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Background: In 2009, the Chinese government incorporated severe mental disorders into the central subsidized local health funding project for the effective management, treatment, and reintegration of patients with severe mental disorders from hospitals into the community (Project 686). The conditions that were classified as 'severe' by this project included: schizophrenia, schizoaffective disorders, paranoid disorders, bipolar disorders, mental disorders caused by epilepsy, and mental retardation accompanying mental disorders. Patients in rural communities received better care after project implementation, of which 62.91% were farmers. Objective: This paper attempts to investigate the complex impact of Project 686 on the levels of rehabilitation of patients by their families. Methods: The last follow-up visit of the community psychiatrists in city H in 2020 was used as the time point. Finally, 174 samples were used in the analysis model. The type of kinship between family caregivers and patients with mental disorders was operationalized according to the information provided under the 'primary caregiver' item within the basic information section of the follow-up form. The software Stata15 was used to perform descriptive statistics, baseline regression model analysis, and a robustness test on the types of kinship identified and patients' recovery. Results: The types of kinship, current symptoms, and medication use all affected patients' recovery, were found to have regression coefficients of −0.148, −1.756, and 0.902, respectively. Parents of patients with mental disorders remain in the caregiver category with the largest proportion. Community acceptance of patients is high; current symptoms, medication use, and types of caregiver-patient relationships influence patients' recovery levels. Conclusions and discussion: Project 686 has solved some of the rehabilitation and living difficulties of patients with mental disorders in rural communities. The types of kinship between family caregivers and patients with mental disorders in rural communities affect patients' rehabilitation levels. Patients' current symptoms and medication use can effectively moderate the impact of kinship type on patients' recovery in terms of complete self-knowledge, productive work, and life and good social relationships. It is necessary for mental illness prevention-treatment organizations to establish supplemental, replacement, and substitution mechanisms for the life and rehabilitation of patients with mental disorders in rural communities. Furthermore, the sense of reward and concern for family caregivers should be actively enhanced, and greater scientific use of the rehabilitation function of the 'family care + village doctor management' model should be made. [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]

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

Young adults are at high risk of experiencing economic abuse—a form of intimate partner violence (IPV)—and Chinese young adults in non-marital cohabitation are especially vulnerable. To reduce economic abuse, an important question to answer is: What factors are associated with economic abuse? After controlling for constructs (e.g., demographic information and other types of IPV) that were linked to economic abuse, we investigated how financial behaviors (i.e., individuals' money management capability) were associated with power (im)balance (i.e., whether individuals shared equal influence with the romantic partner) and, in turn, economic abuse among non-marital cohabitating Chinese young adults. We also investigated whether associations among financial behaviors, power (im)balance, and economic abuse varied across young adults' gender and SES. We used a Qualtrics survey to collect data from 445 non-marital cohabitating Chinese young adults (53.3% male vs. 46.7% female; 22.7% lower socioeconomic status [SES] vs. 77.3% higher-SES). A structural equation model was conducted to test the associations of research interests. We found that money management capability (e.g., spending within budget and tracking expenses) is associated with balanced power—the individual sharing equal influence with the partner in the decision-making process—and, in turn, less experience of being economically abused. These associations were statistically equivalent across gender and SES. Collectively, our findings suggested that promoting money management capability be a timely and new avenue for reducing economic abuse among Chinese young adults in non-marital cohabitation, possibly because this population faces common and severe economic abuse but generally lacks the opportunity to learn money management. [ABSTRACT FROM AUTHOR]

Objective: Focusing on the relationship between unpaid labor and the occurrence of depressive symptoms, this study aimed to explore the factors influencing the inequality of depressive symptoms and their contribution among Chinese urban and rural employed people. Methods: This study utilized the 2020 China Family Panel Studies' national resampling data. Multivariate logistic regression was used to explore the factors influencing the occurrence of depressive symptoms among employed persons in urban and rural areas in China, respectively. Fairlie decomposition was used to explore the contribution of influencing factors such as unpaid labor to the difference in the occurrence of depressive symptoms between urban and rural areas. Results: About 2,136 (21.70%) participants had depressive symptoms, of which 1,197 (24.75%) rural employed people had depressive symptoms and 939 (18.75%) urban employed people had depressive symptoms. The results of Fairlie decomposition analysis showed that 70.51% of the differences in depressive symptoms between urban and rural Chinese employed people could be explained by the covariates included in this study, including education level (52.44%), age (−11.91%), housework time (10.42%), self-rated health status (10.22%), self-rated income status (2.53%), exercise (2.36%), job satisfaction status (1.99%), chronic disease status (1.90%), and marital status (1.79%). Conclusion: This study found that the proportion of depressive symptoms was lower among urban employed residents than among rural employed residents. This difference was mainly caused by unpaid labor time, socioeconomic status, personal lifestyle, and health status. Housework, which is one of the unpaid labor, contributed to this depressive symptom difference in the third place. [ABSTRACT FROM AUTHOR]

