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Objective: This study aimed to explore the qualitative aspects of nursing undergraduates' experience of participating in the Internet + nursing program and their spiritual education needs from the perspective of the Neuman system model. Methods: Using a descriptive qualitative study design, twelve full-time undergraduates at Chengde Medical University from June to July 2022 who had completed their clinical internship were interviewed one-on-one, and a purposive sampling method was adopted. Moreover, Colaizzi's phenomenological method was employed to analyze the data and improve the themes. Results: In the Internet + nursing program, the lack of spiritual education for undergraduates can be summarized into the following four themes: lack of spiritual consciousness; lack of spiritual education and spiritual nursing knowledge; high demand for spiritual education; and cognition of the current situation of basic nursing education in China and thoughts on incorporating Internet-related technologies into future nursing education. Conclusion: At the school and hospital level, importance should be placed on the basic education of spirituality and psychological nursing, and appropriate measures should be taken to improve the knowledge level of spirituality and psychological nursing as well as the capacity of spiritual nursing, in order to ensure high-quality nursing services.

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Introduction Periodontal diseases, encompassing gingivitis and periodontitis, are prevalent and complex conditions with significant implications for overall health, particularly in India. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding periodontal diseases among first-year undergraduate students across various faculties at Krishna Vishwa Vidyapeeth Deemed to be University, Karad. Methods A cross-sectional questionnaire-based survey was conducted among 200 students from the medical, dental, physiotherapy, pharmacy, and nursing faculties. Descriptive statistics and Pearson's chi-squared test were utilized for data analysis. Results They revealed suboptimal oral hygiene practices among participants, with only 30% reporting twice-daily tooth cleaning. Additionally, less than half of the participants used soft toothbrushes and fluoridated toothpaste. Notably, 40% had never visited a dentist. While 86% recognized the correlation between gum and systemic health, significant proportions had experienced symptoms of gum disease. Dental first-year undergraduate students have a better understanding, attitude, and practices toward periodontal diseases, while nursing first-year undergraduate students displayed the lowest KAP scores compared to other faculties. Conclusion The first-year dental students demonstrated a better understanding, attitude, and behavior towards periodontal diseases compared to students in other faculties. Our study emphasizes the necessity of incorporating oral and periodontal health education into both healthcare professional curricula and those of higher secondary school students. Such educational programs will empower individuals to enhance their oral and systemic health. Moreover, equipping medical and paramedical practitioners with proper knowledge of periodontal health will ultimately lead to improved oral health outcomes for the general population.

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Primary dysmenorrhea (PD) is a common global health concern. However, limited studies explored the association between soft drinks intake and PD among female undergraduates in China. To determine the association between soft drinks (carbonated soft drinks, etc.) as well coffee intake and the incidence/severity of PD among female undergraduates in China. We performed a cross-sectional study among 1809 female undergraduates in China from September 29, 2020 to October 22, 2020. The demographic information and menstrual information of the participants were collected by a self-administrated questionnaire. Chi-square test, ANOVA test, and logistic regression test were used to investigate the association between soft drinks intake and the incidence/severity of PD. We also conducted stratification analysis among different locations (rural or urban). The prevalence of PD was 47.1% (n = 852). There were 221 (25.9%) participants suffered from severe pain. In the participants with PD, the OR of carbonated soft drinks intake was 1.244 (95% CI 1.010-1.533). Among the participants with PD from rural areas, the OR of carbonated soft drinks intake was 1.402 (95% CI 1.045-1.881), compared with the non-carbonated soft drink group. In the participants with moderate and severe PD, the OR of coffee intake was 0.451 (95% CI 0.228-0.892), compared with the non-coffee-drinking group. There was a significant association between carbonated soft drinks intake frequency and the severity of PD (P < 0.05). Our study showed that carbonated soft drinks intake is a risk factor for PD, especially in participants from rural areas. Coffee intake is a protective factor for the severity of PD. Periodical awareness programs about adverse effects of excessive soft drink consumption should be introduced to reduce the prevalence and exacerbation of PD. Coffee intake might be helpful to relieve the severity of PD.

