-academic ability and negatively with child internalizing behaviors, but such associations were only significant for children with more mindful mothers. Maternal mindfulness did not moderate the negative association between maternal involvement and child externalizing behaviors. Findings highlighted the role of maternal mindfulness in child development, suggesting that it may be crucial to promote maternal involvement and mindfulness during the pandemic and perhaps beyond. [ABSTRACT FROM AUTHOR]

The paper collaboratively probes the diachronic, cultural and psychological resources inherited from the classical heroic myth of China, Kuafu Chases after the Sun. With the conceptual system of Analytical Psychology and Chinese culture, starting with ancient mythological texts, the authors carry out studies on three dimensions of the historical and contemporary images of Kuafu, the conscious and unconscious contents, and the collective and the individual psyche. First, the paper explores the collective representations of consciousness based on ancient and modern works of art, reviews and cultural phenomena. Second, on collective and cultural unconscious symbols, Kuafu is a heroic archetypal image, and there are four dynamic images from change to transformation. Third, the exploratory study of a case with Sandplay Therapy finds the projection and emergence of the Kuafu myth for individual consciousness is of great clinical value for helping the client experience and transform their psychological conflicts. [ABSTRACT FROM AUTHOR]

The ageing population has been rapidly growing over recent years. Theoretically, religion seemingly plays an important role in improving older people's health. This study examines whether believing in religion is related to better health conditions among Chinese older adults through a meta-analysis. Two researchers independently extracted the studies from a comprehensive database and grey literature search and evaluated their scientific quality. From the 3,777 potentially eligible papers, just 76 were selected. The pooled effect size detected no significant difference between Chinese religious and non-religious older adults' overall health and wellbeing. Dividing the outcomes into different categories, religious older adults reported both a higher level of anxiety (Hedge's g = −0.392, 95% confidence interval (CI) = −0.494, −0.290; p = 0.004) and yet a higher level of happiness (Hedge's g = 0.342, 95% CI = 0.074, 0.610; p = 0.018). Having a higher proportion of females in the sample is related to a smaller effect size in overall health outcomes (β = −2.205, 95% CI = −3.800, −0.613; p = 0.007) and social support specifically (β = −4.660, 95% CI = −6.261, −3.058; p < 0.0001). This study is among the first to synthesise the quantitative evidence regarding health differences between older religion believers and non-believers in China. It calls for future studies investigating the pathways underlying the religion–health relationship. [ABSTRACT FROM AUTHOR]

The novel coronavirus disease 2019 (COVID-19) has placed tremendous pressure on public health systems across the world. Compared with the healthy population, cancer patients are more prone to developing psychological problems, including depression and anxiety, because of worries about cancer recurrence, cancer symptoms, treatment-related discomfort, a lack of social interaction and the impact on their financial well-being. This paper aimed to identify existing evidence on psychological symptoms and their associated factors among cancer patients in the Chinese Mainland during the COVID-19 pandemic, and on interventions to effectively manage these symptoms. Articles related to the prevalence, the risk factors and interventions of psychological symptoms among cancer patients in the Chinese Mainland during COVID-19 published between December 2019 and August 2020 were searched in two English (PubMed and Embase) and two Chinese (CNKI and Wan Fang Data) databases. A total of 180 studies were identified, and 18 studies were included in the review after removing duplicates and screening for relevancy. The results suggest that patients with cancer in the Chinese Mainland have suffered psychological pressure during COVID-19, with a high prevalence of psychological distress, depression and anxiety reported across most of the reviewed studies. Pandemic-related factors such as treatment discontinuation and worry about being infected are associated with these symptoms. Nurses may help to relieve these symptoms by identifying stressors, providing relevant information through mass and social media and referring patients to specialists for psychological support. However, evidence about treatments and interventions for these symptoms is limited, and additional research is warranted to identify effective interventions to promote resilience in this patient population. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the knowledge and practices of Chinese doctors in the management of osteoporotic fractures after the Chinese osteoporotic fracture guidelines update and aseries of medical education in 2017. Methods: This was a cross‐sectional survey of doctors in 71 cities across Mainland China. Based on the 2017 Chinese guidelines for the diagnosis and treatment of osteoporotic fractures, a questionnaire was designed and pre‐tested for reliability and validity. Doctors were surveyed with the questionnaire after scientific meetings during February 2017 to January 2018 through WeChat or conference digital platforms or in paper form. Descriptive statistics was used to analyze the responses to the questionnaire. Results: Overall, 314 valid questionnaires were confirmed. Regarding diagnosis, 77% agreed that osteoporosis could be diagnosed once an osteoporotic fracture occurred; 83% believed that the bone mineral density criteria for osteoporosis diagnosis would be T ≤ −2.5 SD. For treatment, almost all (99.7%) agreed with anti‐osteoporosis treatment being one of the basic principles of osteoporotic fracture treatment; 71.6% considered bisphosphonates as the most commonly used anti‐osteoporosis drug; 97% believed that patients who have used anti‐osteoporosis drugs should reassess osteoporosis after osteoporotic fractures instead of discontinue; 95% thought that the patients who did not use anti‐osteoporosis medications before osteoporotic fracture should be treated with anti‐osteoporosis drugs after fracture treatment as early as possible; 89% agreed that the standard use of bisphosphonates after osteoporotic fracture would not affect bone healing adversely; 59% believed the course of bisphosphonates treatment for osteoporosis would be 3–5 years, and 27% considered it to be 1–3 years. The patient follow‐up rate was poor: 46% selected follow‐up rate <30%; only 20% selected follow‐up rate >50%. Only 31% of the hospitals had long‐term management programs for osteoporotic fractures. Conclusions: Doctors generally adhered to the updated Chinese guidelines for osteoporotic fractures; frequent participation in medical education can help doctors to increase their awareness of osteoporosis as well as their acceptance and practice of the guidelines. [ABSTRACT FROM AUTHOR]

