Valid Response Rate Research Articles

CONSUMER PERCEPTION TOWARDS M-COMMERCE WITH SPECIAL REFERENCE TO GUJARAT

This study aims to investigate the key factors influencing consumers' perceptions of m-Commerce in Gujarat, with a focus on the roles of social influence, trust, and perceived cost. This study's sample size is 434 people, with a valid response rate of 78.91 percent. The proposed research model was tested using simultaneous multiple regression. According to the findings, perceived usefulness, social influence, and trust have a significant positive impact on customers' intentions, whereas perceived cost has a significant negative impact on consumer perception of m-commerce use. Furthermore, perceived ease of use has a negligible impact on consumers' attitudes toward m-commerce in Gujarat. The generalizability of this study's findings is limited: 1) Because this study is limited to Gujarat; 2) Other potential variables are not included in the model.

LOCAL COMMUNITY PERCEPTION ABOUT TOURISM IMPACT AND COMMUNITY SUPPORT FOR FUTURE TOURISM DEVELOPMENT: A STUDY ON SYLHET, BANGLADESH

Tourism is a well-established industry and is known as an income-generating sector and it influences the social aspects for developed as well as countries those are developing. The aim of this paper is to assess the local community perception about tourism’s impact and their support for future tourism development. To conduct this study, a conceptual framework was developed. Additionally, data were collected from 330 respondents, of which the valid response rate is 78.57%. The projected relationships were evaluated by using Partial Least Squares- Structural Equation Modeling technique (PLS-SEM). The findings show a positive relationship among social, economic, and environmental factors and it also influences the quality of life of the local community. This study also specifies the local community’s positive perception towards the development of future’s tourism. This study will make a significant theoretical and practical contribution to the development of community-based tourism in Bangladesh.

Prevalence of and Factors Associated with Negative Psychological Symptoms among Elderly Widows Living Alone in a Chinese Remote Sample: A Cross-Sectional Study

(1) Background: Research indicates that most elderly widows are at a high risk of experiencing negative psychological symptoms. It is common for elderly women in rural and remote areas to live alone without family support to cope with stress due to the mass rural-to-urban migration of China’s youth labor force. Such a situation further worsens their psychological health and well-being. However, the prevalence of and risk factors associated with negative psychological symptoms (loneliness, depression, and anxiety) among remote elderly widows living alone in China are currently unclear; (2) Methods: A cross-sectional study was conducted in Hunan Province, China. The loneliness was assessed through the University of California at Los Angeles Loneliness Scale (ULS-8). The depression and anxiety were assessed with the Short Form Geriatric Depression Scale (GDS-15) and Generalized Anxiety Disorder Scale (GAD-7), respectively. The Chi-square test and correlation analysis were conducted to identify factors associated with negative psychological symptoms. Logistic regression was performed to predict risk and protective factors contributing to loneliness, depression, and anxiety symptoms. The significance level was set as p < 0.05; (3) Results: A total of 271 remote elderly widows living alone were enrolled in the present study. Additionally, 234 valid questionnaires were returned (valid response rate = 86.3%). The prevalence of loneliness, depression and anxiety was 8.1%, 44.0%, and 16.7%, respectively. Acute or chronic medical conditions, marital happiness, being the primary caregiver before widowhood and anticipating the death of the spouse differed significantly in the distribution of negative psychological symptoms. Logistic regression analysis predicted that participants who were satisfied with their marriage had a lower likelihood to experience loneliness, depression, and anxiety (p < 0.05). Being the spouse’s primary caregiver before widowhood was more likely to have symptoms of loneliness (p < 0.01). Those with various acute or chronic medical conditions were more likely to suffer from depression (p < 0.01); (4) Conclusions: Remote elderly widows living alone in China are prone to loneliness, depression, and anxiety symptoms. Being the primary caregiver before widowhood and having many acute or chronic medical conditions are risk factors for loneliness and depression, respectively. Marital happiness is the protective factor against negative psychological symptoms. To accomplish the goal of equitable access to mental health care in China, evidence-based policy and resource development to support psycho-social interventions that prevent and manage negative psychological symptoms for remote elderly widows living alone are urgently needed.