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BACKGROUND: Loneliness was associated with interpersonal sensitivity, but the factors contributing to this relationship in nursing students remain unclear. This study investigated the relationship between loneliness and interpersonal sensitivity among nursing undergraduates, with a specific focus on the mediating roles played by problematic internet use and bedtime procrastination. METHOD: This study was conducted as a cross-sectional survey at a university in China between November and December 2022. Data were collected using a self-administered online questionnaire that included demographic characteristics, the Three-Item Loneliness Scale (T-ILS), the Chinese Version of Short Form of Interpersonal Sensitivity Measure (IPSM-CS), the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6), and the Bedtime Procrastination Scale (BPS). Pearson correlation analysis was employed to explore the relationships among loneliness, interpersonal sensitivity, problematic internet use, and bedtime procrastination. Structural equation modeling (SEM) was conducted using AMOS software to examine the mediating role of problematic internet use and bedtime procrastination between loneliness and interpersonal sensitivity. RESULTS: Loneliness was positively related to interpersonal sensitivity among nursing undergraduates (ß = 0.44, P < 0.001). There was a significant chain mediation role of problematic internet use and bedtime procrastination in the relationship between loneliness and interpersonal sensitivity. CONCLUSIONS: The study contributed to deepening the understanding of the relationship between loneliness and interpersonal sensitivity and provided valuable insights into the improvement of interpersonal sensitivity in nursing undergraduates.

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Background: There are numerous wars and ongoing political violence in Palestine and little is known about how they have affected Palestinian undergraduate students' mental health and coping strategies. This study aimed to assess the prevalence of depression, and anxiety symptoms and coping mechanisms among Palestinian university students during the times of current political violence in Palestine after October 7, 2023. Methods: A cross-sectional descriptive study design was utilized for a sample of students from 3 universities in Palestine (Al Quds University, Hebron University, and An-Najah University) and 1815 participants responded. Data were collected using self-reported questionnaires, including Hospital Anxiety and Depression Scale (HADS) and Brief COPE scale. Person correlation test, chi-square test, and bivariate analysis were performed to examine the associations between research variables. Results: The estimated prevalence of depression was 65.9, and 60.9% for anxiety. The logistic regression showed that students from the Arts Faculty, females, and those with working parents were significantly more likely to experience depression and anxiety symptoms. Also, active coping, emotional support, and humor reduced the likelihood of experiencing depression symptoms, while active coping, positive reframing, humor, and acceptance decreased the likelihood of developing anxiety symptoms. Further, the study found that using religion, self-blame, denial, and behavioral disengagement increased the likelihood of depression symptoms while planning, venting, religion, self-blame, denial, and behavioral disengagement increased the likelihood of anxiety symptoms. Conclusion: The study found that political violence often leads to symptoms of depression and anxiety among undergraduates. Furthermore, the use of maladaptive coping mechanisms increases the likelihood that these symptoms will occur. Providing immediate assistance to university students affected by political violence and conflicts is crucial for their emotional and mental recovery and coping with difficulties.

