Yan Jin

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

BackgroundPhysical activity and Physical fitness have received tremendous attention in the field of physical and mental health. However, limited attention has been given to the associations of self-reported physical fitness with some health-related outcomes. Given the COVID-19 pandemic is still active in many Chinese regions, assessing health-related physical fitness in adolescents using field-based assessment is unrealistic, therefore, this study was conducted via a self-reported questionnaire.PurposeThe present cross-sectional study was aimed at delving into the relationship between self-reported physical fitness with self-rated health, depression, anxiety, and body satisfaction in adolescents. Three thousand eight hundred and seven study participants from 12 public schools in South-eastern China were recruited and 2,407 of them provided valid data on variables that this study needed for analysis.Materials and methodsStudy participants were asked to self-report their sociodemographic factors, independence, and outcomes. Generalized linear models were used to explore the associations of self-reported physical fitness with depression, anxiety, and body satisfaction. A total of 2,407 children and adolescents with a mean age of 13.82 years were included in the final study analysis.ResultsHigher self-reported levels of general physical fitness and cardiorespiratory fitness were associated with better self-rated health, and body satisfaction but with lower risks of depression and anxiety.ConclusionThe current study offered evidence on the roles of self-reported physical fitness and health-related outcomes. To facilitate health in children and adolescents, advocating fitness education, and promotion could be a feasible approach.

Background Moral resilience enables nurses to navigate ethical challenges and mitigate moral distress, supporting well-being and high-quality care. Aim To synthesize evidence on the level of moral resilience among nurses and identify potential moderating factors. Methods A systematic review and meta-analysis were conducted across nine electronic databases from inception to December 2024, updated in August 2025. Observational studies reporting quantitative data using the Rushton Moral Resilience Scale (RMRS) were included. Two reviewers independently performed study selection, data extraction, and quality assessment. Random-effects meta-analysis, subgroup analyses, and meta-regression were used to pool data and explore heterogeneity. Ethical considerations Ethical approval was not required as the review synthesized publicly available data. Results Twenty-four cross-sectional studies comprising 9510 nurses from seven countries were included. The pooled mean moral resilience score was 2.88 (95% CI: 2.78–2.99), indicating a moderate level. Subscale means were: response to moral adversity 2.66 (95% CI: 2.45–2.87), relational integrity 2.79 (95% CI: 2.62–2.96), personal integrity 2.95 (95% CI: 2.80–3.11), and moral efficacy 3.19 (95% CI: 3.06–3.32). Clinical department and employment type significantly moderated moral resilience. Conclusions Nurses globally demonstrate moderate moral resilience, with the lowest capacity in responding to moral adversity. Targeted training and systemic support are needed, particularly for high-stress departments and non-permanent staff, to enhance ethical practice and safeguard nurse well-being.

BackgroundPrevious studies have focused on the opposite relation between muscle strength, obesity, and depression in adults. Moreover, the evidence has indicated that obesity and depression in adults might be significantly decreased with Muscle Strength Exercise albeit it might be insufficient. Therefore, the current study aimed to investigate the association between MSE, adiposity, and depression among United States adolescents.Materials and methodsThis cross-sectional study used the Youth Risk Behavioral Survey data. In YRBS, a cluster sample was used, and the investigation was divided into three stages. The study surveyed 13,677 high school students and conducted self-reported questionnaires on sex, grade, race/ethnicity, MSE days, overweight, obesity, and depressive symptoms. The study got the nationally representative population of American students in Grade 9 to 12.ResultsA total of 13,677 participants were included in the final analysis. The participants meeting the guidelines’ requirements seemed more likely to be obese than those not meeting. There was no statistical significance in the relations between the MSE guidelines and overweight and depression. For all the participants, the prevalence of those conforming to MSE was 30.1%. One-fifth of the participants reported no MSE per week, 7.8% reported 3 days of MSE per week, and 7.7% reported 7 days.ConclusionThe main finding of this study indicated a positive relationship between the normative MSE required in guidelines and low-level obesity. Beyond that, the evidence was insufficient to confirm the positive links between MSE and depression among American adolescents. Our study could offer evidence for future MSE interventions in adolescents.

Background The ethical competence of head nurses plays a pivotal role in nursing ethics. Ethical climate is a prerequisite for ethical competence, and moral resilience can positively influence an individual’s ethical competence. However, few studies have focused on the relationship between ethical climate, moral resilience, and ethical competence among them. Objectives To investigate the relationship between ethical climate, moral resilience, and ethical competence, and examine the mediating role of moral resilience between ethical climate and ethical competence among head nurses. Design A quantitative, cross-sectional study. Methods A total of 309 Chinese head nurses completed an online survey, including ethical climate questionnaire, Rushton moral resilience scale, and ethical competence questionnaire. Inferential statistical analysis includes Pearson’s correlation and a structural equation model. Ethical considerations This study received ethical approval from the Institutional Review Board of Xiangya Nursing School of Central South University (No. E2023146). Results Head nurses’ ethical climate score positively impacted ethical competence (r = 0.208, p