Exploring an Applied Ecological Model of the Effects of Household, School, and Community Environments on Adolescent Mental Health in Japan

Adolescent mental health is an urgent global public health issue and is affected by household, school, and community environments. However, few studies, and none in Japan, have used applied ecological models to identify environmental factors that affect adolescent mental health. This study aimed to examine an applied ecological model of sequential association between household, school, and community environmental factors and their effects on adolescent mental health in Japan (ECO-AM model). This was a secondary analysis of data from the 2013 Japanese Comprehensive Survey of Living Conditions. Participants were 893 adolescents aged 12-14 years and their household heads living in Japan. Data for 728 adolescents were analyzed after excluding participants with missing values (valid response rate: 81.5%). Screening using the six-item Kessler Psychological Distress Scale demonstrated that 33.8% of adolescents had mood and anxiety disorders. Covariance structure analysis yielded a model with strong goodness-of-fit that described associations between mood and anxiety disorder and vitality, and household, school and community environments. The explanatory variables accounted for 36% of mood and anxiety disorder scores. The study emphasizes the importance of the relationship between different environments and suggests that a better understanding of environmental factors would help support adolescent mental health.

Factors Influencing Live Streaming Continuance Watching Intention

This study aims to explore the determinants of parasocial interaction (PSI) and the causal relationships between PSI and live streaming continuance watching intentions. Besides, we also examine the moderating effect of skepticism between PSI and live streaming continuance watching intentions. Out of 400 questionnaires distributed, 313 valid questionnaires were returned, yielding a valid response rate of 78.25 percent, and it tested the proposed hypotheses by using structural equation modeling (SEM).&#x0D; &#x0D; The results found that likeability, expertise, physical attractiveness and self-disclosure had significant positive effects on PSI. PSI significantly affected live streaming continuance watching intentions. Finally, skepticism played a moderating role between PSI and willingness to continue watching the live streaming. This study focused on the live streaming industry on YouTube; thus, caution is required in generalizing the findings. The current study not only aims to expand the scope of research on PSI but also to prompt researchers and organizations to consider effective communication strategies for online audiences to increase viewing rates.

Utility and optimal cut-off point of the Somatic Symptom Scale-8 for central sensitization syndrome among outpatients with somatic symptoms and related disorders

BackgroundCentral sensitization syndrome (CSS) involves severe functional symptoms due to central sensitization. for patients with severe somatic symptoms and related disorders (SSRDs), central sensitization may be responsible for their functional symptoms. We hypothesized that screening for CSS in patients with SSRDs would identify those with severe disease. The Somatic Symptom Scale-8 (SSS-8) is a simple tool to assess medical conditions related to SSRDs, but the cut-off point to identify severe cases of comorbid CSS is unknown. This study aimed to determine the optimal cut-off point of SSS-8 for screening the CSS of patients with severe SSRDs.MethodsIn total, 143 patients with SSRDs attending outpatient clinics of a university hospital in Japan were included in the study. The participants were evaluated using the SSS-8 for somatic symptoms, Hospital Anxiety and Depression Scale (HADS) for anxiety and depressive symptoms, Pain Catastrophizing Scale (PCS) for catastrophic thoughts, and Central Sensitization Inventory (CSI-A, B) for CSS. Receiver operating characteristic (ROC) curve analysis was performed using the propensity score. The area under the curve (AUC) was calculated using a propensity score considering PCS, age, sex, HADS, and CSI-B as confounders of SSS-8 and CSS to evaluate differences in diagnostic accuracy between patients with and without SSS-8. The sensitivity and specificity of the ROC analysis were then used to determine the cut-off point for discriminating severe cases of SSS-8.ResultsOf the 143 participants, 126 responded (51 CSS group and 75 non-CSS group), with a valid response rate of 88.1 percent. In the ROC analysis, the propensity score including SSS-8 was statistically more accurate. The optimal cut-off point was 13, with an AUC of 0.88, sensitivity of 84.3 percent, and specificity of 77.3 percent.ConclusionsThe SSS-8 is a useful tool for discriminating severe cases of SSRDs comorbid with CSS.

