The Multipurpose Application WeChat: A Review on Recent Research

Unheard Voices: Understanding Male Victims of Campus Sexual Harassment in a Gender-Inclusive Study

This study investigates the characteristics of male victims of campus sexual harassment, revealing that there is little difference in the proportion of male and female victims. Both genders are subjected to sexual harassment by students, faculty members, and off-campus personnel, with the largest difference in frequency being 13.79% and the smallest 0.06%. Most forms of harassment show less than a 5.00% difference between male and female students. T-test results indicate that, except for harassment by faculty members, there is no significant difference in the frequency of harassment between genders (p > .05). Furthermore, male victims are more likely to be familiar with the perpetrators than female victims. Campus sexual harassment negatively impacts both genders, with male victims reporting higher negative effects in academic, social, and self-evaluation aspects. Male victims are less likely to take proactive measures or seek assistance when facing harassment. Regression model and Shapley value decomposition analyses reveal that gender significantly influences the frequency of harassment, particularly when the perpetrator is the faculty member. Overall, this study highlights the need for increased attention to male victims of campus sexual harassment and the importance of addressing gender differences in coping strategies.

Single online self-compassion writing intervention reduces anxiety: With the feedback of ChatGPT

With the aim of universal prevention, there is still a lack of non-clinician-led or self-help interventions designed for the general population experiencing psychological distress. This study aims to address this gap by exploring a convenient, single-session, and effective method for reducing anxiety using ChatGPT feedback. Using a mixed-factorial experimental design, we recruited 98 participants online to compare changes in self-compassion and anxiety before and after the intervention among three groups: self-compassion writing with ChatGPT feedback (Experimental Group 1), self-compassion writing alone (Experimental Group 2), and an Active Control Group. Results showed that both Experimental Group 1 and 2 experienced significant increases in self-compassion and Experimental Group 1 experienced significant decreases in anxiety after the intervention, with Experimental Group 1 showing greater improvements. There were no significant changes in the control group. This study demonstrates that single online self-compassion writing intervention can effectively reduce anxiety and that using ChatGPT to provide highly empathetic feedback can enhance the effectiveness, making psychological support more accessible, cost-effective, and suitable for the general population.

The impact of nurses' adversity quotient on their work stress: the mediating role of professional identity

PURPOSE

To explore the influence of nurses' adversity quotient on their work stress and to further explore whether professional identity can mediate in this process.

METHODS

From July to September 2023, an online questionnaire survey was conducted among nurses in six public tertiary hospitals in Suzhou and Wuxi, China, including demographic information, Adversity Response Profile (ARP), The Professional Identity Scale for Nurses (PIS) and Stress Overload Scale (SOS). Analyzed the collected data using correlation, multiple linear regression, and structural equation modeling.

RESULTS

1,578 nurses completed the questionnaires, resulting in 1,468 valid questionnaires. The average score of Stress Overload Scale of the surveyed nurses was 65.26 ± 17.93 points (Total score of Stress Overload Scale: 110). The correlation analysis showed a significant positive relationship between nurses' adversity quotient and their professional identity (r = 0.59, P < 0.01); professional identity and work stress were negatively correlated (r=-0.44, P < 0.01); and adversity quotient was also negatively correlated with work stress (r=-0.31, P < 0.01). The structural equation model indicated that professional identity might mediate between stress and adversity quotient.

CONCLUSION

Clinical nurses suffer from heavy work stress, and nurses' adversity quotient could change their work stress level by affecting their professional identity. Strategies and measures to improve professional identity is expected to buffer the impact of adversity quotient on nurses' work stress.

Search for meaning alleviated individual depressive symptoms during COVID-19 pandemic: The mediating role of optimism

The COVID-19 pandemic and subsequent quarantine measures have disrupted people's normal pace of life and created excessive pressure. The current study examined the mitigating effect of search for meaning in life on individual depressive symptoms and the mediating role of optimism during COVID-19 lockdown period. A total of 462 participants (Mage = 37.42 years, SD = 13.15, 166 males) residing in Wuhan, China were recruited online at the beginning of April 2020 when the city was still under lockdown measures. Data were collected four times spanning from April to May 2020, with an interval of roughly 2 weeks in between. The results indicated that search for meaning and optimism was positively correlated with each other concurrently, and both of them were negatively correlated with depressive symptoms. Specifically, search for meaning at T1 could positively predict optimism at T2, which in turn negatively predicted depressive symptoms at T3, suggesting that optimism acted as the mediator for the buffering effects of search for meaning on one's depressive symptoms. Results highlighted the protective role of search for meaning for individual psychological adjustment under such adverse situation as COVID-19 epidemic, and provided practical implications for people to deal with stressful period like quarantine.

Remote symptom monitoring with patient-reported outcomes and nudges during lung cancer immunotherapy in China (PRO-NET): protocol for a randomised controlled trial

INTRODUCTION

Lung cancer is the leading cause of cancer-related mortality globally, with non-small cell lung cancer (NSCLC) comprising the majority of cases. For advanced NSCLC, immunotherapy offers substantial survival benefits but is often accompanied by severe immune-related adverse events symptoms, significantly affecting health-related quality of life (HRQoL). Routinely collection of patient-reported outcomes (PROs) followed by automated alerts has been shown to improve overall survival and HRQoL for cancers. However, there is limited evidence for PRO-based symptom monitoring on advanced NSCLC during immunotherapy. This study proposes an electronic PRO-based symptom tracking intervention, integrated with reactive alerts and nudges (PRO-NET) to improve HRQoL for advanced NSCLC patients receiving immunotherapy in China. Secondary objectives include assessing the effect of PRO-symptom monitoring on survival, physical function, symptom control, mental health, cost-effectiveness and implementation fidelity.

METHODS AND ANALYSIS

The PRO-NET study is a two-arm, parallel randomised controlled trial. The study will enrol at least 300 advanced NSCLC patients undergoing immunotherapy in China. Participants will be randomly assigned to either the intervention or control group in a ratio of 1:1 via PRO-NET programme. The intervention involves weekly electronic collection of immune-related PROs and reactive alerts sent directly to patients, combined with nudges over a 6-month period. Patients in the control group will follow usual care and will not trigger the alerts. Both the intervention and control groups will receive outcome assessments at baseline, 3 months and 6 months. Primary outcome focuses on HRQoL, while secondary outcomes include survival, physical function, symptom burden, mental health, cost-effectiveness and implementation fidelity. Differences in HRQoL between the groups will be compared using general linear mixed model, accounting for potential confounding.

ETHICS AND DISSEMINATION

The study was approved by the Institutional Review Board of the Peking University protocol on 21 July 2024 (No. IRB 00001052-24066). This protocol is based on V2.0, 6 July 2024 of the protocol. The results of this study will be disseminated through peer-reviewed publications and academic conferences.

TRIALS REGISTRATION NUMBER

ChiCTR2400088408.

mHealth-Based Diabetes Prevention Program for Chinese Mothers With Abdominal Obesity: Randomized Controlled Trial

BACKGROUND

Among people with abdominal obesity, women are more likely to develop diabetes than men. Mobile health (mHealth)-based technologies provide the flexibility and resource-saving opportunities to improve lifestyles in an individualized way. However, mHealth-based diabetes prevention programs tailored for busy mothers with abdominal obesity have not been reported yet.

OBJECTIVE

The aim of this study is to evaluate the feasibility and acceptability of an mHealth-based diabetes prevention program and its preliminary efficacy in reducing weight-related variables, behavioral variables, psychological variables, and diabetes risk among Chinese mothers with abdominal obesity over 6 months.

METHODS

A randomized controlled trial was conducted at health management centers in 2 tertiary hospitals in Changsha, China. The mHealth group (n=40) received 12 weekly web-based lifestyle modification modules for diabetes prevention, 6 biweekly individualized health education messages based on their goal settings, and a Fitbit tracker. The control group (n=40) received 12 weekly web-based general health education modules, 6 biweekly general health education messages, and a Fitbit tracker. Data were collected at baseline, 3 months, and 6 months on the feasibility and acceptability outcomes, weight-related variables (waist circumference and BMI), diabetes risk scores, glycemic levels, behavioral variables (daily step count, active minutes, fruit and vegetable intake, calorie consumption, and sleep duration), and psychological variables (self-efficacy and social support for physical activity and diet, perceived stress, and quality of life). Generalized estimating equations were used for data analysis.

RESULTS

Approximately 85% (68/80) of the participants completed 6 months of follow-up assessments. Regarding the feasibility and acceptance of the program in the mHealth group, the average number of modules reviewed was 7.9 out of 12, and the satisfaction score was 4.37 out of 5. Significant improvements at 6 months between the intervention and control groups were found in waist circumference (β=-2.24, 95% CI -4.12 to -0.36; P=.02), modifiable diabetes risk scores (β=-2.5, 95% CI -4.57 to -0.44; P=.02), daily steps (β=1.67, 95% CI 0.06-3.29; P=.04), self-efficacy for physical activity (β=1.93, 95% CI 0.44-3.43; P=.01), social support for physical activity (β=2.27, 95% CI 0.80-3.74; P=.002), and physical health satisfaction (β=0.82, 95% CI 0.08-1.55; P=.03). No differences were found in BMI, total diabetes risk score, daily active minutes, daily intake of fruits and vegetables, sleep duration, daily calorie consumption, self-efficacy, and social support for diet (P>.05).

CONCLUSIONS

This study addresses the potential role of tailored lifestyle interventions based on mHealth technology by offering tailored web-based health modules and health information in managing diabetes risk among mothers with abdominal obesity. The mHealth diabetes prevention program provides a flexible, customized, and resource-saving model for busy mothers. Future research could further explore the efficacy improvement on dietary behaviors to better serve the health care needs of this population.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2400090554; https://www.chictr.org.cn/showproj.html?proj=226411.

