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Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Conclusion: Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students. [ABSTRACT FROM AUTHOR]

The researchers' aim to quantitatively study the impacts of education, health expenditure, Internet, mobile phone, and open-access articles in medical science on women's health in China. We found that there are very strong significant negative correlations between the data of women's mortality rates and female school enrollment (p≪0.01), whereas there are strong significant negative correlations for open-access papers in eight disciplines of medical science, individuals using the Internet, and mobile cellular subscriptions (p≪0.01). The first principal component explains 96.8%, 96.6%, and 99.6% of the variation in the mortality rate of female infants (p = 0.002 < 0.01), females under-5 (p = 0.003 < 0.01), and female adults (p = 0.002 < 0.01), respectively. There is a similar relationship between open-access medical papers and women's health. The above results could be helpful to interdisciplinary audiences (patients, practitioners, and policymakers) to develop strategies for the effective implementation of knowledge on women's health (how to disseminate knowledge more effectively in the whole society). [ABSTRACT FROM AUTHOR]

The risk quotient (RQ) related to Estrone (E1), 17β–E2 (E2), Estriol (E3) and 17α-ethynylestradiol (EE2) in sediment of water resources in China was calculated using Monte Carlo Simulation (MCS) method. Fifty-four papers with 64 data-reports included in our study. The rank order of steroid hormones in sediment based on log-normal distribution in MCS was E1 (3.75 ng/g dw) > E3 (1.53 ng/g dw) > EE2 (1.38 ng/g dw) > E2 (1.17 ng/g dw). According to results, concentration of steroid hormones including E1, E2 and E3 in sediment of Erhai lake, northern Taihu lake and Dianchi river was higher than other locations. The rank order of steroid hormones based on percentage high risk (RQ > 1) was EE2 (87.00%) > E1 (70.00%) > E2 (62.99%) > E3 (11.11%). Hence, contamination control plans for steroid hormones in sediment of water resources in China should be conducted continuously. [ABSTRACT FROM AUTHOR]

Most Chinese pre-arrival training programs are focused on English language training without preparing students with psychological readiness to overcome potential adversities. This paper explores the effectiveness of an innovative six-week pre-arrival training program that integrated English training with resilience training through the lens of social constructionism. The program involved a mix of English proficiency training using stories with an underlying resilience theme coupled with further reinforcement of resilience skills through interactive narratives, bibliotherapy and art therapy. Thirty Chinese students who were enrolled in a joint venture training program between China and the U.K. were randomly divided into an experimental group and a control group. The result of the pretest and posttest comparison after students participated in the training program showed a significant improvement in the experimental group's overall English skills and resilience, and a decrease in their anxiety, stress, and depression compared to the control group. [ABSTRACT FROM AUTHOR]

Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time. Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time. Main outcome measures: SRH at two time points with a -two-year span. Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards. Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time. [ABSTRACT FROM AUTHOR]

The current study aimed to explore the protective factors and underlying mechanisms associated with loneliness and psychological distress among older Chinese adults within the framework of a longitudinal design. This investigation specifically focused on the mediating role of attitudes toward own aging (ATOA) in the relationship between social support and the experience of loneliness and psychological distress (comprising depression, anxiety, and stress) amidst the backdrop of the COVID-19 pandemic. A cohort of 345 elderly individuals (mean age = 83.84 years, standard deviation = 8.49 years; 55.1% females) participated in this research endeavor. The participants were required to complete self-report instruments measuring their perceived levels of social support at Time 1 (T1), attitudes towards own aging, ATOA at Time 2 (T2), and their experiences of loneliness, and psychological distress (including depression, anxiety, and stress) at T1 and Time 3 (T3). The data collection timeline encompassed baseline data collection at T1 in September 2020, a subsequent six-month follow-up at T2 in March 2021, and a one-year follow up at T3 in September 2021. The findings of this investigation unveiled a negative predictive relationship between social support at T1 and psychological distress (encompassing depression, anxiety, and stress) at T3. Furthermore, it was discerned that ATOA at T2 acted as a mediating mechanism, elucidating the longitudinal association between social support at T1 and the manifestation of loneliness and psychological distress (including depression, anxiety, and stress) at T3. The discussion section of this paper delves into an exploration of the limitations and implications inherent in these conclusions, particularly concerning their relevance to potential intervention strategies. [ABSTRACT FROM AUTHOR]

MOOCs (massive open online courses) have attracted a great deal of research and attention; however, few studies have focused on the factors that influence MOOC teacher effectiveness, which is the key to the development of MOOCs. Based on the perspective of professional capital and social exchange theory, this paper aims to study the factors that influence MOOC teacher effectiveness. First, the research hypotheses are proposed from the teacher's perspective to build the research model based on factors affecting MOOC teacher effectiveness. Second, the iCourse platform is selected as the research object because it has the largest number of active users in China. As of March 1, 2019, the effective research data of 7380 teachers were obtained from iCourse to build a multivariate regression model. The results highlight the main factors that affect MOOC teacher effectiveness from the perspective of professional capital. Finally, relevant suggestions are proposed for the development of MOOC. [ABSTRACT FROM AUTHOR]

The formation of information security behavioural intention (ISBI) can be complex and dynamic in different contexts. This paper aims to examine and compare different users' ISBI formalisation mechanisms when dealing with their personal affairs (non-work users) and organisational affairs (work users). Drawing on two principles of Conservation of Resources (COR) theory (i.e. resource loss principle, and resource gain principle), we developed two models to examine how situational support affects ISBI formation. The results of a study of 432 non-worker users and 261 work users indicate a curvilinear relationship between situational support and ISBI through subjective norms and risk perception for non-worker users, whilst a linear relationship via subjective norms is found for worker users. This is the first time that COR has been applied to explain the formation of ISBI. The findings broaden the research scope of individuals' ISBI by revealing how situational support affects the formalisation mechanism for different users in cross-contexts. The theoretical and practical implications of the findings and the future study are discussed. [ABSTRACT FROM AUTHOR]