Due to cultural and systemic factors, Chinese-Canadians tend to use mental health services less or when mental health problems are more severe. Services need to be more culturally responsive in their treatment of mental illness. Around important life events, when there may be heightened vulnerability to mental illness, this is especially important. In this study, postpartum cultural practices were examined among recent immigrant, longer-term immigrant, and Canadian-born Chinese women. We conducted a longitudinal cohort study of 493 women in Toronto, Ontario, with livebirths in 2011–2014. Participants completed a demographic survey and Postpartum Rituals Questionnaire. Most women (82.2%) practiced at least one postpartum ritual. Younger age (OR 0.93; 95% CI 0.87–0.99) and greater participation in the heritage culture (OR 1.28; 95% CI 1.02–1.61) were associated with ritual practice. From among five types of postpartum rituals identified (i.e., avoidance of homeostatic disturbances, dietary practices, wind avoidance, organized support, and cold avoidance), dietary practices were most commonly undertaken and cold avoidance was least commonly undertaken. There were differences in postpartum ritual patterns by immigration status, with immigrant women being more likely to undertake a greater number of rituals, to attribute these rituals to Chinese culture, and to ascribe health benefits to these rituals and being less likely to feel forced into performing these rituals. Our findings underscore the importance of clinicians becoming more aware of Chinese postpartum rituals to provide women with culturally competent and patient-centered care. [ABSTRACT FROM AUTHOR]

Background: In the pandemic era, stressful life events (StressLEv) aggravated the impact on mental health. However, youths exhibited different responses to StressLEv because of diverse coping strategies, social support, and emotional intelligence before and after the pandemic. Aims: To explore the changes in StressLEv and coping strategies before and after the coronavirus 2019 pandemic, as well as report the associations among mental health and related factors in a sample of Chinese youths experiencing the post-pandemic era. Method: A cross-sectional study using convenience sampling was conducted from July 1 to August 30, 2022, covering 3,038 youths aged 14 to 25 in China. Multiple logistic regression was conducted for crude odds ratios (ORs) and adjusted ORs. The relationships between lasso-selected variables was examined using structural equation modeling. Results: More StressLEv and limited coping strategies were reported after the pandemic. In the post-pandemic era, BSI-positive youths (youths diagnosed as considered case by Brief Symptom Inventory, BSI) reported more StressLEv (BSI-positive: mean = 75.47; BSI-negative: mean = 28.69), less social support (BSI-positive: mean = 31.81; BSI-negative: mean = 39.22), and lower emotional intelligence (BSI-positive: mean = 75.34; BSI-negative: mean = 89.42). The willingness to engage in mental health counseling (OR: no vs. yes: 1.89; uncertain vs. yes: 4.42), being punished (OR: 1.27), adaptation problems (OR: 1.06), task-oriented coping (OR: 0.95), social diversion coping (OR: 0.90), objective support (OR: 0.90), utilization of social support (OR: 0.81), and regulation of emotion in oneself (OR: 0.94) were associated with mental health. Structural equation modeling supported our theoretical framework. Conclusions: Pandemic-induced mental health problems should not be ignored. The proposed response mechanisms could guide the development of effective interventions, which can help youths better cope with StressLEv and maintain good mental health. [ABSTRACT FROM AUTHOR]

Background: Dissociation remains a controversial topic in terms of its prevalence, cross-cultural validity, and relationship with childhood trauma and adversities. Aims: This study investigated the prevalence of dissociative symptoms and probable dissociative disorders among Chinese high school students and tested the trauma model of dissociation. Methods: A total of N = 1,720 high school students completed standardized measures of positive and adverse childhood experiences (PCEs and ACEs), dissociation, depression, and anxiety. Results: The prevalence rates of dissociative symptoms and (probable) DSM-5 dissociative disorders (DDs) were 11.2% and 6.9%, respectively. Dissociation was a reliable construct (ICC =.682 to.752, p <.001) and was moderately correlated with general psychopathology (r =.424 with depressive symptoms, r =.423 with anxiety symptoms). Participants with a probable DD reported more ACEs, fewer PCEs, and more mental health symptoms than those without a probable DD. ACEs were significantly associated with dissociative symptoms (β =.107, p <.001) even after controlling for age, depressive, and anxiety symptoms. PCEs moderated the relationship between ACEs and dissociative symptoms. Conclusions: This is the first report of the prevalence of dissociative symptoms and probable DSM-5 DDs among nonclinical children. We provide cross-cultural evidence that dissociation is a reliable and valid clinical phenomenon associated with psychopathology in children across cultures. The findings partly support the trauma model of dissociation. This study contributes to the limited literature on dissociation in children. It also offers empirical data to facilitate the ongoing controversy about (childhood) trauma and dissociation. Our findings imply that dissociation is cross-culturally associated with childhood adversities, but trauma is not the only, sufficient cause. Theoretical and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the relationship between stressful life events (SLE) and school engagement and to determine if there are some likely mediating variables between them. A sample of 1517 Chinese junior high school students (51.5% female) completed the adolescent self-rating life events checklist (ASLEC), Utrecht Work Engagement Scale-student (UWES-s), cognitive fusion questionnaire (CFQ), and positive psychological capital questionnaire (PPQ). The model was calculated using the PROCESS macro in SPSS. The serial mediator model revealed a significant negative effect of SLE on school engagement through psychological flexibility and psychological capital (effect = −.08, 95% CI [−.10, −.06]). There was also a direct mediating effect through psychological capital (effect = −.17, 95% CI [−.21, −.13]). The results of the present study may help to clarify mechanisms that might explain the association between SLE and school engagement. Future research on improving school engagement should consider the critical roles of psychological flexibility and psychological capital. [ABSTRACT FROM AUTHOR]