Analysis of "Dr Ding Xiang" on WeChat in China to Determine Factors Influencing Readership on Medical Social Media: Observational Study

BACKGROUND

With the rapid expansion of social media platforms, the demand for health information has increased substantially, leading to innovative approaches and new opportunities in health education.

OBJECTIVE

This study aims to analyze the characteristics of articles published on the "Dr Ding Xiang" WeChat official account (WOA), one of the most popular institutional accounts on the WeChat platform, to identify factors influencing readership engagement and to propose strategies for enhancing the effectiveness of health information dissemination.

METHODS

A total of 5286 articles published on the "Dr Ding Xiang" WOA from January 2021 to December 2021 were collected and analyzed. Additionally, a random sample of 324 articles was selected for detailed text analysis. Univariate analysis was conducted using the chi-square test, and multivariate analysis was performed using multivariable logistic regression.

RESULTS

In 2021, the total number of reads for "Dr Ding Xiang" articles reached 323,479,841, with an average of 61,196 reads per article. Articles exceeding 100,000 reads accounted for 33.90% of the total. Most articles were published during the time slots of 8:00-10:00 AM, 11:30 AM to 1:30 PM, and 8:30-10:30 PM. Analysis indicated that the order of publication, style of the title sentence, number of likes, number of in-views, total likes on comments, and number of replies to comments were significantly associated with an article's number of reads. Text analysis further revealed that the article's reasoning approaches and concluding methods also had a significant impact on readership.

CONCLUSIONS

To enhance readership and the effectiveness of health communication, health-focused WOAs should consider key factors such as optimal publication timing, engaging title design, and effective content structuring. Attention to these elements can improve user engagement and support the broader dissemination of health information.

Effectiveness of an Internet-Based Acceptance and Commitment Therapy Intervention for Reducing Psychological Distress in Health Care Professionals: Randomized Controlled Trial

BACKGROUND

Psychological distress is prevalent among health care professionals and can lead to poor-quality patient care. Internet-based acceptance and commitment therapy (iACT) is a promising intervention for improving mental health due to its low cost and easy access. However, there is limited evidence of its effectiveness in reducing health care professionals' psychological distress.

OBJECTIVE

This study aims to examine the effects of iACT on psychological distress (stress, anxiety, and depression) among health care professionals in China.

METHODS

From October 2022 to February 2023, a total of 108 health care professionals were recruited via WeChat and randomized into a 6-week iACT intervention program with therapist support (n=54) or waitlist control group (n=54). The intervention included 21 self-guided sessions combining teaching videos, mindfulness practices, and journal writing, followed by 7 live conferences to share experiences and discuss questions, all conducted via WeChat. Primary outcomes (stress, anxiety, and depression) and secondary outcomes (burnout and psychological flexibility) were collected using the Sojump platform, the most popular web-based survey platform in China. Generalized estimating equations were used to compare the outcomes between groups and assess the effects of group, time, and group-by-time interaction. Subgroup and sensitive analyses were performed to test the robustness of our findings across various groups.

RESULTS

Among the 108 health care professionals, 68 (63%) completed the follow-up assessment at week 10, including 35 (64.8%) in the iACT group and 33 (61.1%) in the waitlist control group. Of the 54 participants in the iACT group, all attended at least 2 sessions, and 25 attended all 28 sessions. On average, participants attended 20 (71%) sessions. The iACT group showed significant improvement in the Depression Anxiety and Stress Scales-21 total score (d=0.82, 95% CI 0.39-1.26), and the effects were sustained for 4 weeks after the intervention (d=1.08, 95% CI 0.57-1.59). Compared to the control group, the iACT group showed significantly lower scores in burnout at week 6 (d=1.42, 95% CI 0.95-1.89) and week 10 (d=1.52, 95% CI 0.98-2.06). The iACT group showed significantly higher psychological flexibility at week 6 (d=1.23, 95% CI 0.77-1.69) and week 10 (d=1.15, 95% CI 0.64-1.66).

CONCLUSIONS

The iACT effectively decreased health care professionals' psychological distress and burnout and improved their psychological flexibility. Our findings provide implications and guidance for the development and broad implementation of iACT in health care settings to improve the mental health of health care professionals.

TRIAL REGISTRATION

Chinese Clinical Trial Register ChiCTR2400093584; https://tinyurl.com/38werwsk.

HIV disclosure and intimate partner violence among HIV-infected men who have sex with men in marriage of convenience in China

Marriage of convenience is a unique phenomenon in China where a gay man and a lesbian get married to fulfill social expectations while retaining their homosexual identities. Men who have sex with men (MSM) are at increased risk of HIV infection and intimate partner violence (IPV) following HIV disclosure. A sample of 232 HIV-infected MSM in the marriage of convenience was recruited online and completed questionnaires about experiences of IPV, HIV disclosure, and their sociodemographic, clinical, and psychosocial characteristics. Our results showed that over half (57.3%) of HIV-infected MSM had disclosed their HIV status to their lesbian spouses. Bisexual men, having children with their lesbian spouse, HIV diagnosis time >24 months, having a current fixed gay partner, having disclosed HIV to their current fixed gay partners, higher levels of social support, lower levels of self-stigma related to HIV infection, no depression, and no suicidal ideation were all independently associated with an increased likelihood of disclosing to lesbian spouses. Approximately 61.6% of participants experienced at least one type of IPV from either a gay partner, a lesbian spouse, or both in the past 12 months. HIV disclosure to lesbian spouses was associated with an increased risk of IPV. Our findings reveal the high prevalence of IPV among HIV-infected MSM in the marriage of convenience and its association with HIV disclosure, which warrants policy, clinical, and research efforts to design targeted and comprehensive interventions to improve HIV disclosure while preventing IPV among this population.

A Qualitative Thematic Analysis Exploring Chinese Young Adults' Experiences in Decision Making on the Management of Low-Risk Papillary Thyroid Cancer

Background: Thyroid cancer is the most common endocrine neoplasm in China. Questions regarding the extent of patient involvement in shared decision-making (SDM) processes persist; this is particularly pertinent to patients considering treatment options for low-risk papillary thyroid cancer (PTC). In this study, we aimed to explore Chinese young adults' experiences of SDM relating to the choice of treatment for low-risk PTC. Methods: The study used a qualitative descriptive design and semistructured interviews. Interviews were conducted with 24 patients (ages ranging from 18 to 38 years; 4 men and 20 women) diagnosed with low-risk (PTC) between March 2023 and May 2024. Twenty-two of 24 patients' tumor size measured 1 cm or smaller; the largest tumor size measured 1.47 cm. Reflexive thematic analysis was used to identify key themes from the transcribed interviews. Results: The analysis revealed that the SDM experiences of young patients with low-risk PTC involve four themes: challenges in information sharing; reasons for information seeking; factors influencing decision making; and self-positioning in treatment decision making. Three self-positions relating to treatment decision making were identified. These included dependent positioning, which reflects a "paternalistic" decision-making pattern; collaborative positioning, reflecting a "sharing" of decision making; and autonomous positioning, reflecting an increased sense of personal responsibility for both managing their health and engagement in decision making. Limited treatment options being offered, overuse of medical terminology, and communication gaps between clinicians and patients were the main challenges described during the information-sharing process. Information that needs persisting after physician-patient consultations resulted in active information-seeking behavior. The key variables identified in this study that potentially affected the decision-making process were future personal considerations, language used to discuss cancer, and negative emotions. Conclusions: These results highlight the necessity of adopting flexible strategies when supporting collaborative treatment decision making in the context of the doctor-patient interaction for low-risk PTC. Based on these findings, clinicians can take measures to enhance the quality of SDM by inquiring about patients' role preferences, providing details of the full range of treatment options, and encouraging patients to share their preferences and concerns relating to possible treatment options.

Effects of a mobile health intervention based on a multitheoretical model of health behavior change on anxiety and depression, fear of cancer progression, and quality of life in patients with differentiated thyroid cancer: A randomized controlled trial

BACKGROUND

Despite the high cure rate of differentiated thyroid cancer (DTC), patients endure side effects from treatment and psychological distress, impacting their quality of life. The potential of mobile health (mHealth) interventions to address these issues remains unexplored. The purpose of this study is to develop an mHealth intervention based on the Multi-Theoretical Model of Health Behavior Change (MTM) and evaluate its impact on reducing anxiety, depression, fear of cancer progression, and enhancing quality of life in DTC patients.

METHODS

A single-blind, single-center, prospective, randomized controlled trial was conducted. One hundred and eleven consecutive DTC patients from Harbin Medical University's Fourth Hospital were enrolled from March 2023 to March 2024. Participants were randomized into a control group and an intervention group that received a 3-month mHealth intervention based on MTM theory. Outcomes were assessed using web-based questionnaires at baseline and conclusion.

RESULTS

One hundred four patients with DTC completed the study, with 7 lost to follow-up (6.3%). The intervention group experienced a significant drop in PHQ-4 scores post-MTM-mHealth intervention (P < .026), with no change in the control group, demonstrating a significant difference. The intervention group also had significantly lower anxiety (P < .015) and depression (P < .032) scores compared to controls. All PHQ-4 scores improved in the intervention group except for "Little interest or pleasure in doing things." Anxiety levels were significantly lower in the intervention group (P < .026) but remained unchanged in controls. The control group exhibited a significant increase in FCR-4 scores at follow-up, differing from the intervention group (P < 0.001). Quality of life scores did not differ at baseline but saw a significant improvement in the intervention group, while the control group experienced no significant change. The intervention group had higher VAS scores (P < .030) and greater health education satisfaction across all dimensions (P < .019).

