BackgroundAging and type 2 diabetes mellitus are important risk factors for the development of cognitive deterioration and dementia. The objective of this research was to investigate the effects of an exercise intervention on cognitive function in older T2DM patients.MethodsEight literature databases were searched from inception to 20 January 2022. The researchers examined randomized controlled trials that evaluated the impact of exercise on the cognitive performance of older T2DM patients. The Cochrane risk-of-bias tool for RCTs was used to assess each study. (...) The quality of evidence was assessed using the GRADE approach. The mini-mental state examination, Modified MMSE, and Montreal cognitive assessment were used to evaluate the cognitive outcomes. We performed a subgroup analysis with stratification according to exercise intervention modality, duration, and cognitive impairment.ResultsFive trials were eligible, with a total of 738 T2DM patients. The combined findings revealed that exercise improved global cognitive function significantly. In the studies that were included, no relevant adverse events were reported.ConclusionExercise is beneficial in improving global cognitive function in older adults with T2DM. Studies with bigger sample sizes and higher quality are additionally expected to draw more definite conclusions.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022296049]. (shrink)

處於現代性價值衝突的道德困境下，自由主義從誕生之日起，就不得不面臨諸如自由與平等、權利與善的衝突。 對於這樣的兩難選擇，究竟該何去何從？ 《自由主義的道德處境》通過分析和辯駁反自由主義者們對自由主義的批判觀點，展開為自由主義作辯護性的寫作。自羅爾斯《正義論》問世以來，各種反自由主義者對自由主義的批評，以及自由主義者的回應、辯護和修正，成 為當代西方政治哲學爭論的主題。周楓以這場大爭論為背景，對自由主義和反自由主義的根本分歧作了系統的、歷史的考察與評論。其要義在於指出：處於現代性價值衝突的道德困境下，自由主義從誕生之日起，就不得不面臨著 諸如自由與平等、權利與善的兩難選擇。對衝突的任何一方價值的選擇，都是對另一方價值的損害。自由主義者選擇自由優先於平等，權利優先於善，這是否有充分的道德根據？這一選擇又讓人類付出了怎樣的代價？《自由主義 的道德處境》試圖就這些問題作一深入的探討。.

The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 is challenging the dental community to an unprecedented degree. Knowledge of the increased risk of infection in dental settings has been disseminated to the public and guidelines have been formulated to assist dental attendance decision-making. However, dental attendance behaviors incompatible with treatment need is not uncommon in clinical settings. Important gaps remain in the knowledge about how psychological factors are affecting dental attendance behaviors during the COVID-19 epidemic. (...) In this cross-sectional study, a questionnaire survey was performed during February and March 2020. A total of 342 and 294 dental patients who attended and avoided dental visits, respectively, were included. The participants were classified into four groups based on dental attendance behavior and emergent/urgent dental treatment need. Bivariate analysis was performed to investigate factors associated with dental attendance. Multivariable logistic regression based on principal component scores was performed to identify major psychological constructs associated with unnecessary dental avoidance and attendance. Among all the factors explored, inability to wear masks during dental treatment was most closely associated with the overall pattern of dental attendance among participants. Multivariable regression suggested that unnecessary dental avoidance was associated with perceived risk of infection in general and in dental settings, perceived impact of COVID-19 and dental problems on general health, and personal traits such as trust and anxiety. Unnecessary dental attendance was associated with optimism toward the epidemic and trust. Multidisciplinary efforts involving dental and medical professionals as well as psychologists are warranted to promote more widespread adoption, among the general public, of dental attendance behaviors compatible with dental treatment need during the COVID-19 epidemic. (shrink)

Previous research demonstrates the critical role moral disengagement plays in unethical decision-making. This study investigates the relationships among moral endorsement, shareholder-value orientation, moral disengagement, and moral judgment on issues of different moral intensities. The results of a scenario-based survey conducted in China confirm the negative (positive) impact of moral disengagement (moral intensity) on moral judgment. The findings reveal that both moral endorsement and shareholder-value orientation of decision-makers significantly influence moral judgment and that moral intensity moderates the relationships between moral endorsement (...) and moral judgment, and between shareholder-value orientation and moral disengagement. The study’s theoretical contributions, managerial implications, and limitations are discussed. (shrink)