Highlights • This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. • Lower level of exclusion from social relationships was associated with less likely to report fair or poor SRH. • Lower level of subjective feelings of exclusion was associated with less likely to report fair or poor SRH. • Lower level of subjective feeling of exclusion was associated with less likely to report depression. • Lower level of exclusion from financial products was associated with less likely to report depression. Abstract Background It is well established that social exclusion is a key social determinant of health; however, such association between social exclusion and health outcomes among older people remain a relatively under-researched area. This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. Methods This paper includes 8038 individuals aged 60 and over from the first wave national multi-stage probability sample (2014) from the China Longitudinal Aging Social Survey (CLASS). Descriptive univariate information for individual variables and four dimensions of social exclusion are presented. Multinomial and binary logistic regression models are used to examine the associations between social exclusion and self-rated health and depression. Results Older people who were in the lower level of exclusion from social relationships or subjective feelings of exclusion were significantly less likely to report fair or poor self-rated health than people in the higher level of exclusion (lower level of exclusion from social activities was significantly associated with being less likely to report poor SRH only). Older people who were in the lower level of subjective feeling of exclusion or exclusion from financial products were significantly less likely to report depression. Conclusions Different dimensions of social exclusion have different effects on self-rated health and depression. Social policies need to reflect this and efforts of services could usefully be oriented to prevent multi-dimensions of social exclusion. Ultimately, such policies should have the potential to enhance the health of older people in China. [ABSTRACT FROM AUTHOR]

Aiming to solve the safety problems of high-speed railway operation and management, one new method is urgently needed to construct on the basis of the rough set theory and the uncertainty measurement theory. The method should carefully consider every factor of high-speed railway operation that realizes the measurement indexes of its safety operation. After analyzing the factors that influence high-speed railway safety operation in detail, a rough measurement model is finally constructed to describe the operation process. Based on the above considerations, this paper redistricts the safety influence factors of high-speed railway operation as 16 measurement indexes which include staff index, vehicle index, equipment index and environment. And the paper also provides another reasonable and effective theoretical method to solve the safety problems of multiple attribute measurement in high-speed railway operation. As while as analyzing the operation data of 10 pivotal railway lines in China, this paper respectively uses the rough set-based measurement model and value function model (one model for calculating the safety value) for calculating the operation safety value. The calculation result shows that the curve of safety value with the proposed method has smaller error and greater stability than the value function method’s, which verifies the feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

China’s fast economic growth contributes to the rapid development of its urbanization process, and also renders a series of industrial accidents, which often cause loss of life, damage to property and environment, thus requiring the associated risk analysis and safety control measures to be implemented in advance. However, incompleteness of historical failure data before the occurrence of accidents makes it difficult to use traditional risk analysis approaches such as probabilistic risk analysis in many cases. This paper aims to develop a new methodology capable of assessing regional industrial safety (RIS) in an uncertain environment. A hierarchical structure for modelling the risks influencing RIS is first constructed. The hybrid of evidential reasoning (ER) and Analytical Hierarchy Process (AHP) is then used to assess the risks in a complementary way, in which AHP is hired to evaluate the weight of each risk factor and ER is employed to synthesise the safety evaluations of the investigated region(s) against the risk factors from the bottom to the top level in the hierarchy. The successful application of the hybrid approach in a real case analysis of RIS in several major districts of Beijing (capital of China) demonstrates its feasibility as well as provides risk analysts and safety engineers with useful insights on effective solutions to comprehensive risk assessment of RIS in metropolitan cities. The contribution of this paper is made by the findings on the comparison of risk levels of RIS at different regions against various risk factors so that best practices from the good performer(s) can be used to improve the safety of the others. [ABSTRACT FROM AUTHOR]