CONCLUSIONS

The MTM-based mHealth intervention significantly benefits DTC patients by reducing anxiety, fear of cancer recurrence, and improving quality of life, though its effect on depression requires further investigation.

TRIAL REGISTRATION

China Clinical Trial Registry ChiCTR2200064321.

Clarifying the relationship between insecure attachment and problematic social media use across platforms: a network analysis

BACKGROUND

Despite evidence suggesting that insecure attachment is a significant risk factor for Problematic Social Media Use (PSMU), there remains a lack of comprehensive studies exploring this relationship, and a unified understanding of its role has yet to be established.

METHODS

We employed network analysis to construct an integrated model for examining the complex interrelations between negative emotions, trait and state attachment, motives, and PSMU across three platforms (i.e., WeChat, Sina Weibo, and TikTok), as well as for identifying potential mediating variables between attachment and PSMU. Data were collected from 685 young adults via online self-reported questionnaires.

RESULTS

We found that negative emotions are positively correlated with insecure trait and state attachment but have a negligible direct relationship with PSMU. The conformity motive and state attachment security emerged as important central nodes when measured by strength, closeness, and betweenness. Moreover, attachment states and motives were found to be clustered. Such strong interrelationships were also evident between insecure attachment and PSMU, while trait attachment anxiety and avoidance were observed to be related to PSMU across various platforms.

CONCLUSIONS

Our findings promote a deeper understanding of the relationship between insecure attachment and PSMU from a cross-platform perspective and offer novel insights into the mechanisms underlying their co-occurrence, which may guide the development of effective interventions for healthier social media engagement.

Effect of a Mobile Health-Based Remote Interaction Management Intervention on the Quality of Life and Self-Management Behavior of Patients With Low Anterior Resection Syndrome: Randomized Controlled Trial

BACKGROUND

People who undergo sphincter-preserving surgery have high rates of anorectal functional disturbances, known as low anterior resection syndrome (LARS). LARS negatively affects patients' quality of life (QoL) and increases their need for self-management behaviors. Therefore, approaches to enhance self-management behavior and QoL are vital.

OBJECTIVE

This study aims to assess the effectiveness of a remote digital management intervention designed to enhance the QoL and self-management behavior of patients with LARS.

METHODS

From July 2022 to May 2023, we conducted a single-blinded randomized controlled trial and recruited 120 patients with LARS in a tertiary hospital in Hefei, China. All patients were randomly assigned to the intervention group (using the "e-bowel safety" applet and monthly motivational interviewing) or the control group (usual care and an information booklet). Our team provided a 3-month intervention and followed up with all patients for an additional 3 months. The primary outcome was patient QoL measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. The secondary outcomes were evaluated using the Bowel Symptoms Self-Management Behaviors Questionnaire, LARS score, and Perceived Social Support Scale. Data collection occurred at study enrollment, the end of the 3-month intervention, and the 3-month follow-up. Generalized estimating equations were used to analyze changes in all outcome variables.

RESULTS

In the end, 111 patients completed the study. In the intervention group, 5 patients withdrew; 4 patients withdrew in the control group. Patients in the intervention group had significantly larger improvements in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 total score (mean difference 11.51; 95% CI 10.68-12.35; Cohen d=1.73) and Bowel Symptoms Self-Management Behaviors Questionnaire total score (mean difference 8.80; 95% CI 8.28-9.32; Cohen d=1.94) than those in the control group. This improvement effect remained stable at 3-month follow-up (mean difference 14.47; 95% CI 13.65-15.30; Cohen d=1.58 and mean difference 8.85; 95% CI 8.25-9.42; Cohen d=2.23). The LARS score total score had significantly larger decreases after intervention (mean difference -3.28; 95% CI -4.03 to -2.54; Cohen d=-0.39) and at 3-month follow-up (mean difference -6.69; 95% CI -7.45 to -5.93; Cohen d=-0.69). The Perceived Social Support Scale total score had significantly larger improvements after intervention (mean difference 0.47; 95% CI 0.22-0.71; Cohen d=1.81).

CONCLUSIONS

Our preliminary findings suggest that the mobile health-based remote interaction management intervention significantly enhanced the self-management behaviors and QoL of patients with LARS, and the effect was sustained. Mobile health-based remote interventions become an effective method to improve health outcomes for many patients with LARS.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2200061317; https://tinyurl.com/tmmvpq3.

Eyes on me: how social media use is associated with urban Chinese adolescents' concerns about their physical appearance

Introduction

Social media usage carries risks of negative impacts on one's perception of physical attractiveness, especially among adolescents who are developing their self-image. These findings suggest that targeted interventions focusing on attention-seeking behaviors may be effective in addressing appearance-related anxieties among adolescents.

Methods

We employed Bayesian analysis with Markov Chain Monte Carlo algorithms on survey data from 11,926 middle school students in China.

Findings

Our findings indicate that while the amount of daily social media usage does not significantly correlate with appearance concerns, the desire for social media attention through interactions such as liking, commenting, and sharing shows a clear positive association. Female adolescents exhibit a higher degree of concern about their physical appearance compared to males. Additionally, behaviors aimed at improving perceived physical attractiveness, such as exercising and using skin-whitening products, are positively associated with increased appearance concerns.

Discussion

These findings suggest that targeted interventions focusing on attention-seeking behaviors may be effective in addressing appearance-related anxieties among adolescents.

Information management of full-cycle inpatient bed reservation for cancer patients under the normalised prevention and control of the COVID-19 pandemic

BACKGROUND

During the prolonged COVID-19 pandemic, hospitals became focal points for normalised prevention and control. In this study, we investigated the feasibility of an inpatient bed reservation system for cancer patients that was developed in the department?s public WeChat account. We also explored its role in improving operational efficiency and nursing quality management, as well as in optimising nursing workforce deployment.

METHODS

We utilised WeChat to facilitate communication between cancer patients and health care professionals. Furthermore, we collected data on admissions, discharges, average number of hospitalisation days, bed utilisation rate, and the number of bed days occupied by hospitalised patients through the hospital information system and nurses? working hours and competency levels through the nurse scheduling system. The average nursing hours per patient per day were calculated. Through the inpatient bed reservation system, the number of accepted admissions, denied admissions, and cancelled admissions from the reservation system were collected. The impact of the bed reservation system on the department?s operational efficiency was analysed by comparing the number of hospitalisation discharges before and after reservations, as well as the average hospitalisation and bed utilisation rates. By comparing nurses? working hours per month and average nursing hours per patient per day, the system?s impact on nurses? working hours and nursing quality indicators was analysed.

RESULTS

The average hospitalisation length, bed utilisation rate, and nurses? working hours were significantly lower, and the average number of nursing hours per patient per day was significantly higher after the implementation of the reservation system. The full-cycle bed information management model for cancer patients did not affect the number of discharged patients.

CONCLUSION

Patients? ability to reserve bed types from home in advance using the department?s official WeChat-based inpatient bed reservation system allowed nurses to prepare for their work ahead of time. This in turn improved the operational efficiency of the department and nursing quality, and it optimised the deployment of the nursing workforce.

WeChat usage and preservation of cognitive functions in middle-aged and older Chinese adults: indications from a nationally representative survey, 2018-2020

PURPOSE

To investigate the associations between the most popular social media platform WeChat usage and cognitive performance among the middle-aged and older Chinese population using data from a nationally representative survey.

METHODS

In total, 17,472 participants (≥ 45 years old) from the China Health and Retirement Longitudinal Study (CHARLS, Wave 4, 2018) were analyzed. Cognitive performance including episodic memory and executive function was assessed using Mini-Mental Status Examination (MMSE). Other confounding variables included socio-economic characteristics, medical status, and lifestyle-related information. Multiple linear regression models were used to test the association between cognitive performance and WeChat usage by introducing covariates hierarchically. Subgroup analyses of age and gender were conducted to estimate the robustness of the primary findings.

RESULTS

After adjusting for multiple confounders across all linear models, WeChat usage is significantly associated with executive function, episodic memory, and global cognitive performance (all p values<0.05). Such results remained robust in subgroup analyses, stratified by age and gender, and also verified according to longitudinal analyses. Compared to 'Chat-only' users who only used WeChat for online interpersonal communication, further usage of WeChat functions such as using 'Moments' appeared to be significantly associated with better cognitive performance, especially for episodic memory.

CONCLUSION

Social media usage is significantly and positively associated with better cognitive performance among the middle-aged and older Chinese population. Along with point-to-point messaging, using 'Moments' and extended social media platform functions may correlate to better cognitive performance.

Improving Parental Health Literacy in Primary Caregivers of 0- to 3-Year-Old Children Through a WeChat Official Account: Cluster Randomized Controlled Trial

Background

Parental health literacy is important to children's health and development, especially in the first 3 years. However, few studies have explored effective intervention strategies to improve parental literacy.

Objective

This study aimed to determine the effects of a WeChat official account (WOA)-based intervention on parental health literacy of primary caregivers of children aged 0-3 years.

Methods

This cluster randomized controlled trial enrolled 1332 caregiver-child dyads from all 13 community health centers (CHCs) in Minhang District, Shanghai, China, between April 2020 and April 2021. Participants in intervention CHCs received purposefully designed videos via a WOA, which automatically recorded the times of watching for each participant, supplemented with reading materials from other trusted web-based sources. The contents of the videos were constructed in accordance with the comprehensive parental health literacy model of WHO (World Health Organization)/Europe (WHO/Europe). Participants in control CHCs received printed materials similar to the intervention group. All the participants were followed up for 9 months. Both groups could access routine child health services as usual during follow-up. The primary outcome was parental health literacy measured by a validated instrument, the Chinese Parental Health Literacy Questionnaire (CPHLQ) of children aged 0-3 years. Secondary outcomes included parenting behaviors and children's health outcomes. We used the generalized linear mixed model (GLMM) for data analyses and performed different subgroup analyses. The β coefficient, risk ratio (RR), and their 95% CI were used to assess the intervention's effect.

