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Hedge is defined as the expression of provisionalness and possibility that makes scientific messages tentative, vague, and imprecise, thereby reducing the force of claims scientists make. Linguistic study of hedges began in the early 1970s in generative semantics. Since then, the focus has shifted from seeking linguistic properties in spoken discourse to analyzing its pragmatic functions in written contextual communication. The purpose of this paper was to analyze hedges in Chinese and English scientific articles from the perspective of contrastive pragmatics. Based on a contextual analysis of 5 Chinese and 5 English scientific articles, selected randomly, from two journals in molecular biology--Science in China and Proceedings of the National Academy of Sciences of the United States of America, there were significant differences between Chinese and English scientific articles in use of hedges.

Background: With the emergence of numerous scientific outputs, growing attention is paid to research misconduct. This study aimed to investigate knowledge, attitudes and practices about research misconduct among medical residents in southwest China. Methods: A cross-sectional study was conducted in southwest China from November 2022 through March 2023. The links to the questionnaire were sent to the directors of the teaching management department in 17 tertiary hospitals. Answers were collected and analyzed. Logistic regression analysis was performed to explore the factors associated with research misconduct among residents. Results: 6200 residents were enrolled in the study, and 88.5% of participants attended a course on research integrity, but 53.7% of participants admitted to having committed at least one form of research misconduct. Having a postgraduate or above, publishing papers as the first author or corresponding author, attending a course on research integrity, lower self-reported knowledge on research integrity and lower perceived consequences for research misconduct were positively correlated to research misconduct. Serving as a primary investigator for a research project was negatively associated with research misconduct. Most residents (66.3%) agreed that the reason for research misconduct is that researchers lack research ability. Conclusions: The high self-reported rate of research misconduct among residents in southwest China underscores a universal necessity for enhancing research integrity courses in residency programs. The ineffectiveness of current training in China suggests a possible global need for reevaluating and improving educational approaches to foster research integrity. Addressing these challenges is imperative not only for the credibility of medical research and patient care in China but also for maintaining the highest ethical standards in medical education worldwide. Policymakers, educators, and healthcare leaders on a global scale should collaborate to establish comprehensive strategies that ensure the responsible conduct of research, ultimately safeguarding the integrity of medical advancements and promoting trust in scientific endeavors across borders. [ABSTRACT FROM AUTHOR]

In this paper, we present findings from four separate studies using different data sources and methods to examine Chinese attitudes toward the United States amid the COVID-19 pandemic. The empirical results consistently indicate a marked and significant decline in Chinese attitudes toward the US between late 2019 and the end of 2022. Using a quasi-experimental design and granular survey data that exploit daily variations in public opinion, we offer additional evidence that the decline in Chinese attitudes toward the United States followed a distinct pattern not true for Chinese attitudes toward other countries. Specifically, the rise in Chinese unfavorability toward the United States closely corresponded to the heightened Chinese attention to the pandemic's progression in the United States. These results collectively suggest a causal effect of COVID-19, shedding light on how public health crises, international relations, and media jointly shape the increasing enmity between the two great powers., Competing Interests: Competing interests statement:The authors declare no competing interest.

Residents' environmental attitudes (EAs) towards ecological restoration programs are vital for evaluating program effectiveness and promoting environmental management. However, most local studies have neglected the indirect environmental contextual influences on residents' EAs, and have omitted the regional variations in the environmental contextual influences. To investigate the multilevel factors affecting residents' EAs, we conducted a transect survey that included the eastern, middle, and western regions in northern China's drylands, where have experienced ecological restoration. Multilevel linear models (MLMs) were applied to analyse the direct and indirect impacts of environmental contexts and individual characteristics on rural residents' EAs. The results showed the environmental context can indirectly impact EAs by amplifying the influence of individual characteristics such as family structure and income on EAs. The EAs are influenced by different local environmental contexts among the east, middle and west of China's drylands. The humidity attitude was influenced by precipitation only in the highly arid western and middle regions, while precipitation attitude is strongly influenced by land surface temperature and humidity in eastern China's drylands. These findings hold important implications for understanding the cross-scale impact of environmental contexts on EAs in drylands., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The rural B&B industry is a key component of rural tourism, local economic development, and the wider rural revitalization strategy. Despite the abundance of tourism resources in Yunnan, the B&B sector faces significant challenges. It is therefore imperative to accurately identify the most pressing issues within the current B&B industry and formulate appropriate solutions to advance Yunnan's rural revitalization efforts. This study uses recent reviews of rural B&Bs on Ctrip.com and employs machine learning techniques, including Bert, CNN, LSTM, and GRU, to identify the key management challenges currently facing Yunnan's rural B&B industry. An analysis is then conducted to identify the key stakeholders involved in the process of improving the management of Yunnan's B&Bs. To assess the willingness of each stakeholder to support the improvement of the rural B&B industry, this paper establishes a three-party evolutionary game model and examines the dynamic evolutionary process of management improvement within Yunnan's rural B&B industry. Two scenarios of evolutionarily stable strategies are analyzed, and parameters impacting stakeholders' strategy choices are simulated and evaluated. The results show that: i) Improving the "human factor" is the top priority for the current management improvement because tourists are most concerned about the emotional experience. Operators need to focus on improving service attitude and emotional experience; ii) The main stakeholders in the current management optimization process of Yunnan B&Bs are the local government, B&B operators, and tourists. Under appropriate conditions, the evolutionarily stable strategy of (1, 1, 1) is reachable. iii) variables such as additional costs, tourists' choice preferences, and government penalties significantly affect the strategy choices of stakeholders, especially B&B operators. This paper offers effective strategies for improving B&B management that can benefit the government, B&B operators, and tourists, and ultimately contribute to the promotion of quality rural revitalization. The paper not only identifies focal areas for improving B&B management in rural Yunnan, but also provides an in-depth understanding of stakeholder dynamics. As a result, it provides valuable insights to further the cause of quality rural revitalization., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Jin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aims to investigate the knowledge and attitudes of participants and potential participants in clinical trials toward electronic informed consent. We conducted a survey-based cross-sectional study in Hunan Province, China in March 2021. A total of 547 respondents were included in this study. All questions in an 8-item survey section assessing participants' knowledge of electronic informed consent received correct answers from at least 70% of participants. In terms of attitude scores, most participants (86.3%) believed that electronic informed consent is more convenient than the paper-based version, and more than half (51.2%) believed that electronic informed consent could completely replace the paper-based version. Responses indicated that common concerns about electronic informed consent were its security and confidentiality, legal benefits, and implications for rights protection. [ABSTRACT FROM AUTHOR]

Public electric bus (PEB) usage remains critical in reducing carbon emissions, traffic congestion, energy consumption, resource exhaustion, and environmental pollution. PEB usage revolves around consumer acceptance, and assessing the psychological factors accounting for using PEBs is essential in mitigating these challenges for a sustainable environment. The study extends the reasoned action theory (TRA) with environmental awareness, convenience, and personal norms in investigating residents' intention to use electric buses in Nanjing, China. 405 responses were gathered through an online survey and evaluated using Structural Equation Modeling (SEM). Statistical analysis showed that the structural model (66.4%) explained public electric bus use better than the original TRA model (20.7%). Attitude, subjective norms, personal norms, environmental awareness, and convenience directly influenced the intention to use PEBs. Personal norms related to attitude positively. Environmental awareness related to personal norms in PEB use. Subjective norms partially mediated the impact of personal norms on the intention to use PEBs. Convenience moderated the interaction between personal norms and intention to use PEBs. Respondents differed in income level, educational level, and employment but not gender in their inclinations to use PEBs. The current study recommends potent policy implications to enhance and ensure the maximum use of PEBs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