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BACKGROUND: Adequate professional preparation of nursing undergraduates is conducive to developing health care careers. Deep learning is important for enhancing nursing competencies and the overall quality of students. However, limited research has been conducted to explore deep learning and its associated factors for students in higher nursing education. OBJECTIVE: To describe the level of deep learning and explore its associated factors among Chinese nursing undergraduates. DESIGN: A cross-sectional study. SETTING: This study was conducted at a medical university in Anhui Province, China. PARTICIPANTS: Convenience sampling was used to survey 271 nursing undergraduates between July and September 2023. METHODS: The survey included questions about general information, deep learning, and critical thinking disposition. Nonparametric tests were used to distinguish the intergroup differences. Correlations were evaluated using Spearman's rank correlation analysis. Hierarchical multiple regression analysis was performed to determine the influencing factors. RESULTS: The deep learning score of the nursing undergraduates was 3.82 (3.56, 4.00). Hierarchical multiple regression analysis revealed that gender (ß = 0.10, P = 0.044), experience as a student leader (ß = 0.10, P = 0.049), and critical thinking disposition (ß = 0.60, P = 0.000) significantly impacted deep learning. All the variables explained 41.1 % of the total mean score variance for deep learning. CONCLUSION: Chinese nursing undergraduates showed upper-middle levels of deep learning. Gender, experience as a student leader, and critical thinking disposition were significantly associated factors of deep learning. Nursing educators should provide targeted interventions for deep learning to facilitate the professional competencies of these students.

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Sexual harassment is a serious health issue prevalent on campuses worldwide, with significant implications for individuals' well-being. Past research has highlighted the close association between sexual harassment and eating disorders, yet little is known about the mechanisms underlying this relationship. This study aimed to investigate the potential mediating roles of self-objectification and self-control in linking sexual harassment to binge eating, drawing upon objectification theory and self-control resource theory. A sample of 801 Chinese female undergraduates, with a mean age of 19.60 years (SD = 1.42), participated in the study by completing questionnaires on sexual harassment experience, self-objectification, self-control, and binge eating. The results indicated that sexual harassment experience exhibited a significant positive correlation with binge eating and self-objectification, while showing a negative correlation with self-control. And an increased frequency of sexual harassment experiences and self-objectification were associated with lower levels of self-control. Furthermore, mediation analyses utilizing Hayes' PROCESS macro (2013) for SPSS (Model 6) demonstrated that both self-objectification and self-control independently and sequentially mediated the relationship between sexual harassment and young women's binge eating. In other words, young women who had experienced sexual harassment were more likely to exhibit increased self-objectification, leading to decreased self-control and ultimately culminating in binge eating behaviors. This study provides valuable insights into how sexual harassment affects young women's binge eating by elucidating the mediating roles of self-objectification and self-control, thus enhancing our understanding of developing strategies to mitigate the negative consequences of experiencing sexual harassment.

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The study was conducted in order to study breakfast skipping (BKS) frequency, factors associated with, health consequence and undergraduate students academic performance during Covid-19 pandemic as earliest studies focusing on this area. A cross-sectional study was carried out among 2225 of undergraduate students. The study was carried between the period of 15/1/2020 to 3/4/2020 using an online self-report Breakfast Eating Habit Survey (BEHS). The BEHS survey was divided into two sections. The first sections included sociodemographic information (gender, BMI, age, smoking, residency, parental education, family income, studying system and stage (public or private), and studying institution (university or institute) academic performance. The second part included questions regarding breakfast eating habits including frequency of skipping meals, factors related to BKS health consequences and types of snacks. Logistic regression is a common technique used for modeling outcomes that fall into the range of 1 and 0. For this purpose, a logistic regression was performed to find adjusted odds ratio and crude odds ratio. The results showed that the majority of participants were female (1238, 55.7%). Out of 2,224 students, 2059 are aged between 18 to 24 years. Most of the participants were from first level (26.5%), second level (32.8%), third level (17.6%) or the fourth level (21.3%). Over 92% of participants were single and about 68% came from families of medium income families. The statistical analysis showed that the odds of BKS is reduced among students who live in accommodation by 54% (odds ratio = 54%, CI (41-71%), p value = 0.000). It seems that students with low income and normal or higher BMI are more likely to skip breakfast more regularly. The odds of skipping breakfast among students with BMI of 18-24.9 is reduced by 41% (odds ratio = 59%, CI (27%-93%), p value = 0.027) and the odds of BKS is reduced among students with BMI of 25-29.9 by 45% (odds ratio = 55%, CI (31-95%). Additionally, students with medium or high incomes are more likely to skip breakfast as much as twofold in comparison with students with low income (medium income (odds ratio = 1.85, CI (1.08-3.17), p-value = 0.024), high income (odds ratio = 1.98, CI (1.12-3.51), p-value = 0.019). The most common reasons for skipping breakfast included include time constraint, not hungry, breakfast is not ready, afraid to be overweight and lack of appetite. The consequences of skipping breakfast were feeling hungry throughout the day, feeling tired, and not paying attention in class and low academic performance. To concluded, BKS during Covid-19 is more common among students with higher BMI, higher income and living in accommodation. The main reason is time constraint and the most common health problems are being tired and luck of attention.