Results

After the 9-month intervention, 69.4% (518/746) of caregivers had watched at least 1 video. Participants in the intervention group had higher CPHLQ total scores (β=2.51, 95% CI 0.12-4.91) and higher psychological scores (β=1.63, 95% CI 0.16-3.10) than those in the control group. The intervention group also reported a higher rate of exclusive breastfeeding (EBF) at 6 months (38.9% vs 23.44%; RR 1.90, 95% CI 1.07-3.38) and a higher awareness rate of vitamin D supplementation for infants younger than 6 months (76.7% vs 70.5%; RR 1.39, 95% CI 1.06-1.82). No significant effects were detected for the physical score on the CPHLQ, breastfeeding rate, routine checkup rate, and children's health outcomes. Furthermore, despite slight subgroup differences in the intervention's effects on the total CPHLQ score and EBF rate, no interaction effect was observed between these subgroup factors and intervention factors.

Conclusions

Using a WHO literacy model-based health intervention through a WOA has the potential of improving parental health literacy and EBF rates at 6 months. However, innovative strategies and evidence-based content are required to engage more participants and achieve better intervention outcomes.

Study Recruitment, Retention, and Adherence Among Chinese American Immigrants During the COVID-19 Pandemic

BACKGROUND

Chinese American immigrants have been underrepresented in health research partly due to challenges in recruitment.

OBJECTIVES

This study aims to describe recruitment and retention strategies and report adherence in a 7-day observational physical activity study of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic.

METHODS

Foreign-born Chinese women aged 18-45 years, with a gestational diabetes index pregnancy of 0.5-5 years, who were not pregnant and had no current diabetes diagnosis were recruited. They wore an accelerometer for 7 consecutive days and completed an online survey. Multiple recruitment strategies were used: (a) culturally and linguistically tailored flyers, (b) social media platforms (e.g., WeChat [a popular Chinese platform] and Facebook), (c) near-peer recruitment and snowball sampling, and (d) a study website. Retention strategies included flexible scheduling and accommodation, rapid communications, and incentives. Adherence strategies included a paper diary and/or automated daily text reminders with a daily log for device wearing, daily email reminders for the online survey, close monitoring, and timely problem-solving.

RESULTS

Participants were recruited from 17 states; 108 were enrolled from August 2020 to August 2021. There were 2,479 visits to the study webpage, 194 screening entries, and 149 inquiries about the study. Their mean age was 34.3 years, and the mean length of U.S. stay was 9.2 years. Despite community outreach, participants were mainly recruited from social media (e.g., WeChat). The majority were recruited via near-peer recruitment and snowball sampling. The retention rate was 96.3%; about 99% had valid actigraphy data, and 81.7% wore the device for 7 days. The majority of devices were successfully returned, and the majority completed the online survey on time.

DISCUSSION

We demonstrated the feasibility of recruiting and retaining a geographically diverse sample of Chinese American immigrants with prior gestational diabetes during the COVID-19 pandemic. Recruiting Chinese immigrants via social media (e.g., WeChat) is a viable approach. Nonetheless, more inclusive recruitment strategies are needed to ensure broad representation from diverse socioeconomic groups of immigrants.

Effectiveness of WeChat-assisted preoperative education to reduce perioperative anxiety in breast cancer patients: a prospective randomized controlled study protocol

BACKGROUND

Breast cancer is the most prevalent cancer among women globally, and surgical procedures continue to be the primary treatment. However, over 50% of patients experience preoperative anxiety due to the unknown and fear associated with surgery. Although drug therapy is commonly used to address this anxiety, its side effects have led to a heated debate regarding its effectiveness. Consequently, non-pharmacological therapies, such as preoperative education, have emerged as an alternative approach to alleviate anxiety. WeChat, a widely popular social media platform, offers a public platform that can potentially be utilized for effective preoperative education. This study aims to evaluate the use of WeChat public platform as a tool for preoperative education in patients undergoing breast surgery.

METHODS

This is a prospective, randomized, and controlled trial will involve 392 adult women scheduled for breast cancer resection. Participants will be randomly assigned to either the WeChat education group or the regular group. In addition to regular preoperative visits, the WeChat education group will also watch science videos through the WeChat public platform. The regular group will only receive education from ward nurses during preoperative visits. The primary outcome measure will be the incidence of preoperative anxiety, defined by scores of the State Anxiety Inventory (SAI) exceeding 40 points. Secondary outcome measures include the incidence of severe anxiety (SAI > 44) on the day before surgery, incidence of anxiety 72 h after surgery, incidence of severe anxiety 72 h after surgery, NRS scores for pain at rest and during activity 24, 48, and 72 h after surgery, incidence of nausea and vomiting within 24 h after surgery, subjective sleep score at 1 week postoperatively, quality of life QoR-15 scores at 1 and 3 months postoperatively, incidence of chronic pain at 3 months postoperatively, bowel function recovery, length of hospital stay, and hospitalization expenses.

DISCUSSION

This is the first clinical trial to investigate the use of WeChat public platform for delivering preoperative education on perioperative anxiety in breast cancer patients. By utilizing the renowned WeChat public platform, our study aims to improve patient outcomes by providing video education that explains the disease, surgery, and anesthesia in a more accessible manner, thereby reducing the incidence of perioperative anxiety. If our hypothesis is confirmed, this non-pharmacological approach can be universally acknowledged as a cost-effective and practical method in clinical care. Its application can also be extended to other medical fields beyond breast cancer.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05291494. Registered on 29 December 2021.

Effects of Wuxi CDC WeChat official account article features on user engagement in health promotion

OBJECTIVE

To identify the characteristics of subscribers to assess users' needs and analyze the features of articles published on Wuxi CDC WeChat official account (WOA) to evaluate the effectiveness of health education dissemination and guide future communication strategies.

METHODS

Collect data from the WeChat official account (WOA) of the Wuxi Center for Disease Control and Prevention (CDC) to identify factors affecting the effectiveness of health education dissemination as measured by shares and 100% reading completion rate between January 1, 2022, and December 31, 2022. Multivariate logistic regression analysis was utilized to identify influencing features of articles associated with health education dissemination.

RESULTS

By the end of 2022, our account had accumulated 891,170 subscribers, of which, 523,576 were females (58.75%), 349,856 were males (39.3%), mainly located in third-tier cities (82.59%). Age distribution peaked in the 26-35 and 36-45 age groups (43.63% and 30.6%, respectively). A total of 170 articles were included in the analysis. Multivariate logistic regression analysis revealed that articles with a lower word count (OR = 0.999, 95% CI = 0.998 ~ 1), lower picture count (OR = 0.892, 95% CI = 0.828 ~ 0.962), dominated headlines (OR = 2.454, 95% CI = 1.234 ~ 4.879) and thematically focused on Nutrition and food-borne diseases (OR = 5.728, 95% CI = 1.778 ~ 18.458) demonstrated higher engagement, as measured by shares and 100% completion rates.

CONCLUSIONS

Our findings suggest that future content should prioritize conciseness, optimize images, and align with subscriber interests, particularly in nutrition and food hygiene. Additionally, maintaining informative yet engaging content formats remains crucial for maximizing reach and impact.

Mobile-Delivered Mindfulness Intervention on Anxiety Level Among College Athletes: Randomized Controlled Trial

BACKGROUND

College athletes are a group often affected by anxiety. Few interventional studies have been conducted to address the anxiety issues in this population.

OBJECTIVE

We conducted a mobile-delivered mindfulness intervention among college athletes to study its feasibility and efficacy in lowering their anxiety level and improving their mindfulness (measured by the Five Facet Mindfulness Questionnaire [FFMQ]).

METHODS

In April 2019, we recruited 290 college athletes from a public university in Shanghai, China, and 288 of them were randomized into an intervention group and a control group (closed trial), with the former (n=150) receiving a therapist-guided, smartphone-delivered mindfulness-based intervention and the latter receiving mental health promotion messages (n=138). We offered in-person instructions during the orientation session for the intervention group in a classroom, with the therapist interacting with the participants on the smartphone platform later during the intervention. We used generalized linear modeling and the intent-to-treat approach to compare the 2 groups' outcomes in dispositional anxiety, precompetition anxiety, and anxiety during competition, plus the 5 dimensions of mindfulness (measured by the FFMQ).

RESULTS

Our intent-to-treat analysis and generalized linear modeling found no significant difference in dispositional anxiety, precompetition anxiety, or anxiety during competition. Only the "observation" facet of mindfulness measures had a notable difference between the changes experienced by the 2 groups, whereby the intervention group had a net gain of .214 yet fell short of reaching statistical significance (P=.09). Participants who specialized in group sports had a higher level of anxiety (β=.19; SE=.08), a lower level of "nonjudgemental inner experience" in FFMQ (β=-.07; SE=.03), and a lower level of "nonreactivity" (β=-.138; SE=.052) than those specializing in individual sports.

CONCLUSIONS

No significant reduction in anxiety was detected in this study. Based on the participant feedback, the time availability for mindfulness practice and session attendance for these student athletes in an elite college could have compromised the intervention's effectiveness. Future interventions among this population could explore a more student-friendly time schedule (eg, avoid final exam time) or attempt to improve cognitive and scholastic outcomes.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR1900024449; https://www.chictr.org.cn/showproj.html?proj=40865.