This paper analyzes the policy effects of China's largest social assistance program on the psychological health and wellbeing of the recipients by the regression discontinuity approach based on the 2014 China Family Panel Studies Survey (CFPS). By excluding other confounding factors and addressing the endogeneity problems, this paper shows that China's minimum living security system (MLSS) has produced significant welfare stigmatizing effects which have negatively influenced recipients' psychological health and wellbeing. The MLSS reduces recipients' self-satisfaction towards life, decreases the levels of happiness and self-confidence, and results in poorer interpersonal relationships and self-evaluations. It also increases the probabilities of feeling depressed, helpless and hopeless. The frequencies reporting having the difficulties of doing something are significantly higher among the MLSS recipients. Corresponding strategies and professional services are required for reducing the welfare stigmatizing effects on recipients' psychological health and wellbeing. [ABSTRACT FROM AUTHOR]

This paper aims to optimize a desirable fare structure for the public transit service along a bus-subway corridor with the consideration of those factors related to equity in trip, including travel distance and comfort level. The travel distance factor is represented by the distance-based fare strategy, which is an existing differential strategy. The comfort level one is considered in the area-based fare strategy which is a new differential strategy defined in this paper. Both factors are referred to by the combined fare strategy which is composed of distance-based and area-based fare strategies. The flat fare strategy is applied to determine a reference level of social welfare and obtain the general passenger flow along transit lines, which is used to divide areas or zones along the corridor. This problem is formulated as a bi-level program, of which the upper level maximizes the social welfare and the lower level capturing traveler choice behavior is a variable-demand stochastic user equilibrium assignment model. A genetic algorithm is applied to solve the bi-level program while the method of successive averages is adopted to solve the lower-level model. A series of numerical experiments are carried out to illustrate the performance of the models and solution methods. Numerical results indicate that all three differential fare strategies play a better role in enhancing the social welfare than the flat fare strategy and that the fare structure under the combined fare strategy generates the highest social welfare and the largest resulting passenger demand, which implies that the more equity factors a differential fare strategy involves the more desirable fare structure the strategy has. [ABSTRACT FROM AUTHOR]

In order to trace the research trends and hotspots related to the field of driver behavior research both in China and worldwide, a bibliometric analysis was performed to systematically analyze 7208 scientific papers about driver behavior in the Web of Science database from 1957 to 2018, and the results were discussed from the 6 perspectives of growth trends of publications, geographical distribution, subject categories, institutions, authors and keywords distribution. The results show that research on driver behavior has been increasing rapidly since the 1990 s, but research in Europe and the United States started more than 20 years earlier than in China. Currently, transportation, engineering, computer science and behavioral science have replaced the traditional subject categories, becoming the most important domains in this field. Research on driver behavior focuses on safety and systems using simulation models which is interacted with almost everything concerning traffic operation and safety. The current trend is that more researchers are working on understand the driver-vehicle-system interactions under the environment of connected and autonomous vehicle. Further research is needed to focus on unsafe driving behavior based on driver-vehicle-system interactions. This study will provide scholars in related academia and industry with panoramic knowledge of driver behavior research, as well as research hotspots and future research directions. [ABSTRACT FROM AUTHOR]

In China, nursing is a profession with considerable stress, which may cause both physiological and psychological problems. The present study conducted a cross‐temporal meta‐analysis of 244 papers using the Symptom Checklist 90 (SCL‐90) to investigate the changes in the mental health level of Chinese nurses (N = 71,286) from 1998 to 2016. Results showed that (a) relationships between scores of all nine types of mental problems in the SCL‐90 and year were significantly positive, indicating that the mental health level of nurses decreased steadily in the past 19 years; (b) relationships between three social indicators (patient‐to‐nurse ratio, unemployment rate, and divorce rate) and scores of all nine types of mental problems in the SCL‐90 were significantly positive, suggesting that the increase in these social indicators may be responsible for the decrease in Chinese nurses' mental health level. [ABSTRACT FROM AUTHOR]

In this paper, I explore Chinese Daoist theoretical connections with modern conceptions of dialogue and Western theories of psychology. I investigate and compare these lines of Western thinking with classical Chinese thought, noting the complexities in each. I discuss and disseminate how the Daoist principle of yin yang may be related to the dialogic understandings of Bakhtin. I also contend that the Western field of psychology, particularly the work of Carl Jung , has incorporated Daoist principles of yin yang in its conception and practice. I argue that present Western thought in general may have connections with Chinese Daoist thinking in conceiving of a reality that is in dynamic and in flux. [ABSTRACT FROM AUTHOR]

Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to be in tension with being an activist, which requires pragmatism, simplicity, certainty and, above all, action. In this paper I explore this apparent dichotomy, using the case example of my own involvement in international efforts to end forced organ harvesting from prisoners of conscience in China. I conclude that these tensions can be managed and that academic bioethics requires a willingness to be activist. [ABSTRACT FROM AUTHOR]

It is stated that people's need to live a good life is the key task of the whole nation in China. This paper proposed a pathway to human's good life in the Chinese culture context. The access to the goal should be in the human's spirituality. According to Existential Positive Psychology originated in the west and Yangming Theory of Mind in the east, individuals may find or create their meaning in life (meaning therapy) by flexibly adopting PURE strategies (a process of Purpose, Understanding, Responsible action, and Enjoyment or Evaluation), ABCDE strategies (a process of Acceptance, Belief, Commitment, Discovery, and Evaluation or Enjoyment) and another integrative strategies. The meaning-centered therapy includes cognitive approaches, narrative approaches, and acceptance & commitment therapy, etc. Also, it mainly bases on meaning management theory and the dual-systems model. Finally, with the ability of self-transcendence or people's spirituality, along with conscience and responsibility, people are responsible for everything in their life consciously and transcend self and circumstance to achieve good life at last. And the implications for Chinese community's mental health service are discussed in the background of current social reality of China. [ABSTRACT FROM AUTHOR]

Although urbanization in China is growing at a fast pace, there is still a large section of population (45%) living in rural or remote locations. In this developing country with the world's largest population, the government's strict household registration (hukou) control policy results in less opportunity for children with rural hukou status to have access to adequate education resources. The aim of this study is to explore the individual and contextual factors that are conducive to rural students' academic resilience. We use data from the Chinese Family Panel Studies (2012 wave) that include 1729 Chinese children aged 10–15 years (boys 53.8%; girls 46.2%) from more than 25 provinces. Among them, 70.1% are from the rural area, 25.2% are of urban hukou, 4.7% are those with no hukou or foreigners, and 50.1% are primary school students. Through comparison between rural non-resilient and resilient groups, this paper finds different pathways for rural Chinese children's academic resilience. Having high parental expectation and attending key schools are important in the Chinese context while helping to check homework seems ineffective in improving Chinese rural children's academic performance. The findings provide empirical evidence that understanding resilience needs to take contexts and culture into consideration. [ABSTRACT FROM AUTHOR]

Test anxiety was a commonly known or assumed factor that could greatly influence performance of test takers. With the employment of designed questionnaires and computer-based spoken English test, this paper explored test anxiety manifestation of Chinese college students from both macro and micro aspects, and found out that the major anxiety in computer-based spoken English test was spoken English test anxiety, which consisted of test anxiety and communication apprehension. Regard to proximal test anxiety, the causes listed in proper order as low spoken English abilities, lack of speaking techniques, anxiety from the evaluative process and inadaptability with computer-based spoken English test format. As to distal anxiety causes, attitude toward learning spoken English and self-evaluation of speaking abilities were significantly negatively correlated with test anxiety. Besides, as test anxiety significantly associated often with test performance, a look at pedagogical implications has been discussed in this paper. [ABSTRACT FROM AUTHOR]

China is facing severe pressure on its water resources and water environments. Calculating the industrial water efficiency of each province is an important index for the central government to evaluate local governments. In the traditional water resources evaluation index, the industrial water use efficiency and pollutant discharge are evaluated separately. In this paper, we collected industrial input data, output data and pollutant discharge data with a four-stage data envelopment analysis to calculate China's industrial water use efficiency with and without considering pollutant discharge, and then analyzed the factors influencing the industrial water use efficiency. The results show that the eastern coastal provinces of China have the highest water use efficiency and are less affected by pollutant discharge than other provinces. The industrial water use efficiency of the central and western provinces is lower than that of the other provinces, and the industrial water use efficiency in the central provinces is greatly affected by pollutant discharge. Factor endowment, economic development level, scientific and technological progress, industrial structure, proportion of foreign investment, water consumption per 10000 yuan of value-added by industry, industrial sewage treatment capacity and educational investment have a significant influence on the industrial water use efficiency of China. We suggest that the government strengthen the construction of sewage plants and other related infrastructure in central provinces when conducting the industrial transfer of heavy polluting enterprises. [ABSTRACT FROM AUTHOR]

