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\"Competition and Compassion in Chinese Secondary Education examines the nature of academic competition in Chinese schools and demonstrates its debilitating effects on adolescents' psychosocial development. Zhao shows how global economic competition induces changes in national education policies, which in turn shapes how school-aged youth are encouraged by their parents and teachers to relate to others and society. Facing extreme pressures of global economic competition, how can education both in the East and West sustain the kind of humanistic learning that is critical for promoting public reasoning or discourse? The book proposes a research-based approach for balancing academic achievement with the promotion of social and civic engagement in China and elsewhere\"-- Back cover.

In 2020, the Coronavirus disease (COVID-19) triggered the latest wave of anti-Asian discrimination. During the first year of the pandemic, symptoms of depression and anxiety increased seven-fold within Asian Pacific Islander Desi American (APIDA) communities. Among this population, APIDA college students were at particularly high risk for mental health challenges due to COVID-19-related racial discrimination. This study examined the association between COVID-19-related racial discrimination and the mental health of APIDA college students, conceptualizing ethnic identity as a moderator in the association. Secondary analysis was conducted on data from 2,559 APIDA college students aged 18 to 29 who participated in the Fall and Winter/Spring Cohorts of the 2020-2021 Healthy Minds Study (HMS), a non-probability web-based survey administered to students in higher education in the United States. Descriptive statistics, comparative analysis (e.g., Chi-square and t-test), and multivariable linear regression were conducted using STATA 17.1 (StataCorp LLC, College Station, TX). Survey weights were applied in all analyses. There were significant positive associations between COVID-19-related racial discrimination and symptoms of depression (b = 2.15, p < 0.001) and anxiety (b = 1.81, p < 0.001) among the overall sample. Furthermore, a greater sense of ethnic identity was associated with lower symptoms of depression (b = -0.15, p< 0.001) among the overall sample. Finally, ethnic identity buffered the association between COVID-19-related racial discrimination and symptoms of anxiety among East Asian students and symptoms of both depression and anxiety among Native Hawaiian and Pacific Islander students. In contrast, ethnic identity intensified the association between COVID-19-related racial discrimination and symptoms of depression among Filipino students. The research found that COVID-19-related racial discrimination was associated with increased symptoms of depression and anxiety among the full sample of APIDA college students during the first year of the pandemic. Additionally, higher levels of ethnic identity were associated with decreased depression among the entire group. The striking results on the moderating role of ethnic identity among subgroups call for further research on the ethnic identity development of APIDA college students, to help mitigate the effects of racial discrimination within a variety of systemic, complex, and dynamic sociocultural contexts.

Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents. Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents. Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31-2.57; father] and 1.42 [95% CI 1.02-1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different. This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

There is a growing emphasis on developing Quality Physical Education (QPE) programs. However, a research gap exists due to the lack of measurement instruments to assess QPE for students. This study aimed to develop an instrument to assess QPE implementation and its validity and reliability in China. This study comprised three phases. In Phase 1, a conceptual framework for QPE was established using grounded theory based on interviews with 22 PE teachers and 20 students. In Phase 2, using the conceptual framework from Phase 1, we developed an item pool supported by a literature review, expert evaluations, and student interviews. In Phase 3, a cross-sectional study was conducted with secondary school students (705 participants) to analyse the items and assess the instrument’s reliability and validity through exploratory and confirmatory factor analysis, as well as test-retest analysis. The final 45-item instrument, comprising four subscales (student, family, school, and community) across 10 factors, demonstrated strong validity and reliability. Model fit indices met established thresholds (e.g., CFI and TLI ≥ .90, as well as RMSEA ≤ .08). The composite reliability and average variance extracted values for each factor exceeded.7 and.5, respectively, with the test-retest reliability also exceeding.7, indicating high reliability and validity. This study addresses a critical methodological gap in QPE research by developing a culturally contextualized assessment instrument that explicitly identifies and measures students’ perceptions of QPE implementation. This instrument enables systematic monitoring of QPE practices from students’ perspectives, informing evidence-based policymaking and resource allocation. Integrating student, family, school, and community subscales supports holistic interventions to improve the quality of PE.