With the expanding use of English around the world, it is important to understand various stakeholders' attitudes towards it from a Global Englishes (GE) perspective. The GE perspective has challenged native speakerism and recognized the multilingual nature of the English language. In particular, a GE perspective leads to the sustainable development of a language from both sociolinguistic and ecolinguistic perspectives. Echoing the diversity and complexity of the English language use and teaching, this paper investigates senior high school students' attitudes towards the local variety of English in China, and unpacks their negotiation and construction of identity through their English-language learning journey. Through a series of interviews, this study found that the students still perceive English as a school subject, and see themselves as perennial learners of English. As the GE perspective was not widely recognized, and that students have not developed their awareness of the global use of English, several implications of teaching English from the GE paradigm, from curriculum design and teaching materials, are provided to increase the awareness of the global use of English. This paper also highlights the importance of viewing the development of English from an ecolinguistic perspective for the sustainable development of the language. [ABSTRACT FROM AUTHOR]

Purpose: Patients with epilepsy (PWE) remain completely and permanently banned from driving under the latest changes to China's laws. The twoaims of this study were, firstly, to evaluate the driving status of PWE with a driving license and the determinants of them continuing to drive; secondly, to investigate awareness and perceptions of epilepsy driving restrictions among PWE and the general population., Methods: Patients with epilepsy with a driver's license who attended the Fourth Affiliated Hospital and the Second Affiliated Hospital of Zhejiang University for treatment of their condition were invited to participate in a questionnaire survey between June 2021 and June 2022. During the same period, age-matched people with driver's licenses without epilepsy living in the cities of Hangzhou and Yiwu, Zhejiang province were invited to participate in the questionnaire study., Results: A total of 291 PWE with a driver's license and 289 age-matcheddrivers among the general public participated in the survey. Of the sample, 41.6% of PWE and 26.0% of general drivers stated that they were aware of legal driving restrictions for PWE in China. In the past year, 54% of PWE had driven and 42.5% drove a vehicle daily. Logistic regression revealed that male sex (95% confidence interval [CI]: 1.36-3.61, P = 0.001), age (95% CI: 1.12-3.27, P ≤ 0.036), and the number of antiseizure medications taken (95% CI: 0.24-0.25, P ≤ 0.001) were independently associated with illegally driving with epilepsy. In terms of legalissues, 71.1% of PWE did not support a lifetime ban on driving and 50.2% disagreedwith physician reporting of PWE to the traffic authorities., Conclusion: Illegal driving is highly prevalent among PWE who hold a driving license, and male gender, age, and number of ASMs had an independent association with illegal driving in patients with epilepsy. There are highly varying opinions on the current driving laws with respect to PWE. Detailed national standards for medical fitness for driving that are easy to implement and enforce are urgently required for China., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Research ethics provides the ethical standards for conducting sound and safe research. The field of medical research in China is rapidly growing and facing various ethical challenges. However, in China, little empirical research has been conducted on the knowledge and attitudes of medical postgraduates toward research ethics and RECs. It is critical for medical postgraduates to develop a proper knowledge of research ethics at the beginning of their careers. The purpose of this study was to assess the knowledge and attitudes of medical postgraduates toward research ethics and RECs. Methods: This cross-sectional study was conducted from May to July 2021 at a medical school and two affiliated hospitals in south-central China. The instrument of the study was an online survey that was distributed via WeChat. Results: We found that only 46.7% were familiar with the ethical guidelines for research with human subjects. In addition, 63.2% of participants were familiar with the RECs that reviewed their research, and 90.7% perceived RECs as helpful. However, only 36.8% were fully aware of the functions of RECs. In the meantime, 30.7% believed that review by an REC would delay research and make it more difficult for researchers. Furthermore, most participants (94.9%) believed that a course on research ethics should be mandatory for medical postgraduates. Finally, 27.4% of the respondents considered the fabrication of some data or results to be acceptable. Conclusion: This paper serves to suggest that research ethics education should be prioritized in medical ethics curriculum, and course syllabi or teaching methods should be revised to provide medical postgraduates with a deeper understanding of the principles, regulations, and specifics of research ethics. We also recommend that RECs provide diverse approaches in their review procedure to facilitate the understanding of medical postgraduates of the functions and processes of RECs and to enhance their awareness of research integrity. [ABSTRACT FROM AUTHOR]

The environmentally responsible behaviors of residents and tourists are great significance to the protection of natural resources and sustainable development of ecotourism. This paper takes China's Qilian Mountains National Park as the case place. By constructing a theoretical model of perceived value on environmentally responsible behavior and studying the relationship between residents' and tourists' perceived value, satisfaction and environmentally responsible behavior from both subject and object perspectives, the study shows that. Educational level and occupational distribution have significant effects on residents' and tourists' perceptions of ecotourism environmentally responsible behaviors, but age only has a significant effect on residents' perceptions of ecotourism environmentally responsible behaviors. Gender differences do not affect residents' and tourists' perceptions of ecotourism environmentally responsible behaviors. The theoretical model between residents' perceptions of environmentally responsible behaviors, environmentally responsible behaviors, and satisfaction was basically confirmed. Perceived environmentally responsible behaviors of tourists does not affect satisfaction. Satisfaction has a positive effect on tourists' environmentally responsible behaviors. Perceived environmental responsibility of tourists has a significant positive effect on tourists' environmentally responsible behaviors. The overall level of residents' perception of environmentally responsible behaviors in ecotourism is higher than tourists' perception. Residents and tourists have a poor perception of ecological and environmental protection policies. This paper expects to strengthen residents' and tourists' perceptions of ecologically responsible behaviors. Establishing the sentiment of satisfaction and commitment to environmental protection motivates residents and tourists to implement environmentally responsible behaviors and contribute to the sustainable development of ecotourism., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Currently, China has the largest generation volume of waste mobile phones (WMPs), but the recycling rate is still negligible. How to improve the willingness to hand (WTH) over to formal recycling channels and willingness to pay (WTP) have become the most core problems in the e-waste recycling industry. As the important link between WMPs generation and collection, the residents' role and function are attracting more and more attention. Thus, this study is designed to identify the determinants of the residents' WTH and WTP for WMPs through the contingent valuation method (CVM). At the same time, it will explore the current existing gaps from the urban and rural residents. Especially, this study also considers Guiyu Town as one special rural region for understanding the differences with other regions. The results show that the respondents generally have the relatively lower knowledge and cognition on WMPs recycling. Only 9.4% respondents are satisfied with the current government's management of WMPs. Personal information leakage is an important reason for low WTH. The WTH of Guiyu, urban and rural respondents were 51.3%, 45.9% and 41.2%, respectively; while their WTP were 46.80%, 31.70% and 37.80%, respectively. Finally, it is estimated that their WTP values were 18.75 ($2.81), 16.14 ($2.42) and 15.85 ($2.38) RMB per unit, respectively. The demographic variables, cognition and attitude are important factors on all residents' WTH and WTP. Meanwhile, it is indicated that if owning higher WTH, the residents will trend to higher WTP. Especially, the WTH and WTP of Guiyu residents are higher than other residents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Understanding households' attitudes and willingness to pay (WTP) for clean heating can provide a scientific basis for decision-makers to assess the potential to develop clean heating, choose heating methods, and formulate subsidy standards in the region. In this paper, the double-bounded dichotomous contingent valuation method-modified by the spike model-was used to better estimate the actual WTP of households through a sample survey of 456 households in rural areas of Yongcheng City, China, in 2021. The factors influencing attitudes and WTP were examined to reveal mechanisms of accepting clean heating. The results showed that 94.96% of households were willing to pay for clean heating. The annual WTP was 1071 yuan per household, more than eight times the current heating cost. Factors that affect clean heating attitudes do not necessarily affect the WTP. Specifically, gender, length of time spent living at home, and family income had significant influences on WTP, whereas the educational level, adaptive perceptions in relation to environmental perceptions, and the recognition variables for gender equality in energy consumption had a significant impact on attitudes. It is worth noting that elderly people and females were identified as vulnerable groups in the implementation of clean heating., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The effective treatment of rural domestic waste is the key to solving rural environmental pollution and realizing rural ecological revitalization. Giving full play to the main role of farmers' domestic waste classification can improve the efficiency and effect of domestic waste treatment. To explore the key factors affecting the farmers' perception, attitude, and behavior of domestic waste classification, this study with 318 farmers in Sichuan Province as the research object, the research framework of domestic waste classification behavior was constructed based on the theory of planned behavior, and then, the logistic regression model was used for the empirical test. The results show that the farmers' education levels, subjective norms, relatives' and neighbors' views on waste classification, farmers' awareness regarding the negative environmental impacts caused by waste, farmers' private benefits, and farmers' views on the waste management ability of local governments are significantly positively correlated with the classification behavior of farmers' domestic waste. The distance between farmers' houses and waste collection points is significantly negatively correlated with the classification behavior of farmers' domestic waste. This paper provides a certain theoretical reference for realizing the reduction, resourcization, and positive development of rural domestic waste management in China.