Adolescent suicide has become an increasingly serious social problem in China. Bullying victimization was found to be an influential factor of suicidal tendency, but less attention has been paid to the internal mechanisms of the relationship. This paper examined the relationship between adolescents' bullying victimization and suicidal tendency, and the mediating effects of internalizing problems and non-suicidal self-injury (NSSI). Generalized Structural Equation Model was employed to a sample of 3,575 Chinese secondary school students. Bullying victimization has a direct positive impact on adolescents' suicidal tendency, but also has an indirect impact on suicidal tendency through three paths: the independent mediating role of internalizing problems and NSSI, and the chain mediating role of internalizing problems and NSSI. The results suggested that students who are bullied tend to have a higher risk of suicidal tendency, and internalizing problems and NSSI are usually the prelude to suicidal behaviors. [ABSTRACT FROM AUTHOR]

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

Vibration contributes large increases in railway passenger discomfort during long-term sitting. Discomfort caused by vibration may differ in different operation conditions. This paper conducted field measurements to investigate the interrelationships between the three. Participants completed a 240-min train journey with their whole-body vibration, subjective comfort ratings and train operating parameters being recorded. A large correlation was observed between the estimated vibration dose value and subjective comfort. The relationship that vibration magnitude significantly increases with increasing the train speed and tunnel density was also found and quantified. A vibration exposure limit of 2.08 m/s1.75 corresponding to the boundary between subjective ratings of comfortable and discomfortable was obtained. Based on the exposure limit and the quantified relationship, a vibration comfort prediction method that can calculate the passenger's maximum tolerance time under a given operation condition was proposed and may help in determining the optimal operating speed and tunnels distribution to alleviate vibration discomfort. Practitioner summary: Similar to the guide to effect of vibration on health in current standard, a vibration exposure limit regarding comfort was provided for reference when assessing long-term vibration comfort. Meanwhile, a prediction method was proposed for determining the best train operating speed and tunnels distribution, thereby alleviating railway passengers' vibration discomfort. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. A total of 18 journal papers were included in this review. The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population. [ABSTRACT FROM AUTHOR]

Hedonia and eudaimonia have been proposed as pathways to well-being. However, the direction of the causal relationship between them remains unclear. This study examined if happiness motivations may be resources leading to a happy life, or vice versa. Cross-lagged associations between happiness motivations (i.e. hedonic motivation and eudaimonic motivation) and subjective well-being (i.e. positive affect, negative affect, and life satisfaction) were tested. Four hundred and ninety-four Chinese adolescents (233 males; mean age 13.26 ± 0.70 years) participated in a two-wave paper and pencil study. The cross-lagged analysis showed that eudaimonic motivation was a significant predictor of positive affect and life satisfaction over time. No cross-lagged effects between eudaimonic motivation and negative affect, or between hedonic motivation and subjective well-being components were established. The results highlight the predictive power of eudaimonic motivation on adolescents' subjective well-being later on. [ABSTRACT FROM AUTHOR]

With the increased popularity of mobile learning, there is a growing demand on the understanding of how the scalable technology, such as mobile devices, influences individual learning behaviours as well as their learning outcome. A theoretical model was built based on the adaptive structuration theory (AST) and the knowledge spiral theory. Using this model, we examined the relationship between structural sources, individuals' adaptive structural behaviours, and their perceived learning. A Structural Equation Modeling method was employed in our empirical study. Findings indicate that users' task adaptation had a positive influence on their perceived learning, In addition, their exploitive technology adaptation influenced the ultimate perceived learning, but the impact of users' exploratory technology adaptation on learning was mediated by their task adaptation. Contrary to expectations, the effect of computer self-efficacy on exploitive and exploratory technology adaptation was negative, and exploratory technology adaptation negatively affected exploitive task adaptation. A detailed discussion of the findings and implications are provided in this paper. [ABSTRACT FROM AUTHOR]

China and some other Asian countries have experienced skewed sex ratios, triggering intense competition and pressure in the marriage market. Meanwhile, China has more smokers than any other country, with half of men smoke while few women smoke. Men are the major income earners in most Chinese families and thus bear much of the financial burden in preparation for children’s marriage. This paper investigates how a demographic factor—a large number of surplus men in the marriage market in China—affects their fathers’ smoking behavior. We utilize a household longitudinal survey as well as a random subsample of the China Population Census to examine fathers’ smoking in response to skewed sex ratios. Strikingly, fathers smoke more for families with a son living in counties with higher sex ratios. In contrast, those with a daughter do not demonstrate this pattern. Coping with the marriage market pressure is a most plausible pathway linking skewed sex ratios and intense smoking among fathers. Considering worsening sex ratios and highly competitive marriage market in the coming decade as well as lasting health impacts due to smoking, policies suppressing unbalanced sex ratios could lead to welfare gains. [ABSTRACT FROM AUTHOR]