Confidence in self-care after heart failure hospitalization

BackgroundUnderstanding patient perspectives of self-care is critical for improving multidisciplinary education programs and adherence to such programs. However, perspectives of self-care for patients with heart failure (HF) as well as the association between patient perspectives and patient-physician communication remain unclear. MethodsConfidence levels regarding self-care behaviors (eight lifestyle behaviors and four consulting behaviors) and self-monitoring were assessed using a self-administered questionnaire survey, which was directly distributed by dedicated physicians and nurses to consecutive patients hospitalized with HF in a tertiary-level hospital. Patient-physician communication was evaluated according to the quality of physician-provided information regarding “treatment and treatment choices” and “prognosis” using the Prognosis and Treatment Perception Questionnaire. Out of 202 patients, 187 (92.6 %) agreed to participate, and 176 completed the survey [valid response rate, 87.1 %; male, 67.0 %; median age, 73 (63–81) years]. Multivariate logistic regression analyses were conducted to predict low confidence in self-care (score in the lowest quartile). ResultsHigh confidence (confident or completely confident >75 % of patients) was observed for all self-care behavior categories except low-salt diet (63.1 %), regular exercise (63.1 %), and flu vaccination (65.9 %). Lower confidence in self-care behavior was associated with low quality of patient-physician communication. With regard to self-monitoring, 62.5 % of patients were not confident in distinguishing worsening symptoms of HF from other diseases; non-confidence was also associated with low quality of patient-physician communication. ConclusionsHospitalized patients with HF had low confidence regarding regular exercise, salt restriction, and flu vaccination. The results also suggest patient-physician communication affects patient confidence.

INVESTIGATING THE RELATIONSHIP BETWEEN ACTIVE LEADERSHIP AND CONSTRUCTION RISK MANAGEMENT AMONG CONTRACTORS IN KINGDOM OF SAUDI ARABIA

Contractors have given importance to risks in the construction process as it causes time and cost overrun, delays and total desertion in activities and events present in the construction project. The uncertainty in the completion time, cost and quality during construction relates to construction risks. One important factor to deal with construction project complexities is active leadership. Present research examines the significant relation of active leadership on construction risk management associated with contractors working in Kingdom of Saudi Arabia (KSA). Based on Organization Control theory, current research (quantitative in nature) discusses the influence of active leadership on construction risk management with the moderation role of government acts, laws and policies among 303 big size company (&gt; 250 number of employees) contractors working in Kingdom of Saudi Arabia (KSA) using PLS-SEM technique. Survey questionnaires were distributed with valid response rate of 82% using 5 point Likert scale. PLS-SEM is a composite based approach, which provides parameter estimation with high efficiency and increased statistical power for analyzing complex models. It is a causal-predictive method approach in which data distribution assumption is not taken into account for estimation of complex models which contains various constructs with variable indicators and structural paths. Results depict that government acts, laws and policies and active leadership positively influence construction risk management. In addition, moderation of government acts, laws and policies has positive relation among active leadership and construction risk management. It is difficult to control power in term of risk occurrence and low practice of government acts, laws and policies results high level of risk occurrence reducing efficiency of delivery output resulting construction risk management less effective. The reduction in risk occurrence during construction phase of project is supported by active leadership with lengthening the theory by inspecting extensive construction project risk ranges which includes equipment and labor risk, finance risk, design risk, material risk and administrative or management risk making organization effective. Organizational management can reduce risk occurrence within project by building conditions for enhancing active leadership among their employees.

Promoting tourism business through digital marketing in the new normal era: a sustainable approach

PurposeThis paper aims to measure the intention to use digital marketing strategies to enhance the performance of tourism business as well as the extent of digital renovation applications in tourism for sustainable business in a new normal era.Design/methodology/approachThis paper is an insight from the existing relevant literature on the tourism business from time immemorial. The conceptual framework of this study is designed based on previous studies of digital marketing practices for tourism businesses. Furthermore, data were collected from 270 respondents, of which the valid response rate is 72.97%. Partial least square (PLS)-structural equation modeling (SEM) is used to validate the conceptual framework and hypotheses testing.FindingsAmong the nine hypotheses path, seven were supported. This study result shows that perceived usefulness, perceived ease of use, social media marketing and tourism business performance are critical factors for adopting digital marketing in tourism. Thus, tourism service providers' intention has a positive impact to meet the expectation of tourists and adoption of digital marketing.Research limitations/implicationsThe study's results will assist tourism researchers and service providers in understanding an authentic relationship between digital practices of tourism business and tourist satisfaction. In addition, the legacy of tourism business through digital marketing empowers the owner and community.Originality/valueThe study is the first to explore the relationship between tourism business performance and digital marketing during the new normal era for the empowerment of local community and expanded business in tourism sector.

