Yoxas/statistical_literacy huggingface dataset:
China hosts around 68,000 international medical students (IMSs) primarily from lower income countries in Africa and Asia, who have the potential to contribute to international medical services. Understanding how these IMSs make career decisions can help better address the issue of global medical workforce shortage. However, such research is limited. Our study aims to explore the career decision-making process of China-educated IMSs, the challenges they experienced and the strategies they employed.In this exploratory qualitative study, we conducted semi-structured interviews with IMSs educated in China in 2022 using purposeful sampling. Twenty virtual one-on-one interviews were conducted, and data were analysed through directed qualitative content analysis. Cognitive Information Processing (CIP) theory was applied as the guiding framework for organising and analysing the data.The career decision-making process of the participants generally followed the stages of decision-making cycle in CIP theory, with a combination of urgent migration decisions and specialisation considerations adding layers of complexity to their career trajectories. Identified challenges encompassed lack of knowledge about oneself and career options, lack of decision-making skills, concerns of contextual complexities that limited the career decision-making process, low motivation and negative thoughts. Specific challenges due to their role as IMSs arose, which were related to career information access, self-capability evaluation, degree accreditation, employment competitiveness and mental states. Participants' proposed strategies were categorised into personal and institutional aspects, providing insights into addressing these challenges.This study substantiates and expands the application of the CIP theory within the sphere of the particular cultural and educational context of IMSs educated in China. It highlights the significance of integrating migration decision-making into career guidance for IMSs, and contributes to the literature by proposing an evidence-based tiered career intervention programme for IMSs.
China used to be the world's leading nation in terms of international (outward) tourism till the COVID-19 outbreak. However, due to the COVID-19 crisis, several new macro and micro-level factors might affect their international (outward) traveling behavior. The purpose of the current research was to examine the avoidance of international traveling for leisure in the Chinese population. The goal of the study was to highlight the importance of information self-efficacy and digital literacy as the key factors influencing tourists' traveling readiness. To achieve the goal, the study adapted the quantitative instruments from existing sources to map media exhaustion, information overload, and perceived health concerns, i.e., perceived effectiveness of health-protective measures, fear of new possible outbreaks, and pandemic crisis at source and destination. Chinese citizens' opinions were collected during the third quarter of the year 2022. Specifically, the quantitative survey from China collected a total number of 1308 respondents. This study used the statistical analysis software SPSS to analyze collected data. The findings conclude that the role of media is pivotal to shaping and predicting future trends in tourism preferences, perception of protective measures against COVID-19, and perceived seriousness of the pandemic crisis in the Chinese population. In addition, technology readiness (as hard self-efficacy) and health-related information literacy (soft self-efficacy) are critical to cope with the dark aspects of information exhaustion, overload, and pandemic seriousness in the post-truth era. The study is unique, as it examines the role of the seriousness of the pandemic at its source and destination and fear of new outbreaks simultaneously, underlining the potential future of immersive tourism (i.e., virtual reality, augmented reality, or mixed reality-based tourism). This study has drawn interesting theoretical and practical implications for researchers, policymakers, and academicians.
Chinese Martial Arts (CMAs) have garnered a global following, with their rich historical and cultural heritage transcending geographical and cultural differences, sparking profound interest among an international community. As an increasing number of non-Chinese individuals persist in practicing CMAs, investigating the motivations behind their continued participation has emerged as a compelling question. This study aims to delve deeper into the factors driving international practitioners to sustain their practice of CMAs, thereby broadening our understanding of the global resonance of CMAs. Employing Self-Determination Theory, 226 international CMAs practitioners completed the Physical Activity and Leisure Motivation Scale, Perceived Belonging Scale, and Persistence in Practicing CMAs Scale. SPSS 20.0 was utilized for conducting descriptive statistics, common method bias tests, and correlation analyses. Structural equation modeling was performed using AMOS 26.0. Motivation for Practicing CMAs, comprised of enjoyment, mastery, physical condition, psychological condition, and appearance, has a positive impact on Persistence in Practicing CMAs (β = 0.297, p < 0.01). Sense of Belonging also positively affects Persistence in Practicing CMAs (β = 0.268, p < 0.01). The aforementioned variables account for 22.1% of the variance in Persistence in Practicing CMAs. Furthermore, Affiliation, Competition/Ego, and Others' Expectations were found to have no significant correlation with Persistence in Practicing CMAs. The formation of persistence in the practice of CMAs among international practitioners is propelled by their ongoing desire for skill mastery, enjoyment, enhanced physical and mental health, body shape improvement, and a Sense of Belonging. The study reveals that a stronger motivation and Sense of Belonging significantly enhance their commitment to CMAs. Recommendations include that international instructors should center their teaching strategies around the practitioners, helping them to find joy in their practice, achieve skill mastery, and foster the development of physical, mental, and aesthetic qualities, alongside virtues and etiquette. Additionally, building a supportive CMAs community and cultivating a sense of ritual are essential. Such strategies are intended to reinforce practitioners' self-affirmation and group identity, thus boosting their Sense of Belonging and encouraging their continued engagement in CMAs.