Objectives: This paper studies the institutional inequality that exists in the prevalence of diabetes and hypertension, as well as their diagnosis and medication management, between urban and rural residency status (hukou) holders in China. Methods: Exploiting the Chinese Health and Nutrition Survey, we primarily demonstrate that while a lower proportion of rural residency holders suffer from diabetes and hypertension, a larger proportion have never been diagnosed with these conditions and do not take medicine to control them. We explore the determinants of these disparities by the non-linear decomposition method. Results: Decomposition results illustrate that a large part of disparities in the prevalence of diabetes and hypertension can be explained by the differences in demographic structure and occupational socio-economic status. Regarding the ruralurban disparity in the under diagnosis and under-medication rates, the differences in demographic structure, household affluence, occupational socio-economic status and consumption patterns make the greatest contributions. Conclusions: This evidence suggests that improving the institutional economic inequality and enhancing the occupational mobility of rural residency holders are of paramount importance to mitigate any inequality in health and healthcare utilisation. [ABSTRACT FROM AUTHOR]

This study integrates the theory of planned behavior with a structural approach to examining social capital to investigate how bonding social capital affected Chinese women's tampon use intentions. Bonding social capital was operationalized as network closure, which included two main dimensions: density and hierarchy. Results from an online survey (N = 766) showed that network density was positively associated with attitudes toward, social norms about, and perceived behavior control around tampon usage, while network hierarchy negatively predicted attitudes only. Moreover, the indirect effects of network density on tampon use intentions were mediated by descriptive norms and perceived behavior control. Examining women's intentions to adopt a rarely used product in China, this study extended the theory of planned behavior into the realm of social capital in an understudied context. The findings provide practical implications for health communication practitioners in public education concerning feminine hygiene products and gynecological health. [ABSTRACT FROM AUTHOR]

Previous research on plagiarism has increased awareness and knowledge of the various aspects of this issue, such as contributing factors to plagiarism, students' and teachers' perceptions of plagiarism, and institutional policies and regulations on plagiarism. Yet much of this research, especially on the latter two aspects, has been conducted in Anglo-American contexts or English-as-a-second-language (ESL) settings (where English is an official or important language in the larger societal context), while the diversity of English-as-a-foreign-language (EFL) contexts (where English as a foreign language is largely used only in the language classroom) remains relatively under-researched. Of those studies that did focus on EFL contexts, the majority were based on survey data that were limited in the depth of information collected. To address this relative lack of in-depth understanding of how plagiarism is understood and acted against in EFL contexts, this paper reports on an interview study with 13 EFL teachers from 12 universities in mainland China. The study focused on the teachers' knowledge and attitudes concerning plagiarism, plagiarism-related pedagogical practices, as well as perceived stances and expectations of their institutions in plagiarism prevention. Its findings contribute to the current knowledge base of EFL academics' views and practices regarding plagiarism, add to our understanding of EFL teachers' experiences concerning plagiarism in specific educational settings, and inform institutions' efforts to develop and improve strategies and policies for preventing plagiarism. [ABSTRACT FROM AUTHOR]

Microblogs are revolutionising the way users produce, consume and distribute short content. The continuous content contributions of users are crucial for the sustainable development of microblogs. Knowledge regarding this user behaviour is scarce. Based on the uses and gratifications theory (U&G) and the social influence theory (SIT), this paper proposes an integrated research model with the aim of understanding the factors that affect users' continuous content contribution behaviours (CCCB) on microblogs. The data were collected from 379 microblog users in China. The empirical results indicate that perceived gratification had a positive but surprisingly trivial effect on continuous content contribution behaviours. Social influence had a strong and significantly positive effect on users' CCCB, it also had a positive moderating effect on the relationship between perceived gratification and CCCB. Users' perceived gratification was positively affected by the antecedents of self-expression, anticipated extrinsic rewards and anticipated reciprocity but negatively affected by privacy concerns. The platform attributes of microblogs (i.e. accessibility and interactivity) also influenced users' perceived gratification. This research contributes to social media research with regards to the theory of users' CCCB. [ABSTRACT FROM AUTHOR]

Background:The third nationwide hepatitis B virus (HBV) sero-epidemiological survey conducted in China in 2006 showed a hepatitis B surface antigen (HBsAg)-positive rate of 7.18% and the number of carriers to be 93 million. To compensate for the lack of data on the national prevalence of hepatitis B from 2006 onwards, we performed a meta-analysis to investigate HBsAg-positive rates among the general Chinese population aged 1–59 years.Methods:We systemically reviewed published studies (January 2007 to September 2013) from full-text databases such as VIP, Chinese National Knowledge Infrastructure, and PubMed and assessed HBsAg-positive rates using a random effects regression model with comprehensive meta-analysis software.Results:After evaluation of the quality of the papers, 36 were finally included, with a total sample size of 314 103 individuals. The meta-analysis showed that the combined HBsAg-positive rate was 6.1% (95% confidence interval (CI), 5.4–6.8%) among general Chinese populations aged 1–59, with a higher HBsAg-positive rate in males (6.6%; 95% CI, 5.7–7.7%) than in females (5.1%; 95% CI, 4.4–5.9%). Our data also showed a higher HBsAg-positive rate of 6.9% in mid-western China (95% CI, 5.2–9.1%) against 5.6% in eastern China (95% CI, 4.9–6.4%).Conclusion:This meta-analysis suggested that the positive rates of HBsAg in China are reducing compared with previous 2006 sero-survey results, and China has changed from a high endemic area for HBV to an intermediate endemic area. However, owing to the large population, there remain an estimated 80 million HBsAg carriers in China. Thus, the prevention and control of hepatitis B represent a serious challenge, particularly in mid-western China. [ABSTRACT FROM AUTHOR]