Understanding Consumers' Intentions to Purchase Clean Label Products: Evidence from Taiwan.

In light of the fact that increasing consumer emphasis is being placed on the concepts of safety, health, and environmental protection, and that consumer groups are now attentive to the issues of “greenism” and sustainable development, the certification label has become an important tool. This study explores individual needs from the perspective of food “clean label” certification, highlighting that the importance of general food certification to consumers is different from the previous literature that only focused on the impact of organic labeling, nutrition labeling, and food safety certification on consumer behavior. In this study, the consumer purchase intention for the use of the “clean label” and its influencing factors are discussed, using product knowledge and involvement as the independent variables. The target is the consumer who has experience with “clean label” products. This study employs snowball sampling. A formal questionnaire was sent to 292 participants. After eliminating the invalid samples, we retained 265 valid questionnaires for the analysis (a valid response rate of 90.75%). Structural equation modeling (SEM) was applied to test the research hypotheses. The results indicated that: (1) consumers’ involvement with “clean label products significantly influences their purchase intention; and (2) consumers’ product knowledge of “clean label” products significantly influences their purchase intention and involvement. Based on these results, enhancing consumers’ knowledge of food security is suggested. Furthermore, the findings provide crucial insights for marketing channels, suggesting that the food industry can target consumer confidence over certification labeling and “clean label” products as keys to purchase intention, and to attract business by developing practical marketing strategies.

The Psychological Impact and Influencing Factors during Different Waves of COVID-19 Pandemic on Healthcare Workers in Central Taiwan.

Background: This study aims to explore differences of psychological impact and influencing factors that affected Taiwanese healthcare workers (HCW) during the first and second wave of COVID-19. Methods: a cross sectional survey of first-line HCW during November 2021 to February 2022: 270 paper questionnaires were issued and the valid response rate was 86% (231). For statistical analysis, descriptive statistics, Pearson correlation, and multivariate linear regression were used. Results: regardless of the wave of the pandemic, nearly 70% of HCW had anxiety, nearly 60% felt depressed, half of them suffered from insomnia, and one in three felt insufficient social support, which means a high level of loneliness. With an increased number of infected patients during the second wave, HCW felt significant changes of workload and schedule, with higher concern over risk of infection, and these factors induced higher levels of anxiety, but they manifested better satisfaction over public health policies and information provided by hospitals and governments. Changes of working schedules or duties positively relate to levels of anxiety and insomnia. The risk of infection causes anxiety, depression, and insomnia. Workplace relationships significantly relate to depression and loneliness. A negative family support causes an adverse psychological impact. Conclusions: the pandemic has a negative psychological impact on HCW. Early recognition of significant influencing factors, providing psychological support and therapy, are helpful strategies for reducing the adverse psychological effects.

Factors associated with community commitment among older adults: a stratified analysis of community group leaders and members