This paper focuses on performance assessment of a freight network with stochastic capacities by using reliability analysis, in which a node denotes a supplier, a transfer center, a distribution center, or a market, while an arc denotes a logistics service provider offering the freight traffic service for a pair of nodes. Due to some uncertainties in real environment, the available capacity of the provider along each arc is stochastic. Thus, network reliability that at least d units of commodity demand can (...) be successfully delivered from the source to the destination denotes the operational performance of such a freight network. A d-minimal path–based method is developed to evaluate the freight network reliability. To advance the efficiency of solving d-minimal paths, an improved model is established by redefining capacity bounds of arcs and minimal paths. Furthermore, a new concept of expected capacity grounded on network reliability is presented to measure the service performance of the freight network. A practical case related to the coal delivery network is studied to demonstrate the implications of both network reliability and expected capacity. (shrink)

The sizes of individual data files have steadily increased along with rising demand for customized services, leading to issues such as low efficiency of web-based geographical information system -based data compression, transmission, and rendering for rich Internet applications in complicated visualization systems. In this article, a WebGIS-based technical solution for the efficient transmission and visualization of meteorological big data is proposed. Based on open-source technology such as HTML5 and Mapbox GL, the proposed scheme considers distributed data compression and transmission on (...) the server side as well as distributed requests and page rendering on the browser side. A high-low 8-bit compression method is developed for compressing a 100 megabyte file into a megabyte-scale file, with a compression ratio of approximately 90%, and the recovered data are accurate to two decimal places. Another part of the scheme combines pyramid tile cutting, concurrent domain name request processing, and texture rendering. Experimental results indicate that with this scheme, grid files of up to 100 MB can be transferred and displayed in milliseconds, and multiterminal service applications can be supported by building a grid data visualization mode for big data and technology centers, which may serve as a reference for other industries. (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. COVID-19疫情的爆發，突顯出公共健康倫理中自主性與公共健康之間的緊張關係。以“publichealth”、“ethics”、“autonomy”為主題詞在WebofScience核心合集數據庫中 進行文獻收集，借助CiteSpace6.1軟件進行信息可視化分析，發現2020年1月1日至2022年5月14日期間，生命倫理/公共健康倫理領域對於“自主性”概念的討論大體上集中在“知情同意”、“健康保 健政策"、“健康質量”、“信息技術”和“老年歧視/老年群體”範圍。本文在此基礎上提煉分析COVID-19疫情中的四個“自主性‘‘難題 如何避免以公共健康/公共利益為名過度限制自主性、在數字技術應用中如何保障自主性、如何保障老年群體的自主性和生命權，如何通過促進自主性來推動公共健康目標的實現。COVID-19疫情是一個重塑公共健康倫理 自主性概念的歷史契機。冷酷的病毒已經作為一種媒介把人類的命運緊密地聯繫起來，而基於關懷倫理和共同體倫理重塑的自主性概念則有望給疫情下的世界帶來團結、温暖和希望。 In the field of public health ethics, the COVID-19 pandemic has highlighted the tension between autonomy and public health. Using CiteSpace 6.1 software and information visualization analysis, we performed a search of literature in the Web of Science core collection database using thematic words such as “public health”, “ethics” and “autonomy”, we found that from January 1, 2020 to May 14, 2022, discussions on the concept of “autonomy” (...) within the field of bioethics/public health ethics were generally focused on the following topics: “informed consent”, “health care policy”, “health quality”, “information technology”, “ageism” and “elderly group”. In this paper, we distill and analyze four controversial issues: how can we avoid excessive restrictions on autonomy in the name of public health/public interest? How can we protect autonomy when using digital technology? How can we protect the autonomy and rights of the elderly? How can we advance the goals of public health by promoting autonomy? The COVID-19 pandemic is a unique historical opportunity to reshape the concept of autonomy within the field of public health ethics. Although the virus has bound the fate of humanity together, a reinvented concept of autonomy based on care and community ethics holds the promise of bringing solidarity, comfort, and hope to the world in the midst of the pandemic. (shrink)