Psychological hotlines are widely used, convenient, and effective means to help people overcome their stress reactions. In this article, we focused on integrating somatic and mental-micro interventions into the psychological assistance hotline process. In addition to verbal communication, dance movement therapy based on the body-mind interaction can help clients re-establish their connection with psychological resources, such as creativity and resilience in addition to verbal communication. Based on the basic steps and core points of the SAFER-R model, we explored how embodied movement elements can be applied to the hotline setting for body-mind micro-interventions. Furthermore, we proposed the CREATE model and explained how it can be used to intervene and realise the basic functions of psychological hot line service through four case vignettes. Through this article, we added new perspectives and options for the provision of psychological support during public health events, and we enriched the working methods of psychological hotline assistance. [ABSTRACT FROM AUTHOR]

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

The study aims to investigate the association of learning participation with the quality of life (QoL) in older Chinese adults, verifying how the differing types of learning activity participation may influence their QoL. We conducted two studies to gain a better understanding of learning participation and QoL among adults over 55 years of age. In the first study, we conducted five focus groups among 43 older adults about their understanding of learning benefits and their general well-being. In a second study, we assessed the QoL using the EUROHIS-QOL 8-item index, while learning participation was measured through a questionnaire addressing the frequency of involvement in educational activities among 579 Chinese older adults. The results indicate that being engaged in learning activities in old age has the potential to increase the QoL of older adults. Moreover, in contrast to nonformal learning, the results of the hierarchical linear regression model demonstrate that both informal and formal learning have a significant positive influence on QoL. The paper concludes by discussing the implications for research and practice pertaining to the encouragement of learning participation in later life. [ABSTRACT FROM AUTHOR]

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This paper examines the findings from an extensive geographic mapping study of female sex work venues located in the south western Chinese city of Zigong, in Sichuan province. Drawing upon the findings from quantitative research, secondary historical sources and field notes, composed during participant observation, we provide a nuanced portrait of how the operation of sex work can be conceptualised in spatial terms, where ‘space' is regarded as something socially constructed and historically contingent. The sex work geographies we analyse hold important implications for prevention work conducted in the region. When the sexual practices between sex workers and their clients are viewed against a wider geographic and historical backdrop, focus shifts from the properties and intentionalities of individuals towards the kinds of spaces where sex work operates, the organisation of which are underpinned by economic forces that have given rise to the rapid proliferation of small urban spaces in contemporary China. [ABSTRACT FROM PUBLISHER]

A phytochemical investigation of the EtOH extract from the aerial parts ofViburnum betulifoliumBatal. afforded four new tetrahydrofuran lignans, betulifolium A-D (1,2,4, and5), together with two known compounds vibsanol-9′-al (3) and sarcomeginal (6). This paper deals with the isolation and structure elucidation of the new compounds on the basis of spectroscopic methods, including 1D NMR, 2D NMR analyses and HR-ESI-MS data. [ABSTRACT FROM PUBLISHER]

China's rapid economic growth over the last three decades has led to increased population wealth and the proliferation of entertainment centres where people can conduct business, relax and meet new people. Little is known about the sexual risk behaviours of employees at high-tier entertainment centres. This paper addresses this gap in knowledge by comparing HIV risk perception and sexual and reproductive health behaviours among female and male employees at three high-tier entertainment centres in two cities in China, comparing those who report a history of transactional sex to those who do not. In both cities, participants who reported a history of transactional sex were more likely than those without a history of transactional sex to report multiple sexual partnerships, more lifetime sexual partners, a history of sexually transmitted infections (STIs), having anal sex and/or recent abortions, and were more likely to perceive themselves to be at risk for STIs/HIV. However, risk behaviour was also high among those with no history of transactional sex. These findings highlight the need for targeted sexual and reproductive health initiatives for employees in these work settings. [ABSTRACT FROM PUBLISHER]

Teachers are considered to be one of the most important influences in the lives of students. Teachers' assessments of students may be a primary source of information on children's mental and behavioral health; however, this topic has received little attention in research. We examined this issue through linking teachers' ratings of students and mental and behavioral outcomes of children affected by HIV. The hypothesis is that teacher ratings will be predictive of specific child mental and behavioral health outcomes. A quantitative cross-sectional design with self-administered paper-and-pencil instruments was used. The sample included 1221 children (aged 6–18, grades 1–11) affected by HIV including 755 orphans who lost one or both parents to AIDS and 466 vulnerable children living with HIV-infected parents in a central province of China. The corresponding teacher sample included 185 participants. Each child completed an assessment inventory of demographic information and mental and behavioral health measures. Teachers completed a questionnaire about children's school performance. SEM analyses revealed a good model fit according to all fit indices: comparative fit index = 0.93, root mean square error of approximation = 0.07, and standardized root mean square residual = 0.04. Structural equation modeling revealed that problem ratings by teachers were positively associated with child loneliness and behavioral problems, social competence ratings by teachers were negatively related to child depression, and personal growth and social interaction ratings by teachers were negatively related to child loneliness, depression, and trauma. The current study represents a unique contribution to the field in that it recognizes that teachers can be a valuable source of information on children's psychological health. Results from this study have implications for health prevention and intervention for children and families suffering from HIV/AIDS. [ABSTRACT FROM AUTHOR]