BackgroundIn the early days of COVID-19 outbreak, the normally orderly health system was severely challenged by large numbers of feverish patients and shortage of healthcare workers. The outbreak played a harmful role in the mental health of these healthcare workers.ObjectiveWe aim to assess the prevalence of moderate or severe anxiety and depression symptoms of healthcare workers in different regions during COVID-19 disaster and identify the potential risk factors.MethodsWe did a cross-sectional study on ADS of healthcare workers in epicenter-Hubei province and regions in lower epidemic-other provinces by questionnaire online. The data of ADS, the demographic characteristics, occupational exposure, physical condition, family situation, and coping styles were collected and analyzed.ResultsA total of 24.68% of the respondents had experienced moderate or severe ADS. Moderate or severe ADSs were in a higher prevalence in Hubei than other provinces. Suspicious symptoms on their own and in family members were independent risk factors of moderate or severe ADS of all health workers. Working on the frontline was the independent risk factor for participants in Hubei province, whereas quarantine was the independent risk factor for those in other provinces. Moreover, among all participants, those with negative coping style were more than four times more likely to have moderate or severe ADS than those with positive coping style.ConclusionModerate or severe ADSs were in a higher prevalence in healthcare workers of Hubei province during COVID-19 outbreak. The coping style may have major impact on ADS in such situation.

After a thousand years of feudal middle ages, the west entered a new era, namely the Renaissance, from the 14th century. With the influence of humanism on the cultural field, people's individuality consciousness has been released. Western pop music is a western art form with profound connotation and eternal value. In recent years, many scholars and music educators have carried out a series of research and popularization of western pop music. Through scientific methods, the students' ability to control pop music can be transformed into the basic quality of solfeggio listening training, so as to achieve the combination of the advantages of pop music and serious music, so as to complete the interactive, concise and diversified solfeggio teaching and broaden new teaching ideas. The role and influence of religious songs on the development of western vocal music art is incalculable. Its value is reflected in various fields of vocal music art. Therefore, while singing and appreciating religious songs, we should also strengthen the study and research of their background and historical development.

IntroductionNew nurses struggled with time management, which was a prominent theme in safety care for patients. However, the transition training of time management for new nurses was complicated and ignored by clinical managers. The purpose of this study was to understand the level of new nurses’ TMD from a nationwide perspective and detect the influencing factors of the TMD.Materials and methodsA cross-sectional study design with a stratified sampling method was sampled in China. Six hundred and seventy new nurses within the first year of employment were recruited. New nurses’ time management disposition, job stressors, self-efficacy, clinical communication competence, and safety behavior were measured by corresponding scales.ResultsNew nurses showed the best sense of time’s value, followed by the sense of time efficacy and time monitoring view for time management disposition. The related factors of time management disposition were communication skills, safety behavior, job stressors, and being without a preceptor. New nurses’ time management disposition was at a moderate level and they performed worse in time allocation. The highest education, with or without a preceptor, the experience of part-time jobs, and class cadre were significantly influencing the time management disposition of new nurses.ConclusionNursing managers should pay attention to new nurses’ time management disposition. Reducing the job stressors, improving communication ability, and safe behavior were important measures to improve the time management disposition.

Teams are more or less structured in function. Whether team structure is beneficial or harmful for the teams entail debates in current literature. Past studies mainly investigate the effects of team structure through learning or creativity. In this study, we tend to examine the effect of team structure on team performance through team coordination. We conducted two independent field studies with samples of 56 and 67 work teams to test our hypotheses. In both two substudies, we found team structure positively affect team performance by improving team coordination. Moreover, we found team longevity was able to moderate the relationship between team structure and team performance through team coordination, such that the positive relationship between team structure and team coordination were more significant when team longevity was high rather than low.

This essay explores Zen hermeneutics by locating gong'an episodes at the juncture of Zen Buddhism, Heideggerian ontological hermeneutics, and Derridean deconstructive hermeneutics. Employing Heidegger's understanding of truth as aletheia and the Derridean deconstruction of the subject oriented metaphysical mode of thinking, this essay aims to shed light on the special function that hermeneutics plays in our understanding of philosophy's and philosophers' relation to truth and meaning and show how Zen gong'an shares some visions with the hermeneutical discipline in our time

Index by building offshore outsourcing for various industries in China from 1997 to 2002 the status of offshore outsourcing and its impact on the export structure of study: the degree of participation in outsourcing, China's capital-intensive industries than labor-intensive industries developed countries tend to capital-intensive production process labor-intensive processes to China, so China's capital-intensive exports increased year by year the proportion of total exports, while the labor-intensive and resource-intensive products of export share decreased. In addition, empirical analysis, comparative advantage and economies of scale is the basis for offshore outsourcing, industry, labor-intensive and labor productivity index and other indicators of offshore outsourcing to a certain extent. These factors affect the way through the offshore outsourcing of China's export structure. By constructing an offshore outsourcing index and analyzing the outsourcing status in different industries as well as their effects on the export structure in China during 1997-2002, this paper indicates that capital-intensive industries in China accept more offshore outsourcing than labor-intensive industries, that developed countries incline to transfer the labour-intensive part in capital-intensive production to China, which makes China's capital-intensive products export increase steadily, while labor-intensive or resource-intensive products export is the reverse. The paper also makes an empirical study to the influential factors in China's offshore outsourcing receiving, of which the result proves that relative advantage and scaled economy are the important elements, whereas labor intensity and working efficiency also have impacts on outsourcing. All of these factors influence China's industry and export structure