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BACKGROUND: This study aimed to assess the effectiveness of the BOPPPS model (bridge-in, learning objective, pre-test, participatory learning, post-test, and summary) in otolaryngology education for five-year undergraduate students. METHODS: A non-randomized controlled trial was conducted with 167 five-year undergraduate students from Anhui Medical University, who were allocated to an experimental group and a control group. The experimental group received instruction using the BOPPPS model, while the control group underwent traditional teaching methods. The evaluation of the teaching effectiveness was performed through an anonymous questionnaire based on the course evaluation questionnaire. Students' perspectives and self-evaluations were quantified using a five-point Likert scale. Furthermore, students' comprehension of the course content was measured through a comprehensive final examination at the end of the semester. RESULTS: Students in the experimental group reported significantly higher scores in various competencies compared to the control group: planning work (4.27 ± 0.676 vs. 4.03 ± 0.581, P < 0.05), problem-solving skills (4.31 ± 0.624 vs. 4.03 ± 0.559, P < 0.01), teamwork abilities (4.19 ± 0.704 vs. 3.87 ± 0.758, P < 0.05), and analytical skills (4.31 ± 0.719 vs. 4.05 ± 0.622, P < 0.05). They also reported higher motivation for learning (4.48 ± 0.618 vs. 4.09 ± 0.582, P < 0.01). Additionally, students in the experimental group felt more confident tackling unfamiliar problems (4.21 ± 0.743 vs. 3.95 ± 0.636, P < 0.05), had a clearer understanding of teachers' expectations (4.31 ± 0.552 vs. 4.08 ± 0.555, P < 0.05), and perceived more effort from teachers to understand their difficulties (4.42 ± 0.577 vs. 4.13 ± 0.59, P < 0.01). They emphasized comprehension over memorization (3.65 ± 1.176 vs. 3.18 ± 1.065, P < 0.05) and received more helpful feedback (4.40 ± 0.574 vs. 4.08 ± 0.585, P < 0.01). Lecturers were rated better at explaining concepts (4.42 ± 0.539 vs. 4.08 ± 0.619, P < 0.01) and making subjects interesting (4.50 ± 0.546 vs. 4.08 ± 0.632, P < 0.01). Overall, the experimental group expressed higher course satisfaction (4.56 ± 0.542 vs. 4.34 ± 0.641, P < 0.05). In terms of examination performance, the experimental group scored higher on the final examination (87.7 ± 6.7 vs. 84.0 ± 7.7, P < 0.01) and in noun-interpretation (27.0 ± 1.6 vs. 26.1 ± 2.4, P < 0.01). CONCLUSION: The BOPPPS model emerged as an effective and innovative teaching method, particularly in enhancing students' competencies in otolaryngology education. Based on the findings of this study, educators and institutions were encouraged to consider incorporating the BOPPPS model into their curricula to enhance the learning experiences and outcomes of students.