Background and aims: Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases. Methods: From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases. Results: A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases. Conclusions: Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional. [ABSTRACT FROM AUTHOR]

Background: Burnout, depression, and anxiety are highly prevalent among medical students, which often leads to their attrition. We aim to assess the inter-relationships of depression, burnout, and anxiety symptoms with dropout intention among Chinese medical undergraduates using the network analysis. Method: A total of 3,648 Chinese medical undergraduates were recruited through snowball sampling. Learning burnout scale, 9-item Patient Health Questionnaire (PHQ-9), and General Anxiety Disorder Scale (GAD-7) was used to assess burnout, depression, and anxiety symptoms, respectively. We used the EBICglasso model to estimate the network. We compared the network based on gender, study phase, and clinical experience. Results: After removing repeated submissions and incorrect responses to the trap question, 3,536 participants were included in the final analysis. The prevalence of burnout, depression, anxiety, and dropout intention was 38, 62.7, 38.4, and 39% respectively, which is consistent with previous findings. Network analysis suggested that anxiety and depression items clustered together and displayed several strong bridge connections, while burnout items formed another cluster. All the strongest edges were within the respective distress. Cynicism symptoms 'I am fed up with study' and 'I want to study but I feel that studying is boring' were the most central symptoms, while 'fatigue' and 'worthless' were the bridge symptoms within the burnout-depression-anxiety network. Other central symptoms included 'worthless', 'I can handle my courses', 'nervous', and 'uncontrollable worry'. Cynicism symptoms 'I am interested in my major' and 'I feel that the knowledge I have learned is useless' were mostly related to dropout intention. Gender, study phase, and clinical experience didn't affect the global strength of the burnout-depression-anxiety network. Conclusion: Our results indicated the predominance of cynicism symptoms within the burnout-depression-anxiety network and its substantial impact on dropout intention, suggesting that early detection and intervention for cynicism symptoms in Chinese medical students are in urgent need. Other central and bridge symptoms might also serve as potential targets for the prevention and treatment of burnout, depression, and anxiety among medical students. For example, studies suggest cognitive-behavioral therapy could quickly improve 'worthless', which might be beneficial in treating burnout, depression, and anxiety in medical students. [ABSTRACT FROM AUTHOR]

Background: Patients with schizophrenia in rural areas of China face severe delays in getting appropriate treatment due to poverty, transportation, and limited availability of mental healthcare services. However, the experiences of care-seeking among patients with delayed diagnosis and treatment in rural areas remain poorly understood, and it remains unclear how these experiences influence patients' medical mistrust or expectations of care. This study aims to fill that void. Methods: We applied a qualitative phenomenological method. Patients were recruited through purposive sampling at a psychiatric hospital in Harbin, China. Semi-structured, one-to-one interviews were conducted, guided by an interview outline. Thematic analysis was performed using Colaizzi's seven-step method. Results: Data saturation was achieved after interviewing 13 participants aged 21 to 53 years. Three themes with eight subthemes were identified: (i) Barriers to seeking care, (ii) Feelings for psychiatric treatment, and (iii) Demand for mental healthcare. Several factors that may impede the timely diagnosis and treatment were identified, including patients, physicians, and institutions. The participants described their feelings of adverse treatment experiences, as well as expectations arising from this process. It predominantly covers awareness of the disease, supportive access to care, and geographic accessibility of services. Conclusion: Patients with delayed diagnosis and treatment in rural areas often have negative experiences and various needs for mental health services in the pursuit of effective treatments. Policymakers and health planners should seriously consider the current challenges in rural mental healthcare to develop comprehensive strategies for improving prehospital delays and medical experience for this group of patients. [ABSTRACT FROM AUTHOR]