With the continuous prominence of environmental problems, some online environmental platforms have been built in China. Such platforms provide an important carrier for public to learn environmental knowledge and participate in environmental protection. However, whether such platforms can play a substantive role in promoting users' green consumption behaviors is still unclear. Focusing on this question, the influence of online environmental platform services on public green consumption behaviors is explored. A model based on the theory of stimulus-organism-response is established to analyze the influential mechanism, using the online environmental platform services as the independent variable, users' green consumption behaviors as the dependent variable, environmental attitude as the mediator, and users' price sensitivity as the moderator. Survey data are used to test the model. The empirical results show that online environmental platform services have a significant positive impact on users' green consumption behaviors. Environmental attitude plays a partial mediating role and price sensitivity negatively moderates the mediating role of environmental attitude. Suggestions are given from the perspectives of platform operators and government. This paper provides both theoretical and practical implications for sustainable consumption.

Background: China is the country with the largest elderly population. To actively respond to this ageing population, China has proposed the Community Aged Care Service Centre (CACSC) network as the major elderly care development policy. However, many residents resisted the development of the CACSC network, which affected its smooth implementation. Based on the theory of "Not in My Backyard" (NIMBY), this paper proposes a model of the influencing factors of community residents on the opposition to the construction of CACSCs., Methods: Residents living in urban communities over the age of 20 in China are the target of this study. The questionnaires were collected in the form of electronic questionnaires created on a professional website, and hyperlinks to the questionnaires were distributed through social media. The descriptive statistical analysis, T-tests, ANOVA and structural equation modelling were performed on cross-sectional survey data from 509 questionnaires., Results: The research results show that superstition, the NIMBY attitude, and perceived risk have a significant positive impact on the opposition to the construction of CACSCs, while the negative impact of perceived benefit on the opposition intention is not significant. Moreover, perceived knowledge has a significant positive impact on perceived benefit and a significant negative impact on superstition and perceived risk., Conclusions: Strengthen policy advocacy on ageing, clarify the service content of CACSC and encourage young people to participate in public welfare activities for the elderly can reduce the opposition of community residents to the construction of a CACSC., (© 2022. The Author(s).)

Aims and objectives: To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China. Background: Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China. Methods: An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists. Results: Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses. Conclusions: There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers. Relevance to clinical practice: Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed. [ABSTRACT FROM AUTHOR]

There is a lack of quantitative studies on the acceptance of extramarital sex in China. Based on data from the Chinese General Social Survey 2013 (CGSS2013), this paper used a zero-inflated Poisson regression model to analyze the factors influencing the public's attitudes toward extramarital sex. When other variables were controlled, groups of younger ages, higher educational levels, and stronger tendencies toward "liberalization" and non-Islamic beliefs were more tolerant toward extramarital sex, whereas gender and Christian beliefs had no significant influence. In this regard, family and marriage counseling, and society's moral tolerance and social control of religion are discussed, and further research on cross-cultural verification is needed.

The impact of mandatory policies on residents' willingness to separate waste and how they respond to such measures is not clearly understood. To answer this question, based on deterrence theory, theories of belief change, the theory of rational behavior, and the theory of cognitive consistency, this paper established a mechanism model for the impact of mandatory policies on residents' willingness to separate waste, and analyzed the roles of attitude, subjective norms, and new ecological paradigms. Through a questionnaire survey of 442 ordinary residents in Shanghai, hierarchical regression and bootstrapping analysis were used to verify the above model. The results showed that:(1) mandatory policies positively affected residents' attitude and subjective norms toward waste separation; (2) through the mediation of attitude and subjective norms, mandatory policies positively affected residents' willingness to separate waste; and (3) the new ecological paradigm moderated the above effects. For residents with higher ecological paradigm, the positive influence of mandatory policies on attitudes and subjective norms was stronger, and the mediation effect of attitude and subjective norms was also stronger., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This paper explores how general environmental knowledge shapes environmental attitudes, behavioral intentions, and pro-environmental behaviors in relation to the surrounding environment. Structural equation modeling (SEM) with bootstrapping estimation was conducted to assess a causal chain from environmental knowledge to pro-environmental behaviors with a nationally representative sample of 2824 respondents from China. The results show that environmental knowledge has a significant positive effect on environmental attitudes, environmental attitudes have a significant positive effect on environmental behavioral intentions and pro-environmental behaviors, and environmental behavioral intentions have a significant positive effect on pro-environmental behaviors. We also concluded that although environmental knowledge has no significant direct effects on pro-environmental behaviors, it is a crucial distal variable whose significant effect is fully mediated by environmental attitudes and environmental behavioral intentions. The results of the multigroup SEM showed that the moderating effect of external context on the relationship between environmental behavioral intentions and pro-environmental behaviors and various demographic variables (e.g., gender, urban vs. rural residence, education level, and region) have diverse effects on the model in this study., Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, “How Does Environmental Knowledge Translate into Pro- Environmental Behaviors?: The Mediating Role of Environmental Attitudes and Behavioral Intentions”., (Copyright © 2020 Elsevier B.V. All rights reserved.)

With both cost and safety taken into account in the context of the life-threatening COVID-19 pandemic globally, rural tourism is expected to be the top choice for Chinese residents for relaxation and enhancing parent-child relationships. In this paper, a structural equation (SEM) model was proposed to compare risk knowledge, risk perception, risk aversion attitudes and behavioral intentions towards rural tourism. According to the empirical results, there was a large proportion of tourists showing preference for rural tourism recently. Potential participants in rural tourism paid most attention to the performance realization and time cost of scenic spots, while the psycho-social risk posed by COVID-19 had little impact. The inherent risk nature of risk aversion attitudes made knowledge of the pneumonia risk less effective in reducing tourists' intentions, while knowledge of the pneumonia risk was more effective in alleviating the risk perception that potential tourists have towards rural tourism. With regard to travel intention and recommendation intention of rural tourism, the negative impacts of risk aversion attitude were more considerable compared to risk perception. Meanwhile, the parallel mediating effect of risk perception and risk aversion attitude in rural tourism needed to be taken into consideration together.