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OBJECTIVE: To explore the association between insomnia symptoms and cognitive flexibility among undergraduates, along with its potential neural mechanisms. METHOD: A total of 102 participants were divided into insomnia (n = 55) and control (n = 47) groups based on sleep status. Cognitive flexibility was assessed using the Cognitive Flexibility Inventory (CFI) and the Number-Letter Task (N-L task). EEG data were recorded during the N-L task. RESULTS: The insomnia group exhibited lower CFI scores and higher switch costs in reaction time and accuracy compared to the control group. ERP analysis showed differences in P2, N2, and P3 component amplitudes between the two groups, with reduced N2 amplitude in the insomnia group under repeat trials. Time-frequency analysis revealed larger theta band event related synchronization in the frontal region and smaller theta band ERS in the parietal region under switch trials in the control group; the alpha band event-related desynchronization in the parietal region under repeat trials was significantly smaller in the control group compared to switch trials. CONCLUSION: Compared to undergraduates with normal sleep, those with insomnia symptoms exhibited reduced cognitive flexibility, which may be associated with some alterations in brain electrophysiological activities.

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Objectives: The purpose of this study was to assess the level of knowledge, attitudes, and practices (KAP) of university students in China regarding the need for PARI and public health education. Methods: A cross-sectional online and offline survey was conducted in China website through Wenjuanxing and in different cities such as Changsha Hunan Province, Shanghai, Chongqing and in different public scenarios, such as hospitals, universities, and commercial venues between September 1 and September 7, 2023, using a 28-question questionnaire designed and reviewed by multidisciplinary experts. Results: A total of 4,096 respondents were recruited for this study, with 3,957 valid questionnaires. The mean knowledge score was 1.84 ± 0.52, the mean attitude score was 2.12 ± 0.51, and the mean practice score was 3.18 ± 0.55. Regression analyses found that: region, grade, school, and weekly anaerobic exercise time were influences on the knowledge score; region, grade, school, and weekly anaerobic exercise time were influences on the attitude score; region, grade, school attended, weekly anaerobic exercise time and weekly anaerobic exercise time as influences on the practice score. Subgroup analyses revealed that undergraduates from southern regions and 985 schools had higher knowledge attitude scores and lower practice scores. As the grade level increased, the knowledge and attitude scores showed a V-shaped trend and the behavior scores showed an inverted V-shaped trend. Correlation analysis found a positive correlation between knowledge and attitude scores, and a negative correlation between both and behavior, respectively. The public health education needs survey found that undergraduate students generally preferred guided instruction methods and content centered on the RICE principles, they preferred learning through books and pamphlets, and they were happy to see relevant content promoted in the campus environment. Conclusion: This study shows that Chinese undergraduate students have less knowledge, neutral attitudes, and good behaviors regarding PARI prevention. Special attention should be paid to meeting the needs of undergraduate students for public health education to equip them with relevant knowledge so that they can better behave in PARI prevention.

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Few young Japanese adults regularly consume a well-balanced diet composed of staples, main courses, and sides. We hypothesised that adopting the recommended planetary health diet with regular breakfast consumption would promote well-balanced diets among young Japanese male undergraduates. This study aimed to examine the structural association between the planetary health diet with regular breakfast consumption and a well-balanced diet intake. This cross-sectional study included 142 male engineering undergraduates who completed a 2022 online questionnaire via Google Forms at a public university in Hyogo Prefecture. The planetary health diet comprises the consumption of the recommended eight items. A covariance structure analysis was performed in a hypothetical model with factors (regular breakfast consumption and eight items) potentially associated with the intake of a well-balanced diet at least twice daily. After excluding chicken dishes and nuts from the eight recommended items of the planetary health diet, goodness-of-fit became acceptable. Frequent consumption of the remaining six recommended items (fish, eggs, soybeans/soybean products, dairy foods, vegetables, and fruits) was significantly positively correlated with regular breakfast consumption and a significant positive path to a well-balanced diet. Among male university students, regular breakfast consumption and the planetary health diet may lead to a well-balanced diet.