There is evidence showing that the triarchic model of grit and its dimensions (i.e., perseverance of effort, consistency of interests, and adaptability to situations) predict engagement and well-being outcomes in high school and undergraduate students during the COVID-19 pandemic outbreak. However, there has been limited research on how this model of grit relates to engagement and optimal psychological outcomes in primary school students. This research investigates the association of grit's dimensions with academic engagement in math and science as well as well-being outcomes (i.e., positive emotions, negative emotions, and flourishing) in primary school students. Participants were primary school students (Mage = 10.42; SDage = 1.26) from Hong Kong (n = 279) and Macau (n = 124). Results showed that perseverance of effort positively predicted cognitive and behavioral engagement in math as well as positive emotions even after controlling for demographic covariates (i.e., age, gender, setting, and year level), conscientiousness, and achievement goal orientations. Adaptability to situations positively predicted cognitive and social engagement in math and flourishing. Consistency of interests negatively predicted both cognitive engagement in science and negative emotions. Indeed, this study indicates that perseverance and adaptability may facilitate children's positive academic and psychological functioning during the COVID-19 pandemic outbreak. [ABSTRACT FROM AUTHOR]

Background: Although stigma and caregiving burden are important in relation to mental health recovery, few studies have been conducted on affiliate stigma and caregiving burden among family caregivers of persons with schizophrenia (FCPWS) in rural China. Aims: This study aimed to examine the severity level of affiliate stigma and caregiving burden, and identify the correlates among FCPWS in rural China. Methods: A mental health survey was conducted (N = 253 FCPWS) in Xinjin county, Sichuan province, China. Affiliate Self-Stigma Scale and Zarit Burden Interview Short Form were used. The regression analysis was performed to explore the correlates of stigma and burden. Results: Most FCPWS reported experiencing high and severe level of affiliate stigma (78.66%) and caregiving burden (95.26%). Family caregivers who were middle aged, unemployed, with high caregiving burden and low quality of life (QoL), showed more severe affiliate stigma. Family caregivers who were female, older, with low income, high affiliate stigma and low QoL, experienced greater caregiving burden. Conclusions: The large majority of FCPWS in rural China experienced severe affiliate stigma, caregiving burden and poor QoL. It is crucial to develop culture-specific anti-stigma interventions to reduce caregivers' stigma and caregiving burden, and improve QoL. Specific risk factors of family caregivers' affiliate stigma and caregiving burden should be considered for development of health policy and community-based mental health services. [ABSTRACT FROM AUTHOR]

Bullying is a growing concern in China, yet there are few validated scales designed to measure different types of bullying among Chinese children. In this present study, a bilingual team of researchers use a forward-backward translation process to adapt the Bullying, Harassment, and Aggression Receipt Measure (BullyHARM) for Chinese youth. BullyHARM has previously been shown to be a reliable scale for measuring six bullying domains (i.e., physical, verbal, social/relational, cyber, property, sexual) among children in the United States (US). After cultural and linguistic adaptation, we enrolled 397 middle school students from Beijing, China in a validation study to assess the psychometric properties of the new BullyHARM-China scale. Results of confirmatory factor analysis suggest the final 21-item scale displays strong internal consistency. Consistent with findings from the US, the first-order model of six factors (i.e., six bullying subscales) displays the best fit to the data. Our findings suggest that BullyHARM-China is a reliable tool for measuring bullying victimization among Chinese students. [ABSTRACT FROM AUTHOR]

This study aims to explore the effects of the social-emotional classroom climate on academic achievement in mathematics and literature for elementary students in grades 3 through 6. The research specifically focuses on the indirect role of creative thinking (convergent and divergent thinking). Structural equation modeling techniques were used to examine data collected from 1365 Chinese elementary students. The results indicate that in mathematics and literature classrooms, (1) the social-emotional climate had a positive effect on school achievement, and (2) divergent and convergent thinking play indirect roles between social-emotional climate and academic achievement. The findings suggest that elementary students' positive perception of social-emotional classroom climate, including the perceptions of teacher support and student cohesiveness, can promote divergent and convergent thinking and ultimately contribute to the output of academic achievement in mathematics and literature. [ABSTRACT FROM AUTHOR]