This paper presents an evaluation of the effectiveness of two types of deceleration markings on freeways in China: fishbone-shaped (FS) markings and edge-rate (ER) markings. An actual 4-lane, 6-km long freeway in Province Hebei was created in a driving simulator and used for the experiments. Three scenarios of deceleration markings were adopted: one without markings, one with FS markings, and the third with ER markings. For each scenario, three traffic flow levels were adopted (low, medium, and heavy). The appropriate dimensions of deceleration markings were first established using relevant design guidelines and then used to develop the simulation scenarios using Multigen Creator software. Sixty drivers carried out the simulation experiments with eye tracker equipment. The adequacy of deceleration markings was analyzed with respect to speed, perceived distance, pupil diameter, and geometric parameters. The results showed that both types of deceleration markings made a certain effect on vehicle speed, drivers’visual behavior, and mental characteristics. However, the effect of the FS markings was more pronounced than that of the ER marking. Specifically, the FS markings showed a speed reduction of 12.3 km/h to 15.2 km/h and a perceived distance of 70 m to 90 m, compared with 6.7 km/h to 9.9 km/h and 40 m to 60 m, respectively, for the ER markings. Application comments of the results are provided in the conclusion. [ABSTRACT FROM AUTHOR]

This paper reports the development and baseline data of a vignettes-based measure of gender equality. Methods: Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China. Results: Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings. Conclusion: This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist. [ABSTRACT FROM AUTHOR]

Individuals in developing countries often engage in paid and unpaid work till late in life due to low household savings and limited welfare provisions. Yet, physical disabilities associated with aging can limit their ability to work. While work can be beneficial for economic and psychological well-being, this paper investigates whether engagement in paid and unpaid work mediates the impact of physical disabilities on quality of life for older adults. We exploit the different levels of health services and social security in rural and urban China and India to examine the effect of public provisions in the process. We use nationally representative data of individuals aged 50 and above from the World Health Organization Study on Global Ageing and Adult Health Wave 1, conducted in 2008–10 in China and in 2007–08 in India. Using a causal mediation analysis framework, we find that paid work plays a minor role in mediating the effect of physical disabilities on quality of life in all societies, and the mediated effect is smaller in urban China than in other societies. Unpaid work is beneficial only in urban China, and it does not mediate the impact of physical disabilities on quality of life elsewhere. The findings indicate that promoting productive engagement alone, without improving basic public provisions, will have limited impact on improving quality of life of the aging population in developing countries. • In developing countries, both paid and unpaid work is common out of necessity. • Older adults bear a double burden of paid and unpaid work in rural China and India. • Productive aging has limited impact on quality of life in developing countries. • Impact of productive aging on quality of life varies with public provisions. • Physical disabilities associated with aging is less consequential in urban China. [ABSTRACT FROM AUTHOR]

The apparent conspicuous consumption of luxury vehicles by Chinese international students attending a public Michigan University provides an opportunity to examine the convergence of different ideas about automobility. Upwardly mobile Chinese families send their children to Michigan, a state with a tradition of auto-production, for educational opportunities not available in China. The resulting 'car talk' of local residents about Chinese students and their cars speaks to broader anxieties about Michigan's shifting relationship to the global economy. However, the paper focuses on the meanings of auto-owning created by Chinese students who make decisions about the purchase and use of their autos within a social world oriented primarily to other Chinese students and societal ideas about auto-owning circulating among friends, family and society in China. For Chinese students, car owning encompasses meanings of status, safety and sociability that are created within the context of study abroad. [ABSTRACT FROM AUTHOR]

This paper reports three eye-tracking experiments using the visual world paradigm to explore the meaning of conditionals in Mandarin Chinese. Experiment 1 found that, when all the tokens were actually true in the experimental setting, the conditional connective if … then …  didn't elicit significantly more anticipatory fixations than the conjunctive connective  … and …  on a token that is appropriately to be merged by the sentential connectives. By contrast, Experiments 2 and 3 found that, when a token was designed as hypothetically but not actually true in the experimental setting, the conditional connective elicited significantly more anticipatory fixations than the conjunctive connective on this hypothetical token. The implications of the experimental paradigm and the observed results were then discussed in relation to theories of conditionals, and to models of rationality in general. [ABSTRACT FROM AUTHOR]

Family Interventions in Psychosis (FIP) have been promoted internationally but have been criticised for being based on western cultural models. This paper reports on a focus group study with 10 Integrated Mental Health Service Managers in Guangzhou, China using thematic analysis. Managers believed FIP might benefit families but identified potential difficulties due to (a) families avoiding services due to the ‘shame’ of mental illness (b) unrealistic expectations of services amongst families (c) deferral to ‘key decision-makers’ within families when discussing family issues with workers. The findings indicate that FIP work should focus on interaction between carers in the first instance with service users being introduced into sessions at a later date and that more attention needs to be given by the research community to how FIP may be adapted to cultural norms within China. [ABSTRACT FROM AUTHOR]