Application of the patient-reported outcome-based postoperative symptom management model in lung cancer: a multicenter randomized controlled trial protocol

INTRODUCTION

Lung cancer is the most common cancer in China, with the highest mortality rate. Surgery is the primary treatment for early lung cancer. However, patients with lung cancer have a heavy burden of symptoms within 3 months after surgery, which seriously affects their quality of life (QOL). The symptom management model based on the patient-reported outcome (PRO) is considered the best caregiving model. The clinical evidence about the symptom management of lung cancer within 3 months after the operation is very limited. Herein, we propose a randomized controlled trial to evaluate the PRO score-based monitoring and alert system for follow-up on psychological and physiological symptoms of lung cancer patients within 3 months after surgery and further investigate the effect of intervention measures based on this PRO score-based system.

METHODS AND ANALYSIS

This multicenter, open-label, randomized, parallel superiority trial will be conducted at four hospitals in China. A total of 440 lung cancer patients will be recruited in this study, who will be randomly assigned to the intervention group or the control group in a ratio of 1:1. Any of the target symptoms reaches the preset threshold (score ≥ 4), the patients will accept the symptom management advices based on the PRO. The patients in the control group will follow the current standard procedure of symptom management. The symptom management system is an electronic management system based on WeChat mini programs. All patients will be evaluated for symptoms through the lung cancer module of the MDASI lung cancer-specific scale on the day before surgery, days 1, 3, 5, and 7 after surgery, and once a week during the 12-week post-discharge period. Simultaneously, the EORTC QLQ-C30 scale will be used to evaluate patients' quality of life at baseline and the fourth and twelfth week after the surgery. The mean number of symptom threshold events of the intervention and the control groups were compared by t-test, and the changes of PRO were compared by a mixed effect model. The primary endpoint has been set as the 12-week post-discharge period.

DISCUSSION

This study will test the feasibility of the symptom management system based on the mobile social media applet in postoperative caregiving and the efficacy of psychiatrist-assisted treatment and provide evidence in managing the symptoms of patients in the medium and long term.

TRIALS REGISTRATION

Trials registration number: ChiCTR 2200058876, Registered 18 April 2022.

How Integrated Digital Tools Can Improve Tuberculosis Medication Adherence: A Longitudinal Study in China

Background: Poor medication adherence remains one of the major problems in the treatment of tuberculosis (TB) patients, while digital technologies have been proven effective to improve the treatment results. However, reports on the effectiveness of comprehensive practice integrating different intervention methods and technologies are limited. The aim of this study is to evaluate the effectiveness of an integrated digital adherence intervention for TB patients. Methods: We developed a digital adherence intervention platform integrating instant WeChat message, electronic medication monitors (EMMs), and manual reminders. The primary goal of the platform was to improve the accessibility of digital adherence technologies, and thus improve treatment adherence. TB patients were newly diagnosed at 10 TB-designated hospitals and came from 220 communities, from January to June 2022. The basic characteristics and treatment adherence of TB patients in WeChat, EMM, and conventional groups were compared, and the influencing factors of high medication adherence were analyzed by logistic regression. Results: A total of 2,498 TB patients were enrolled in the study, 14.5% were managed by digital technologies, 9.5% by WeChat, and 5.0% by EMM, respectively. After intervention, the median medication rate of TB patients was significantly higher in the WeChat group (95.3%) and EMM group (95.7%) compared with that of the conventional group (83.8%). On the contrary, the median number of missed medications among patients of the conventional group (nine times) was significantly higher than that in the WeChat (three times) group and EMM (three times) group. The proportion of high adherence (adherence medication rate ≥90%) among TB patients was 64.7%, 64.5%, and 43.2% in WeChat, EMM, and conventional group, respectively. Conclusions: The application of the integrated digital adherence intervention platform could significantly improve medication adherence among TB patients. The accessibility of digital adherence technologies could be improved by integrating complementary technologies in practice.

Understanding Motivations for Dating App Use Among Gay and Bisexual Men: Validation, Latent Profile Analysis, and Differences in Health Outcomes

While there has been a proliferation in gay dating app (GDA) use in China, research into their potential effects on health outcomes, particularly mental health outcomes, among gay and bisexual men is lacking. The motivations for GDA use are diverse, and understanding users' motivation profiles may provide a necessary starting point for exploring the heterogeneous effects of GDA use on health outcomes. A cross-sectional survey of the motivations for GDA use and other health outcome variables (i.e., condom use frequency, self-stigma, and subjective emptiness) was conducted among 366 Chinese gay and bisexual men. The results of exploration structure equation modeling indicate that the GDA Use Motivation Scale, with a four-factor first-order model, had strong psychometric properties. Then, latent profile analysis (LPA) based on the mean scores of four aspects of motivation was performed. The results of the LPA revealed the existence of four profiles: "Weak motivations" (30.9%), "Differentiated motivations" (17.8%), "Moderate motivations" (30.3%), and "Strong motivations" (21.0%). Differences in health outcomes among the motivation profiles were found by using the Bolck-Croon-Hagenaars approach. Overall, most participants (60.1%) tended to use condoms consistently, regardless of how strong their GDA use motivation was; however, stronger GDA use motivations were associated with higher levels of self-stigma and subjective emptiness. We call for more research to focus on the real needs behind and motivations for GDA use so that all such app users' voices can be heard, as well as to raise awareness about the potential health risks associated with GDA use among Chinese gay and bisexual men.

Correlates of supportive care needs among Asian Americans with colorectal, liver, or lung cancer from a web-based patient navigation portal intervention: The Patient COUNTS study

BACKGROUND

Cancer is the leading cause of death among Asian Americans, who often face barriers to cancer care. Cancer supportive care needs among Asian Americans remain understudied.

AIMS

We examined cancer supportive care needs and participant factors correlated with these needs, identified profiles of supportive care needs, and examined whether needs profiles are associated with quality of life among Asian American adults.

METHODS AND RESULTS

We recruited 47 Asian American adults with colorectal, liver, or lung cancer who spoke Chinese, English, or Vietnamese, and were starting or undergoing cancer treatment. We assessed cancer supportive care needs in four domains: cancer information, daily living, behavioral health, and language assistance. Hierarchical cluster analysis was used to identify clusters of participants based on their supportive need profiles to further examine the association between need profiles and quality of life (QoL) assessed by the Functional Assessment of Cancer Therapy. Participants (mean age = 57.6) included 72% males and 62% spoke English less than very well. Older participants (age ≥ 65) and those with annual income <$50K reported higher daily living needs. Men and younger participants (age < 50) reported higher behavioral health needs. We found three clusters displaying distinct cancer supportive need profiles: Cluster 1 (28% of the sample) displayed high needs across all domains; Cluster 2 (51%) had low needs across all domains; and Cluster 3 (21%) had high needs for cancer information and daily living. Cluster 1 participants reported the lowest QoL.

CONCLUSION

Cancer supportive care needs among Asian American patients with colorectal, liver, and lung cancer were associated with patient characteristics and QoL. Understanding cancer supportive care needs will inform future interventions to improve care and QoL for Asian American patients with cancer.

CLINICALTRIALS

gov Identifier: NCT03867916.

Development of the WeChat Public Account I Love Parasitology and its Preliminary Application in the Teaching of Human Parasitology

OBJECTIVE

To better construct teaching resources, enhance real-time interaction and feedback between teachers and students in and out of class, and improve the teaching quality of parasitology, our team set up a WeChat public account I love Parasitology.

METHODS

The data sources were mainly from original pictures and multimedia materials of different parasites collected and produced by our team, as well as related materials collected from traditional publications and digital media. With the instant interactive platform, course schedules and corresponding teaching contents were sent by push notifications, case-based learning was carried out, and 2-way communication between students and teachers was achieved. Teaching effectiveness was assessed using a self-evaluation questionnaire.

RESULTS

A WeChat public account suitable for our daily teaching of parasitology was established. The second recursion and implementation of the learning resources allowed students to conduct in-depth reading and get unrestricted access to high-quality resources through the public account. In addition, all contents were in digital forms and made the original resources reborn, which would make up for our current and future shortage of physical teaching specimens. Moreover, the results from the questionnaire indicated that all these actions encouraged students to master theoretical knowledge, improved their abilities of case analysis and communication, and increased their knowledge of academic progress.

CONCLUSION

Our WeChat public account can provide excellent learning materials for students and is a good supplement to the routine education of human parasitology.

Development and usability evaluation of a culturally adapted stroke prevention educational programme on WeChat apps

Background

The persistently high incidence of stroke in many nations is suggestive of an area for further improvement on existing strategies of primary stroke prevention. Although the era of digitalisation has led to the increasing use of mobile applications (apps) in healthcare, more studies are needed to determine the efficacy of apps in producing the desired health outcomes across different nations and cultures.

Objective

To describe the development and evaluate the usability of a mobile app in delivering a culturally adapted stroke prevention educational programme for middle-aged adults in the Republic of China.

Methods

The educational programme was developed in three phases. In Phase 1, the process involved analysing requirements and designing structured modules. Phase 2 concentrated on expert consultation and technical development to deliver the educational programme. Phase 3 included a usability trial and refinement of the educational program based on trial results.

Results

Educational content was derived from the Chinese Guidelines for the Prevention and Treatment of Stroke and the Dietary Guidelines for Residents. The WeChat platform was used to deliver the educational programme. Participants expressed satisfaction with the content, interface, and functions of the apps, indicating that the apps have good usability.

Conclusions

The development process of the Educational Programme was designed to maximise the culturally appropriate, and impact of lifestyle changes and stroke prevention. An app-based educational programme that has demonstrated good usability is a vital factor prior to deploying it in an intervention to evaluate its effects on health outcomes.

