ABSTRACT Objective To explore the distribution of Chinese medicine constitution (CMC) types across the spectrum of health states related to nasopharyngeal carcinoma (NPC) and provide evidence‐based information for the prevention and treatment of NPC at different stages of the disease. Methods PubMed, Embase, Web of Science, and three major Chinese databases were searched to retrieve literature reporting the correlation between populations across related health states of NPC and CMC, using the same standardized classification since 2009. Three authors independently screened and evaluated the quality of the methodology. The main outcomes were the single proportion and the odds ratio (OR) of each constitution type across related health states of NPC, and the effect sizes were expressed as proportions or as ORs with 95% confidence intervals (CI). Sensitivity and subgroup analyses were performed to determine the sources of heterogeneity. Results Data of 1174 patients from 11 different studies were included in the present study. Qi‐deficiency (QD), balanced, and Yang‐deficiency constitutions accounted for 25.5% (95% CI: 19.0–32.0, p < 0.01), 16.1% (95% CI: 18.1–26.1), and 15.4% (95% CI: 9.5–21.4), respectively. The distribution across related health states of patients with NPC varied across different stages of the disease. QDC showed a significant association with both Epstein–Barr virus infection and NPC diagnosed status in the included populations compared with that in healthy controls. Conclusion QDC is a major factor associated with NPC across different health statuses. However, the cross‐sectional nature of the available evidence highlights the need for more high‐quality prospective cohort studies to clarify the temporal relationship and causal role of specific constitutions in NPC development.

Teacher feedback has been considered a potent lever for promoting learning. However, empirical studies often fail to reveal a positive relationship between feedback and learning outcomes. To unveil the complex mechanisms through which teacher feedback works, scholars have increasingly investigated student factors that can enable its benefits. Grounded in feedback literacy and self-regulated learning (SRL) theories, the present study explored the mediating roles of students' emotion (i.e., reading enjoyment) and cognition (i.e., reading strategies) in the relationship between feedback and reading achievement. Multilevel structural equation modeling was conducted with 592,249 15-year-old students from 79 countries/territories in the Programme for International Student Assessment (PISA) 2018 data. The results showed that teacher feedback had a negative direct effect on reading achievement but a positive indirect effect through reading enjoyment and strategies. These findings underscore the critical roles of students' emotions and cognition in realizing the benefits of teacher feedback. Pedagogical implications for how teachers enhance adolescents' positive emotions and learning strategies in feedback processes are discussed.

ABSTRACT Self‐concept and self‐efficacy have received much attention from second/foreign language (L2) researchers. However, very few studies have empirically deciphered their similarities and distinctions. Even fewer have investigated how their contributions to L2 achievement vary across L2 proficiency levels. The current study examined the commonality and specificity of self‐concept and self‐efficacy and their relative contributions to English achievement and their fluid effects on English achievement across different proficiency groups based on the Island Ridge Curve theory. A sample of 369 Chinese undergraduate students completed two questionnaires of self‐concept and self‐efficacy, and their English achievement was represented using College English Test Band Six scores. Bifactor structural equation modeling (SEM) revealed that the combined scale shared one commonality factor and two specific factors. Multi‐group bifactor SEM found that the general factor and specific self‐concept factor were positively related to English achievement and their respective effects fluctuated across English proficiency groups.

Situated expectancy-value theory emphasizes the role of cultural context in shaping expectancy-value factors such as self-efficacy and utility value. Long-term orientation, as a cultural value, reflects a holistic view of time valuing both the past and the future. Although it is viewed as related to motivational beliefs, few studies investigating educational outcomes have examined long-term orientation, self-efficacy, and utility value concurrently. This study examined the interplay between long-term orientation, self-efficacy, and utility value, in determining Business English proficiency. Participants involved 140 undergraduates in East China. They responded to a survey measuring long-term orientation, Business English self-efficacy and utility value. Business English proficiency was indicated by self-rated proficiency and terminal exam scores. The results of structural equation modeling showed that: (1) self-efficacy was directly related to self-rated Business English proficiency; (2) utility value had a non-significant relation to Business English proficiency; (3) long-term orientation only had an indirect positive relation to self-rated Business English proficiency through self-efficacy; and (4) there was no interaction between long-term orientation and expectancy-value factors in determining Business English proficiency. The findings highlight the importance of cultivating long-term orientation to promote motivation and learning outcomes.