BackgroundCommunity commitment through group activities in the community is associated with improved health outcomes in older adults and has a ripple effect on community development. However, factors associated with community commitment through group activities in the community have not been examined. The purpose of this study was to examine individual factors and group-related factors in association with community commitment among older adult leaders and members of community groups in Japan.MethodsWe mailed self-administered questionnaires to all older adults participating in a community group (N = 1,898) in a ward of Yokohama city, the largest designated city in Japan. Variables included demographic characteristics, community commitment (Community Commitment Scale), individual factors, and group-related factors. We used logistic regression analysis to assess the association among study variables.ResultsA total of 1,154 people completed the questionnaire. The valid response rate was 48.8%. Respondents’ mean age was 78.3 years (standard deviation [SD] = 6.1, range 65–100 years), 79.6% were women, 55.9% were married, and 10.0% were employed. Factors associated with community commitment among group leaders were scores for self-efficacy in the health promotion scale (SF-15; mean ± SD: 48.5 ± 7.1), 5-item World Health Organization Well-Being Index (mean ± SD: 17.9 ± 4.3), and Lubben Social Network Scale, Japanese version (mean ± SD: 19.5 ± 6.9), as well as a perception of deriving pleasure from group participation (mean ± SD: 91.2 ± 9.4). Factors associated with community commitment among group members were economic status (Sufficient; n [%]: 749 [85.9]), frequency of going out (mean ± SD: 5.1 ± 1.8), years of group participation (mean ± SD: 6.2 ± 5.0), and perceptions of their role in the group (Yes; n [%]: 254 [30.4]) as well as the above factors for leaders. A supplementary qualitative analysis of participants’ free-text responses extracted seven categories: community support, resource mobilization, partnership action, asset management, participatory decision-making, linkages and networking, and community dissemination, related to perception of a role in the group.ConclusionOur results emphasize the importance of considering the different associations of community commitment through group activities in the community between group leaders and members, including the role of older adults in community groups, and suggest different approaches for group leaders and members.

The structure and efforts of the health sectors in municipalities from the first infected case to the second wave of COVID-19

Objective To describe the structure and efforts of the health sectors in municipalities to address the COVID-19 pandemic from the first infected case to the second wave.Method We conducted self-administered postal questionnaires with the department head or an equivalent position of the 1,741 municipal health departments (108 cities or districts with public health centers (PHC) and 1,633 general municipalities) in Japan as of November 1, 2020. The survey period was from November 11, 2020 to January 8, 2021. The respondents were asked to provide the type of local government they were affiliated with, the number of COVID-19 cases in their municipality between January 16 to November 1, 2020, the operational structure of the health sectors after the pandemic began, and efforts made to address it. The analysis tested for the differences in response rates by cities with PHC and general municipalities, and by population size of the general municipalities.Results A total of 1,270 valid questionnaires (valid response rate 72.9%) were returned from 83 cities with PHC and 1,187 general municipalities. Concerning the operational structure, over 90% of the cities with PHC transferred personnel from other departments to the department of infection control. Over 80% of all municipalities found a way to hold meetings remotely. More than half of the cities with PHC centers had employees working from home. Fewer than 50% of the general municipalities had a business continuity plan (BCP) prepared and in place for an outbreak, such as a novel influenza. Concerning the efforts within the local government, high rates of "secured supplementary budgets" and "monitored and secured infection control equipment" were reported. Concerning the efforts directed toward related organizations, over 70% of the cities with PHC "supported contact tracing at the PHC" and "monitored the stock of infection control equipment and procured equipment to address the shortages at medical institutions, welfare facilities, etc." Meanwhile, approximately 80.5% of general municipalities "corresponded and coordinated with medical institutions concerning the health examinations and services, etc." Concerning the efforts directed toward the public, over 90% of the respondents, regardless of local government type, "wrote articles and disseminated information regarding the infections in public relations (PR) reports or online" and "responded to inquiries from the public." In general municipalities, the larger the population size, the higher the percentage of implementation.Conclusion Although the municipalities responded to the transmission of the COVID-19, there were some issues. Further preparation for the pandemic is required.

Public health nurses' activities during normal times and factors associated with their promotion of residents' mutual support during disasters