ObjectiveBasic combat training is a kind of necessary high-intensity training to help each military recruit convert into a qualified soldier. In China, both the physical fatigue and passive psychological state have been observed in new recruits during BCT. However, after same-intensity training, the degree of fatigue and passive mood vary among recruits. Therefore, this study aimed to explore the effect of BCT on mood state of recruits with different physical fitness levels from a perspective of fatigue.Materials and methodsBefore and after (...) BCT, the degree of fatigue and mood state of participants were evaluated via the Borg Rating of Perceived Exertion Scale and Profile of Mood States Questionnaire immediately after 20 push-ups as RPE and POMS scores [total mood disturbance, passive mood and positive mood ]. The participants were divided into two groups according to the RPE score measured after BCT: group 1: RPE score after BCT < 13 and group 2: RPE score after BCT ≥ 13.ResultA total of 564 recruits were included. After BCT, in group 1, TMD and passive mood Ttension, Tfatigue, Tdepression, Tconfusion declined significantly, but positive mood both increased significantly ; while in group 2, only Tanger and Testeem increased significantly.ConclusionBCT could alleviate passive mood and add to positive mood for recruits with better physical fitness, while had no ameliorative effects on or even deteriorate most of the passive mood for recruits with worse physical fitness. (shrink)

It is not only difficult to be a sports expert but also difficult to grow from a sports expert to a sports elite. Professional athletes are often concerned about the differences between an expert and an elite and how to eventually become an elite athlete. To explore the differences in brain neural mechanism between experts and elites in the process of motor behavior and reveal the internal connection between motor performance and brain activity, we collected and analyzed the electroencephalography findings (...) of 14 national archers and 14 provincial archers during aiming and resting states and constructed the EEG brain network of the two archer groups based on weighted phase lag index; the graph theory was used to analyze and compare the network characteristics via local network and global network topologies. The results showed that compared with the expert archers, the elite archers had stronger functional coupling in beta1 and beta2 bands, and the difference was evident in the frontal and central regions; in terms of global characteristics of brain network topology, the average clustering coefficient and global efficiency of elite archers were significantly higher than that of expert archers, and the eigenvector centrality of expert archers was higher; for local characteristics, elite archers had higher local efficient; and the brain network characteristics of expert archers showed a strong correlation with archery performance. This suggests that compared with expert archers, elite archers showed stronger functional coupling, higher integration efficiency of global and local information, and more independent performance in the archery process. These findings reveal the differences in brain electrical network topologies between elite and expert archers in the archery preparation stage, which is expected to provide theoretical reference for further training and promotion of professional athletes. (shrink)

The effect of authentic leadership and leader competency on employee job performance has received growing attention in the past decades; however, few studies have simultaneously integrated these two leadership perspectives. We have thus developed a mediated moderation model to test the interactive effect of authentic leadership and competency on followers’ job performance through work engagement. Based on a sample of 248 subordinate–supervisor pairs, hierarchical regression analyses reveal that authentic leadership positively relates to followers’ task performance and organizational citizenship behavior ; (...) leader competency moderates the relationship between authentic leadership and OCB; and followers’ work engagement mediates the main effect of authentic leadership and the interactive effect of authentic leadership and competency on followers’ task performance and OCB. All the three results are consistent with our hypotheses. (shrink)

Job shop scheduling problem is one of the most difficult optimization problems in manufacturing industry, and flexible job shop scheduling problem is an extension of the classical JSP, which further challenges the algorithm performance. In FJSP, a machine should be selected for each process from a given set, which introduces another decision element within the job path, making FJSP be more difficult than traditional JSP. In this paper, a variant of grasshopper optimization algorithm named dynamic opposite learning assisted GOA is (...) proposed to solve FJSP. The recently proposed dynamic opposite learning strategy adopts the asymmetric search space to improve the exploitation ability of the algorithm and increase the possibility of finding the global optimum. Various popular benchmarks from CEC 2014 and FJSP are used to evaluate the performance of DOLGOA. Numerical results with comparisons of other classic algorithms show that DOLGOA gets obvious improvement for solving global optimization problems and is well-performed when solving FJSP. (shrink)

The autophagy initiation complex is brought about via a highly ordered and stepwise assembly process. Two crucial signaling molecules, mTORC1 and AMPK, orchestrate this assembly by phosphorylating/dephosphorylating autophagy‐related proteins. Activation of Atg1 followed by recruitment of both Atg9 vesicles and the PI3K complex I to the PAS (phagophore assembly site) are particularly crucial steps in its formation. Ypt1, a small Rab GTPase in yeast cells, also plays an essential role in the formation of the autophagy initiation complex through multiple regulatory (...) pathways. In this review, our primary focus is to discuss how signaling molecules initiate the assembly of the autophagy initiation complex, and highlight the significant roles of Ypt1 in this process. We end by addressing issues that need future clarification. (shrink)