A growing body of research has shown that people's attitudes toward food safety is affected by their availability and accessibility to food risk information. In the digital era, the Internet has become the most important channel for information acquisition. However, empirical evidence related to the impact of Internet use on people's attitudes towards food safety is inadequate. In this study, by employing the Chinese Social Survey for 2013 and 2015, we have investigated the current situation of food safety perceptions and evaluations among Chinese residents and the association between Internet use and individuals' food safety evaluations. Empirical results indicate that there is a significant negative correlation between Internet use and people's food safety evaluation in China. Furthermore, heterogeneity analysis shows that Internet use has a stronger negative correlation with food safety evaluation for those lacking rational judgment regarding Internet information. Specifically, the negative correlation between Internet use and food safety evaluations is more obvious among rural residents, young people, and less educated residents. Finally, propensity score matching (PSM) is applied to conduct a robustness check. This paper provides new evidence for studies on the relationship between Internet use and an individuals' food safety cognition, as well as additional policy enlightenment for food safety risk management in the digital age.

Background: The household expired drugs disposal has been a huge public issue in many countries, including China, which may affect various side and toxic effects on human health and environment, water resources, and soil too. This paper explores the knowledge, attitude, and practice of Guangzhou city residents regarding household expired drugs and their effect on human health and provided the scientific pieces of evidence to carry out the long-term recovery mechanism for expired medicines. Methods: An observational, cross-sectional study was conducted using a self-structured questionnaire. Descriptive analysis, including univariate and unconditional logistic regression models, was carried out to analyze the data. Results: A total of 613 community residents with a 99.4% response rate enrolled for the study. More than half 60.2% of residents stated that expired drugs pollute the environment, soil, and water resources, where 81.2% of respondents knew that it would produce side effects or toxic effects. However, still, 71.6% of respondents disposed of directly into the trash bin or sink, and, only 24.8% had good practice that they use a designed recycling bin. Likewise, only 8.3% of respondents placed expired drugs into collection points nearly 3– 5 times in a year, while 65.1% of participants never disposed of in the collection point, which found a worse practice. Conclusion: Overall, the knowledge, attitude, and practice of Guangzhou residents regarding household expired drugs disposal were not ideal. To improve the resident's awareness about family expired drugs disposal, ensure the financial support for the recycling process, establish an accessible and acceptable recycling point, and introduce relevant laws and regulations for the long-term mechanism. [ABSTRACT FROM AUTHOR]

Climate change poses a potential risk to coastal infrastructure, thus threatening the economics or even the safety of human beings. Thus, a better understanding of the attitude of port organizations toward climate adaptation and mitigation is essential. This paper addresses this research gap by investigating 18 port organizations in China. The questions include the impediments and the impact of context, systems, and other factors on the implementation of adaptation strategies. The results indicate that port organizations are generally aware of climate change impacts and agree that some further steps are needed. However, policy support serves as a key factor in implementing adaptation plans. Apart from offering important insight on the attitude of port organizations, the study also serves as a platform for further research on climate adaptation planning in China. [ABSTRACT FROM AUTHOR]

A main purpose of the present study was to examine and compare attitudes toward inclusive education between parents of children with ASD, parents of typically developing children, and classroom teachers in China. The investigators also sought to explore factors influencing different stakeholders' perspectives. An attitude survey was distributed to 14 institutions in Shanghai and Anhui Province in China, including four kindergartens, two elementary schools, four special schools, and four private training agencies. Seven hundred and twelve responses were received, including 170 from parents of children with ASD, 337 from parents of typically developing children, and 197 from classroom teachers. Both multivariate and univariate analyses were conducted to compare differences in attitudes between groups. The results indicate that parents of children with ASD held the most positive attitudes toward inclusion, whereas classroom teachers held the least positive attitudes toward the inclusion of children with ASD. Further analyses revealed that not only were adults' attitudes influenced by their identities as parents or teachers, but their background may also influence how they perceive inclusive education. The findings of the study provided a comprehensive view on how different parties perceive inclusive education of ASD. It also provided empirical evidence that inclusion generally has a positive impact on people's attitudes toward ASD. Implications and suggestions for future research and practices were further discussed in the paper. [ABSTRACT FROM AUTHOR]

Purpose Economic interest groups such as seed, pesticide, feed, and food companies play an important role in supporting or preventing the production of genetically modified (GM) crops. The purpose of this paper is to examine firm managers’ attitudes toward GM technology, biotechnology R&D investment, and political lobbying activities.Design/methodology/approach Using data from surveys of 160 managers in the food, feed, chemical, and seed industries in 2013-2014, this paper employed three probit models to examine the determinants of managers’ attitudes, biotechnology R&D investment, and lobbying activities.Findings The results show that most Chinese agribusiness managers are concerned about GM foods and oppose its adoption. Nevertheless, one-third of the firms invest in biotechnology R&D and less than 15 percent of managers lobbied the government to change biotechnology policies. The econometric estimation results suggest that profit change expectation is the main factor affecting managers’ attitudes and biotechnology R&D investment decisions, whereas lobbying activities are significantly influenced by their attitudes and biotechnology R&D investment. In addition, managers’ attitudes toward GM foods also significantly influence firms’ decisions to invest in biotechnology R&D.Originality/value This paper has improved on previous research in two ways. First, it analyses the determinants of agribusiness firm managers’ attitudes toward GM technology, biotechnology R&D investment, and lobbying activities. Second, the methodology involves an analysis of agribusiness firm survey data in the food, feed, chemical, and seed industries, which is the first time to use such data to research on economic interest group in agricultural biotechnology field. [ABSTRACT FROM AUTHOR]

The aim of this paper is to measure the knowledge and attitudes of primary care physicians toward antibiotic prescriptions and their impacts on antibiotic prescribing. A questionnaire survey was conducted on 625 physicians from 67 primary care facilities in Hubei, China. Structural equation modelling (SEM) was applied to test the theoretical framework derived from the Knowledge, Attitudes, and Practices (KAP) theory. Physicians' knowledge, five sub-types of attitudes, and three sub-types of behavioral intentions towards antibiotic use were measured. Physicians had limited knowledge about antibiotic prescriptions (average 54.55% correct answers to 11 questions). Although they were generally concerned about antibiotic resistance (mean = 1.28, SD = 0.43), and were reluctant to be submissive to pressures from consumer demands for antibiotics (mean = 1.29, SD = 0.65) and the requirements of defensive practice (mean = 1.11, SD = 0.63), there was a lack of motivation to change prescribing practices (mean = -0.29, SD = 0.70) and strong agreement that other stakeholders should take the responsibility (mean = -1.15, SD = 0.45). The SEM results showed that poor knowledge, unawareness of antibiotic resistance, and limited motivation to change contributed to physicians' high antibiotics prescriptions ( p < 0.001). To curb antibiotic over-prescriptions, improving knowledge itself is not enough. The lack of motivation of physicians to change needs to be addressed through a systematic approach.