Objective To clarify the actual state of activities conducted by public health nurses (PHNs) during normal times and assess factors related to the implementation of such activities for the promotion of residents' mutual support during disasters, across different municipalities in Japan.Methods We conducted a nationwide cross-sectional self-report questionnaire survey of PHNs in 1,463 municipalities. The questionnaires included descriptions of municipalities, activities related to disaster prevention and the rationale for them, and the details of activities that were being conducted to promote residents' mutual support in times of disaster. We conducted multiple logistic analyses to examine the associated factors.Results We analyzed 535 responses (valid response rate of 36.6%). The proportion of municipalities in which oriented district activity systems and oriented business activity systems were used jointly by PHNs was 81.7%. The proportion of municipalities in which PHNs participated in the formulation of regional disaster prevention plans was 31.6%. "Individual support" would be implemented for persons requiring support in evacuation activities in 41.7% of municipalities; "cooperative support for community organizations," in 34.8%; and other "activities for the purpose of residents' mutual support," in 29.9%. Reasons for not implementing such measures included "outside the division of duties" and "having no contact with residents' organizations." Logistic regression analyses showed that the oriented district activity system, participation of PHNs in the formulation of regional disaster prevention plans, and preparation of an activity manual on disaster countermeasures for PHNs were significantly associated with the performance of activities during normal times for promotion of residents' mutual support during disasters.Conclusion Our findings clarified that the PHNs' activities during normal times for the promotion of residents' mutual support during disasters were not carried out sufficiently. It is important to review activities according to the district, to ensure supervisory PHNs play a greater role, to provide external support to municipalities for the participation of PHNs in the formulation of regional disaster prevention plans, and to prepare an activity manual on disaster countermeasures for PHNs.

Maternal knowledge, attitudes and practices related to neonatal jaundice and associated factors in Shenzhen, China: a facility-based cross-sectional study

ObjectiveThis study aimed to assess knowledge, attitudes and practices related to neonatal jaundice among mothers in Shenzhen, China, and analyse associated factors.DesignA cross-sectional study.SettingThis study was conducted in Shenzhen Hospital,...

The Cultural Art Aesthetic Behavior of Entrepreneurship Education for College Students in the Characteristics of Film and Television Media.

This exploration aims to promote the organic integration of innovation and entrepreneurship education and art education, further promote the reform of college Students’ cultural and aesthetic education, improve college Students’ aesthetic perception ability, and help contemporary colleges establish a correct political morality. This thesis aims to further promote the reform of college Students’ cultural and aesthetic education, improve college Students’ aesthetic perception ability, and help contemporary colleges establish correct political and moral values. First, the connotation of college Students’ aesthetic education and the definition of cultural aesthetics are introduced, which is based on the characteristics of two-way interaction, multiple selectivity, timeliness and popularization of film and television media in the new media era; then, the way of questionnaire is adopted. With five universities as the research object, 250 questionnaires are distributed, and 235 valid questionnaires are collected, with a valid response rate of 94%. Finally, through the six questions, it is concluded that 68.9% of the students watch 3–5 h a day, and 4.3% of the students watch more than 7 h; 89.4% of the students hold that the same products as stars in film and television will exert an impact on consumption. Film and television culture and art have a positive and negative impact on college Students’ cultural aesthetic perception. The positive impact is that the film and television media not only provides a good way to cultivate the aesthetic perception ability of contemporary college students, but also helps them to establish the correct aesthetic values. The negative impact is mainly reflected in two levels, namely, the vulgarization of film and television media works and the consumption of aesthetic concepts. The advantage of this exploration is to put forward the reform measures of college Students’ cultural and artistic aesthetic education under the current educational background in China to help colleges better carry out college Students’ cultural and artistic aesthetic education. Based on this, the reform measures of college Students’ cultural aesthetic education under the current education in China were put forward, so as to help colleges and universities better carry out college Students’ cultural aesthetic education.

A Study of the Financial Behavior Based on the Theory of Planned Behavior

Personal finance and investments are closely related to people&amp;rsquo;s lives. Most investors focus on return rates than on risks. However, when the market changes considerably or unexpectedly, investors may incur losses. Employees in the electronics industry are a middle- to high-income group. However, their work may prevent them from acquiring financial knowledge and factors affecting investments. This group should also understand methods of reducing risks in investments and avoiding losses. This study examines employees in the electronics industry in Taiwan and uses the theory of planed behavior to investigate the effects of demographic variables and intention to manage personal finances and invest on investment behavior. A total of 600 questionnaires were distributed, and 469 were returned. Among the 469 questionnaires, 41 were incomplete and invalid and thus disregarded, posting a response rate and valid response rate of 78.16% and 71.33%, respectively. SPSS 20 and structural equation modeling were used for analysis. The results demonstrate that financial attitude has a significant and positive effect on financial knowledge and subjective norms, that subjective norms have a significant and positive effect on perceived financial control, and that financial knowledge has a significant and positive effect on financial behavioral intention. However, subjective norms and perceived financial control do not significantly affect financial knowledge. The results suggest that individuals should reduce risks in their personal finances and investments. Potential directions for further research are also provided.