Background: Turnover among general practitioners (GPs) has become a significant public health concern worldwide. Aims: This study aimed to investigate the interrelationships between job satisfaction, professional identity, burnout, and turnover intention among GPs in China and to assess the mediating effect of job satisfaction on the association between burnout and turnover intention and the moderating effect of professional identity on the association between burnout and job satisfaction. Method: A cross-sectional study was conducted to collect data from 3,236 GPs in eastern, central, and western China between October 2017 and February 2018 using a self-administered questionnaire. Pearson's correlation analysis and hierarchical regression were used to identify the relationships between job satisfaction, professional identity, burnout, and turnover intention among Chinese GPs. Results: Among these respondents, 65.02% reported a medium or high level of emotional exhaustion (EE), 35.38% reported a moderate or high level of depersonalization (DP), and 62.05% reported reduced personal achievement (PA). Overall, 71.08% of GPs expressed a relatively high intention to seek another position (turnover intention). We found all 3 dimensions of burnout contributed to job dissatisfaction while turnover intention arising from burnout was associated with EE and DP. Job satisfaction had a direct negative impact on turnover intention and partially mediated the impact of EE and DP on turnover intention. Professional identity played a partial moderated role between EE and job satisfaction. Conclusions: The prevalence of burnout and turnover intention among GPs is high in China. The effect of EE and DP on turnover intention is mediated by job satisfaction, and the effect of EE on job satisfaction is moderated by professional identity. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had lasting impacts on people’s interpersonal relationship and mental health. Using four-wave data in China (N = 222, 54.50% female, Mage = 31.53, SD = 8.17), the current study examined whether prepandemic relationship satisfaction was related to postpandemic COVID-19 anxiety through midpandemic perceived social support and/or gratitude. The results showed that people’s COVID-19 anxiety decreased from the peak to the trough stage of the pandemic; perceived social support increased markedly from prepandemic to the peak and remained stable subsequently, while relationship satisfaction remained unchanged throughout. Further, it was midpandemic perceived social support, not gratitude, that mediated the association between prepandemic relationship satisfaction and postpandemic COVID-19 anxiety, indicating that perceived social support played a crucial role in this process. Finally, it is suggested that perceived social support should be distinguished from gratitude as two different components of social interactions. [ABSTRACT FROM AUTHOR]

Past studies of the relation between teacher-student relationship (TSR) and students' academic achievement (SAA) yielded mixed results, so this study determined the overall link between TSR and SAA, along with their moderators. This three-level meta-analysis of 90 independent effect sizes in 74 empirical studies of 233,961 students showed an overall positive link between TSR and SAA in China (r =.259, 95% CI = [.227;.290]). This relationship was higher in: (a) China's central region (.305) than its eastern (.238) or western regions (.166); (b) senior high school (.345), followed by junior high school (.251), then primary school (.221); (c) English (.302), followed by math (.272), Chinese (.269), and science (.202); and (d) females (B =.507) than males. These results suggest the value of improving teacher-student relationships in policies and practices. [ABSTRACT FROM AUTHOR]

Background: High prevalence of smartphone addiction among medical students may contribute to adverse physical and mental health outcomes. Aim: To estimate the prevalence of smartphone addiction, and explore the influencing factors and related mental health symptoms of smartphone addiction among Asian medical students. Design: Systematic review and meta-analysis. Methods: PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and EMBASE were searched for relevant literature from the inception to September 10, 2021. Using Stata software 11.0, the meta-analysis of prevalence and the influencing factors of smartphone addiction were determined with 95% confidence intervals. Results: Nineteen articles, published between 2014 and 2019, were included, producing medical student studies from seven different Asian countries. The included studies were conducted in India (n = 11) and Malaysia (n = 3), with China, Saudi Arabia, Turkey, Nepal, and Iran each contributing one study. Among a total of 5,497 medical students, the participants included 3,214 females, of whom 2,181 were medical students with smartphone addiction. The prevalence of smartphone addiction among Asian medical students was 41.93% (95% CI [36.24%, 47.72%]). The influencing factors of smartphone addiction among medical students included gender, duration of smartphone use, smartphone function, and marital status. Ten studies (52.63%) explored related mental health symptoms of smartphone addiction among Asian medical students. Smartphone addiction was positively correlated with poor sleep quality (r = .17-.31), stress (r = .30-.40), anxiety, depression, neuroticism, and general health among Asian medical students. Conclusion: Smartphone addiction is highly prevalent among Asian medical students. Smartphone addiction may adversely affect mental health, resulting in sleep disturbance, stress, anxiety, depression, and neuroticism. It is necessary to take appropriate precautionary actions and interventions to prevent smartphone overuse among medical students. [ABSTRACT FROM AUTHOR]

This study compares the findings of two qualitative research studies on meanings of divorce endorsed by Chinese divorced women in Hong Kong conducted in 1998–2002 and 2016–2018, respectively. It is clearly shown that ideas about divorce have changed enormously in the past two decades. While the ideas that divorce is not acceptable and divorced women are failures were still prevalent, particularly in the divorce decision-making process, there has been a move towards a more dominant modern stance on divorce, although two powerful obstacles, the welfare of children and social stigmatisation, have persisted. [ABSTRACT FROM AUTHOR]

Research has consistently supported the significance of parental attachment in behavioral development during adolescence. Based on the attachment theory and the engine of well-being model, the current study examined the mediating effect of hope in the relation between parental attachment and social problem-solving skills in Chinese early adolescents (N = 745, 6th to 8th grade, age range 11 to 15 years, mean = 12.76, SD = 0.74). Data were collected across two time points, with six months between each time. After confirming the measurement model, the structural equation modeling analysis results showed that hope fully mediated the relation between maternal and paternal attachment, respectively, and social problem-solving skills. The findings are consistent with previous research conducted in the United States showing the mediating role of hope in the relation between family resources and adolescents' positive goal-directed behavior. These findings also support the application of the attachment theory and the engine of well-being model in Chinese culture and possibly Eastern culture in general. Implications for school psychologists and other mental health professionals to help parents understand how they influence adolescents' social problem-solving skills (via hope), especially in the Eastern cultural context, are discussed. [ABSTRACT FROM AUTHOR]