Female sex workers are a priority population for HIV prevention and health promotion in China. This paper examines the patterns of and factors associated with the utilisation of HIV-related and general health services by establishment-based sex workers in Hongkou District, Shanghai. Participants were recruited through a three-stage sampling strategy and invited to self-complete a brief survey in 2012. The median age of the 400 participants included in the analyses was 33 years (range = 18–52 years old), with over three-quarters being married at the time of the survey. Participants were mostly internal migrants, more than half had lived in Shanghai for six months or longer and nearly two-thirds were working in an establishment with a total of less than five female sex workers. Routine physical examination and HIV testing were the most commonly accessed health services in the previous 12 months. Altogether, 347 women (86.8%) had actively sought, including 157 women had obtained, free health services mainly from local Community Health Service Centres (CHSCs) in the previous 12 months. The active seeking of free, largely CHSC-provided health services was associated with a longer duration of residence in Shanghai (adjusted odds ratio [AOR] = 2.55, 95% CI = 1.32–4.93;p< 0.01) and having tested for HIV in the previous 12 months (AOR = 3.68, 95% CI = 1.84–7.38;p< 0.001). Conversely, a higher annual income (AOR = 0.41, 95% CI = 0.21–0.80;p< 0.01), working in a larger establishment (AOR = 0.40, 95% CI = 0.20–0.79;p< 0.01) and knowing that HIV can be transmitted through blood transfusion with unscreened blood (AOR = 0.21, 95% CI = 0.05–0.91;p< 0.05) were associated with not actively seeking such services. Free, community-based health services are highly demanded by establishment-based female sex workers in Shanghai. Scaling-up of free and integrated health services provided by community-based health service providers in metropolitan areas in China and beyond holds promise for promoting health and well-being of female sex workers. [ABSTRACT FROM AUTHOR]

Objectives: Person-centered care (PCC) is one of the most desirable approaches for elderly with dementia. However, it has not been initiated and systematically studied in China, on which lacking of reliable and valid measurement tools is one of the key barriers. This paper aims to validate person-centered care assessment tools (P-CAT) in a Chinese context. Method: The original 13-item was translated and back translated. And 11 items were added based on literature review and expert consultation. The resulting 24-item P-CAT-C was validated among a sample of formal caregivers (n = 330) in all 34 residential care facilities in urban Xi'an, a representative city in north-western China. Chinese versions of staff-based measures of individualized care for institutionalized persons with dementia (IC) and caregiver psychological elder abuse behavior (CPEAB) scale were used to test the criterion validity. Results: Confirmatory factor analysis (CFA) showed that a three-factor 15-item solution provided adequate fit indices to the data (χ2 = 145.691, df = 81, p < 0.001, comparative fit index (CFI) = 0.926, Tucker-Lewis index (TLI) = 0.905, root mean square error of approximation (RMSEA) = 0.050). Four new items were identified and two original items were excluded. The three factors are named as (1) individualized care (6-item); (2) organizational support (6-item); and (3) environmental accessibility (3-item). The internal consistency coefficient (Cronbach's α = 0.684) is satisfactory. The interscale correlation among P-CAT-C, IC, and CPEAB showed good criterion validity. Conclusion: P-CAT-C is a culturally adapted version of the original P-CAT, which showed satisfactory reliability and validity for evaluating PCC in Chinese residential care facilities. It also provides insight to other developing countries. [ABSTRACT FROM AUTHOR]

In this paper, we explore the strong familial responsibility sense of people living with HIV (PLHIV) in rural western China, based on the data obtained from in-depth interviews. The data show that PLHIV were coping positively with a poor family economic status, caring for their family more than themselves, and taking concrete steps to fulfill their familial obligations. However, unique economic, cultural, and social factors exert negative impact on their ability to achieve their aims. The findings from our study illustrate that proper governmental and social interventions should be launched based on the actual situation and needs of local PLHIV and their families. [ABSTRACT FROM PUBLISHER]

Objective. Obesity prevalence is unequally distributed across gender and ethnic group in Malaysia. In this paper, we examine the role of socioeconomic inequality in explaining these disparities. Design. The body mass index (BMI) distributions of Malays and Chinese, the two largest ethnic groups in Malaysia, are estimated through the use of quantile regression. The differences in the BMI distributions are then decomposed into two parts: attributable to differences in socioeconomic endowments and attributable to differences in responses to endowments. Results. For both males and females, the BMI distribution of Malays is shifted toward the right of the distribution of Chinese, i.e., Malays exhibit higher obesity rates. In the lower 75% of the distribution, differences in socioeconomic endowments explain none of this difference. At the 90th percentile, differences in socioeconomic endowments account for no more than 30% of the difference in BMI between ethnic groups. Conclusions. Our results demonstrate that the higher levels of income and education that accrue with economic development will likely not eliminate obesity inequality. This leads us to conclude that reduction of obesity inequality, as well the overall level of obesity, requires increased efforts to alter the lifestyle behaviors of Malaysians. [ABSTRACT FROM AUTHOR]

This paper's design is descriptive and correlational based on retrospective self-report survey data collected in Kunming city, China. The study investigated the difference between a group of Chinese HIV positive (N=36) and negative (N=131) opioid dependent adults maintained on methadone treatment. Comparisons were based on their quality of life (QOL), methadone treatment adherence, adverse symptom occurrence related to methadone treatment, and HIV-related behavior changes. No significant differences were found between the two groups in age, methadone maintenance dose, methadone adherence, sex desire, and drug craving level. Participants who were HIV positive reported significantly lower scores on physical health and total health-related qualify of life. They also reported greater engagement in injection related risk behavior before methadone treatment than those who tested HIV negative. For both groups, sexual and injection risk behavior significantly decreased following initiation of methadone treatment. A regression model revealed that those infected with HIV, associated significantly with higher likelihood of reporting constipation and lack of appetite, and higher frequency of reporting abdominal pain and nausea than HIV negative patients. The primary implication of these findings is that HIV positive persons in methadone treatment may require more focused services to meet their special HIV care and substance treatment needs. [ABSTRACT FROM AUTHOR]