Knowledge and willingness toward SARS-CoV-2 rapid antigen testing among older adults in China: a nationwide cross-sectional study

BACKGROUND AND AIMS

The end of the zero-COVID-19 policy placed a large number of older adults in China at increased risk of COVID-19 infection. SARS-CoV-2 rapid antigen testing (RAT) is a promising tool for scaling up testing and ensuring that patient management and public health measures can be implemented without delay. We aimed to understand the knowledge and willingness of RAT, and its correlates among older adults in China.

METHODS

A nationwide cross-sectional survey on knowledge and willingness about RAT among older adults in China was conducted between January 14 and 28, 2023, shortly after the end of the zero-COVID-19 policy. An online questionnaire was used to collect information on sociodemographic characteristics, health characteristics, sources to access RAT information, and attitudes toward COVID-19 and its RAT. Logistic regression was used to assess correlates of knowledge of RAT and willingness to take RAT among older adults.

RESULTS

A total of 1030 older adults (494 women and 536 men, mean age 68.7 ± 7.0 years) were recruited. 49.4% of the participants had a high level of RAT knowledge. After adjusting for sociodemographic characteristics, chronic diseases (0.70, 0.49-0.99), learning RAT from new media (5.46, 3.48-8.68) and traditional media (3.35, 2.13-5.34), and perceiving RAT as convenient (4.03, 2.80-5.85) were associated with levels of RAT knowledge. 53.3% of the participants were willing to take RAT. After adjusting for sociodemographic characteristics, learning RAT from new media (8.46, 5.26-14.0) and traditional media (1.63, 1.04-2.55), perceiving RAT as convenient (2.97, 2.10-4.22), and worrying about (re)infection with COVID-19 (2.12, 1.55-2.92) were associated with willingness to take RAT.

CONCLUSION

The levels of RAT knowledge and willingness to take RAT among older adults in China may hinder the scale-up of RAT. Health education about RAT should be strengthened among older adults. Special efforts should be made to integrate traditional and new media to promote RAT among older adults, specifically, for virus susceptibility and the convenience of RAT. Given the reopening of society, our study could inform our response to future novel infectious diseases and aid in the timely scale-up of RAT.

Does WeChat use intensity influence Chinese college students' mental health through social use of WeChat, entertainment use of WeChat, and bonding social capital?

Background

Previous research notes that the usage of WeChat is significantly related to individuals' mental health, but the underlying mechanism is still not completely discovered. The present study aimed to explore the sequential mediating roles of WeChat use motivations and bonding social capital on the effects of WeChat use intensity on mental health in Chinese college students.

Method

The present study adopted an online survey with a total of 487 Chinese college students. Correlation analysis and serial mediation analysis were measured by process regarding the hypothesis.

Results

The study presented findings indicating that WeChat use intensity had both direct and indirect impacts on the levels of life satisfaction and loneliness experienced by college students in China. Specifically, the utilization of WeChat for social motivation and entertainment motivation was found to have a suppressive effect on the relationship between the intensity of WeChat usage and individuals' life satisfaction. The association between the intensity of WeChat usage and mental health outcomes (life satisfaction and loneliness) was found to be mediated by bonding social capital. Furthermore, the association between the intensity of WeChat usage and mental health was found to be mediated by the sequential mediation effects of using WeChat for social motivation and bonding social capital, as well as the sequential mediation effects of using WeChat for entertainment motivation and bonding social capital.

Conclusion

Our findings provide implications for policymakers and social workers regarding renovating the perceptions of the relationships between WeChat use intensity and overall mental health. Specifically, practical online activities and services of SNSs are recommended to be designed for meeting social and recreational gratifications and boosting bonding social capital, which in turn promotes psychological wellbeing.

The challenges of returning to work for differentiated thyroid cancer survivors in china: a qualitative study

PURPOSE

Although thyroid cancer survivors have a good prognosis and the survival rate of differentiated thyroid cancer is close to 100%, treatment and its side effects seriously affect the quality of life of patients, especially rehabilitation at work. The purpose of this study was to explore the challenges faced by differentiated thyroid cancer survivors in returning to work and maintaining employment.

METHODS

A purposive sample of differentiated thyroid cancer patients who had undergone surgical treatment and were followed up at the outpatient departments of thyroid surgery wards of two tertiary care hospitals in Jiangsu Province, China, between January and March 2023, were subjected to semi-structured interviews. An inductive content analysis was conducted to identify themes.

RESULTS

A total of 27 participants, aged 23-56 years, were interviewed. Three themes and eight subthemes were identified: pressure perception including social pressure in the workplace, regular appointments conflict with work schedules, and dilemma of career development; the challenges of self-adjustment including physical disorder, unable to adapt to the pace of work, and unstable mood affects working condition; and lack of social support including lack of access to information or support groups, lack of sympathy and understanding from employers, and lack of professional support.

CONCLUSIONS

Our study identified that our participants with differentiated thyroid cancer patients face challenges in trying to return to work or maintain employment within the confines of their disease. Multilevel interventions, ranging from employer and co-worker understanding to information, psychological and other support from health care professionals, can facilitate the process of returning to work and help patients reconcile illness and work.

Empirical Investigation of How Social Media Usage Enhances Employee Creativity: The Role of Knowledge Management Behavior

Employee use of social media in the workplace has become a common phenomenon. Thus, how to effectively manage and utilize employee social media usage in the workplace has become a new issue. This study examines how employees' work-related and social-related social media usage at work can present different impacts upon their creativity through knowledge management behaviors. To test the research model, this study collected data from 425 employees in various industries in China and utilized a covariance-based structural equation model (CB-SEM) to test the hypotheses. The results suggested that work-related social media usage enhances employee creativity through promoting knowledge sharing and restraining knowledge manipulation. On the contrary, social-related social media usage cannot indirectly influence employee creativity through knowledge management behaviors. This study contributes to the literature on social media research by providing theoretical arguments on how employee use of social media for different purposes affects their creativity. Furthermore, this research offers the insight of the different paths of work-related and social-related social media usage that influence employee creativity rather than treating social media usage as a unitary concept and linking it simply with work results. This study also explores the role of three knowledge management behaviors in the relationship between social media usage and employee creativity.

Follow-Up Effect of Wechat Group on Discharged Patients with Colles Fracture

This work explores the effect of a Wechat group on follow-up and continuation of nursing for discharged patients with Colles fracture. A total of 96 patients with Colles fracture are enrolled and randomized into two groups by the random number table method. The control group is followed up and guided by traditional methods. Based on the follow-up method adopted in the control group, a Wechat group is combined with Wechat constant tracking. The regular follow-up rate, a satisfaction of with continuing care, Gartland-Werley wrist score, the exercise of self-care agency score (ESCA score), and complications are compared and analyzed. The regular follow-up rate, satisfaction, Gartland-Werley wrist score, and self-care ability of patients in the Wechat group are significantly higher than those in the control group (p < 0.05). Statistical analysis of postoperative complications showed that although there is no significant difference in the incidence of median nerve irritation and incision infection (p > 0.05), the proportion of joint stiffness in the control group is significantly higher (p < 0.05). The establishment of Wechat groups to follow up and continue nursing for discharged patients with Colles fracture is helpful to achieve better clinical efficacy and improve the effective way for doctor-patient communication, which is worthy of active promotion.

Associations between changes of smartphone pedometer-assessed step counts and levels of obesity-related breast cancer biomarkers in non-cancer women: A population-based observational study

While a higher level of physical activity (PA) is inversely associated with a higher breast cancer (BC) risk, the health benefits of daily steps on obesity-related BC biomarkers remain unclear. We aimed to understand the associations of changes in step counts with levels of five obesity-related BC biomarkers during a two-year follow-up. In total, 144 non-cancer women (47.96 ± 5.72) were observed on both 2019 and 2021. A structured questionnaire, daily steps and fasting blood samples were collected before (t0, 2019) and after (t1, 2021). Levels of biomarkers (IGF-binding proteins 3, adiponectin, soluble leptin receptor, C-reactive protein, and resistin) were assayed by ELISA. Participants were divided into persistent low steps, decreasing steps, increasing steps, and persistent high steps. Associations of categories on proposed biomarkers were estimated using linear regression models, with persistent low steps as reference. Associations between time-varying step counts with biomarkers were quantified using mixed linear models. Compared with persistent low steps, increasing steps is associated with a reduction in C-reactive protein level (β=-0.74, 95%CI=-1.23--0.26, P-value = 2.98 × 10-3). An inverse association between time-varying step counts with C-reactive protein level was identified, consistent across different obesity types and baseline step level categories. No association with daily step counts was observed for other proteins.

The effect of video visitation on intensive care unit patients and family members outcomes during the COVID-19 pandemic: A randomised controlled trial

OBJECTIVE

To investigate the effect of video visitation on intensive care patients' and family members' outcomes during the COVID-19 pandemic.

DESIGN

This is a randomised controlled trial.

SETTING

An adult intensive care unit in a tertiary hospital in Beijing, China.

METHODS

A total of 121 adults, who were >18 years of age, conscious, able to communicate verbally, and admitted to the intensive care unit for over 24 hours were randomised into the intervention (video visitation) (n = 65) and control (n = 56) Groups. A total of 98 family members participated. Patient primary outcomes included anxiety and depression, measured using the Hospital Anxiety and Depression Scale. Secondary outcomes included patient delirium and family anxiety assessed using the Confusion Assessment Method scale and Self-Rating Anxiety Scale, respectively; and patient and family satisfaction, measured using a questionnaire routinely used in the hospital.