Bioethical debates on the use of human embryos and oocytes for stem cell research have often been criticized for the lack of empirical insights into the perceptions and experiences of the women and couples who are asked to donate these tissues in the IVF clinic. Empirical studies that have investigated the attitudes of IVF patients and citizens on the (potential) donation of their embryos and oocytes have been scarce and have focused predominantly on the situation in Europe and Australia. This article examines the viewpoints on the donation of embryos for stem cell research among IVF patients and students in China. Research into the perceptions of patients is based on in-depth interviews with IVF patients and IVF clinicians. Research into the attitudes of students is based on a quantitative survey study (n=427). The empirical findings in this paper indicate that perceptions of the donation of human embryos for stem cell research in China are far more diverse and complex than has commonly been suggested. Claims that ethical concerns regarding the donation and use of embryos and oocytes for stem cell research are typical for Western societies but absent in China cannot be upheld. The article shows that research into the situated perceptions and cultural specificities of human tissue donation can play a crucial role in the deconstruction of politicized bioethical argumentation and the (often ill-informed) assumptions about "others" that underlie socio-ethical debates on the moral dilemmas of technology developments in the life sciences.

Background: The administration of anesthesia during gastrointestinal endoscopy potentially contributes to post-anesthesia cognitive dysfunction (PACD), with detrimental impacts for cognitive function. This study aimed to assess the knowledge, attitudes, and practices (KAP) towards PACD among patients undergoing gastrointestinal endoscopy in Wenzhou region. Methods: This cross-sectional study was conducted between June and August 2023, and recruited individuals undergoing gastrointestinal endoscopy. Demographic data and KAP scores were collected through questionnaires. Pearson correlation analysis was applied to evaluate correlations between KAP scores, and logistic regression was utilized to identify influential factors. Results: We collected 405 valid questionnaires, with 54.57% being male and 29.88% aged 31–40 years. Mean KAP scores were 13.99 ± 4.80, 16.19 ± 2.35, and 15.61 ± 2.86, respectively (possible range: 0–16, 0–25, and 0–25). Pearson correlation analysis demonstrated significant positive correlations between knowledge and practice (r = 0.209, P < 0.001), attitude and practice (r = 0.233, P < 0.001), and knowledge and attitude (r = 0.328, P < 0.001). Multivariate logistic regression revealed negative associations of opting for standard gastrointestinal endoscopy (without anesthesia) with knowledge (OR = 0.227, 95%CI: 0.088–0.582, P = 0.002) and practice scores (OR = 0.336, 95%CI: 0.154–0.731, P = 0.006). Additionally, the presence of cognitive-related diseases or symptoms before undergoing gastrointestinal endoscopy was negatively associated with knowledge scores (OR = 0.429, 95%CI: 0.225–0.818, P = 0.010). Conclusion: Patients undergoing gastrointestinal endoscopy demonstrated good knowledge, neutral attitudes, and moderate practices regarding PACD. Educational interventions and behavior modification are recommended, particularly for individuals with lower monthly income, undergoing standard gastrointestinal endoscopy, or experiencing cognitive-related conditions. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the attitudes of Chinese college students toward using a blended learning approach to enhance their English speaking skills. Participants include 105 non-English major students from a regular university in western China. A quantitative analysis was conducted based on the data from a designed questionnaire. The findings identify the majority of students were satisfied with using the blended learning approach during the courses to improve their English-speaking skills. Furthermore, most students showed a preference for using blended learning in future English-speaking learning because of its user-friendliness, flexibility in terms of time and location, access to self-directed learning, and diverse teaching resources. The study further demonstrated the successful and effective implementation of blended learning in English-speaking instruction as part of an educational reform process in a regular university in Western China. The researcher attempted to provide some tips to enhance blended English-speaking learning including diversified instructional designs, increased teacher-student interaction, the active use of spoken English in the classroom, practice opportunities outside of class, and the dissemination of rich oral language learning resources. [ABSTRACT FROM AUTHOR]

This paper presents a descriptive analysis of data gathered by personal interviews from a multistage random sample of 1640 residents aged 18⁻34 years in Wuhan, China. First, alcohol drinkers and abstainers were compared based on demographic, attitude, and belief variables. Next, the drinkers from the sample were classified into four groups based on frequency-quantity of alcohol use, and the frequency-quantity groups were compared on the same variables. For Abstainers versus Drinkers, we found no difference by age or gender in this sample. Married people and people with children were more likely to be abstainers. University-educated, currently-employed individuals in mid-level jobs were more likely to abstain from alcohol. Vocational/Technical graduates, people who were currently attending college, currently unemployed and never-employed individuals were more likely to be drinkers. Abstainers also responded with less-positive attitudes and beliefs about drinking and attached more importance to reasons for not drinking compared to drinkers. When the drinking frequency-quantity groups were compared, gender differences became significant: more high-quantity drinkers were women; however the guideline for quantity for women was >1 drink at a time compared to >2 drinks at a time for men. Quantity and frequency of drinking was significantly associated with having children, educational level, employment status, and type of occupation. Age, marital status, and being in college did not relate significantly with quantity and frequency of drinking alcohol. Attitudes and beliefs about drinking tended to be more positive among high-frequency and high-quantity drinkers. Drinkers in all frequency-quantity groups attached greater importance to social reasons for drinking compared to personal/psychological reasons for drinking. Drinkers in the lowest frequency-quantity group attached the most importance to reasons for not drinking. These findings confirmed that in China drinking plays an important role in socializing and celebrating, and that there are important differences between alcohol drinkers and abstainers and between frequency/quantity groups of drinkers. Western models of individualized motivation of behaviors may not accurately explain alcohol use in China. We believe the findings from this study suggest the need for more detailed studies of alcohol drinking and abstaining.

Food waste is a worldwide problem due to its effects on carbon emission, water pollution, and arable lands. Previous studies of food waste generation and reduction focus on demographic, psychological, and situational factors, whereas the effects of culture in different countries have been ignored. This paper investigates the influence of Confucian culture on behaviors that waste food, considering additional factors of face saving and group conformity. We used an integrated behavioral intention model combining the TPB model and Lee's modified Fishbein model. The results show that including the constructors of Confucian culture increases the predictive power of the model. Face saving and group conformity are found to significantly influence attitude toward food waste reduction. Face saving can greatly reduce the intention to pack leftovers, and group conformity has a significant effect on the ordering of small portion sizes. Based on these results, we give a discussion and put forward with suggestions to the government and the catering industry. Limitations and implications for future research are provided accordingly.

Attitude is an important resource for courtroom discourse to perform interpersonal functions. This paper analyzes the attitude expressions in the audio recording transcripts of eight trials and finds that: judgement is the most important way for courtroom participants to express attitude, followed by appreciation, while affect is the least frequently used. In the four criminal trials, the defendants express attitude most frequently and most negatively; in the four non-criminal trials, the plaintiffs express attitude most frequently and most negatively. In the debate section of criminal trials, judgements of legality and capacity and non-judgement invoking appreciations are employed by the prosecutors and defense attorneys to express attitude and debate each other. Non-judgement invoking appreciations are used not only to evaluate the evidence, but also to introduce substantial statements, serving as an intermediate link between the two. [ABSTRACT FROM AUTHOR]