Background Creativity is a highly desirable general competence in the 21st century worldwide, but the potential of reading literacy in predicting general creativity competence is understudied. Materials and Methods The current study examined the relationship between reading literacy and general creativity competence at the student and school levels. We used the Programme for International Student Assessment (PISA) 2022 produced by 5557 Hong Kong adolescents (Mage = 15.81, SD = 0.29, females = 49%) nested within 163 schools. Hong Kong was chosen for its consistent efforts to integrate creativity into the educational curriculum. We included student socio-economic status (SES) and gender (0 = female, 1 = male) at the student level and school SES at the school level as covariates. Results A two-level path analysis indicated that: (1) student reading literacy produced a large predictive effect on student creativity competence; (2) school mean of reading literacy had a large positive effect on school collective creativity competence; (3) student SES had a small positive effect on student creativity competence and gender had a medium negative effect on student creativity competence in favor of females; and (4) school SES had a large positive effect on school collective creativity competence. Conclusion The results showed the importance of fostering creativity competence through reading interventions and school resource investment.

Test anxiety is generally perceived to impede L2 achievement. One focus of test anxiety studies has been on predictors of test anxiety, aiming to detect factors that may reduce the harm of test anxiety to L2 achievement. Considerable efforts have been invested in psychological and contextual factors at the neglect of cognitive factors such as uncertainty tolerance. The current study examined the interplay between uncertainty tolerance and test anxiety in predicting L2 achievement, with a focus on the mediation of test anxiety between uncertainty tolerance and L2 achievement. Participants involved 400 Grade 10 students from a high school in East China. Structural equation modeling results showed that (1) test anxiety was negatively associated with L2 achievement, (2) uncertainty tolerance was positively associated with L2 achievement, and (3) test anxiety partly mediated the relationship between uncertainty tolerance and L2 achievement. The study provided theoretical and practical implications for L2 instruction.

Textual unfamiliarity has been a major concern of second/foreign language (L2) reading test validation. The state-of-the-art for controlling the textual unfamiliarity effect has exclusively relied on test providers, neglecting the agentic role of test-takers. The current study proposes the utility of social-cognitive theory in equipping test-takers with the agency to reduce the impact of textual unfamiliarity on their reading test performance. To demonstrate, this study recruited 1176 undergraduate students (Mage = 18.95, SD = .76; females = 48%) from two Chinese universities and collected data on their English self-efficacy, metacognitive strategies, textual unfamiliarity, and English reading test performance. Results of structural equation modeling showed that: (1) reading test performance was negatively predicted by textual unfamiliarity but positively predicted by self-efficacy; and (2) self-efficacy and metacognitive strategy use negatively predicted textual unfamiliarity, leading to reduced textual unfamiliarity and its effect on reading test performance. These findings provide new evidence for the reconceptualization of language competence by positioning background knowledge as an integral component of language ability. These findings also argue for broadening the scope of test validation from a test-provider-centered model to encompass test-taker agency. For L2 educators, these findings may inspire them to help students navigate unfamiliar reading texts by enhancing their self-efficacy and metacognitive strategies.

A critical concern for English Medium Instruction (EMI) programs is the relationship between learning English and mastering subject content. While existing studies on EMI have mainly focused on transferring cognitive factors across learning in English and non-English subjects, very few have explored the transmission of motivational factors (e.g. self-concept) between learning in the two domains. We examined how achievements in English and maths impact EMI students' subsequent self-concepts in corresponding and non-corresponding domains under the dimensional comparison theory (DCT). Participants involved 865 first-year secondary school students studying in EMI programs. Results of structural equation modelling showed that English achievement was positively associated with English self-concept but negatively associated with maths self-concept, thereby supporting the contrast effect hypothesis. Meanwhile, maths achievement had positive relationships with both maths self-concept and English self-concept, thereby failing to confirm the contrast effect. Implications and limitations were discussed.

BackgroundSituated expectancy-value theory (SEVT) is a prominent motivation framework explaining how expectancy (e.g. self-concept) and value factors (e.g. utility value) predict learning achievement. However, existing second/foreign language (L2) motivation studies usually assume a linear relationship between these factors and L2 achievement. The Island Ridge Curve (IRC) offers a theoretical alternative, positing that the effects of cognitive and motivational factors on L2 achievement fluctuate across distinct stages of L2 competence development. Integrating SEVT with IRC would enable a nuanced examination of the dynamic association between motivation and L2 achievement.PurposeThis research examined the changing associations between two motivation factors (self-concept and utility value of schooling) and English as an L2 achievement across struggling, low, medium, and high achievers.MethodologyThe sample comprised 2325 eighth-graders from 16 Hong Kong schools. Multilevel mixture modeling was employed for data analysis.FindingsResults showed that (1) the positive association between English self-concept and English achievement varied significantly across the struggling, low, medium, and high achievers, with a significantly larger effect in the medium achievers; and (2) the positive association between utility value of schooling and English achievement fluctuated across the four groups, but the associations were all nonsignificant. Overall, the findings support the IRC, particularly regarding the role of learners' self-concept in determining L2 achievement.ValueThis study underscores the value of synthesizing SEVT and IRC to explicate the complex, nonlinear relationship between motivation and L2 achievement, suggesting that future research on motivation should account for proficiency-dependent variations rather than assume uniform effects.