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BACKGROUND: Understanding undergraduates' dietary literacy, including dietary knowledge, attitude and practice (KAP), is important for future health promotion policies. Therefore, this study aimed to investigate the current status and influencing factors of dietary literacy in Chinese college undergraduates and explore whether a nutritional lecture could improve their dietary literacy. METHODS: This study included two parts: a cross-sectional study (n = 1026) conducted by a dietary literacy questionnaire, and a randomized controlled trail (RCT) that enrolled 99 college undergraduates who were randomized to a control group or a nutritional lecture group. Data from the questionnaire and 72 h food records were obtained on day 0, day 3 and day 100 before and after intervention. RESULTS: This cross-sectional study showed that the mean scores of dietary KAP were respectively 100.0 (33.3), 59.1 (13.6) and 71.7 (11.7), with an excellent rate of 36.6%, 1.9% and 3.4%. Female upper-grade undergraduates and those with medicine-related majors illustrated higher dietary knowledge scores (p < 0.001). Dietary attitude rather than dietary knowledge had a significant impact on dietary practice (p < 0.001). This finding was in line with the results in the RCT study. Compared with the control group, dietary knowledge was significantly improved in the nutritional lecture group on both day 3 (p = 0.002) and day 100 (p = 0.023) after intervention. However, dietary behavior was improved only on day 3 post nutritional lecture (p = 0.029) but decreased to the original level 100 days later (p < 0.001). CONCLUSIONS: This study discovered the unsatisfying status and discrepancy between dietary literacy among college undergraduates of different sex, majors and college years. Dietary attitude instead of dietary knowledge was discovered as a determining role in dietary practice. One nutritional lecture could improve undergraduates' dietary literacy but the effect was not long-lasting. Further studies with more reinforced and durable interventions are warranted.

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Objectives: The objective of this study is to develop a consensus among experts on a comprehensive and scientifically sound physical activity-related injuries (PARI) public health education program specifically tailored for undergraduates. Methods: This study designed three rounds of expert consultation by using a Delphi method. A panel of 30 experts from the fields of public health education, sports medicine, anesthesia pain, emergency medicine, and emergency nursing participated in the study. Results: This study successfully established a consensus among experts on the goals, content, teaching methods, and time allocation for the PARI Public Health Education Program for undergraduates. The program encompasses 10 objectives divided into 2 main categories: professional knowledge and skill goals. In terms of content, it includes 5 primary indicators, 22 secondary indicators, and 56 detailed tertiary indicators. Six teaching methods were identified as suitable. Additionally, a typical 60-min educational session was segmented into eight parts, with a proposed time arrangement for each, ensuring comprehensive coverage of all topics. Conclusion: The consensus achieved in this study on the PARI Public Health Education Program for undergraduates lays a crucial foundation for the advancement of health literacy and proactive health management within this demographic. We presented a comprehensive framework for PARI public health education, integrating diverse learning methods and content areas. This systematic approach not only enriched the resources available for undergraduate health education, especially of PARI but also had the potential to significantly impact the implementation and effectiveness of health promotion strategies.

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Purpose: The study aimed to explore the status of four common health problems (ie, smoking, internet addiction, physical inactivity, psychological disorder) among college students and analyze the relationship between psychological resilience, coping tendency and health problems. Participants and Methods: The convenience sampling method was used to recruit 500 college students from four universities. The General Information Questionnaire, Adolescent Psychological Resilience Scale, Simplified Coping Style Questionnaire and Health Risk Behavior Questionnaire were used for survey. Results: Among the students, there were 71 smokers (15.4%) and 61 internet addicts (13.2%). Over a third of the students reported physical inactivity (35.9%) and a minority had psychological disorder (6.3%). The psychological resilience score differed between students who smoked, had internet addiction, physical inactivity, psychological disorder and those without these health-risk behaviors. Logistic regression analysis showed that negative coping tendency was the common contributing factor of physical inactivity, internet addiction and psychological disorder. Coping tendency played a partial mediating effect in the relationship between psychological resilience and health problems, with a mediating effect of 37.93%. Conclusion: Psychological resilience can not only affect health problems directly but also influence health problems indirectly through coping tendency. Educators and administrators in universities can apply effective measures to improve psychological resilience and positive coping to prevent or reduce health problems among undergraduates.