INTRODUCTION Electronic cigarettes are increasingly popular worldwide, especially among youth. There is growing evidence of the negative health consequences of vaping. Our objective was to assess university students' knowledge and attitudes regarding electronic cigarettes (e-cigarettes), their use, as well as the associated influencing factors for their use. METHODS The study involved an online cross-sectional survey conducted between November 2019 and March 2020 in a university in Hangzhou, China. A total of 563 students completed the questionnaire. Descriptive statistics were used to assess characteristics, knowledge, and attitudes; t-tests, χ²-tests and logistic regression models were used to identify factors associated with ever e-cigarette use. RESULTS In all, 59.9% of respondents were female and the average age was 20.38 years (SD=1.32). Only 42.6% of the respondents thought that e-cigarettes contain nicotine, 31.1% thought e-cigarettes are tobacco products, and 8.2% of the students reported being ever e-cigarettes users. In regard to attitude, the average score of the students in the Safety dimension was 3.34 (SD=0.64), followed by the Restriction dimension (Mean=2.66, SD=0.83). Correlates of ever use included regions, friends' and roommates' ever e-cigarette use, and higher attitude score in the Supervision dimension. CONCLUSIONS The university students' level of knowledge regarding e-cigarettes was not high, and their attitudes regarding e-cigarettes were not that supportive. Students' ever use of e-cigarettes at a university in Hangzhou was higher than for university students in other cities in China, but lower than for those in foreign countries. [ABSTRACT FROM AUTHOR]

Background: Continuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) engage playing pivotal roles in administering CRRT, but there is paucity of evidence-based research on joint training and management strategies. This study armed to evaluate the knowledge, attitude, and practice (KAP) of ICU staff toward CRRT, and to identify education pathways, needs, and the current status of CRRT implementation. Methods: This study was performed from February 6 to March 20, 2023. A self-made structured questionnaire was used for data collection. Descriptive statistics, T-tests, Analysis of variance (ANOVA), multiple linear regression, and Pearson correlation coefficient tests (α = 0.05) were employed. Results: A total of 405 ICU staff from 66 hospitals in Central and South China participated in this study, yielding 395 valid questionnaires. The mean knowledge score was 51.46 ± 5.96 (61.8% scored highly). The mean attitude score was 58.71 ± 2.19 (73.9% scored highly). The mean practice score was 18.15 ± 0.98 (85.1% scored highly). Multiple linear regression analysis indicated that gender, age, years of CRRT practice, ICU category, and CRRT specialist panel membership independently affected the knowledge score; Educational level, years of CRRT practice, and CRRT specialist panel membership independently affected the attitude score; Education level and teaching hospital employment independently affected the practice score. The most effective method for ICU staff to undergo training and daily work experience is within the department. Conclusion: ICU staff exhibit good knowledge, a positive attitude and appropriately practiced CRRT. Extended CRRT practice time in CRRT, further training in a general ICU or teaching hospital, joining a CRRT specialist panel, and upgraded education can improve CRRT professional level. Considering the convenience of training programs will enhance ICU staff participation. Training should focus on basic CRRT principles, liquid management, and alarm handling. [ABSTRACT FROM AUTHOR]

Purpose: KAP studies serve to enhance health consciousness and furnish foundational data for appraising, strategizing, and enacting disease management and prejudice eradication initiatives. There remains a dearth of published studies elucidating the dimensions of knowledge, attitudes, and practices among psoriasis patients in China. To investigate the knowledge, attitudes and practices (KAP) towards psoriasis among patients and their family members in Northern China. Methods: This web-based, cross-sectional study was conducted among psoriasis patients and their family members through a self-administered questionnaire. Results: Among patients (n=260), their mean KAP scores were 9.76± 5.69 (range: 0– 19), 35.64± 11.48 (range: 14– 70), and 56.73± 10.98 (range: 16– 80), respectively. Among family members (n=237), their mean KAP scores were 11.93± 5.34 (range: 0– 19), 35.80± 4.34 (range: 8– 40), and 37.04± 4.38 (range: 8– 40), respectively. Structural equation modeling (SEM) analysis for patients indicated significant and negative path relations between knowledge and attitudes (β=− 2.271, P< 0.001), and between knowledge and practice (β=− 0.398, P< 0.001). Extended SEM analysis, which divides knowledge into K1, K2, and K3 parts, showed negative path relations between K3 and attitude (β=− 1.300, P=0.002), between attitude and practice (β=− 0.634, P< 0.001). Moreover, SEM for family members showed positive path relations between knowledge and attitude (β=1.536, P< 0.001), between attitude and practice (β=0.682, P< 0.001). Conclusion: Patients in Northern China demonstrated insufficient knowledge, negative attitude, and proactive practice, while their family members had insufficient knowledge, positive attitude, and proactive practice toward psoriasis. It is recommended to implement educational interventions addressing knowledge gaps among patients and families. [ABSTRACT FROM AUTHOR]

Purpose: Controversy exists on whether or not elective oocyte cryopreservation (eOC) can be conducted in public hospitals in China. Policymakers should take into account the benefits and risks in the Chinese population. This study explored basic data concerning the awareness, attitudes of eOC, and fertility desire of eOC in China to offer evidence for policy making. Methods: A total of 442 people in four areas of China responded to a survey. The questionnaire was divided into three parts: awareness, attitude, and fertility desire of eOC. Descriptive analysis and multivariable regression analysis were used in the study. Results: Generally, the respondents had a positive or neutral attitude towards eOC. However, about 90% of respondents did not know the cost of eOC. In general, a more positive attitude was found towards eOC among participants who had heard of the procedure compared with those who had not. Most women did not desire to reproduce by eOC. After adjusting for access to information, we found that female, older age groups, and singles were more likely to have increased awareness than their counterparts. The awareness of participants who accessed information from any source had a higher relative probability of having good awareness levels compared to participants who had not accessed the information. Undergraduates exhibited significantly higher levels of cognitive understanding, as indicated by their increased familiarity and comprehension, compared to high school students (relative risk ratio = 1.44, confidence interval = 0.48,4.29). Conclusion: Continued discussion is needed regarding the ethical, legal, and social aspects of performing eOC in public hospitals. Furthermore, policies are needed to regulate eOC to protect the reproductive freedom of healthy women. [ABSTRACT FROM AUTHOR]