The current study examines the association between socio-economic status (SES) and reading achievement, and it also investigates whether student enjoyment of reading and teacher job satisfaction moderate this association. We used the PISA 2018 data, focusing on the reading domain. The participants were 2473 secondary school students (Mage = 15.76, SD = .29) and 1409 reading teachers nested in 97 schools from the United Kingdom. The results show that: (1) at the student level, reading enjoyment amplified the positive relationship between SES and reading achievement, suggesting that higher-SES students tend to benefit more from reading enjoyment in reading achievement. (2) At the school level, teacher job satisfaction neither enlarged nor weakened the relationship between school SES and school reading achievement.

According to the situated expectancy-value theory (SEVT), reading achievement can be driven by two key motivational factors (expectancy and task value) and the interaction between them. Existing studies on reading have mostly focused on the main effects at the expense of insufficient attention to interaction. Besides, interaction has merely been operationalized as the product term between expectancy and value (i.e., expectancy multiplying value, Type 1 interaction), neglecting the relative (or comparative) importance of expectancy and value (i.e., the competition between them, Type 2 interaction) in determining reading achievement. To address these gaps, the current study examined the main effects of and the two types of interaction between two expectancy-value factors, namely, reading enjoyment (indicating value) and self-concept (indicating expectancy), in predicting reading achievement. We used the Program for International Student Assessment (PISA) 2018 data generated by 532,835 students (Mean age = 15.79, SD = 0.29, 51

INTRODUCTION This study evaluates the public response to Shanghai's strict smoking ban through an analysis of calls made to the 12320 Health Hotline. The focus is on identifying the types of violations reported, the locations involved, and how these calls can inform future enforcement strategies. METHODS We collected 41614 call records from March 2016 to March 2019 and used natural language processing (NLP) techniques to analyze these data. Calls containing tobacco-related complaints, consultations, help-seeking requests, or suggestions were included. RESULTS Following the implementation of the amended regulations, tobacco-related hotline activity peaked in March 2017. During this month, 6937 eligible calls were recorded, of which 4705 (68%) were complaints, 1212 (17%) were consultations, and 829 (12%) were help-seeking requests, while only 172 calls (2%) involved suggestions. Workplaces accounted for the largest proportion of reported locations (35%; n=2399), followed by food and beverage establishments (14%; n=960) and leisure or hospitality venues (13%; n=902), with schools least frequently reported (1%; n=86). CONCLUSIONS Hotline-based surveillance provides a practical approach for characterizing public concerns related to smoking ban enforcement. Further studies are needed to examine demographic predictors of call patterns, assess long-term trends beyond the initial implementation period, and explore how such data sources may complement conventional tobacco control monitoring systems.

ObjectiveOur study aims to explore the health service issues of public concern through analyzing the basic characteristics of callers and information from the health hotline in Shanghai. The findings of this study will provide a reference to relevant government departments and assist the government in optimizing the allocation of health resources.MethodsOur research utilized 16,962 original work orders from the 12,320 health hotline, collected since 2015. We applied natural language processing (NLP) to analyze the content of these work orders, facilitating effective text mining and information extraction. Initially, we performed data cleaning to remove irrelevant information and protect caller privacy by anonymizing personal details. This cleaned data was then organized into a structured database for further analysis. Using text mining, we examined various aspects of the calls, including duration, purpose, and topics discussed, to identify patterns and themes that emerged.ResultsThe calls were categorized into four main groups: complaints, suggestions, inquiries, and requests for assistance. Complaints were the most frequent category, totaling 8,669 (51.11%), followed by help-seeking at 3,335 (19.66%), consultations at 2,727 (16.08%), and comments and suggestions at 1,484 (8.75%). The analysis revealed that men made 6,689 (56.88%), surpassing the 5,071 (43.12%) from women. Additionally, calls from parents numbered 2,126 (56.84%), slightly exceeding the 1,614 (43.16%) from children. The top 10 health service concerns identified in Shanghai included medical staff attitudes, medications, fees, registration, family planning, medical disputes, ambulance services, environmental health, illegal medical practices, and immunization.ConclusionsThis study not only identifies critical issues within the Shanghai health service system but also offers actionable insights to inform targeted policy interventions. The high volume of complaints regarding service attitudes and medical expenses underscores the need for stronger policies to improve patient-provider communication and ensure transparency and fairness in healthcare costs. Additionally, the data reveals considerable public concern about the availability and quality of medical services, suggesting that existing policies on resource allocation and service delivery may not adequately meet population needs. The methodologies employed here can be applied to other urban health contexts, providing a valuable framework for improving public health strategies globally.