This study examined the circular structure of values in China. The circular structure is a central element of Schwartz value theory and visualises the idea that some values are similar while others conflict with one another. Whereas numerous studies addressed the question whether the circular structure of values can be generalised cross‐culturally, results for China are inconclusive. In this paper, we argue that taking a closer look at China provides a challenge to the circular structure and allows for drawing conclusions regarding the limits versus generalizability of Schwartz' theory. For this purpose, we first conduct a re‐analysis of Chinese data from a former meta‐analysis (Study 1) and second, present results from a large study of 10,652 Chinese college students (Study 2). Results of Study 1 revealed that graphical representation of the circular structure matched theoretical expectations but five out of six samples showed relatively bad fit to the theorised structure. By contrast, data in Study 2 showed a good model fit. As an overall conclusion, the circular structure is well supported in the Chinese context, and small sample sizes in previous studies might have caused the imperfect match to the prototypical circular structure. [ABSTRACT FROM AUTHOR]

This paper examines processes of adaptive governance and authoritarian resilience through the lens of community governance, bringing together hitherto unrelated fields of study. It argues first that adaptation has unintended consequences that can threaten stability but do not necessarily cause regime crisis. Second, it contends that the structural fault-lines of institutionalised categorical inequality, marketisation, and professionalization, along with the pathologies of Leninist authoritarianism, undermine adaptive community governance. The paper draws on qualitative research in two neighbourhoods of Shanghai. [ABSTRACT FROM AUTHOR]

Lacking the presence of human and social elements is claimed one major weakness that is hindering the growth of e-commerce. The emergence of social commerce might help ameliorate this situation. Social commerce is a new evolution of e-commerce that combines the commercial and social activities by deploying social technologies into e-commerce sites. Social commerce reintroduces the social aspect of shopping to e-commerce, increasing the degree of social presences in online environment. Drawing upon the social presence theory, this study theorizes the nature of social aspect in online SC marketplace by proposing a set of three social presence variables. These variables are then hypothesized to have positive impacts on trusting beliefs which in turn result in online purchase behaviors. The research model is examined via data collected from a typical e-commerce site in China. Our findings suggest that social presence factors grounded in social technologies contribute significantly to the building of the trustworthy online exchanging relationships. In doing so, this paper confirms the positive role of social aspect in shaping online purchase behaviors, providing a theoretical evidence for the fusion of social and commercial activities. Finally, this paper introduces a new perspective of e-commerce and calls more attention to this new phenomenon of social commerce. [ABSTRACT FROM AUTHOR]

This paper discusses the initial value sensitivity (IVS) of Chinese stock market, including the single stock market and the Chinese A-share stock market, with respect to real markets and evolving models. The aim is to explore the relationship between IVS of the Chinese A-share stock market and the investment psychology based on the evolving model of genetic cellular automaton (GCA). We find: (1) The Chinese stock market is sensitively dependent on the initial conditions. (2) The GCA model provides a considerable reliability in complexity simulation (e.g. the IVS). (3) The IVS of stock market is positively correlated with the imitation probability when the intensity of the imitation psychology reaches a certain threshold. The paper suggests that the government should seek to keep the imitation psychology under a certain level, otherwise it may induce severe fluctuation to the market. [ABSTRACT FROM AUTHOR]

Context: It is common practice worldwide for health professionals to study abroad. However, the outcome of such experience has not been rigorously evaluated in China. Our current study aimed to quantify the impact on research of studying abroad among Chinese health professionals. Methods: A self-administered structured questionnaire was developed among health professionals in Harbin Medical University and its affiliated hospitals who had studied abroad ('returning' professionals) and health professionals who did not have experience abroad ('resident' professionals). 166 'returning' professionals (Group A) and 166 age-, sex- and specialty-matched 'resident' professionals (Group B) were included in the study. SPSS software was used for data entry and analysis. Results: The total IF of papers published by Group A and Group B was, respectively, 1933.52 and 629.23 (P < 0.01) and the number of NSFC was 154 and 34 (P < 0.01), respectively. The total IF of papers published abroad was associated with the duration abroad (P < 0.01) and not with the age of going abroad (P > 0.05). The total IF of papers published at home, and the number of NSFC had no relationship with the duration abroad (both P > 0.05) nor the age of going abroad (both P > 0.05). The total IF of papers published at home and the number of NSFC were positively correlated with the total IF of papers published abroad (both P < 0.01). Conclusions: This study reflects the beneficial experience of working overseas. The opportunity for overseas experience should not be limited by age. Overseas study should be prolonged. [ABSTRACT FROM AUTHOR]