Purpose: The knowledge, attitude, and practices (KAP) concerning antibiotics by healthcare students have the potential impact on controlling antibiotic abuse and antimicrobial resistance (AMR) growth. This study aims to evaluate the levels and explore the associated factors with KAP on antibiotic use and AMR in Chinese nursing students. Methods: A cross-sectional survey using a self-administered questionnaire consisting of demographics and selected features and KAP on antibiotic use and AMR was conducted to measure KAP levels among nursing students at various universities in Hubei Province, China. The logistic regression analyses were performed to analyze the potential factors associated with the KAP. Results: The survey eventually included a total of 1959 nursing students. The mean scores for KAP were 57.89 ± 26.32, 55.00 ± 12.50, and 71.88 ± 15.63, respectively. Regarding knowledge, 54.3% of participants were unaware that antibiotic was ineffective against viral infections. Regarding attitude, 36% of participants agreed that current antibiotic abuse existed; 96.2% of participants thought it necessary to set up a special course on antibiotics. Regarding practice, only 48.4% of participants usually purchased antibiotics with a prescription. Multivariable analyses indicated that lack of discussion on AMR in school courses was an independent risk factor against KAP, respectively. The main knowledge sources of antibiotic being outside the classroom was an independent risk factor related to knowledge and practice. The average score > 80 points was an independent protective factor related to knowledge and practice. Conclusion: The KAP level on antibiotic use and AMR among Hubei nursing students was general and required further strengthening. Nursing students with risk factors should be prioritized in educational interventions. The findings of our study pointed out some directions for tailored interventions to improve the training on antibiotics. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to describe the knowledge, attitudes and practices (KAP) of nurses in implementing advance directives (ADs) for older patients and analyze the influencing factors before the establishment of the first advance directives act in China. Design: Multicenter cross‐sectional survey. The standards for reporting the STROBE checklist are used. Methods: This cross‐sectional study developed a self‐designed structured questionnaire to assess nurses' knowledge, attitudes and practices about ADs. Nurses were recruited by stratified random sampling through the Nursing Departments of 12 hospitals in southwest China and were asked to fill out the questionnaire face to face about knowledge, attitudes and practices. Data were analyzed following descriptive statistics, rank‐sum test and multiple linear regression. Results: This study included 950 nurses. The study found that nurses were extremely supportive of ADs. Unmarried nurses had better knowledge of ADs than married ones. Nevertheless, there was a discrepancy between the participants' knowledge, attitude and practice. The participants' practice was lower (4.3%) compared with their attitude (81.9%) and knowledge (42.2%). Knowledge on, attitudes towards and standardized procedures for ADs in the workplace affected nursing practice. Conclusions: The study recommends that courses on ADs and appropriate support from medical institutions should be provided to nurses to increase their knowledge and confidence in implementing ADs. Healthcare professionals should be sufficiently equipped to implement ADs and handle their execution appropriately to provide adequate end‐of‐life care corresponding to patients' wishes. Relevance to Clinical Practice: The study results inform rich insights as it discusses the numerous interrelating factors influencing these three fundamental aspects that affect the success of any AD policy by surveying the knowledge, attitudes and practices of clinical nurses. Furthermore, our results hint at distinct areas of improvement in the nursing practice to facilitate the wider implementation and acceptance of ADs in China. Patient or Public Contribution: This study involved no patient. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, the pursuit of a master's degree has become a social phenomenon of wide concern. It is essential to understand why large number of students choose to pursue master's degree. This study aims to empirically analyze the factors that influence the intent to pursue a master's degree. Method: Based on the extended theory of planned behavior, this study conducts a questionnaire survey of university students in Shandong Province, which has had the highest number of people taking the postgraduate entrance examination in China for several years. A total of 440 questionnaires were finally collected, including 417 valid questionnaires. And then ordinary least squares (OLS) regression was used to analyze the factors that influence the intent to pursue a master's degree. Results: In general, the intent to pursue a master's degree is positively influenced by attitude (β = 0.161, p < 0.01) and subjective norms (β = 0.208, p < 0.01), and negatively influenced by risk perception (β = -0.084, p < 0.05). Compared with male students, female students' intent is more likely to be influenced by risk perception (β = -0.144, p < 0.05) and social factors (β = 0.140, p < 0.05). The intent of upperclass students tends to be positively influenced by perceived behavioral control (β = 0.125, p < 0.05), whereas the negative impact of risk perception (β = -0.219, p < 0.05) on the intent is significant for underclass students. The intent of students in rural areas are more sensitive to risk perception (β = -0.194, p < 0.01) than those of students in cities. In private universities, social factors (β = 0.445, p < 0.05) significantly affect the intent to pursue a master's degree. In ordinary public universities, the intent of students is more likely to be influenced by risk perception (β = -0.082, p < 0.05). Conclusion: The study is helpful to strengthen the understanding of the influencing factors of the intent to pursue a master's degree. In general, the intent to pursue a master's degree is mainly influenced by attitude, subjective norms and risk perception. Moreover, the influencing factors vary among different groups (e.g., female vs. male, rural areas vs. cities). Furthermore, attitude, subjective norms, perceived behavioral control, risk perception, and social factors have greater impacts on the intent of students from low-income households than those from high-income households. This study can provide policy implications for universities to take targeted educational measures to encourage students to make a choice that suits their own development after graduation. [ABSTRACT FROM AUTHOR]

Aim: This study is to investigate the current status of knowledge, attitude and self‐reported practice in hospice care among nurses in Hainan, China, and then to analyse its influencing factors and mediating effects. This provides a basis for formulating scientific and standardized hospice care training programmes for nurses. Methods: This cross‐sectional study investigated knowledge, attitude and self‐reported practice in hospice care among 1819 nurses in Hainan, China. Convenience sampling was used to select participants from 45 hospitals and nursing homes in 14 cities and counties from October to December 2021. A scale of knowledge, attitude and self‐reported practice of healthcare providers in hospice care (Chinese version) was administered to collect data during the study period. Statistical analyses, including t‐tests, one‐way ANOVA, post‐hoc analysis and multiple linear regression, assessed the status of knowledge, attitude and self‐reported practice of hospice care in nurses and identified influencing factors. The PROCESS macro program model 4.0 was employed to explore the mediating effect of attitude on knowledge and self‐reported practice in hospice care. Results: Nurses in Hainan displayed low knowledge (mean = 7.68, SD = 3.53), moderate attitudes (mean = 88.13, SD = 12.10) and self‐reported practice (mean = 51.81, SD = 9.82) in hospice care. Current employment and willingness to engage in hospice care were significant factors influencing knowledge, attitude and self‐reported practice in hospice care. Attitude partially mediated the relationship between knowledge and self‐reported practice. Patient or Public Contribution: This study focuses on nurses' knowledge, attitude and self‐reported practice in hospice care and does not directly involve patients or the public. However, the findings enhance hospice care provided to patients and the broader community by improving nurses' knowledge and skills. This study informs evidence‐based training programmes and interventions, benefiting those in need of hospice care services. [ABSTRACT FROM AUTHOR]

Purpose: Medical insurance fraud has caused huge losses to countries around the world, and public reporting has become an important means to combat medical insurance fraud. The attitude of medical insurance fraud whistleblowers affects people's reporting behavior, and understanding people's attitude toward medical insurance fraud whistleblowers provides a basis for further improving the system and policy of public participation in medical insurance fund supervision. Methods: We adopted the questionnaire method to conduct a national cross-sectional survey of the Chinese public and analyzed the data using Chi-square tests, Fisher's exact tests, and binary logistic regression models. Results: A total of 837 respondents were included, and 81.8% of the population had a supportive attitude toward medical insurance fraud whistleblowers, with gender, whether they had used medical insurance reimbursement, and present life satisfaction being statistically significant (P < 0.05). Conclusion: The public is generally supportive of medical insurance fraud whistleblowers, and women, those who have used medical insurance for reimbursement, and those who are satisfied with their lives are more likely to be supportive of medical insurance fraud whistleblowers. [ABSTRACT FROM AUTHOR]