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To develop and assess the preliminary effectiveness of Ontological Coaching Intervention for nursing undergraduates. Design: A pilot randomized controlled trial with a two-group pre-test and post-test followed by process-evaluation qualitative interviews. An Ontological Coaching Intervention was developed through an integration of prior literature and the collective the research team's experience, consisting of 4-6 sessions over 6-months, each lasting 30-60 minutes. Sessions encompassed exploring ontological coaching concepts, empowering nursing undergraduates to choose topics, and tailoring sessions to individual needs. Sixty undergraduates were recruited; ten were excluded for not completing the baseline questionnaires. Twenty-one nursing undergraduates were randomly assigned to the intervention group and twenty-nine undergraduates to the control group (standard academic support only). Primary (psychological well-being) and secondary (social support quantity and satisfaction, goal-setting, resilience) outcomes were measured at baseline, 3-months, and 6-months. Semi-structured interviews captured post-intervention experiences. Between-group analyses revealed a significant difference in goal-setting scores at 3-months (U = 325.5, p = 0.013), favoring the intervention group (median = 70.50, IQR = 64.25, 76.75). At 6-months, a significant difference in social support satisfaction scores (U = 114.5, p = 0.028) was found between the intervention (median = 33.00, IQR = 29.50, 35.25) and control (median = 30.00, IQR = 30.00, 35.00) groups. However, no significant between-group differences were noted in other outcome measures. Significant within-group differences were found in goal-setting scores at 3- and 6-months in the intervention group and social support quantity scores at 3- and 6-months in the control group. However, no significant within-group differences were noted in other outcome measures. Three themes were identified: Enhanced Holistic Development, Keys to Successful Coaching, and Future Directions for Successful Coaching. There is urgent need to advance research on Ontological Coaching Intervention, particularly, enhancing study rigor, broadening examinations to diverse healthcare student populations and cultural contexts, and addressing identified limitations.

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AIM: It is common for Chinese students to sit quietly during classroom lectures, attentively following teachers' instructions without interacting or asking questions, viewed as passive engagement. This study aims to understand further the passive engagement of Chinese students in relation to classroom questioning, just-in-time feedback and collaborative activities. With objectives to formulate strategies to enhance Chinese students' engagement in a large class learning environment without undermining the cultural dimension of "face". BACKGROUND: Engaging in collaborative educational activities between teachers and students can be challenging in a large classroom learning environment. Within the Chinese context, Confucian-heritage culture may further exacerbate the challenges teachers face. Chinese students often appear passive when responding to questions. In this situation, educators may receive insufficient student feedback to modify and optimise their teaching and learning approaches. DESIGN: A qualitative research method, with an interpretative phenomenological approach was employed in a self-financed institute of higher education in Hong Kong. METHODS: Eight nursing graduates were invited to participate in two focus group interviews to generate teaching and learning strategies. In addition, individual in-depth interviews were conducted with twelve nursing teachers recruited through a snowballing sampling strategy. The narratives were coded, categorised, themed, analysed and interpreted through thematic analysis. RESULTS: Chinese students are concerned with "losing face" and the fear of being teased by their peers in a collectivist culture. Based on these findings, three teaching and learning strategies for engaging students in classroom questioning and collaborative activities were generated. These strategies include using digital learning platforms, the promotion of communication and fostering interpersonal relationships. CONCLUSIONS: In higher education, academic managers and teachers must critically reflect on teaching and learning strategies tailor-made to different cultural and contextual settings. Collaborating on pedagogical reforms can provide solid guidance and insight on implementing student-centred learning for Chinese students in large class learning environments while respecting the cultural dimension of "face".