Background Compassion fatigue is a significant issue in nursing, affecting both registered nurses and nursing students, potentially leading to burnout and reduced quality of care. During internships, compassion fatigue can shape nursing students’ career trajectories and intent to stay in the profession. Identifying those at high risk is crucial for timely interventions, yet existing tools often fail to account for within-group variability, limiting their ability to accurately predict compassion fatigue risk. Objectives This study aimed to develop and validate a predictive model for detecting the risk of compassion fatigue among nursing students during their placement. Design A cross-sectional study was used to capture the prevalence and associations of compassion fatigue among nursing interns, as it allows for timely assessment of key influencing factors without requiring long-term follow-up. Methods A convenience sampling strategy was used to recruit 2256 nursing students from all ten public junior colleges in Hunan province in China between December 2021 and June 2022. Participants completed questionnaires assessing compassion fatigue, professional identity, self-efficacy, social support, psychological resilience, coping styles, and demographic characteristics. Predictors were selected based on prior literature and theoretical frameworks related to compassion fatigue in nursing. Latent profile analysis was used to classify compassion fatigue levels, and potential predictors were identified through univariate analysis and least absolute shrinkage and selection operator (LASSO) regression. Eight machine learning algorithms were applied to predict compassion fatigue, with performance assessed through cross-validation, calibration, and discrimination metrics. The best-performing model was further validated to ensure robustness. Results A three-profile model best fits the data, identifying low (55.73%), moderate (32.17%), and severe (12.10%) profiles for compassion fatigue. Generally, an area under the curve (AUC) above 0.700 is acceptable, and above 0.800 indicates good predictive performance. The AUC values for the eight machine learning models ranged from 0.644 to 0.826 for the training set and 0.651 to 0.757 for the test set, indicating moderate to good discriminatory ability. The eXtreme Gradient Boosting (XGBoost) performed best, with AUC values of 0.840, 0.768, and 0.731 in the training, validation, and test sets, respectively. Shapley Additive Explanation (SHAP) analysis interpreted the model by quantifying the contribution of each variable to the prediction, revealing that psychological resilience, professional identity, and social support were the key contributors to the risk of compassion fatigue. A user-friendly, web-based prediction tool for calculating the risk of compassion fatigue was developed. Conclusions The XGBoosting classifier demonstrates excellent performance, and implementing the online tool can help nursing administrators manage compassion fatigue effectively. It holds practical value for nursing education and practice by supporting early detection and intervention. Future research should validate its use across settings, and longitudinal studies could assess its long-term impact.

Background Stigma adversely affects the rehabilitation among stroke inpatients, which decreases the motivation and functional improvement. According to prior studies, there was a correlation between social alienation and stigma. This study aimed to investigate the factors influencing stigma among stroke inpatients, providing evidence for future targeted stigma interventions. Methods The study was a cross-sectional survey conducted in China from July to November 2023 using a convenience sampling method. Ethical approval for this study was obtained from the Medical Ethics Committee. A total of 220 stroke inpatients completed a demographic questionnaire, the generalized social alienation scale, and the stroke stigma scale. Multiple linear regression analysis was used to evaluate the impact of the diverse factors on stigma. Results The results showed that the score of stigma among stroke inpatients was 47.36 ± 4.28, indicating a moderate level of stigma. Social alienation was positively correlated with stigma( r  = 0.366, P  < 0.001), indicating stigma increased with the increase of social alienation. Age( B =-2.105, P  < 0.001), level of education[Junior high school( B  = 1.545, P  = 0.040), senior high school or technical secondary school( B  = 3.480, P  < 0.001), undergraduate or junior college( B  = 3.716, P  < 0.001), and graduate( B  = 5.483, P  < 0.001)], and social alienation( B  = 0.158, P  < 0.001) were all significantly associated with stigma in stroke inpatients. Among all educational levels, graduate( B  = 5.483, P  < 0.001) showed the most robust correlation with stigma. The results indicated that stroke inpatients who were younger and had higher levels of education had higher levels of stigma. Conclusions Findings suggest that social alienation is a significant contributor to perceived stigma among stroke inpatients, particularly among younger and more educated individuals. Tailored psychosocial interventions that address feelings of social alienation may help reduce stigma in these groups.