Chinese patients face higher risks of gastrointestinal (GI) cancers and greater cancer-related deaths than Canadian-born patients. The older population encounters barriers to quality healthcare, impacting their well-being and survival. Previous studies highlighted Chinese immigrant perceptions of not requiring healthcare support. During the COVID-19 pandemic, their underutilization of healthcare services garnered attention. The present study explores the experiences of older Chinese cancer patients to improve culturally sensitive cancer care. A total of twenty interviews carried out in Cantonese and Mandarin were conducted with Chinese immigrants, aged 60 or above, diagnosed with Stage 3 or 4 GI cancer. These interviews were transcribed verbatim, translated, and subjected to qualitative descriptive analysis. Among older Chinese immigrant patients, a phenomenon termed "Premature Acceptance: Normalizing Death and Dying" was observed. This involved four key themes: 1. acceptance and letting go, 2. family first, 3. self-sufficiency, and 4. barriers to supportive care. Participants displayed an early acceptance of their own mortality, prioritizing family prosperity over their own quality of life. Older Chinese patients normalize the reality of facing death amidst cancer. They adopt a pragmatic outlook, acknowledging life-saving treatments while willingly sacrificing their own support needs to ease family burdens. Efforts to enhance health literacy require culturally sensitive programs tailored to address language barriers and differing values among this population. A strengths-based approach emphasizing family support and practical aspects of care may help build resilience and improve symptom management, thereby enhancing their engagement with healthcare services.
Chinese universities have placed increasing emphasis, on incorporating English as a medium of instruction (EMI) courses to enhance their competitiveness both nationally and internationally. However, the successful implementation of these courses requires learners to acquire content knowledge. To promote EMI courses, specific initiatives and policies have been put in place by universities reflecting a trend in the globalization of higher education and the growing demand for English proficiency in academic settings. Despite the attention given to education in Chinese society, many learners are not adequately prepared to overcome challenges associated with EMI classes. This leads to inefficiencies and drawbacks within the educational system. For instance, some learners struggle with understanding subject matter due to language barriers or encounter difficulties fully engaging with course materials because of language related challenges. This study aims to fill a significant research gap by providing a comprehensive exploration of the main challenges faced by learners in the Chinese EMI context and by highlighting the crucial contribution of EMI courses to China's higher education competitiveness internationally. By identifying factors and variables that can predict success in EMI contexts, particularly by studying learners' academic language-related skills as potential predictors of EMI success, this study offers novel insights into the impact of EMI courses on China's position in the global academic arena. A total of 361 male and female EFL learners participated in the study and completed the EMI Challenges Scale. The data analysis, including descriptive statistics and multiple linear regression, revealed that writing, reading, and listening skills significantly predicted success in EMI. Writing emerged as the best predictor, explaining 28.19 % of the variance in EMI success, followed by reading (19.54 %). The results of this study contribute to current debates on international affairs of higher education by not only illustrating the problems students face in EMI courses, but also providing important suggestions for improving the learning environment on EMI language in China. This leads to ongoing debates about the globalization of higher education and the need for English proficiency in academic settings. In addition, the results of this study are useful for teachers and policy makers; it emphasizes the importance of improving EMI learners' writing, reading, and listening skills in EMI learners to enhance their success in academic settings. In particular, they may consider implementing language development programs and provide EMI learners with additional support to improve their writing, reading and listening skills. This study also highlights the need for appropriate support and resources to address the specific language challenges faced by EMI students, paving the way for better instructional strategies and guidelines in Chinese EMI terms.