Few studies have investigated the distribution of sexual orientation among Chinese university students and identified the socio-demographic factors associated with sexual orientation. For the present study, we administered a paper-based, 5-point, self-report, sexual orientation scale to a stratified, random sample of 9071 undergraduates across all 10 universities in Guangzhou Higher Education Mega Center, Guangzhou, China. Multivariable ordinal regression analysis was used to explore the relationship between demographic factors and sexual orientation. A total of 8320 respondents completed the survey. Of 8182 valid respondents, 80.6% self-reported as exclusively heterosexual, 12.6% self-reported as mostly heterosexual, 5.4% self-reported as bisexual, 0.7% self-reported as mostly homosexual, and 0.8% self-reported as exclusively homosexual. About one fifth of male students and one fourth of female students reported some degree of divergence from exclusive heterosexuality. This indicates that in China there are a large number of university students who are potentially involved in same-sex sexual attraction. [ABSTRACT FROM AUTHOR]

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

Kleinman pioneered the use of intensive case studies in China and elsewhere. Drawing on this approach, this paper shows how two rural Chinese converts to Christianity recovered from prolonged mental sickness incurred during the Cultural Revolution many years earlier. The apparent ‘cure’ is part of local narrative in which rural Chinese Christians' first contact with Christianity has the pragmatic aim of seeking treatment to relieve physical pain, but leads to conversion and believed divine deliverance from psychological as well as physical suffering. In acquiring what they regard as new moral life and becoming dignified ‘divine selves’, they adopt new language and behavior and subtly change their relationships with family and the local power structure, thereby establishing a ‘holy local system’ that is regarded as able to withstand external crises and temporary setbacks. Setting up the holy local system highlights the inadequacy of rural bio-medical assistance, provides treatment for sickness and pain often blamed on Chinese society's relentless pursuit of economic development, and so introduces some compensatory if illusory rural stability. [ABSTRACT FROM AUTHOR]

Reports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform. [ABSTRACT FROM AUTHOR]

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

Based on ethnographic research during 2013–2015, this study describes an alternative form of gentrification in a traditional urban neighbourhood in Shanghai, unpacking how the notion architectural uniqueness of an urban heritage neighbourhood has imbued itself with cultural capital in the eyes of the new residents. By understanding how the original residents mobilise their knowledge of this particular selling point to benefit themselves economically by becoming renters, this study presents a case exemplifying a process of social change in which the ‘original residents’ themselves are active actors. The results of this process are the socioeconomic and ethic diversification of the neighbourhood as well as upward social mobility without any intervention by the local government or real estate developers. By suggesting an alternative process of gentrification in which not all residents are displaced unwillingly, this paper shows that the idea of gentrification demands more attention. [ABSTRACT FROM AUTHOR]

This study examines the impact of home learning environments on Chinese children’s mental health. The Home Observation for the Measurement of Environments was used to measure the degree to which children’s home learning environments are cognitively stimulating and emotionally nurturing . The Devereux Early Childhood Assessment (DECA) was used to assess children’s mental health as indicated by protective factors and behavioral concerns. A convenience sampling method was used to collect data from 137 Chinese mothers living in China who had children ages 3–5. The questions addressed in this paper are as follows: 1) Does the parental provision of home learning environments differ depending on baseline characteristics? 2) Does the parental provision of home learning environments affect children’s mental health (protective/resilience factors and behavioral concerns)? Baseline characteristics such as child’s gender, maternal age and marital status were associated with parental provision of home learning environments. Children of mothers who provided a cognitively stimulating learning environment were more likely to have higher protective/resilience factors and fewer behavioral concern factors. [ABSTRACT FROM PUBLISHER]

Based on the database data of Chinese industrial enterprises from 2000 to 2007 and the LP method, this paper measures the total factor productivity of enterprises and investigates the effect of different mixed ownership forms on enterprises’ efficiency and the effect of heterogeneous ownership balance on the mixed ownership enterprises’ efficiency. The state-owned enterprise and mixed ownership enterprise are identified by the enterprise’s paid-up capital. The results show that, on the whole, for the mixed ownership enterprise, the higher the diversification degree of the shareholders is, the higher the efficiency becomes, and in different types of industries, the mixed forms of shareholders have different effects on the efficiency of enterprises. The heterogeneous ownership balance and the enterprise efficiency show nonlinear U-type relationships. Both the higher and lower heterogeneous ownership balance degrees will promote the enterprise’s efficiency. However, when the ownership balance degree is in the range of [0.2 0.5], the increase in ownership balance will lead to the decline of enterprise efficiency. Therefore, when introducing non-state-owned capital, state-owned enterprises should take full account of their own characteristics by rationally controlling the shareholding ratio of non-state-owned capital and play the positive role of a mixed ownership structure in corporate governance with appropriate ownership balances. [ABSTRACT FROM AUTHOR]