BackgroundMedical disputes, medical disturbances, verbal and physical violence against physicians, and burnout have reached epidemic levels. They may negatively impact both physicians and the healthcare system. The experience of medical disputes, medical disturbances, verbal, and physical violence, and burnout and the correlates in physicians working in public hospitals in China needed to be investigated.MethodsA nationwide cross-sectional survey study was conducted between 18 and 31 March 2019. An anonymous online questionnaire was administered. The questionnaire included the 22-item Maslach Burnout Inventory-Human Services (...) Survey. We also collected data on demographic and job-related factors, as well as physicians’ experiences of medical disputes, medical disturbances, verbal and physical violence from patients and the patients’ family members.FindingsIn total, 22,213 physicians from 144 tertiary public hospitals in all of China’s 31 provinces completed the survey. The overall burnout rate among the surveyed physicians was 31.28%. Moreover, 33.48% of physicians experienced disputes, 20.86% experienced disturbances, 48.52% experienced verbal violence, and 5.84% experienced physical violence in the past 12 months. Factors found to be significantly associated with burnout included younger age, being divorced or widowed, having a lower educational background, working in internal medicine departments, longer working hours per day, working in general hospitals, being in East China, as well as having experienced disputes, disturbances, and physical and verbal violence.InterpretationClose to a third of the Chinese doctors working in the tertiary hospitals reportedly experienced burnout, and the problem is related to the unsafe working environment caused by the worsening doctor-patient relationship. (shrink)

In the analysis of Shaanxi Red Tourism Development status and existing problems, based on the proposed development of red tourism strategic positioning, strategic objectives and strategic measures, through the implementation of the "1312 Project", that is to cultivate a red tourism capital, northern Shaanxi, Guanzhong , 3 large red tourism sector in southern Shaanxi, and 12 fine line, as the red following the Warriors travel to create a new ace after the Shaanxi tourism products. Based on the analysis of the (...) current situation of Shaanxi red-tourism development, strategic positioning, goals and corresponding measures of developing Shaanxi red-tourism are put forward. Through implementing the project of 1312, which stands for one red-tourism center, three red -tourism regions and twelve red-tourism routes, the red-tourism products of Shaanxi would become new trump tourism products. (shrink)

ObjectiveThis study aims to investigate anxiety and its influencing factors in patients with drug-induced liver injury (DILI).Materials and MethodsNinety-four patients with DILI were enrolled and evaluated with a self-rating anxiety scale (SAS). According to the anxiety score, they were divided into four groups: the non-anxiety, mild anxiety, moderate anxiety, or severe anxiety groups, and the scores were analyzed based on demographic and biochemical indicators.ResultsOf the 94 patients with DILI, 63 did not have anxiety and 31 had anxiety (32.9%), of which (...) 27 had mild, 3 had moderate, and 1 had severe anxiety. There were no statistically significant differences in gender, age, occupation, and level of education between the groups (F= 1.42,H= 2.361,H= 6.751,H= 1.796, andP> 0.05); anxiety score and degree of anxiety between the types of drugs that led to the liver injury (H= 0.812,H= 1.712, andP> 0.05); anxiety score between the different degrees of liver injury (H= 2.836,H= 4.957,P> 0.05); or length of hospital stay or prognosis between the degrees of anxiety (F= 1.487,H= 0.761,P> 0.05). However, there were statistically significant differences in the degree of anxiety between different degree and types of liver injury (H= 7.981,H= 8.208,P< 0.05).ConclusionPatients with DILI may have anxiety, especially mild anxiety. The occurrence of anxiety in patients with DILI is not related to gender, age, occupation, or level of education but may be related to the degree and type of liver injury. Anxiety has no impact on the length of stay in hospital or the prognosis of the DILI. These findings may contribute to the development of management strategies for patients with DILI. (shrink)

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students from the Be Resilient to Nursing Career program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest, Med-low, Med-high, and Highest. The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role (...) models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies. (shrink)

Although many studies have provided evidence that abstract knowledge can be acquired in artificial grammar learning, it remains unclear how abstract knowledge can be attained in sequence learning. To address this issue, we proposed a dual simple recurrent network model that includes a surface SRN encoding and predicting the surface properties of stimuli and an abstract SRN encoding and predicting the abstract properties of stimuli. The results of Simulations 1 and 2 showed that the DSRN model can account for learning (...) effects in the serial reaction time task under different conditions, and the manipulation of the contribution weight of each SRN accounted for the contribution of conscious and unconscious processes in inclusion and exclusion tests in previous studies. The results of human performance in Simulation 3 provided further evidence that people can implicitly learn both chunking and abstract knowledge in sequence learning, and the results of Simulation 3 confirmed that the DSRN model can account for how people implicitly acquire the two types of knowledge in sequence learning. These findings extend the learning ability of the SRN model and help understand how different types of knowledge can be acquired implicitly in sequence learning. (shrink)