The concept of growth mindset has been touted as a promising tool to empower learning, but mixed effects emerge. Growth mindset advocates are calling for more attention to the heterogeneity of growth mindset, namely, the interference of other factors at individual or contextual levels (e.g., teacher variables) with the relationship between growth mindset and learning achievements. To seek more evidence for this assumption, the current study explored the role of students’ perception of their teacher support in predicting the quantity of growth mindset and the magnitude of the association between growth mindset and learning achievement in reading. We drew on the Programme for International Student Assessment (PISA) 2018 data from 507,354 students from 74 countries/territories. We analyzed the data with multilevel structural equation modeling with latent interaction. Our findings showed that perceived teacher support did not significantly predict the quantity of growth mindset. Besides, perceived teacher support positively moderated the relationship between growth mindset and reading achievement. Specifically, when teacher support was deficient, the relationship between growth mindset and reading achievement was negative; when teacher support continually increased, the relationship between growth mindset and reading achievement gradually switched to positive. These results indicated that teacher support plays a game-changing role in the relationship between growth mindset and reading achievement, therefore highlighting its significance in revealing the heterogeneous effect of a growth mindset effect on learning achievements.

BackgroundBased on the Chinese Medicine constitution, this study developed a questionnaire specifically tailored for preschool children.MethodsFirst, a TCM constitution scale for children aged 3–6 years was developed using face-to-face interviews, Delphi expert consultation, and Classical Test Theory (CTT). The Delphi method was conducted via email, and five CTT indicators were selected: decision value–critical ratio, dispersion trend, item–total correlation, internal consistency, and factor loading. Second, the psychometric properties of the scale were assessed, including reliability (internal consistency, test–retest reliability, and split-half reliability) and content validity. Exploratory factor analysis (EFA) was used to evaluate the structural validity of the items.ResultsThe CCMQ 2.0 consisted of 47 items selected from the original 49 items of version 1.0. Exploratory factor analysis yielded a Kaiser–Meyer–Olkin (KMO) value of 0.886, and Bartlett’s test of sphericity was significant (χ2 = 5308.679, p < 0.001), indicating that the data were suitable for factor analysis. Nine common factors were extracted, accounting for a cumulative variance contribution of 52.853%. The internal consistency of the CCMQ 2.0 was high, with a Cronbach’s α of 0.924, and the test–retest reliability was satisfactory, with an intraclass correlation coefficient (ICC) of 0.86. Overall, the scale showed promising preliminary psychometric properties, although further validation is needed.ConclusionThis study developed and preliminarily evaluated a 47-item Traditional Chinese Medicine (TCM) constitution scale for assessing the physical and mental health of children aged 3 to 6 years. The scale demonstrated good reliability and validity, providing a promising alternative tool for large-scale pediatric health assessments.

Boredom is believed to have a detrimental effect on second/foreign language learning (L2) achievement. Studies on boredom are usually framed under the control-value theory, believing that appraisals of control (e.g., self-efficacy and L2 proficiency) and value (i.e., importance) can diminish boredom and its effect on L2 achievement. However, the associations are mostly assumed to be linear. The Island Ridge Curve (IRC) theory posits nonlinearity between individual attributes and L2 achievement. Combining the control-value theory and the IRC, the current study examined this nonlinearity in the relationship among self-efficacy, boredom, L2 achievement, and L2 proficiency. A total of 400 10th graders from a Chinese high school participated in the study. Data analysis involved three steps: (1) conducting latent profile analysis to identify the latent English proficiency groups; (2) conducting analysis of variance to compare the difference in the level of boredom across different proficiency groups; and (3) conducting multigroup structural equation modeling to explore the variation of the associations among boredom, self-efficacy, and L2 (English) achievement across different proficiency groups. Our results showed that (1) boredom appeared to be higher (though the difference is non-significant) with students in low and high L2 proficiency groups, (2) the association between boredom and English achievement was negative and fluctuated in the negative-null-negative pattern across different proficiency groups, and (3) the association between self-efficacy and boredom was negative and fluctuated in the negative (non-significant)-larger negative-smaller negative pattern. Our results show the value of combining the control-value theory and the IRC to study boredom.