Chinese/Mandarin language instruction to undergraduate students from non-Chinese speaking countries has become a topic of increasing interest, driven by China's influential role in global political and economic dynamics. With Mandarin being the language spoken by approximately 70% of Chinese speakers, it is not only taught within China but also in institutions around the world. While teaching any second or foreign language presents unique challenges, the specific challenges faced in Mandarin language education have not received comprehensive scrutiny, prompting the need for further investigation. The primary objective of this study was to explore the challenges associated with teaching and learning Mandarin from the perspectives of non-native Mandarin language teachers. By adopting a qualitative (phenomenological) research approach, we aimed to uncover the multifaceted challenges that confront both educators and learners in the context of Mandarin language instruction. The research methodology employed for this study involved the use of semi-structured interviews conducted with 15 Mandarin language teachers, who were chosen through theoretical sampling. These interviews were transcribed into text files and subsequently subjected to qualitative data analysis, which was facilitated by the use of MAQDA software. This approach allowed us to identify and categorize the various challenges and problems encountered in the teaching and learning of Mandarin. The research findings revealed a range of challenges and problems experienced in Mandarin language education. These challenges were grouped into two primary thematic categories: psycho-linguistic and educational challenges. The linguistic challenges are deeply rooted in the distinctive features of the Mandarin language, presenting obstacles that necessitate innovative teaching strategies and materials. Educational challenges extend beyond native speaker proficiency, emphasizing the requirement for a comprehensive pedagogical skill set among instructors. The implications of this research extend to various stakeholders in the field of Chinese/Mandarin language education, including policymakers, educators, curriculum designers, and learners. Understanding the linguistic, educational, and psychological challenges can inform the development of more effective teaching methods, curriculum design, and motivation-enhancing strategies, ultimately promoting a more successful and engaging Mandarin language learning experience for non-native speakers.
Chiropractors commonly treat pediatric patients within their private practices. The objectives of this study were (1) to identify the treatment techniques and health advice used by Quebec chiropractors with pediatric patients; (2) to explore the research priorities of Quebec chiropractors for the pediatric population; and (3) to identify Quebec chiropractors' training in the field of pediatric chiropractics. A web-based cross-sectional survey was conducted among all licensed Quebec chiropractors (Qc, Canada). Descriptive statistics were used to analyze all quantitative variables. The results showed that among the 245 respondents (22.8% response rate), practitioners adapted their treatment techniques based on their patients' age group, thus using softer techniques with younger pediatric patients and slowly gravitating toward techniques used with adults when patients reached the age of six. In terms of continuing education, chiropractors reported an average of 7.87 h of training on the subject per year, which mostly came from either Quebec's College of Chiropractors (OCQ) (54.7%), written articles (46.9%) or seminars and conferences (43.7%). Both musculoskeletal (MSK) and viscerosomatic conditions were identified as high research priorities by the clinicians. Quebec chiropractors adapt their treatment techniques to pediatric patients. In light of limited sources of continuing education in the field of pediatric chiropractics, practitioners mostly rely on the training provided by their provincial college and scientific publications. According to practitioners, future research priorities for pediatric care should focus on both MSK conditions and non-MSK conditions.
Chlamydia trachomatis (CT) Major Outer Membrane Protein (MOMP) holds a neutralising epitope in the Variable Domain 4 (VD4), and this region's immune dominance during infection is well known. This study aimed to assess the antibody response induced after infection and compare it for specificity and functionality to the response following vaccination with the vaccine CTH522, which contains VD4's from serovars D, E, F, and G. We assessed the antibody epitopes in MOMP by a high density peptide array. Furthermore, the role of the VD4 epitope in neutralisation was explored by competitive inhibition experiments with a fusion protein holding the neutralising VD4 linear epitope. This was done in two independent groups: 1) MOMP seropositive individuals infected with CT (n = 10, from case-control study) and 2) CTH522/CAF®01-vaccinated females (n = 14) from the CHLM-01 clinical trial. We identified the major antigenic regions in MOMP as VD4 and the conserved region just before VD3 in individuals infected with CT. The same regions, with the addition of VD1, were identified in vaccine recipients. Overall, the VD4 peptide responses were uniform in vaccinated individuals and led to inhibition of infection in vitro in all tested samples, whereas the VD4 responses were more heterogenous in individuals infected with CT, and only 2 out of 10 samples had VD4-mediated neutralising antibody responses. These data provide insights into the role of antibodies against MOMP VD4 induced after infection and vaccination, and show that their functionality differs. The induction of functional VD4-specific antibodies in vaccine recipients mimics previous results from animal models. This work was supported by the European Commission through contract FP7-HEALTH-2011.1.4-4-280873 (ADITEC) and Fonden til Lægevidenskabens Fremme.