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College student cannabis use is at an all-time high. Although frequent heavy cannabis use is related to cannabis problems, perceived risk of cannabis use is rapidly decreasing. Yet, it is unknown whether specific domains of risk perceptions (general and domain-specific risk, risk to others and personal risk) are related to more cannabis use or related problems. Thus, among 130 undergraduates who reported past-month cannabis use, the present study conducted secondary analyses to test whether, for both perceived risk to others and perceived personal risk: (1) general perceived risk was associated with cannabis-related outcomes (i.e., use, negative consequences, cannabis use disorder (CUD) symptoms, motivation to change), (2) seven specific domains of perceived risk were related to cannabis outcomes, and (3) domain-specific perceived risk was related to cannabis use frequency. General perceived risk to others was negatively associated with cannabis use frequency whereas general perceived personal risk was positively associated with cannabis-related negative consequences, CUD symptoms, and importance and readiness to change. Greater legal and withdrawal/dependence risks were uniquely related to several outcomes (e.g., CUD symptoms). Participants who used cannabis frequently perceived more personal risk in most risk domains and less general risk to others than those who used infrequently. Findings suggest personal risk is an important component to consider when assessing perceived risk of cannabis use and focusing on both general and domain-specific risks may provide valuable insight for future prevention and intervention efforts.

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Aims Chronic obstructive pulmonary disease (COPD) is one of the most common causes of death worldwide. This study assesses the level of knowledge about COPD among undergraduate students that makes it different from other respiratory illnesses. Methods A cross-sectional study was conducted among undergraduate students at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS). The Bristol Chronic obstructive pulmonary disease Knowledge Questionnaire (BCKQ) was used to evaluate the knowledge about COPD, epidemiology, symptoms, exercise, smoking, and breathlessness domains. The questionnaire was distributed among the different male colleges. Results There were 304 respondents from five colleges. The overall BCKQ mean score was 15.16±4.52 (maximum 30). The mean score was highest for the Colleges of Pharmacy (18.89±2.17) and Medicine (18.00±3.84), and the College of Science and Health Professions had the lowest score (11.56±5.58). The highest overall means for the different domains (max=5) were for smoking (2.19±1.2), and epidemiology (2.83±1.27), while symptoms of COPD (2.23±1.06) and breathlessness (1.96±1.13) were the lowest among the domains. Conclusions There was a low level of understanding among undergraduate students in general, but the Colleges of Medicine and Pharmacy had better knowledge. On the other hand, the College of Science and Health Professions had a lower score. This indicates some areas for improvement in the education program. Appropriate development in the education program is recommended, such as increasing the awareness of symptoms of COPD and other aspects of the disease.

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Background: Despite increasing incidence, there is little data on abnormal eating behaviours or disorders in Indian youth, especially medical students. Additionally, little literature exists measuring the association of social media use with abnormal eating behaviours. Aim: To assess the prevalence of abnormal eating behaviours amongst medical students, social media usage, and any association of social media usage with eating behaviours. Materials and Methods: An online cross-sectional questionnaire-based study was conducted with 272 participants at a medical college, and two scales: the Three-Factor Eating Questionnaire-Revised 21items (TFEQ-R21) and the Scale of Effects of social media on Eating Behaviour (SESMEB) were used. Results: 22% of the participants reported abnormal eating behaviours. A significant difference in the effect of social media on eating behaviour according to the year of study [f = 3.08, P = 0.02] was seen with the final years having the lowest and the first years having the highest SESMEB scores. Students using more than 4 social media platforms had a higher SESMEB score [t = -2.02, P < 0.04]. A positive correlation was seen between TFEQ domains such as uncontrolled eating [r = 0.38, P = 0.01], emotional eating [r = 0.30, P = 0.01], and TFEQ total score [r = 0.40, P = 0.01] with SESMEB scores. Conclusion: This study finds a significant correlation between increased social media usage and developing abnormal eating behaviours in medical students. It highlights the need for the creation of policies regulating social media use with eating behaviours in mind.