The paper attends to the increasingly heated debate on the local, the global versus the glocal approaches in transcultural brand communication with an examination of how Disneyland performs emotional branding on social media across US to Hong Kong and Shanghai. Integrating insights from brand communication with linguistics, the present study develops a framework to examine how Disneyland builds emotional attachment of the public to the brand via brand personality appeals and use of interactional features. It is found that on a (...) global-local continuum, brand personality traits exhibit strong globalization propensity whereas interactional features demonstrate strong localization tendency in Hong Kong and Shanghai. Variations also exist in the means of emotional branding between Hong Kong and Shanghai. Finally, the paper provides an account for the differences between Hong Kong and Shanghai and concludes that neither the local approach nor the global approach but the glocal approach can tackle the challenge of transcultural brand communication and that future studies in this area should be oriented further to uncovering the global-local nexus in the process. (shrink)

In this study, we tested a possible mechanism of the association between math anxiety and math achievement: the mediating role of math-specific grit. In Study 1, a sample of 10th grade students completed a battery of personality and attitude questionnaires, and math achievement was indexed by curriculum-based examination scores. Mediation analyses indicated that math-specific grit, but not domain-general grit, mediated the relationship between math anxiety and math achievement. In Study 2, we replicated and extended the above findings with another sample (...) of 11th grade students. Mediation analyses indicated that math-specific grit and math-specific procrastination played sequential mediating roles in the relationship between math anxiety and math achievement. That is, individuals with higher math anxiety were less gritty in math learning, possibly further leading them to be more procrastinated in performing math work, which may finally result in worse math achievement. In summary, the current study provides the first evidence that math-specific grit may mediate the relationship between math anxiety and math achievement. Furthermore, it also demonstrated the value of math-specific grit over domain-general grit in predicting math success, which invites a broader investigation on subject-specific grit. (shrink)

Previous researchers have found that head-down bed rest will affect the emotional state of individuals, and negative emotions such as anxiety are closely related to attention bias. The present study adopted the dot-probe task to evaluate the effects of 15-days of −6° HDBR on the attention bias of threatening stimulus in 17 young men, which was completed before, during, after the bed rest. In addition, self-report inventories were conducted to record emotional changes. The results showed that the participants’ negative affect (...) scores on HDBR-8 were significantly lower than the HDBR-1 in PANAS while there was no significant difference on positive affect scores and anxiety scores in SAI. And the results showed that at the Pre-HDBR, HDBT-1, HDBR-15, Post-HDBR, the response speed to threatening stimulus was faster than neutral stimulus, but no statistical significance. However, reaction time of threatening stimulus is significantly longer than neutral stimulus in the HDBR-8, indicating that HDBR may have an effect on the participants’ attention bias, and this effect is manifested as attention avoidance. (shrink)

Capitalizing on a unique setting in China where auditors disclose their prosocial activities, we examine the role that auditor social responsibility plays in shaping their performance. In one direction, behavior consistency theory implies that individual auditors exhibiting more social commitment in their off-the-job activities behave similarly during engagements, enhancing the quality of their audits. In the other direction, accounting firms’ internal structures along with external disciplinary forces mute the impact of heterogeneous auditor characteristics on their performance. In a staggered difference-in-differences (...) design, we report a significant fall in the magnitude of companies’ discretionary accruals and the incidence of financial reporting irregularities after their auditors begin contributing to social welfare, relative to companies whose auditors refrain from contributing during the same timeframe. Additional evidence implies that the higher audit quality stems from auditors better protecting their independence and improving their competence in the post-contribution period. Collectively, our results provide insights into the importance of auditors’ prosocial attitudes to their external monitoring. (shrink)