RESULTS

There were no statistically significant differences between the groups in patients' anxiety (t = 1.328, p = 0.187) and depression scores (t = 1.569, p = 0.119); and no statistically significant differences in delirium incidence between the groups (7.7 % vs 7.1 %, p > 0.05). There were no significant differences in changes in family members' anxiety scores (t = 0.496, p = 0.621). A statistically significant difference in satisfaction was found between the two group patients (86.1 % vs 57.2 % of patients were satisfied with using video visitation, p < 0.05), and the result of family members' satisfaction was also statistically significant (88 % vs 62.5 % of family members were satisfied with using video visitation, p < 0.05).

CONCLUSION

Video visitation did not seem to influence anxiety, but the use of video visitation can improve the patient and their family members' satisfaction. Future research is needed to determine the feasibility of embedding video visitation into routine practice, and the optimal frequency and length of video visitation in relation to patients' and family members' outcomes.

IMPLICATIONS FOR CLINICAL PRACTICE

Video visitation improved patient and family members' satisfaction. Therefore, clinicians should consider using video visitation when face to face visit is restricted. Video visVitation did not reduce patient anxiety significantly in this study maybe because the average length of intensive care stay was too short. Future research is needed on its effect on long term intensive care patients.

An exploration of the role played by attachment factors in the formation of social media addiction from a cognition-affect-conation perspective

More and more users are overusing social media and the situation is getting worse, yet there is still a lack of research on social media addiction. Based on attachment theory and the Cognition-Affect-Conation (CAC) framework, this study combines the perception of intrinsic motivation and the technical features of social media as extrinsic motivators and explores the formative factors in social media addiction. The results show that social media addiction is determined by an individual's emotional and functional attachment to the platform, and that attachment is in turn influenced by intrinsic motivation (perceived enjoyment and perceived relatedness) and extrinsic motivation (functional support and information quality). The SEM-PLS technique was used to analyze the data collected from a questionnaire survey of 562 WeChat users. The results showed that social media addiction is determined by an individual's emotional and functional attachment to the platform. This attachment is, in turn, influenced by intrinsic motivation (perceived enjoyment and perceived relatedness) and extrinsic motivation (functional support and informational quality). The study first explains the latent antecedents of social media addiction. Second, it examines user attachment, particularly the role of emotional and functional attachment, and explores the platform technology system, which plays a key role in the development of addiction. Third, it extends attachment theory to the study of social media addiction.

Effects of Chinese provincial CDCs WeChat official account article features on user engagement during the COVID-19 pandemic

Background

WeChat has become a potent medium for disseminating public health information, especially during the coronavirus disease 2019 (COVID-19) pandemic. WeChat is important for public health organizations when considering users' information needs and preferences to further explore factors that affect user engagement.

Methods

We collected data from WeChat official accounts (WOAs) of the Chinese provincial Center for Disease Control and Prevention (CDC) to identify factors affecting and predicting the behavior of user engagement as measured by the level of reading and re-sharing during different phases of the COVID-19 pandemic between January 1, 2019, and December 31, 2020. We used multiple logistic regression analyses to identify features of articles with higher reading and re-sharing levels from 31 Chinese provincial CDCs. We developed a nomogram to predict the effect on user engagement.

Results

We collected a total of 26 302 articles. Release position, title type, article content, article type, communication skills, marketing elements, article length, and video length were key determinants of user engagement. Although the feature patterns also varied between different pandemic stages, the article content, release position, and article type were still the most prominent features driving user engagement. Regarding article content, the COVID-19 pandemic report and guidance for public protection were more likely to obtain high-level reading (normalization: odds ratio (OR) = 12.340, 95% confidence interval (CI) = 9.357-16.274) and re-sharing (normalization: OR = 7.254, 95% CI = 5.554-9.473) than other contents throughout the pandemic. When we compared release position with secondary push, users who used main push were more likely to exhibit high-level reading and re-sharing during any period, especially during normalization (OR = 6.169, 95% CI = 5.554-6.851; OR = 4.230, 95% CI = 3.833-4.669). For article type, a combination of text, links and pictures was associated with a higher rate of reading (normalization: OR = 4.262, 95% CI = 3.509-5.176) and re-sharing level (normalization: OR = 4.480, 95% CI = 3.635-5.522) compared to text only. Simultaneously, the prediction model showed good discriminatory power and calibration.

Conclusions

Discrepancies exist in article features between different pandemic stages. Public health agencies should make full use of official WOAs and consider the information needs and preferences of users in order to better carry out health education and health communication with the public when public health events occur.

The stability of transient relationships

In contrast to long-term relationships, far less is known about the temporal evolution of transient relationships, although these constitute a substantial fraction of people's communication networks. Previous literature suggests that ratings of relationship emotional intensity decay gradually until the relationship ends. Using mobile phone data from three countries (US, UK, and Italy), we demonstrate that the volume of communication between ego and its transient alters does not display such a systematic decay, instead showing a lack of any dominant trends. This means that the communication volume of egos to groups of similar transient alters is stable. We show that alters with longer lifetimes in ego's network receive more calls, with the lifetime of the relationship being predictable from call volume within the first few weeks of first contact. This is observed across all three countries, which include samples of egos at different life stages. The relation between early call volume and lifetime is consistent with the suggestion that individuals initially engage with a new alter so as to evaluate their potential as a tie in terms of homophily.

The correlation analysis of WeChat usage and depression among the middle-aged and elderly in China: the mediating role of social participation

BACKGROUND

We aimed to explore the association between WeChat usage and depression in the Chinese middle-aged and elderly and the role of social participation.

METHODS

Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) of 2018. The dependent variable was depressive symptoms, measured with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). We used the propensity score matching (PSM) to match the WeChat users with the non-WeChat users. Correlations between WeChat usage and depressive symptoms were verified by using logistic regression and linear regression, and the mediating role of social participation was verified by using stepwise regression and KHB method.

RESULTS

Four thousand five hundred forty-five samples were ultimately matched for analysis in this study. After including all control variables, results of logistic regression showed that WeChat usage was significantly associated with a lower prevalence of depression (aOR:0.701,95% CI: 0.605-0.812). And the results of linear regression showed that WeChat usage was associated with lower levels of depression which was significant (p < 0.001). The results of the stepwise regression and the KHB method showed a mediating role of social participation in WeChat usage and depressive symptoms. Among the four types of social participation, the mediating effect of recreational activities was significant, while the mediating effects of voluntary activities, cultural activities, and other activities were not significant. Meanwhile, the effect of WeChat usage on depression and the mediating effect of social participation were heterogeneous because of differences in age and gender.

CONCLUSION

Social participation partly mediated the effect between WeChat usage and depression in middle-aged and older adults. Among the four types of social participation, only recreational activities had a mediating effect. Encouraging more active social participation and other types of social activities should be considered to improve the mental health of the middle-aged and older adults in China through social media usage.

Hesitancy about SARS-CoV-2 rapid antigen testing in China: a nationwide cross-sectional study

BACKGROUND

SARS-CoV-2 rapid antigen testing (RAT) could be a useful supplementary test to diagnose larger numbers of acute asymptomatic infection and alleviate the limitations of polymerase chain reaction (PCR) test. However, hesitancy about SARS-CoV-2 RAT may compromise its implementation.

OBJECTIVE

We aimed to understand the prevalence and correlates of hesitancy about RAT among adults uninfected with SARS-CoV-2 in mainland China.

METHODS

A nationwide cross-sectional survey on hesitancy about SARS-CoV-2 RAT was conducted among adults uninfected with SARS-CoV-2 in mainland China between 29 April and 10 May 2022. Participants completed an online questionnaire that covered the following COVID-19 related questions: sociodemographic characteristics, experiences of COVID-19 restrictions and knowledge of COVID-19, and attitude towards COVID-19 and its screening. This study was a secondary analysis of data from the survey. We compared the characteristics of participants by levels of hesitancy about SARS-CoV-2 RAT. Thereafter, logistic regression with the sparse group minimax concave penalty was used to identify correlates of hesitancy about RAT.

RESULTS

We recruited 8856 individuals with diverse demographic, socioeconomic and geographic characteristics in China. 5388 participants (valid response rate 60.84%, 52% men, median age 32 years) were included the analysis. 12.75% (687) expressed hesitancy about RAT. Notably, those who were from the central region (adjusted odds ratio [aOR]: 1.815, 95% confidence interval [CI]: 1.441-2.278), and received COVID-19 information from traditional media (1.544, 1.279-1.863) were significantly more likely to report hesitancy about RAT. However, those who were women (0.720, 0.599-0.864), older (0.982, 0.969-0.995), had postgraduate education (0.612, 0.435-0.858), had children (< 6 years old) and elders (> 60 years old) in family (0.685, 0.510-0.911), had better knowledge about COVID-19 (0.942, 0.916-0.970), and had mental health disorders (0.795, 0.646-0.975) were less likely to report hesitancy about RAT.

CONCLUSIONS

Hesitancy about SARS-CoV-2 RAT was low among individuals who were not yet infected with SARS-CoV-2. Efforts should be made to improve the awareness and acceptance of RAT among men, younger adults, individuals with lower education or salary, families without children and elders, individuals who access COVID-19 information via traditional media. In the midst of a reopening world, our study could inform the development of contextualized mass screening strategies, the scale-up of RAT in particular, which remains an indispensable option in emergency preparedness.

Exploring the use of WeChat for qualitative social research: The case of Italian digital diaspora in Shanghai

The widespread use of digital communication technologies has created new opportunities for social research. In this paper, we explore the limits and potentials of using messaging and social media apps as tools for qualitative research. Building upon our research on Italian migration to Shanghai, we discuss in detail the methodological choice of using WeChat for teamwork, remote sampling strategies, and conducting interviews. The paper highlights the benefits that researchers may have from employing the same technology that the studied community uses in their daily life as a research tool, and advocates for a flexible approach to research that adapts its tools and methods to the specific requirements and characteristics of the fieldwork. In our case, this strategy allowed us to emphasize that WeChat represents a digital migratory space which played a crucial role in understanding and making of the Italian digital diaspora in China.