Using the correlated trait and correlated method minus one model (CT-C(M-1)), this study separated trait effects and trait method-specific effects of attachment figure-domain units in the IPPA-R. The model fit of the proposed model was examined and compared with those of other alternative models using a sample of 1290 adolescents from China. Results indicated that models specifying attachment domains across relationships as methods fitted data better than models specifying attachment domains across relationships as traits in the CT-C(M-1) model. In addition, the factor representing attachment-with-mother was found to significantly predict anxiety, stress, and social efficacy, whereas the attachment-with-father factor was a significant predictor of social self-efficacy, both of which supported the differential functioning of mother and father. Results suggest that the CT-C(M-1) model is a promising approach to separate the unique contributions of different attachment figures and relationship attachment domain-specific effect measured by IPPA-R. [ABSTRACT FROM AUTHOR]

A total of 31 Bachelor of Social Work Chinese graduates were interviewed in college exit interviews in Shanghai about their job search processes. Their responses generated an 87.1 percent major-to-employment mismatch rate between their study major and the postgraduation employment type. Five findings on employment decisions emerged, namely, causation, contextual factors, intervening conditions, job-seeking outcomes, and a positive-but-negative feeling about job searches. This mismatch phenomenon leads to the development of a values-based framework to explain how a combination of professional values and materialistic rewards can influence postgraduation employment decisions. It is connected to the graduates' motivation to apply social work values to match the employment they seek. [ABSTRACT FROM AUTHOR]

Previous research demonstrated the association between parent–adolescent relationship quality and deviant peer affiliation, but it is unclear whether this relation is mediated by other psychological and interpersonal variables, whether father– and mother–adolescent relationship quality have different pathways in predicting deviant peer affiliation, and whether gender moderates these associations. A sample of 543 students from grades 10 to 12 (42.7% male; age M = 16.2 years, SD = 1.0) was selected from a Chinese high school in Shenzhen, China. They provided demographic variables and completed self-report measures of father– and mother–adolescent relationship quality, self-control, friendship quality, and deviant peer affiliation. The results showed that lower father–adolescent relationship quality was associated with lower self-control, which in turn was associated with higher deviant peer affiliation. Mother–adolescent relationship quality did not have direct or indirect association with deviant peer affiliation. In addition, male and female adolescents had no significant difference in the associations between father– and mother–adolescent relationship quality, self-control, friendship quality, and deviant peer affiliation. Implications and limitations of these findings were discussed. [ABSTRACT FROM AUTHOR]

Previous studies have shown that neuroticism is associated with higher levels of posttraumatic stress disorder (PTSD) and depression in individuals who have experienced traumatic events. This study investigated dispositional mindfulness as one pathway in which neuroticism is related to PTSD and depression symptoms among Chinese adolescents who have experienced trauma by considering the role of dispositional mindfulness. Participants were 443 Chinese adolescents who had experienced a severe tornado a year prior to this study. The results showed that our model fitted the data well (χ 2 /df = 2.113, comparative fit index (CFI) = 0.981, Tucker–Lewis index (TLI) = 0.969, root mean square error of approximation (RMSEA) (90% confidence interval (CI)) = 0.061 [0.047, 0.080]) and revealed that dispositional mindfulness partially mediated the relationship between neuroticism and PTSD and depression symptoms. The clinical implications and limitations of our research and recommendations for future research are discussed in this article. [ABSTRACT FROM AUTHOR]

The current Chinese social work licensure program does not mandatorily require formal social work education. This compromised policy is contradictory to the mission of formal social work education and the trajectory of professionalization in other Western countries. This study examined whether social work graduates differ from those who do not have formal social work education in terms of competency, commitment, and turnover intention. Results described the struggles of social work graduates in their experiences in the field. The diminishing role of formal social education may affect the professional identity of social workers in social work development in China. [ABSTRACT FROM AUTHOR]

Background: Rapid socioeconomic changes in China present a mental health challenge and also an opportunity to investigate the relationship between social capital and depression. Materials and methods: Participants (18–45 years old, N = 1,250) were selected using a probability sampling method. The relationship between social capital (measured using the Personal Social Capital Scale) and depression (measured using the Brief Symptom Inventory Depression Subscale) was examined using bivariate analysis, followed by multiple regression to control for covariates. Results: Of the total sample, 54.64% were female with mean age = 35.1 (standard deviation (SD) = 7.5) years old. Depression score was 10.40 (SD = 3.62) for males and 10.36 (SD) = 3.30) for females. The social capital measures (including the total, bonding and bridging) were all negatively associated with depression scores, while the negative social capital was positively associated, after controlling for covariates. Subgroup analysis revealed some differences in the social capital–depression associations. Conclusion: The protective effect of social capital for mental health reported in other countries is also evident in this study. In addition, we found a positive association between negative social capital and depression. In addition to adding new knowledge, findings of this study, if verified with longitudinal design, can be used to support social and behavioral interventions in China to promote mental health by social capital enhancement. [ABSTRACT FROM AUTHOR]