Nurses’ clinical alarm-related behaviors and influencing factors in China†

Abstract Objective To explore the nurses’ behaviors regarding clinical alarms, analyze the related influencing factors, and provide rationales for alarm management. Methods A cross-sectional survey was conducted in China. The self-made questionnaire of nurses’ clinical alarm-related knowledge, attitude, and behavior (NCAKAB) was used. Results The valid response rate was 98.66% (n = 2368). The average nurses’ clinical alarm-related behaviors (NCAB) score was 65.14 ± 7.95 (out of 85). The dimension scores of NCAB from high to low were alarm learning (4.02 ± 0.85, out of 5), alarm response (27.99 ± 3.64, out of 35), alarm setting (19.24 ± 3.88, out of 25), alarm recognition (7.63 ± 1.68, out of 10) and alarm notification (6.25 ± 1.84, out of 10). There were significant differences in alarm behavior scores between nurses of different ages (F = 4.619, P = 0.000), nursing stints (F = 9.564, P = 0.000), professional titles (F = 4.425, P = 0.004), departments (F = 9.166, P = 0.000), and hospital levels (t = 2.705, P = 0.007). The study showed that nurses’ total alarm behavior scores were positively correlated with the total alarm knowledge score (r = 0.267; P &lt; 0.001) and the total alarm attitude score (r = 438; P &lt; 0.001). Conclusions Nurses scored highest in alarm learning, followed by alarm response, alarm setting, alarm recognition, and alarm notification behavior. The factors that influenced alarm behavior included age, title, department, nursing stint, hospital level, professional title, alarm-related training, willingness to participate in alarm-related training, whether or not departments have improved alarm management over the last 3 years, and whether or not departments have formulated norms for alarm management. Nurses with higher scores for clinical alarm knowledge had higher correlating scores for alarm behavior; similarly, nurses with higher scores for clinical alarm attitude had higher scores for alarm-related behavior.

Impact of training on primary care physicians' management of depression and anxiety disorders in rural China.

Primary care physicians (PCPs) in rural township health centers are the most easily accessible doctors to the residents in rural China, which covers 35% of the population. High prevalence of depression was reported among rural left-behind elderly and children as many workers had migrated to urban cities. This study explored mental health care provision by PCPs in rural China and the association with their training background. Rural township health centers in both developed and less developed counties of Zhejiang Province, China were chosen as the study sites. A total of 697 PCPs completed questionnaires between December 2019 and January 2020, and the number of valid questionnaires was 673, with a valid response rate of 79.3%. The rural PCPs reported a median range of seeing 1 to 5 mental health patients per week. Over two-thirds (68.2%) of the respondents had never received any training on treating common mental health disorders (depression and anxiety) while 20.3% received at most 2 days of training; 6.4% received 3 to 20 days of training; and 5.1% received over 20 days of training. PCPs with mental health training were significantly associated with better mental health care in terms of confidence and practice characteristics (e.g. having patients who brought up mental health issues, providing follow-up), while years of practice made a difference in practice but not confidence. Training is the key determinant of the practice of mental health care by the PCPs in rural China. Our findings have implications for national policy to target two-thirds of rural PCPs who received no mental health training.

Mental health in smart cities: The role of technology during COVID-19 pandemic

COVID-19 has changed the daily lives of citizens around the world and exposed the vulnerability of life and the functioning of cities. The pandemic has forced citizens to adapt to new models of remote work during quarantine and access to smart technology-based services. The article aims to assess citizens' perceptions of the technological solutions provided by smart cities and, in particular, the municipality of Paphos before and after the Covid-19 pandemic, as well as to evaluate their impact on citizens' mental health. The results of the study contribute to the understanding of the mental health benefits for citizens living in smart cities compared to people living in low-tech areas, revealing the potential positive effects of smart technologies, as well as the change in people's digital decision-making before and after the pandemic