The effect of applying telehealth education to home care of infants after congenital heart disease surgery

BACKGROUND

The purpose of this study was to investigate the effect of applying telehealth education to home care of infants after congenital heart disease (CHD) surgery.

METHODS

A prospective randomized controlled study was conducted from July 2020 to February 2021 in Fujian Children's Hospital to compare the home care condition of infants after CHD surgery between the intervention group and the control group.

RESULTS

At 3 months after discharge, parents' caring ability and CHD knowledge in the intervention group were significantly better than those in the control group and were significantly improved compared with those at discharge time (P < 0.05). The parental care burden in the intervention group was significantly lower than that in the control group and was significantly lower than that at discharge time (P < 0.05). During the follow-up period, the rate of loss of follow-up and complications in the intervention group were significantly lower than those in the control group (P < 0.05).

CONCLUSION

Telehealth education via WeChat can effectively improve the knowledge of disease and home care ability of parents of infants after CHD surgery and reduce their home care burden, which can effectively reduce the incidence of complications and lost to follow-up rate after discharge.

Burnout and job stress of anesthesiologists in the tertiary class A hospitals in Northwest China: A cross-sectional design

Purpose

Our purpose was to assess job stress and burnout among anesthesiologists in the tertiary class A hospitals in Northwest China, analyze the possible causes and adverse consequences of increased job stress and burnout of anesthesiologists in this region, and put forward suggestions in combination with the current national policies.

Methods

We sent 500 electronic questionnaires to all anesthesiologists practicing in the tertiary class A hospitals in Northwest China from 1960 to 2017 on April 2020. A total of 336 (67.2%) questionnaires were returned and could be used for analysis. Burnout and job stress were assessed by using the modified Maslach Burnout Inventory-Human Services Survey and Chinese Perceived Stress Scale, respectively.

Results

First, as for emotional exhaustion, the situations of anesthesiologists with different working years and workloads are different with statistical significance (P < 0.05). Second, as for depersonalization, the situations of anesthesiologists with different ages, professional titles, working years, physical health status, and workload are different (P < 0.05). Third, as for personal accomplishment, the situations of anesthesiologists with different physical health status are different (P < 0.05). Finally, the regression results showed that the longer the fatigue working years and the worse the physical health of anesthesiologists in Northwest China, the more likely these two factors were to cause burnout (P < 0.05), as for job stress, there was a negative correlation between job stress and physical health status (P < 0.05).

Conclusion

Burnout and high job pressure are common among anesthesiologists in tertiary class A hospitals in Northwest China. We should focus on the allocation of labor intensity, pay attention to the physical and mental health of employees, establish targeted incentive mechanism, and improve the system of promotion and income rises for grassroots doctors. This may be not only conducive to the quality of medical care for patients but also conducive to the development of anesthesiology in China.

Trial registration

Identifier: ChiCTR2000031316.

Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study

Background

Dietary management plays a crucial role in the treatment of patients with ulcerative colitis (UC). While various e-services provide dietary advice, the long-term dietary management requires continuous monitoring and dynamic adjustment to accommodate the evolving nature of the disease and meet the patients' nutritional needs. Consequently, the development of a novel dietary management tool that incorporates diet tracking, personalized nutritional feedback, and evidence-based advice becomes imperative. This study aims to address this need by developing a WeChat applet called "HealthyGut" specifically designed for the dietary management of UC patients, and evaluate its feasibility, acceptability, and preliminary efficacy.

Methods

A total of 134 UC patients were equally allocated into the intervention group (receiving a 12-week mobile-based dietary management via HealthyGut) and control group (receiving a paper-based food diary and routine advice). The feasibility outcomes were recruitment, retention, engagement, satisfaction, and acceptability in the intervention group. Dietary intakes were effective outcomes.

Results

Both groups had satisfactory retention rates (89.6% and 77.6%, respectively). The System Usability Scale in the intervention group yielded "good usability" with a mean score of 79.63 (SD 7.39), and all participants reported good user experiences and perceived benefits after using HealthyGut. At week 12, intervention responders reported significantly higher daily energy intake than control group (Z = -3.089, p = 0.002).

Conclusions and Implications

The results display that HealthyGut as a dietary management tool is feasible and accepted by UC patients, and it may help them make healthier food choices. Larger sample studies should be considered in the future.

Designing a Needs-Oriented Psychological Intervention for Chinese Women Undergoing an Abortion

Accessing good quality abortion care is a fundamental human right and contributes to achieving Sustainable Development Goals. However, well-designed abortion care that meets women's needs is limited. This study aims to systematically develop an intervention to promote the psychological well-being of Chinese women undergoing an abortion. A five-step iterative approach informed by intervention mapping was undertaken to determine the intervention design. Step 1 used in-depth interviews with 14 Chinese women undergoing an abortion to assess real-life stressors and support needs. We identified eight stressors and found women's support needs varied with the time trajectory of the abortion. Step 2 used a focus group discussion with care providers to select modifiable stressors that impact negative psychological outcomes. In Step 3 and Step 4, we determined and integrated the exact strategies to eliminate or mitigate possible modifiable stressors by incorporating information from in-depth interviews and the Transactional Model of Stress and Coping. The integrated strategies were instructional support, informational support, and timely communication. In Step 5, we composed the detailed intervention design according to the best available evidence and, to confirm content validity, consulted 10 women who had undergone abortion in the previous 2-6 weeks. The intervention was titled STress-And-coping suppoRT (START), which included four interacting components: (1) a face-to-face consultation at the first appointment; (2) a printed booklet with information on abortion, self-care, and managing emotions and intimate relationships; (3) a WeChat-based online public profile page offering the same information as the booklet; (4) a telephone hotline. This study paves the way for a new approach to addressing the psychological needs of women experiencing abortion in China. The rigorous process provides an example of developing tailored health promotion interventions.

Clinical Features of Suspected Malignant Hyperthermia in China from 2015 to 2020: A Retrospective Study from China Malignant Hyperthermia Emergency Assistance Group

Purpose

Malignant hyperthermia (MH) is a rare but fatal pharmacogenetic disorder, triggered by inhalational anesthetics or succinylcholine. Since the first nonprofit academic organization China Malignant Hyperthermia Emergency Assistance WeChat-based Group (CMHEA Group) was established in 2015, they have actively participated in the diagnosis and treatment of MH patients. Based on the CMHEA Group, the aim of the study was to retrospectively analyze the characteristics of suspected MH in China from 2015 to 2020.

Methods

We conducted a retrospective analysis of the suspected MH patients from 2015 to 2020, for analyzing the current clinical diagnosis, treatment and prognosis of MH in China.

Results

A total of 58 suspected MH cases occurred from 2015 to 2020, of these, 36 cases were collected with detailed data. The MH clinical grading score of 36 patients ranged from 33 to 73, with a median of 55. Abnormal hyperthermia and hypercarbia were the most common early signs of MH. Four patients were confirmed carrying six different potential MH-causative mutations. Of the total 58 cases, 14 patients (24.1%) received dantrolene and the whole mortality rate was 53.4%. Compared to the patients not receiving dantrolene treatment, the survival rate of patients receiving dantrolene treatment was significantly higher than that of patients not receiving dantrolene (78.6% vs 36.4%, p = 0.007).

Conclusion

The current main diagnostic methods of suspected MH in China are still clinical diagnosis. Hence, it is critical to keep dantrolene for immediate accessibility with the introduction of domestic dantrolene to China. The WeChat group model has played an important but limited role in quick diagnosis and treatment of MH.

The effect of mindfulness on online self-presentation, pressure, and addiction on social media

As social media has become more imperative in daily life, people pay more attention to self-presentation and impression management on social media, and some have even become psychologically dependent. There is a large group of socially addicted users who continuously strive to improve their online self-presentation. Due to stress and burnout arising from social media addiction, people change their social media behavior. The influence of mindfulness on social behavior cannot be ignored. This study aims to explore coping behaviors and the role of mindfulness for people under social media pressure and social media addiction in China's special political environment. We found significant differences in self-presentation, social media pressure, and social media addiction among different circles in the Chinese context. Experiments have shown that people's socially addictive behaviors and abilities to withstand social media pressure are affected by their mindfulness. In addition, the more social media pressure people perceive on social media, the more likely they are to stop using social media and shift to offline interpersonal interactions. However, when there are more offline interpersonal interactions, people's willingness to return to social media platforms increases.

Public Concern about Air Pollution and Related Health Outcomes on Social Media in China: An Analysis of Data from Sina Weibo (Chinese Twitter) and Air Monitoring Stations

To understand the temporal variation, spatial distribution and factors influencing the public's sensitivity to air pollution in China, this study collected air pollution data from 2210 air pollution monitoring sites from around China and used keyword-based filtering to identify individual messages related to air pollution and health on Sina Weibo during 2017-2021. By analyzing correlations between concentrations of air pollutants (PM2.5, PM10, CO, NO2, O3 and SO2) and related microblogs (air-pollution-related and health-related), it was found that the public is most sensitive to changes in PM2.5 concentration from the perspectives of both China as a whole and individual provinces. Correlations between air pollution and related microblogs were also stronger when and where air quality was worse, and they were also affected by socioeconomic factors such as population, economic conditions and education. Based on the results of these correlation analyses, scientists can survey public concern about air pollution and related health outcomes on social media in real time across the country and the government can formulate air quality management measures that are aligned to public sensitivities.