The state of health professions students' self-directed learning ability during online study and the factors that influence it.

BACKGROUND: Universities have widely switched from traditional face-to-face classes to online instruction as a result of the epidemic. Self-directed learning is becoming the new norm for university students' learning styles. The ability of health professions students to learn independently during online study directly impacts the effectiveness of online medical education. The ability to learn on their own initiative may be affected by health professions students' professional identities, defined as their positive perceptions, evaluations, emotional experiences, and identity as professionals related to medicine. This study aimed to look into the current status and the factors that influence health professions students' self-directed learning ability (SDLA) during online study and its relationship with professional identity. METHODS: This study was conducted from September to November 2022 at a medical school in East China. An online questionnaire was used to collect participants' status of online learning, self-directed learning ability (SDLA), and professional identity. RESULTS: One thousand two hundred ninety-eight health professions students demonstrated intermediate self-directed learning ability during online study. In terms of teacher-student interaction (F = 14.778, P < 0.001), student-student interaction (F = 15.713, P < 0.001), and learning concentration (F = 13.424, P < 0.001), there were significant differences in health professions students' self-directed learning ability. Professional identity and self-directed learning ability positively correlated (r = 0.589-0.802, P < 0.01). Academic atmosphere and professional identity were significant predictors. CONCLUSIONS: The self-directed learning ability of health professions students while receiving instruction online is at an intermediate level and is influenced by several factors. Developing health professions students' professional identities can enhance their ability for self-directed learning.

The longitudinal relationships between problematic smartphone use and anxiety symptoms among Chinese college students: A cross-lagged panel network analysis.

Anxiety and problematic smartphone use (PSPU) are prevalent issues among college students, and traditional research has tended to focus on cross-sectional data and grounded only in overall levels, thereby ignoring the complex interactions between the two over time. The development of network analysis methods has provided a new perspective for in-depth exploration of the relationship. This study aimed to explore the complex longitudinal interactions and specific pathways between problematic smartphone use and anxiety among Chinese college students from an internal specific symptom perspective. This study constructed a cross-lagged network model using longitudinal data on problematic smartphone use and anxiety symptoms in two waves of college students collected from 2022 to 2023 (N=741, Mage = 18.49, SD=0.81, 45.6 % male). The study found that anxiety symptoms and problematic smartphone use interacted with each other and had a vicious cycle of symptoms over time, with the effects of anxiety symptoms being more pronounced. "Feeling afraid" and "Uncontrollable worrying" had the most significant effects on the other symptoms, with "Impatient without the phone" and "Can't stand not having a phone" were more likely to be influenced by other symptoms. "Feeling afraid" may be a bridge symptom in the network to connect the anxiety and problematic smartphone use communities. The findings suggest that accurately intervening in the intrinsic link between problematic smartphone use and anxiety symptoms can combat the exacerbation of both problems simultaneously, resulting in more effective and comprehensive treatment.

Global patterns and trends of suicide mortality and years of life lost among adolescents and young adults from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021.

AIMS: We aimed to report an overview of trends in suicide mortality and years of life lost (YLLs) among adolescents and young adults aged 10-24 years by sex, age group, Socio-demographic Index (SDI), region and country from 1990 to 2021 as well as the suicide mortality with age, period and birth cohort effects. METHODS: Estimates and 95% uncertainty intervals for suicide mortality and YLLs were extracted from the Global Burden of Diseases Study 2021. Joinpoint analysis was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to describe the mortality and rate of YLLs trends. Age, period and cohort model was utilized to disentangle age, period and birth cohort effects on suicide mortality trends. RESULTS: Globally, suicide mortality and the rate of YLLs among adolescents and young adults both declined from 1990 to 2021 (AAPC: -1.6 [-2.1 to -1.2]). In 2021, the global number of suicide death cases was 112.9 thousand [103.9-122.2 thousand] and led to 7.9 million [7.2-8.6 million] YLLs. A significant reduction in suicide mortality was observed in all sexes and age groups. By SDI quintiles, the high SDI region (AAPC: -0.3 [-0.6 to 0.0]) had the slowest decline trend, and low-middle SDI region remained the highest suicide mortality till 2021 (7.8 per 100,000 population [6.9-8.6]). Most SDI regions showed generally lower period and cohort effects during the study period, whereas high SDI region showed more unfavourable risks, especially period and cohort effects in females. Regionally, Central Latin America (AAPC: 1.7 [1.1-2.3]), Tropical Latin America (AAPC: 1.5 [0.9-2.0]), High-income Asia Pacific (AAPC: 1.2 [0.7-1.7]) and Southern sub-Saharan Africa (AAPC: 0.8 [0.4-1.2]) had the significance increase in suicide mortality. In 2021, Southern sub-Saharan Africa had the highest mortality (10.5 per 100,000 population [8.6-12.5]). Nationally, a total of 29 countries had a significant upward trend in suicide mortality and rate of YLLs over the past three decades, and certain countries in low-middle and middle regions exhibited an extremely higher burden of suicide. CONCLUSIONS: Global suicide mortality and the rate of YLLs among adolescents and young adults both declined from 1990 to 2021, but obvious variability was observed across regions and countries. Earlier mental health education and targeted management are urgently required for adolescents and young adults in certain areas.

Effect of sedated colonoscopy with different cost coverage on improving compliance with colorectal cancer screening in China.

Background: Colorectal cancer is the third most common cancer worldwide. Colonoscopy is the gold standard for colorectal cancer screening. However, the colonoscopy participation rate in China is much lower than that in Europe and the United States. As only non-sedated colonoscopies are offered in colorectal cancer screening programs in China, the absence of sedation may contribute to this gap. Methods: To explore the effect of free and partially participant-paid sedated colonoscopy on improving colorectal screening participation, we conducted a cross-sectional study under the framework of the Cancer Screening Program in Urban China in Xuzhou from May 2017 to December 2020. The Quanshan district was set as the control group and provided free non-sedated colonoscopy, the Yunlong district was set as a partial cost coverage group and offered partially participant-paid sedated colonoscopy, and the Gulou district was set as the full cost coverage group and offered free sedation colonoscopies. Multivariate logistic regression was used for multivariate analysis of colonoscopy participation and colorectal lesion detection rates between the groups. Results: From May 2017 to May 2020, 81,358 participants were recruited and completed questionnaire, 7,868 subjects who met high-risk conditions for CRC were invited to undergo colonoscopy. The colonoscopy participation rates in the control group, partially cost coverage, and full cost coverage groups were 17.33% (594/3,428), 25.66% (542/2,112), and 34.41% (801/2,328), respectively. Subjects in the partial and full cost coverage groups had 1.66-fold (95% CI: 1.48-1.86) and 2.49-fold (95% CI: 2.23-2.76) increased rates compared with those in the control group. The adjusted PARs for the partially and the full cost coverage group was 9.08 (95% CI: 6.88-11.28) and 18.97 (95% CI: 16.51-21.42), respectively. The detection rates of CAN in the control, partial-cost coverage, and full-cost coverage groups were 3.54% (21/594), 2.95% (16/542), and 5.12% (41/801), respectively. There were no significant differences in the detection rates between the group. However, sedated colonoscopy increases costs. Conclusion: Sedated colonoscopy increased colonoscopy participation rates in both the partial and full cost-covered groups. A partial cost coverage strategy may be a good way to increase colorectal cancer participation rates and quickly establish a colorectal cancer screening strategy in underfunded areas.