Launching the evaluation of water literacy is important for promoting conscientious participation in the construction of a water saving society. This paper established an evaluation system of 3 first-level indices (water knowledge, water attitude, and water behavior), 10 second-level indices, and 27 third-level indices of water literacy. The analytic hierarchy process was used to establish weight index and the Likert scale was used to design a questionnaire that evaluated water literacy in four geographic regions of China: Zhengzhou, Beijing, Hechi, and Qingtongxia. Our results indicate that water behavior is the core of water literacy. Participants got a very strong sense of water environment in the background of environmental pollution. Furthermore, water knowledge, water attitude and water behavior scored differently in different regions, consistent with level of economic development. However, across all regions water literacy scores were low, with water behavior scores, the core of water literacy, ranking the lowest. Therefore, there is still a long way to go to improve water literacy in China. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the role of parental education in child disability in China. We used nationally representative data from China’s National Sample Survey on Disability, iterated twice, in 1987 and 2006, with data of 764,718 children aged 0–14 years. Logit models were used for statistical analysis. Results showed that the prevalence of child disability was significantly associated with each parent’s education. Maternal education was more important than paternal education in child disability in both surveys. The analysis of marginal effect indicated a one-year increase in maternal and paternal schooling led to an average decrease of 0.121% and 0.091% in the probability of child disability in 1987, and 19 years later, these figures had dwindled to 0.091% and 0.072%, respectively. [ABSTRACT FROM AUTHOR]

Aimed at the complicated problems of attraction characteristics regarding passenger flow in urban rail transit network, the concept of the gravity field of passenger flow is proposed in this paper. We establish the computation methods of field strength and potential energy to reveal the potential attraction relationship among stations from the perspective of the collection and distribution of passenger flow and the topology of network. As for the computation methods of field strength, an optimum path concept is proposed to define betweenness centrality parameter. Regarding the computation of potential energy, Compound Simpson’s Rule Formula is applied to get a solution to the function. Taking No. 10 Beijing Subway as a practical example, an analysis of simulation and verification is conducted, and the results shows in the following ways. Firstly, the bigger field strength value between two stations is, the stronger passenger flow attraction is, and the greater probability of the formation of the largest passenger flow of section is. Secondly, there is the greatest passenger flow volume and circulation capacity between two zones of high potential energy. [ABSTRACT FROM AUTHOR]

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Background: Since 1968, China has trained about 1.5 million barefoot doctors in a few years' time to provide basic health services to 0.8 billion rural population. China's Ministry of Health stopped using the term of barefoot doctor in 1985, and changed policy to develop village doctors. Since then, village doctors have kept on playing an irreplaceable role in China's rural health, even though the number of village doctors has fluctuated over the years and they face serious challenges. United Nations declared Sustainable Development Goals in 2015 to achieve universal health coverage by 2030. Under this context, development of Community Health workers (CHWs) has become an emerging policy priority in many resource-poor developing countries. China's experiences and lessons learnt in developing and maintaining village doctors may be useful for these developing countries. Methods: This paper aims to synthesis lessons learnt from the Chinese CHW experiences. It summarizes China's experiences in exploring and using strategic partnership between the community and the formal health system to develop CHWs in the two stages, the barefoot doctor stage (1968-1985) and the village doctor stage (1985-now). Chinese and English literature were searched from PubMed, CNKI and Wanfang. The information extracted from the selected articles were synthesized according to the four partnership strategies for communities and health system to support CHW development, namely 1) joint ownership and design of CHW programmes; 2) collaborative supervision and constructive feedback; 3) a balanced package of incentives, both financial and non-financial; and 4) a practical monitoring system incorporating data from the health system and community. Results: The study found that the townships and villages provided an institutional basis for barefoot doctor policy, while the formal health system, including urban hospitals, county health schools, township health centers, and mobile medical teams provided training to the barefoot doctors. But After 1985, the formal health system played a more dominant role in the CHW system including both selection and training of village doctors. China applied various mechanisms to compensate village doctors in different stages. During 1960s and 1970s, the main income source of barefoot doctors was from their villages' collective economy. After 1985 when the rural collective economy collapsed and barefoot doctors were transformed to village doctors, they depended on user fees, especially from drug sale revenues. In the new century, especially after the new round of health system reform in 2009, government subsidy has become an increasing source of village doctors' income. Conclusion: The barefoot doctor policy has played a significant role in providing basic human resources for health and basic health services to rural populations when rural area had great shortages of health resources. The key experiences for this great achievement are the intersection between the community and the formal health system, and sustained and stable financial compensation to the community health workers. [ABSTRACT FROM AUTHOR]