Host community is one of the most important stakeholders involved in tourism development. Their attitudes and supports for tourism are highly significant to underpin the sustainable development of the industry. However, host community has not been attached adequate importance, and is usually marginalised to be a salient disadvantaged group in the process of tourism development. Although relative deprivation theory (RDT) provides a powerful theoretical tool to analyse the attitudes of disadvantaged social groups, the theory has rarely been documented in tourism literature. This paper takes the case of tourism development in the Zhangjiang National Park, China, and applies RDT to empirically examine how and why host residents suffer from the relative deprivation problem resulting from tourism development and attempts to unveil its influence on their attitudes towards tourism development. The study indicates that there exists a close and negative correlation between the locals' relative deprivation and their attitudes towards tourism development. The more host residents suffer from relative deprivation, the more negative their attitudes towards tourism are, and vice versa. Furthermore, the Relative Deprivation Index proposed in this study proves to be simple and effective in quantitatively depicting the spatial differences/heterogeneity of relative deprivation issues in the case study area. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Several studies have measured the general public's knowledge and attitudes towards Alzheimer's disease; however, much of this work is based on western samples. Due to cultural differences, the western findings may be difficult to generalize to the Chinese general public. In addition, the few studies conducted in China were often restricted to a relatively narrow range of knowledge and attitudes., What this paper adds to existing knowledge? The general public had little knowledge of Alzheimer's disease, especially on the causes, symptoms and risk factors. In terms of attitudes, although the general public held positive attitudes towards persons with Alzheimer's disease, most of them were not sure whether or not to share a diagnosis of Alzheimer's disease with the patient. In daily life, only a low proportion of people kept mentally active., What are the implications for practice? A popularization of a wide range of knowledge about Alzheimer's disease needs to be undertaken, especially focusing on persons with low educational level and emphasizing the causes, symptoms and risk factors. Besides, there is a significant need to draw up evidence-based dietary and lifestyle guidelines for Alzheimer's disease risk reduction. Moreover, health promotion agencies should identify priority groups for Alzheimer's disease risk reduction initiatives, especially those with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases., Abstract Aim The purpose of this descriptive correlational cross-sectional study was to assess the current level of knowledge, attitudes and health behaviours regarding Alzheimer's disease among community residents in Tianjin, China and to identify factors related to these attributes. Method A convenience sample of 140 community-dwelling adults aged 20-75 years was selected to complete a researcher-designed questionnaire about Alzheimer's disease-related knowledge, attitudes and health behaviours. Results The findings revealed that 15.7% of the participants knew the risk factors for Alzheimer's disease. With regard to attitude, 138 participants (98.6%) believed that people with Alzheimer's disease should not be discriminated against, and 55.7% were not sure whether to share a diagnosis of Alzheimer's disease with the patient. In daily life, 28.6% of the participants pursued their interests and hobbies. A lower level of health behaviours was associated with lower income, presence of chronic diseases and a lower level of knowledge about Alzheimer's disease. Discussion These findings provide a strong case for population-level risk reduction initiatives to be undertaken, especially among people with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases. [ABSTRACT FROM AUTHOR]

Once an asset owned exclusively by native English speakers (NESs) in inner circle, the native English speaking norms, specifically the standard varieties of British and American English, have been taken for granted as models for non-native English speakers (NNESs) in outer and expanding circles to imitate and approximate to. But this paradigm is under severe attack given the fact that people who use English as a lingua franca (ELF) have far outnumbered NESs. This paper aims to show how Chinese tertiary-level second language (L2) learners perceive different English accents and how their perceptions were related to their identities within the framework of ELF. By means of an online questionnaire survey, data from 574 English major students were retrieved and analysed with the assistance of SPSS 20.0 and Nvivo 11.0. The current study focuses on ambivalence in respondents' attitudes toward different English accents. On the one hand, there was an obvious bias towards NES norms and accents and a strong bias against Chinese-accented English and other NNES accents; on the other hand, there was an emergence of linguistic rights and learner identity experienced by some respondents, which demonstrated itself in highlighting pragmaticity in communication, endorsing L1-accented Chinese identity, and questioning benchmark roles accorded to NES accent standards. The implication of the current study is to acknowledge an urgency of addressing the controversies between the linguistic reality and the prescriptive standards, and between the respondents' hidden appeals for projecting their identity via L1-accented English and highly-acclaimed NES accent models. [ABSTRACT FROM AUTHOR]

Aims: The aims of this paper were to determine the level of knowledge of and attitude to nuclear power among residents around Tianwan Nuclear power plant in Jiangsu of China., Design: A descriptive, cross-sectional design was adopted., Participants: 1,616 eligible participants who lived around the Tianwan nuclear power plant within a radius of 30km and at least 18 years old were recruited into our study and accepted epidemiological survey., Methods: Data were collected through self-administered questionnaires consisting of a socio-demographic sheet. Inferential statistics, t-test, ANOVA test and multivariate regression analysis were used to compare the differences between each subgroup and correlation analysis was conducted to understand the relationship between different factors and dependent variables., Results: Our investigation found that the level of awareness and acceptance of nuclear power was generally not high. Respondents' gender, age, marital status, residence, educational level, family income and the distance away from the nuclear power plant are important effect factors to the knowledge of and attitude to nuclear power., Conclusions: The public concerns about nuclear energy's impact are widespread. The level of awareness and acceptance of nuclear power needs to be improved urgently.

Introduction: The prevalence of myopia in young generations has dramatically increased over the years, especially in China. This study aims to understand Chinese parents' perspectives on myopia for further improvement of treatment compliance and informing future health planning and policy. Methods: This was a prospective cross-sectional survey study. A self-administrated, internet-based questionnaire was distributed to 2545 parents in China. Detailed information about the demographics, the awareness of myopia, related complications, and practices of myopia prevention and control of the respondents were collected. The distribution of answers was compared among different groups of children's age, children's refractions, and parents' residential locations. Relationships between parental cognition and behavior were also analyzed. Results: Eligible responses were returned by 2500 parents. A total of 55.1% of the respondents considered myopia as a disease and more than 70% of respondents did not realize pathological changes related to myopia. Most parents thought myopia could be prevented (82.0%) and controlled (75.2%), and these parents were more likely to take measures than the parents who did not think so (P < 0.001). The most common myopia control modality was spectacles (87.0%), among which single-vision spectacles are the most used (63.7%). Conclusions: Knowledge about health risks related to myopia was lacking in Chinese parents and their practices of myopia control mainly involved single-vision glasses. Nationwide education for parents about myopia is needed to further advance outcomes of myopia prevention and control. [ABSTRACT FROM AUTHOR]

This paper describes findings from a stratified phenomenological investigation into Chinese nursing students' experiences of learning in practice placements. The investigation was undertaken in China whilst studying at an English University for a post-graduate degree. With the transition of Chinese nursing education into higher education institutions, clinical nursing experience remains a fundamental factor in students' preparation for qualification. This small phenomenological study sought to understand the kinds of experiences students encounter, the factors that supported or inhibited their learning and the ways in which learning in practice could be enhanced. This paper concentrates on the structural factors that influenced students' learning. These structural factors included; the opportunities available for students to learn, students' participation in clinical nursing activities; the relationship that placement staff were willing to engage in with the students and the prevailing learning climate of the placement setting.

Amid criticisms of current paper-and-pencil type questionnaires measuring self-construal across cultural groups, the authors used a graphic representation scale to examine whether Anglo Canadians (N = 220) were more independent than Mainland Chinese (N = 196) and Indians (N = 212) in construing their relationships with closest family member, family members, closest friend, friends, (other) relatives, colleagues, and neighbors. Data generated 5 intriguing findings: (a) Chinese were more interdependent than Canadians but less so than Indians, indicating that Chinese culture has become more individualistic. (b) Canadians were more independent than Chinese in 6 relationship dimensions but were as interdependent as Chinese in self-closest-friend connectedness, somewhat contradicting 1 assumption of theories of independent-interdependent self-construal and individualism-collectivism (I-C). (c) Canadians were more independent than Indians in all relationship dimensions, supporting theories of independent-interdependent self-construal and I-C. (d) Chinese were as interdependent as Indians in self-closest-family-member, self-close-family-members, and self-relatives connectedness but more independent than Indians in the other categories of self-other relationships. (e) Participants' age did not have strong correlations with variables measuring self-construal in any sample, indicating that a person's attachment style may not change greatly over a lifespan. The authors discussed theoretical and methodological implications.