This study used a quasi-experimental design to investigate the impact of Rapid Reading Skills Training (RRST) on some reading outcomes for primary school students in central China and also examined the influence of cognitive flexibility on intervention outcomes. A sample of 108 students (mean age = 11.75 years) were recruited. Students' cognitive flexibility was measured with the Wisconsin Card Sorting Task. Cluster randomization was used to assign students at the whole class level to either an experimental or control condition. A 12-session RRST intervention was completed with the experimental class (N = 54). Silent reading speed and passage comprehension were measured before and after training for all students. Independent samples t-tests and two-factor repeated measures ANOVA revealed that students in the experimental class displayed higher scores for reading speed and effective reading rate post-intervention than those in the control class. Students who had scored higher on cognitive flexibility showed significantly larger increases post-intervention than those scored lower. Results provide preliminary support for using RRST to increase rapid silent reading speed among Chinese primary school students, though replication and more rigorous experimental designs are needed. Cognitive flexibility may enhance gains associated with this type of intervention. Implications for school psychologists are discussed. [ABSTRACT FROM AUTHOR]

Previous studies have shown that when speakers of European languages are asked to turn nonwords into words by altering either a vowel or consonant, they tend to treat vowels as more mutable than consonants. These results inspired the universal vowel mutability hypothesis: listeners learn to cope with vowel variability because vowel information constrains lexical selection less tightly and allows for more potential candidates than does consonant information. The present study extends the word reconstruction paradigm to Mandarin Chinese–a Sino-Tibetan language, which makes use of lexically contrastive tone. Native speakers listened to word-like nonwords (e.g., su3) and were asked to change them into words by manipulating a single consonant (e.g., tu3), vowel (e.g., si3), or tone (e.g., su4). Additionally, items were presented in a fourth condition in which participants could change any part. The participants’ reaction times and responses were recorded. Results revealed that participants responded faster and more accurately in both the free response and the tonal change conditions. Unlike previous reconstruction studies on European languages, where vowels were changed faster and more often than consonants, these results demonstrate that, in Mandarin, changes to vowels and consonants were both overshadowed by changes to tone, which was the preferred modification to the stimulus nonwords, while changes to vowels were the slowest and least accurate. Our findings show that the universal vowel mutability hypothesis is not consistent with a tonal language, that Mandarin tonal information is lower-priority than consonants and vowels and that vowel information most tightly constrains Mandarin lexical access. [ABSTRACT FROM AUTHOR]

With China’s rapidly developing economy and increasing urbanization, many adults from rural areas migrate to urban areas for better paid jobs. A side effect of this migration is that parents frequently leave their children behind (left-behind children). This research investigated left-behind children’s and non-left-behind children’s psychological, behavioral, and educational functioning. Survey participants included 1,708 adolescents (54.8% female; mean age = 15.03 ± 1.93 years) from rural areas in Central China. Additionally, 32 left-behind children and 32 head teachers were interviewed. Data indicated that in comparison to non-left-behind children, left-behind children were at a disadvantage in regard to emotional adjustment (i.e. lower life satisfaction, lower self-esteem, and higher depression), but fared better in educational adjustment (greater school engagement). Mitigating factors which positively influenced outcomes of certain subgroups of left-behind children included the presence of one parent, increased parental contact, and shorter length of time since parental migration. Information gathered from interviews with LBC also indicated adverse effects of parent absence on children’s development. Teachers identified education measures and support offered to left-behind children and reported difficulties in communicating with parents. Based on this study’s findings, and considering the perspective of educators, implications for school-based interventions are explored. [ABSTRACT FROM PUBLISHER]

The article discusses the study on the effects of a priming strategy without fresh frozen plasma (FPP) during cardiopulmonary bypass (CPB) on the coagulation after surgery and clinical recovery in pediatric patients, that found no clinical benefits to prophylactic use of FFP in priming solution. Findings discussed include safe and effective use of artificial colloids as FFP substitute in pump prime, and effectivity of thromboelastography (TEG) to assess postoperative coagulation function.