Obtaining employment is an important part of recovery for many people living with HIV/AIDS (PLHA). However, this population often faces barriers in their attempt to reenter the workplace. One potential barrier lies in the decision-making of employers. Little is known about what influences employers’ decision to hire PLHA. The current paper addresses this gap with findings from 156 quantitative interviews with employers across Chicago, Beijing, and Hong Kong regarding the hiring of people with HIV/AIDS. Hierarchical regression analysis showed that both fear of contagion and perceived incompetence are important factors in employers’ decision to interview even after controlling for variables related to the employers’ business size, their education level, and the provision of health benefits. These two variables accounted for 42% of the variance in employers’ decision to interview. Implications of these findings are considered for better understanding of HIV-related employment stigma and further intervention for employing PLHA. [ABSTRACT FROM PUBLISHER]

The COVID-19 has had an impact on almost every aspect of life throughout the world. The quarantine, limited social life, and fear of contamination have triggered psychological symptoms in societies. The need for mental health services has increased, and online psychological counselling, which provides psychological help with no risk of infection, has become more popular. The purpose of this study was to examine the impact of the COVID-19 on psychological counselling services and compare the general situation of publications on online psychological counselling before and during the pandemic. For this purpose, 463 publications related to online psychological counselling in the Web of Science (WoS) database were examined. The results were discussed in the context of trends and differences before and during COVID-19. [ABSTRACT FROM AUTHOR]

The use of information and communications technology (ICT) has increased across all regions and age groups. However, little research has examined older adults' use of ICT for different purposes. To address this research gap, the current study investigates the effects of ICT use for four purposes – social, leisure, financial, and medical – on the well-being of older adults. Most importantly, this study explores whether social support from friends may account for the observed positive effects of ICT use for social and leisure purposes. A total of 525 Hong Kong Chinese adults aged 60 and above (Mage = 68.7, SD = 6.27, Range = 60–100 years) completed an interview session to measure their ICT use for various purposes, social support from friends, and well-being indicators, including life satisfaction, positive and negative emotions and cognitive functioning. The results demonstrate that ICT use for all four purposes was associated with more frequent positive emotions and improved cognitive functioning. Moreover, ICT use for leisure and financial purposes was associated with higher levels of life satisfaction and fewer negative emotions. Social support was found to partially account for the effects of ICT use for social and leisure purposes on life satisfaction and positive emotions. These findings suggest that ICT use for all purposes is beneficial to older adults, and that ICT use may improve the emotional well-being of older adults by allowing for greater support from friends. [ABSTRACT FROM AUTHOR]

Despite the substantial attention paid to the effects of game violence and game addiction, insufficient research has been conducted on other moral risks of gaming behaviour. Drawing upon the General Learning Model and the Differential Susceptibility to Media Effects Model, the current study utilised a survey approach to investigate the effect of online gameplay on emerging adults' real-life unethical decision-making. The mediation analyses showed no direct effect of gaming intensity on unethical decision-making, but revealed two significant indirect effects: the specific indirect effect through game cheating and the serial indirect effect through game cheating and moral disengagement. Both the indirect effects were contingent upon the moderator of peer cheating. Specifically, the relationship between gaming intensity and unethical decision-making was positively significant at low levels of peer cheating and negatively significant at high levels. In addition to contributing to a broader view of the effects of online gameplay, this study also contributes to the literature on divergent gaming behaviours and online ethics. [ABSTRACT FROM AUTHOR]

College students often face challenges and obstacles which leads them vulnerable to burnout. Though numerous studies have supported an association between mindfulness and burnout, yet little is known about the potential mediating role of mindfulness exerts its effect in this link. This study aimed to explore the relationship between mindfulness and burnout among Chinese college students and investigated the sleep quality and perceived stress as two potential mediators of that relationship. A total of 536 college students (mean age = 21.93, 66.2% female) were investigated and completed the Five Facet of Mindfulness Questionnaire, Pittsburgh Sleep Quality Index, Perceived Stress Scale and Academic Burnout Scale of College Students. Path analyses were employed to examine the mediating effect. Results indicated that mindfulness had significant negative correlation with burnout (r=−.584, p < 0.001). Sleep quality and perceived stress were significant mediators of the observed relationship between mindfulness and burnout. These findings shed light upon the mediating role of sleep quality and perceived stress, and suggest that college students' mindfulness may facilitate their sleep quality and decrease perceived stress, which, in turn, may help prevent and reduce burnout. [ABSTRACT FROM AUTHOR]

Long-term child-parent relationship quality following hospitalization for pediatric traumatic brain injury (TBI) remains poorly understood. We tested whether current child-parent conflict and closeness were related to the children's history of TBI-related experiences and contemporary child/family characteristics. The sample included 202 Chinese children (Boys: 60.4%) with a history of hospitalization for TBI. On average, the children were 11.2 years old (SD = 1.59) and sustained TBI at 8.5 years old (SD = 1.6). TBI-related data were obtained from hospital medical records. Parents provided data on child-parent closeness, child-parent conflict, and parental efficacy 2–4 years (M = 2.7, SD = 0.7) after discharge. Forty-nine children (24.3%) had mild TBI, 139 (68.8%) had moderate TBI, and 14 (6.9%) had severe TBI. Surgical intervention occurred among 128 (63.4%) of the 202 children. Contemporaneous child and family characteristics explained 19% of the variance, history of surgery, length of hospitalization, and recovery status explained another 7%, and the interaction between length of hospitalization and parental efficacy explained another 4% in child-parent conflict. Contemporaneous child and family characteristics explained 29% of the variance, and TBI-related variables explained another 2% in child-parent closeness. Post-TBI child-parent relationship was more associated with child/family characteristics than with TBI variables. Practitioners and families should be aware of the long-term challenges to child-parent relationship following hospitalization for pediatric TBI. [ABSTRACT FROM AUTHOR]