Several previous studies have reported atypicality in resting-state functional connectivity in autism spectrum disorder, yet the relatively small effect sizes prevent us from using these characteristics for diagnostic purposes. Here, canonical correlation analysis and hierarchical clustering were used to partition the high-functioning ASD group into subgroups. A support vector machine model was trained through the 10-fold strategy to predict Autism Diagnostic Observation Schedule scores within the ASD discovery group, which was further validated in an independent sample. The neuroimage-based partition derived (...) two subgroups representing severe versus mild autistic patients. We identified FCs that show graded changes in strength from ASD-severe, through ASD-mild, to controls, while the same pattern cannot be observed in partitions based on ADOS score. We also identified FCs that are specific for ASD-mild, similar to a partition based on ADOS score. The current study provided multiple pieces of evidence with replication to show that resting-state functional magnetic resonance imaging FCs could serve as neural biomarkers in partitioning high-functioning autistic individuals based on their symptom severity and showing advantages over traditional partition based on ADOS score. Our results also indicate a compensatory role for a frontocortical network in patients with mild ASD, indicating potential targets for future clinical treatments. (shrink)

During the COVID-19 pandemic, online education has become an important approach to learning in the information era and an important research topic in the field of educational technology as well as that of education in general. Teacher–student interaction in online education is an important factor affecting students’ learning performance. This study employed a questionnaire survey to explore the influence of teacher–student interaction on learning effects in online education as well as the mediating role of psychological atmosphere and learning engagement. The (...) study involved 398 college students studying at Chinese universities as the research object. Participants filled out a self-report questionnaire. The study found that the level of teacher–student interaction positively affected students’ learning effects. The psychological atmosphere mediated the positive effect of the level of teacher–student interaction on learning effects with mediating effect value of 0.1248. Learning engagement mediated the positive effect of teacher–student interaction on learning effects with a mediating effect value of 0.1539. The psychological atmosphere and learning engagement play a chain-mediating role in the mechanism of teacher–student interaction affecting students’ learning effects; that is, teacher–student interaction promotes students’ learning engagement by creating a good psychological atmosphere, which, in turn, influences learning effects. The mediating effect value was 0.0403. The results indicate that teacher–student interaction not only directly affects students’ learning effects but also influences students’ learning effects through the mediating effect of the psychological atmosphere and learning engagement. (shrink)

ObjectiveTo survey the prevalence of burnout in a national sample of endocrinologists in China and to examine its correlates, with a special focus on gender differences.MethodsAn anonymous online survey was conducted among endocrinologists in 31 provincial government-owned “People’s Hospitals” of each province in mainland China. Demographic and work-related factors were collected from participants. The Maslach Burnout Inventory-Human Services Survey was used to assess burnout, including emotional exhaustion, depersonalization, and reduced personal accomplishment.ResultsA total of 711 endocrinologists completed the survey. Burnout was (...) reported by 32.8% of the participants. There were no significant gender differences in the overall prevalence of burnout or EE, DP, and PA. A multi-level linear regression revealed: In male participants, PA was significantly associated with age, DP was inversely associated with age, EE was significantly associated with shorter sleep duration, and longer work hours. In females, PA was significantly associated with age, EE and DP were both significantly associated with shorter sleep duration. EE and DP were also associated with work hours.ConclusionNearly one-third of endocrinologists in China experienced burnout. Although there were no significant gender differences in the prevalence of overall burnout or EE, DP, and PA scores, male and female participants differed in factors associated with EE, DP, and PA. Interventions need to be tailored to target different aspects in male and female endocrinologists and target different subgroups. (shrink)

全书以灾异思想为切入点，以西汉经学灾异思想与思潮为中心，结合先秦至西汉间的时代背景与思想氛围，在细致考察与解读相关文本的基础上，对西汉经学灾异思想的观念来源与理论先导、创立过程与时代特色、理论形态与建 构方法，以及灾异思潮与现实政治的互动等问题，进行了全面深入的研究和探讨；对于经学灾异思想何以会在西汉建立、经学灾异思潮缘何会在西汉爆发、经学灾异论造成了怎样的历史影响，以及如何评价灾异论氛围中的西汉儒 学与儒生群体等问题，本书也进行了系统的反思，并提出了一系列见解。.

Background Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students’ caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy. Research objective This study aimed to examine the mediating effect of moral sensitivity and the (...) moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours. Research design A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. Participants and research context This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China. Ethical considerations This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students. Results The clinical internship environment ( B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity ( B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students’ caring behaviours via moral sensitivity ( B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours ( B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity ( B = 0.006, 95% CI = [0.003, 0.010]). Conclusion Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students. (shrink)