Cholecystectomy is a commonly performed abdominal procedure, the gold standard currently is the laparoscopic approach and, however, the facilities and expertise for laparoscopy are not available widely, especially in developing countries. A Mini-laparotomy cholecystectomy is an additional approach that is performed through an incision that is less than 5 cm thus minimizing the complications of the traditional open cholecystectomy and the postoperative hospital stay. The study aims to evaluate the outcome of mini-laparotomy cholecystectomy in terms of operative duration, complications, and hospital stay in a rural hospital. This is a retrospective study conducted in El-Dwaim Teaching Hospital, Sudan. All cases of mini-laparotomy cholecystectomy conducted from March 2009 to December 2020 were included and retrospectively studied. Descriptive statistics were applied using SPSS version 25. A total of 512 mini-laparotomy cases were involved in the study, of those 442 aged more than 40 years. The operation lasted less than 60 minutes for 486 of the participants, and the most frequent cholecystitis complication observed intraoperatively was mucocele, occurring in 70 (13.6%) participants. Intraoperative complications due to mini-laparotomy occurred in 4 (0.8%) cases, in the form of bleeding and none of the observed cases converted into open cholecystectomy. Postoperative complications occurred in the form of wound infection in 7 participants, biliary leak in 1 participant, and fistula formation in 1 participant. Post-operative hospital stay was 24 hours for 458 participants. Mini-laparotomy cholecystectomy is a safe minimally invasive approach with low rates of complications and short postoperative hospital stay, making it an optimum approach in facility-deprived countries.
Choline is essential for healthy cognitive development. Single nucleotide polymorphisms (SNPs; rs3199966(G), rs2771040(G)) within the choline transporter SLC44A1 increase risk for choline deficiency. In a choline intervention trial of children who experienced prenatal alcohol exposure (PAE), these alleles are associated with improved cognition. This study aimed to determine if SNPs within SLC44A1 are differentially associated with cognition in children with PAE compared with normotypic controls (genotype × exposure). A secondary objective tested for an association of these SNPs and cognition in controls (genotype-only). This is a secondary analysis of data from the Collaborative Initiative on Fetal Alcohol Spectrum Disorders. Participants (163 normotypic controls, 162 PAE) underwent psychological assessments and were genotyped within SLC44A1. Choline status was not assessed. Association analysis between genotype × exposure was performed using an additive genetic model and linear regression to identify the allelic effect. The primary outcome was the interaction between SLC44A1 genotype × exposure status with respect to cognition. The secondary outcome was the cognitive-genotype association in normotypic controls. Genotype × exposure analysis identified 7 SNPs in SLC44A1, including rs3199966(G) and rs2771040(G), and in strong linkage (D' ≥ 0.87), that were associated (adjusted P ≤ 0.05) with reduced performance in measures of general cognition, nonverbal and quantitative reasoning, memory, and executive function (β, 1.92-3.91). In controls, carriers of rs3199966(GT or GG) had worsened cognitive performance than rs3199966(TT) carriers (β, 0.46-0.83; P < 0.0001), whereas cognitive performance did not differ by rs3199966 genotype in those with PAE. Two functional alleles that increase vulnerability to choline deficiency, rs3199966(G) (Ser644Ala) and rs2771040(G) (3' untranslated region), are associated with worsened cognition in otherwise normotypic children. These alleles were previously associated with greater cognitive improvement in children with PAE who received supplemental choline. The findings endorse that choline benefits cognitive development in normotypic children and those with PAE.
Cholinergic innervation of the frontal cortex is important in higher cognitive functions and may have been altered in humans relative to other species to support human-specific intellectual capacities. To evaluate this hypothesis we conducted quantitative comparative analyses of choline acetyltransferase-immunoreactive axons in cortical areas 9, 32, and 4 among humans, chimpanzees, and macaque monkeys. Area 9 of the dorsolateral prefrontal cortex is involved in inductive reasoning and specific components of working memory processes, while area 32 of the medial prefrontal cortex has been implicated in theory of mind. Area 4 (primary motor cortex) was also evaluated because it is not directly associated with higher cognitive functions. The findings revealed no quantitative species differences in the three cortical areas examined, indicating that human cognitive specializations are not related to a quantitative increase in cortical cholinergic input. However, species-specific morphological specializations were observed. Clusters of cholinergic fibers that may be indicative of cortical plasticity events were present in chimpanzees and humans, but not in macaques. The other significant morphology noted was the common and distinctive oval or ovoid perisomatic staining in macaque cortices. This feature was also sporadically observed in chimpanzee cortex. Our findings suggest a potential alteration of cortical cholinergic afferents within the prefrontal cortex of humans and chimpanzees, to the exclusion of macaque monkeys.