ABSTRACT
OBJECTIVES: The pressure of internal competition at the college level has increased in recent years in China with an impact on nursing students' learning and well-being. This study aimed to investigate the current situation and factors affecting professional identity, learner well-being and self-regulated learning of undergraduate nursing students in the Neijuan ecology of the "double tops" universities, and to explore the relationships between these three variables. METHODS: A cross-sectional design was adopted to conduct an online survey of 322 Chinese undergraduate nursing students from seven "double tops" universities. The survey included socio-demographics characteristics, students' professional identity, learner well-being, and self-regulated learning. RESULTS: Results of Pearson correlation analysis showed that professional identity was significantly and positively correlated with learner well-being (R = 0.795, p < 0.001); professional identity was significantly and positively correlated with self-regulated learning (R = 0.843, p < 0.001); and, self-regulated learning was significantly and positively correlated with learner well-being (R = 0.852, p < 0.001). After mediation effect testing, self-regulated learning had a mediating effect between professional identity and learner well-being (95 % CI 0.366-0.548, p < 0.001). Professional identity had a positive predictive effect on self-regulated learning (a = 0.570, p < 0.001), and self-regulated learning also had a positive predictive effect on learner well-being (b = 0.798, p < 0.001). The direct effect of professional identity on learner well-being (0.225) and its mediating effect (0.455) account for 33.1 % and 66.9 % of the total effect (0.680), respectively. CONCLUSIONS: The learner well-being of undergraduate Chinese nursing students is in the middle to upper range, and it is crucial to enhance professional identity and develop students' self-regulated learning to improve their learner well-being. This study provides empirical evidence to support the mediating effect of self-regulated learning on the relationship between professional identity and learner well-being among undergraduate nursing students in "double tops" universities. Universities are expected to strengthen career planning guidance and professional competence training for students as early as possible in order to develop quality nursing education programs that produce graduates who enter and remain in the workforce.
ABSTRACT
BACKGROUND: Secondhand smoke (SHS) exposure was harmful for brain development. However, the association between SHS exposure and NDDs diagnosis were unclear. OBJECTIVES: To evaluate associations between SHS exposure and NDDs diagnosis, identify critical time windows, and summarize the strength of evidence. METHODS: To investigate the associations of SHS exposure and the development of NDDs, we searched Ovid, EMBASE, Web of Science, Cochrane Library, and PubMed for all the relevant studies up to 31 March 2023. The risk estimates and standardized mean differences (SMD) for the individuals with any NDDs who were exposed to SHS exposure compared with those unexposed or low-exposed. RESULTS: The results showed that a total of 31,098 citations were identified, of which 54 studies were included. We identified significant associations between SHS exposure and the risks of NDDs including specific types of NDDs like attention deficit hyperactivity disorder (ADHD) and learning disabilities (LD) despite the observed heterogeneity for NDDs and ADHD. We also observed a significant association between cotinine exposure and ADHD. However, inconsistent ratings between the two quality-of-evidence methods for all the meta-analyses indicated the current evidence of the associations and the potential exposure window remained inconclusive. DISCUSSION: Our findings suggested that SHS exposure was associated with a higher risk of developing ADHD and LD, with inconclusive quality-of-evidence. In addition, period-specific associations remained unclear based on current evidence.