Background With China’s economic transformation, essential service workers have become a crucial workforce in tertiary industry. These workers face significant occupational health risks, making occupational health literacy (OHL) vital for their health protection. However, the specific influence of these socioeconomic and occupational characteristics on OHL among essential service workers remains largely unexplored, particularly in China’s economically developed regions. Therefore, this study aimed to investigate the associations between socioeconomic and occupational characteristics and OHL among essential service workers in Guangdong, China. Methods A cross-sectional study was conducted among 2,640 essential service workers from the environmental sanitation, transportation, express and food delivery industries. OHL was assessed across four dimensions via the National OHL Surveillance Questionnaire. Multiple logistic regression analyses were performed to examine associations between socioeconomic and occupational characteristics (education level, monthly income, job tenure) with OHL, adjusting for potential confounders (sex, age, ethnic group, marital status, hukou type, enterprise scale, registration type, industry, and other socioeconomic and occupational characteristics). Results The overall OHL level was 52.8%. A higher educational level was positively associated with OHL (adjusted OR = 1.69, 95% CI: 1.19–2.41 for tertiary vs. primary education). Monthly income showed an inverse association, with higher-income workers having lower odds of adequate OHL (adjusted ORs: 0.44–0.60). Longer job tenure was negatively associated with OHL (adjusted OR = 0.36, 95% CI: 0.28–0.47 for ≥ 5 vs. <1 year). Educational level positively influenced OHL across all industries without interaction effects, while monthly income and job tenure showed significant industry-specific interactions, with job tenure negatively associated with OHL only in environmental sanitation and transportation industries. Conclusions Socioeconomic and occupational characteristics significantly influence OHL among essential service workers, with patterns varying across industries. These findings suggest the need for targeted interventions that consider educational background, working experience, and industry-specific characteristics to increase OHL among this vulnerable workforce.

Background This study adapted the Questionnaire Assessing School Physical Activity Environment (Q-SPACE) into Chinese and evaluated its psychometric properties. Methods A total of 253 primary school and 267 secondary school students completed the modified Q-SPACE-Chi twice, with a 2-week interval, between November 2022 and March 2023. A confirmatory factor analysis and the assessment of measurement invariance supported the efficiency of the three-factor Q-SPACE-Chi (i.e., physical environment, social environment, and school policy) across various groups. Results The results confirmed the factorial validity of the three-factor modified A-SPACE-Chi, with all items demonstrating significant loadings in the physical environment, special environment, and social policy dimensions. The predictive validity results revealed significant associations between student’s perceived school physical activity environment and the physical activity level. Moreover, the test-retest reliability and internal consistency of the adapted questionnaire were moderately favorable. Conclusion This modified Q-SPACE-Chi, with element of school policy therefore presents an additional valuable tool for researchers or practitioners aiming to evaluate how Chinese students perceive the school physical activity environments within their schools while the measurement properties of Q-SPACE-Chi was invariant among primary and secondary students.

In order to gain a deeper understanding of the relationship between physical activity and adolescent mental health in the post COVID-19 pandemic era, self-esteem and social anxiety were used as mediating variables to explore the potential mechanisms by which physical activity affects adolescent mental health. The study used the HELP-II Health Promoting Lifestyle Scale, the SPIN Social Phobia Scale, the Self-Esteem Scale, and the 10-item Kessler Psychological Distress Scale to administer questionnaires to 400 Chinese secondary school students, and SPSS 26.0 and PROCESS 3.3 were used to process the data. The findings showed that (1) physical activity was significantly and positively associated with mental health; (2) self-esteem and social anxiety played a fully mediating role between physical activity and adolescent mental health respectively; (3) self-esteem and social anxiety played a chain mediating role between physical activity and adolescent mental health. This study reveals the relationship and influencing mechanism between physical activity and adolescent mental health in the post COVID-19 pandemic era. Appropriate interventions for physical activity, self-esteem, and social anxiety may be beneficial to adolescent mental health. The protective role of self-esteem in adolescent mental health should be the focus of future studies, and further investigations into the association between the COVID-19 and adolescent mental health are warranted.

Teachers' work engagement significantly impacts the overall teaching quality and educational effectiveness of a school. Previous research has identified authentic leadership, school climate, and teacher efficacy as pivotal influencers that substantially shape teachers' work engagement. However, the specific mechanisms through which authentic leadership influences the work engagement of primary and secondary school teachers have not been thoroughly investigated. This study seeks to explore how authentic leadership shapes the work engagement of primary and secondary school teachers through the sequential mediating roles of school climate and teacher efficacy. In June 2024, an anonymous survey was successfully administered to 1043 primary and secondary school teachers (M = 36, SD = 9.547) in Shandong Province. Data analysis was performed using the Structural Equation Model (SEM) in AMOS 24.0 and SPSS 24.0. The findings indicate that: (1) Authentic leadership directly predicts teachers' work engagement; (2) Authentic leadership influences teachers' work engagement through the mediating roles of school climate and teacher efficacy separately; (3) School climate and teacher efficacy play a chain mediating role between authentic leadership and teachers' work engagement. These findings contribute to a deeper understanding of the mechanisms linking authentic leadership and teachers' work engagement, and offer guidance for school administrators and policy makers to implement targeted interventions aimed at bolstering teachers' work engagement, which is essential for elevating the quality of education in schools.