Infertility is a global health problem that carries a high social and economic burden. Assisted reproductive technology (ART) has been developed in mainland China for over 30 years. We aimed to evaluate the accessibility and equity of distribution of ART facilities in mainland China from 2006 to 2018 and quantify the population with reduced geographic access to ART services. A retrospective study was conducted to describe the trend and analyse the equity of distribution of ART clinics in 2006, 2012, and 2018. The accessibility of ART clinics in mainland China increased significantly in the 12 years to 2018 (p ˂ 0.05). Eastern China had the most extensive coverage, followed by the central region, while the western region had the least coverage (p ˂ 0.05). The Gini coefficient for the distribution of ART clinics in 2018 was 0.213, indicating that the equity of distribution of ART clinics was relatively balanced over the country. However, at the end of 2018, there were still 354.9 million people (25.4% of the population) living in 148 cities without access to any ART clinics, which has spurred more targeted policies and cost-effective measures to improve the accessibility and availability of ART services in such areas. [ABSTRACT FROM AUTHOR]

In this study, the researcher aims to examine and provide some knowledge of COVID-19 impact on mother-child relationship, children perceived academic stress and mothers' anxiety among families in mainland China (N = 1512). The researcher confirms that mental health symptoms resulting from Covid-19 are significant, with extensive impacts on mothers' anxieties, children's academic stress, and mother-child conflict and closeness. The researcher also show significant link between students' tremendous academic stress and students completing their final grade. The author highlights the need for health policies to expand families' psychological well-being especially in crisis time. [ABSTRACT FROM AUTHOR]

The Information-Motivation-Behavioral skills (IMB) model of antiretroviral therapy (ART) adherence was applied in people living with HIV/AIDS in Shanghai, China to understand how adherence-related information, motivation and behavioral skills would affect ART adherence. The LifeWindows Information-Motivation-Behavioral Skills ART Adherence Questionnaire (LW-IMB-AAQ) was translated into Chinese and used. The IMB model was then implemented by testing standardized path estimates with standard model fitness indices in the participants. 426 participants from 11 community centres in Putuo district of Shanghai were recruited, of which 95.3% reported a high level of adherence (>95% adherence). The fitness indices of the final adjusted model were χ2 = 6.110, df = 7, p = 0.527(>0.05), CFI = 1.000(>0.9) and RMSEA = 0.000 (<0.08). In the model, information, which was separated into two sections (the perceived effect of ART on health and knowledge about ART medication), had an indirect effect on the ART adherence through behavioral skills, while motivation did not have such an effect. Neither information nor motivation had a direct effect on ART adherence. In addition, motivation was related to the two sections of information. The feasibility of the IMB model of ART adherence is verified by its application to predictive of adherence-related behaviors among HIV+ patients in this study. [ABSTRACT FROM AUTHOR]

Little concern has been paid to the relationship between temperature and varicella among adults. Daily meteorological data and varicella cases in Qingdao among adults from 1 January 2008 to 31 December 2019 were collected. A combination of quasi-Poisson generalized additive model (GAM) and distributed lag non-linear model (DLNM) was conducted to assess the temperature-lag-varicella relationship. We also estimated the lag-response curves for different temperatures and the exposure-response relationships for different lag days. The number of varicella cases was 10,296. Compared with the minimum-varicella temperature (25°C), we found the largest effect of temperature on varicella within 21 lag days was at 1°C (RR, 6.72; 95% CI, 2.90–15.57), and then the effect declined as the temperature increased. A similar trend of rising first and then falling was found in temperature-response curves for different lag days. A reverse U-shape lag pattern was found for different levels of temperatures. Temperature may affect varicella. [ABSTRACT FROM AUTHOR]

This study examined the effects of different writing interventions on late middle-aged and older adults' positive affect (PA) and meaning in life (MIL) and explored the mediating role of MIL in the relationship between PA and physical health. A total of 162 participants from China who were over 55 years old participated in this 3 × 3 mixed experimental design. The between-subjects variable constituted the participant group, including the expressive writing intervention (EWI) group, neutral task writing intervention (NTWI) group, and blank control group. The within-subject variable was time, including pre-intervention, post-intervention, and follow-up. PA, MIL, physical health, and perceived benefits were measured at each time point. We used a mixed linear model from SPSS on the entire sample data to examine the effects of writing interventions. To determine the mediation effect, we conducted structural equation model analysis using the "lavaan" package in R. MIL showed significant interaction with time and group, but PA showed no significant interaction. Compared with the blank control group, EWI buffered the decline of MIL and had no significant intervention effect on PA. NTWI had no significant intervention effect on MIL and PA. Considering the entire sample, MIL mediated the relationship between PA and physical health. This study is the first to demonstrate the effectiveness of EWI on healthy late middle-aged and older adults' MIL. The mediating effect of MIL facilitated a better understanding of the relationship between PA and physical health. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study examined the levels of self-stigma, hope, and family functioning among Chinese people with mental illness (MI). We also investigated the mediating role of family functioning in the relationship between self-stigma and hope. Method: Three-hundred thirty participants with MI (Mage = 42.73, SD = 14.11, 52.09% female, 61.74% schizophrenia) were surveyed. Hayes' PROCESS macro analysis (Model 4) was performed to verify the mediating effect. Results: The analysis revealed that 43.1% of the respondents had a high level of self-stigma, 68.5% indicated a low/moderate level of hope, and 54% had moderate/severe impairment in family functioning. This supports the partial mediating effect of family functioning on the relationship between self-stigma and hope. Conclusions: The self-stigmatizing experiences of Chinese people with MI adversely impair normal family functioning and reduce hope, limiting recovery prospects. Relevant results highlight the influence of the family environment on the psychological mechanisms of PMI. Limitations and future research directions are addressed. [ABSTRACT FROM AUTHOR]