This article reports on the results of a survey of 540 Chinese school children’s adjustment in temporary school relocation after the Wenchuan earthquake. The overall results depicted a positive picture of functioning. The findings were contrary to expectations, as earlier observational reports suggested that pupils had adjustment difficulties. [ABSTRACT FROM PUBLISHER]

A group of 124 children orphaned by AIDS (COA), who resided in two orphanages funded by the Chinese government, participated in a study investigating the efficacy of a grief-processing-based psychological group intervention. This psychological intervention program was designed to specifically help COA process their grief and reduce their psychological distress. Six sessions of group intervention focused on processing grief, reducing traumatic symptoms and psychological distress, and fostering hope about the future. At the three-month post-test, children in both groups (intervention group and control group) reported significant reduction in trauma symptoms and demonstrated similar levels of hope. However, the intervention group reported significantly increased levels of grief processing and decreased levels of trauma symptoms, depression, and threat appraisal. The intervention group also reported subjective improvements in mood, relationships, individual growth, self-confidence, and perceived social support. These outcomes supported the potential efficacy of grief-processing-based psychological intervention to reduce the psychological distress among COA. [ABSTRACT FROM PUBLISHER]

Human albumin is the conventional cardiopulmonary bypass circuit primer. However, it has high manufacturing costs. Crystalloid and colloid solutions have been developed as alternatives, including a new generation of non-ionic hydroxyethyl starch (HES). The efficacy of hydroxyethyl starch with a 130 molecular weight and substitution degree of 0.4 (hydroxyethyl starch 130/0.4) was compared with human albumin for use in cardiopulmonary bypass surgery in American Society of Anesthesiologists’ grade I-II pediatric congenital heart disease patients. Efficacy was evaluated by comparing perioperative hemodynamic parameters, including plasma colloid osmotic pressure, renal function, blood loss, allogeneic blood volumes and plasma volume substitution. The hydroxyethyl starch group exhibited significantly higher preoperative colloid osmotic pressure (p<0.01) and significantly lower operative renal function and postoperative allogeneic blood volumes than the human albumin group. No significant differences were observed in serum creatinine, glucose, hematocrit or lactic acid levels (p>0.05). Our results indicate that hydroxyethyl starch may be a viable alternative to human albumin in pediatric patients undergoing relatively simple cardiopulmonary bypass surgeries. [ABSTRACT FROM PUBLISHER]

The article discusses a study regarding the characteristics of the help-seeking behaviors and pathways of people with physical and mental illness from rural regions of China. Topics discussed include documentation of 203 patients with mental disorders using the World Health Organization (WHO)'s pathway encounter form, the use of Mann-Whitney U test, and lack of awareness about treatment services with mental disorders.

The article presents a retrospective, observational study that examines the use of extracorporeal membrane oxygenation in airway management during tracheal surgery in Shanghai Chest Hospital between 2008 and 2012. The study aims to evaluate the effectiveness of extracorporeal membrane oxygenation. The study also shows that extracorporeal circulation plays an important role in high-risk cases.

The article discusses a study to determine whether correlates can be detected for medical students in a major Chinese medical school. It hypothesized that students with greater exposure to psychiatric patients will report more positive attitudes towards psychiatry, have more open attitudes toward psychiatric services and patients and make more correct diagnoses. Findings statistically confirm a correlation between psychiatric training and an overall positive attitude towards psychiatry.

This study investigated the noun definitions given by Cantonese speakers at different ages. Definitional responses on six concrete nouns from 1075 children aged 4;10 to 12;01 and 15 adults were analyzed with reference to the semantic content and the syntactic form. Results showed that conventional definitions produced by Cantonese adult speakers were realized with specific superordinates and more perceptual than functional attributes. The content was carried by a syntactic frame, “NP1is NP2”, where relative clause was not the predominant form of NP2 as in the English definition forms. Core attributes signifying the defining properties increased significantly with age while non-core attributes were observed relatively evenly throughout all groups. Preschoolers tended to drop the sentential-subject (i.e., NP1) and the copula is, and produce more functional than perceptual attributes. By Primary-2 (P2) (about 7;0), the taxonomic relation was coded with the frame of “NP1is NP2”. Beginning at P4 (about 9;0), children included a superordinate but the specificity of the adult-like superordinate was not achieved even by P6 (about 11;0). In general, developmental trends accorded with the trends observed in other languages, but typological features played a role in framing the development of the syntactic form. [ABSTRACT FROM PUBLISHER]

Background: In order to protect the rights of the mentally ill, legislation on the standards and procedures of compulsory detention has been made at the local and national level in China. Aims: This study aims to examine psychiatrists' attitudes towards seeking involuntary admission in mainland China. Method: Three hundred and fourteen (314) qualified members of the Chinese Psychiatrist Association (CPA) were surveyed using a questionnaire to assess their attitudes about the procedure of involuntary admission to mental hospitals. Data were analysed using χ² and logistic regression. Results: Some psychiatrists in the CPA had several arbitrary attitudes towards the process of admission. Females, aged under 35, with a low education level and a low position in the institution showed stricter attitudes in the procedure of involuntary admission. Areas with mental health legislation showed significant positive relationships with stricter attitudes. Conclusions: Every effort needs to be made to minimize these arbitrary attitudes to prevent potential negative outcomes. There is still a long way to go in protecting the rights of people diagnosed with mental illness. [ABSTRACT FROM AUTHOR]