To examine Chinese-immigrant cancer patients' openness to advance care planning (ACP) in an outpatient oncology setting. Retrospective review of social work assessment data. 150 Chinese-immigrant patient charts were reviewed (55% Cantonese, 45% Mandarin). Data were summarized descriptively and with logistic regression analyses. Sixteen percent of patients had completed ACP prior to meeting with the oncology social worker (OSW). Twenty percent of patients agreed to complete a health care proxy (HCP) after receiving culturally-tailored education in their language of origin from the OSW, while 75% remained open to ongoing consideration of ACP and HCP completion. This study illuminates how Chinese immigrants engage in ACP discussions in an oncology setting. OSWs can play an integral role in advocating, educating, and intervening with this population and can assist the interdisciplinary team in understanding the importance of the cultural differences, even if the OSW's primary language differs from that of a patient's. [ABSTRACT FROM AUTHOR]

Although several studies suggested considering gender in online learning, the literature about how male and female students would behave is fragmented. Little attention has been paid to the effect of gender on online learning behavioural patterns. This study aimed at investigating the roles of gender in online learning behaviours by analyzing the gender-related differences of students' online learning behavioural patterns. We used the case study approach with descriptive statistical analysis, lag sequential analysis, and temporal log data analysis to investigate gender-related differences in students' online learning behaviours. The results indicated no significant difference in the counts of occurrence of online single learning behaviours between female and male students. However, differences were observed in online learning behaviour patterns and how the online learning activities were performed over time. Females were more active in learning behaviours associated with achievement reports and peer list viewing. They tended to view their achievement reports before starting the main course learning activities, indicating that female students might be achievement-oriented. The findings provide further insights from a temporal perspective about how gender is associated with online learning. Implications on designing personalized online learning interventions based on considering gender-related differences are also discussed. [ABSTRACT FROM AUTHOR]

There are a few screening tools to detect psychological symptoms among people with multiple chronic conditions (MCCs) in China. The aim of this study was to examine the validity and reliability of a translated version of the Emotional Thermometer (ET) tool. This cross-sectional study consisted of two phases: (1) translation and content validity testing; and (2) assessment of psychometric properties, including internal consistency, test-retest reliability, and construct validity. For the first phase, the authors used a forward-backward translation approach for the Chinese version of the instrument and tested its content validity with a panel of six experts. For the second phase, the data, including the ET tool and demographic characteristics were collected in a convenience sample of 197 Chinese people with MCCs recruited from a university hospital. The first 50 participants participated in the two-week retest. The Chinese version of the ET tool had satisfactory psychometric properties; content validity index (0.83), internal consistency (0.92), and ICC (0.93 to 0.98 [p < 0.01]). Principal component analysis showed that there was only one component with an eigenvalue greater than 1 (value = 3.80), with 76.67% of the variance responding. All items loaded significantly onto this factor and demonstrated strong loadings of > 0.70. The Chinese-version of the ET tool is psychometrically sound. It has the potential to be used as a screening tool for psychological symptoms in Chinese people with MCCs. Findings from testing the Chinese translation of the Emotional Thermometer indicate this could be a convenient and useful screening tool to detect psychological symptoms in patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Obtaining antiretroviral therapy (ART) was a challenge for people living with HIV (PLHIV) in China during the COVID-19 outbreak. On 26 January 2020, the Chinese Center for AIDS/STD Control and Prevention issued a nationwide directive to relax restrictions on where and when PLHIV could refill ART. This qualitative study explored unexpected barriers under this directive and recommendations to improve future ART delivery. Between February 11 and February 15 2020, in-depth interviews of 4 groups of stake holders related to ART refilling (i.e., PLHIV, community-based organization employees, CDC staff, infectious disease physicians and nurses), were conducted via WeChat. Data were managed by NVivo 11.0 and transcripts were coded using thematic analysis. Sixty-two interviews were conducted. The main barriers to refilling ART included: (1) inconsistent documentation requirements to refill ART, (2) lack of specific protocols on ART refilling, (3) insufficient staffing, and (4) regimen verification and drug shortages. The most common recommendations to improve future ART delivery were: (1) to establish a nationwide system to distribute ART and (2) increase the number of pills delivered with each ART refill. Strengthening protocols and systems to refill ART and improving collaboration is key to preventing interruptions in ART among PLHIV during public health emergencies. [ABSTRACT FROM AUTHOR]

The meaning of patient deaths is key to understanding professional bereavement. To validate its construct, we applied partial least square structural equation modeling (PLS-SEM) to online survey data from 563 Chinese physicians and nurses. Both the personal meaning and professional meaning contribute significantly while not interchangeably to the meaning of patient deaths. In addition to the loss of an acquaintance, the loss of a valuable life, and the loss of a professional goal, patient deaths can also mean trauma, bad luck, identity crisis, a warning, a learning opportunity, and a time to empathize with others' sufferings. [ABSTRACT FROM AUTHOR]