Mediating role of inner strength in the relationship between medication literacy and medication adherence among kidney transplant patients

Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.

Construction and Validity of Chinese Translation of the Universal Mental Health Literacy Scale for Adolescents

Background:In this study,the Universal Mental Health Literacy Scale for Adolescents(UMHL-A)was revised and tested for its reliability and validity in Chinese middle school students,thus establishing a useful tool for assessing the mental health of individuals in this occupation.Methods:Our sample comprised 1208 junior high school students(58.85%male),aged between 11 and 15 years old.The Chinese version of the scale includes a mental health attitude subscale and mental health knowledge subscale,including attitudes towards seeking help,attitudes related to stigma,general mental health knowledge,and knowledge about specific mental illnesses,encapsulated in a total of 17 items.A series of psychometric analyses such as exploratory factor analysis(EFA),confirmatory factor analysis(CFA),and internal consistency reliability estimation were carried out in this study.Results:The results of the CFA indicated that the two-factor model had an acceptable model fit(Attitude(UMHL-A Likert):χ^(2)/df=4.107;RMSEA=0.072;SRMR=0.045;TLI=0.932;CFI=0.954;Knowledge(UMHL-A T/F):χ^(2)/df=3.647;RMSEA=0.066;SRMR=0.044;TLI=0.923;CFI=0.945).The Cronbach’s alpha coefficient of subscales of the Chinese version UMHL-A were 0.80 and 0.78,respectively.Conclusion:In general,the Chinese version of the Universal Mental Health Literacy Scale for adolescents has good reliability and validity and can be used as a tool to measure the mental health literacy of Chinese adolescents.

Association between Mental Health Literacy and Workplace Well-Being of Chinese Grassroots Civil Servants:The Chain Mediating Effects of Regulatory Emotional Self-Efficacy and Resilience

This study aimed to investigate the relationship between mental health literacy(MHL)and workplace well-being(WWB)of Chinese grassroots civil servants,with regulatory emotional self-efficacy(RESE)and resilience as mediating variables.A questionnaire survey was conducted among Chinese grassroots civil servants,with a valid sample size of 2673 after excluding missing values and conducting relevant data processing.The PROCESS was used to examine the relationship between MHL,RESE,resilience,and WWB.The study found that MHL among grassroots civil servants was positively and significantly correlated with WWB(r=0.73,p<0.01).RESE partially mediated the relationship between MHL and WWB(β=0.25,95%CI[0.22,0.28]).Resilience partially mediated the relationship between MHL and WWB(β=0.22,95%CI[0.19,0.26]).MHL had a positive effect on WWB through the chain mediating effect of RESE and resilience(β=0.05,95%CI[0.03,0.07]).There is a close relationship between MHL and WWB,where Chinese grassroots civil servants with higher levels of MHL can develop stronger RESE and resilience,leading to higher WWB.The results of this study remind organizational institutions of Chinese grassroots civil servants that enhancing MHL,RESE,and resilience is an important pathway to promoting their WWB.

An Experimental Study on the Effectiveness of Individualized Online Intervention for Mental Health Literacy of Community Residents

Background:Understanding how to improve mental health literacy is conducive to maintaining and promoting individuals’mental health and well-being.However,to date,interventions for mental health literacy primarily depend on traditional education and contact interventions,which have limitations with regard to pertinence and individualization.Artificial intelligence(AI)and big data technology have influenced mental health services to be more intellectual and digital,and they also provide greater technical convenience for individualized interventions for promoting mental health literacy.However,there is relatively little research on the effectiveness of individualized online intervention for mental health literacy in the literature.This study aims to fill this void.To verify whether individualized online intervention can improve the level of mental health literacy.Methods:We conducted a pretest–post-test control experiment.The participants were recruited from a large community located in central China.A total of 152 participants completed the research.We use mixed linear model estimation and paired t-tests to analyze the data.Results:Individualized online intervention can effectively improve the mental health literacy level of participants.Specifically,we found that compared with the control group,the mental health literacy in the experimental group was significantly improved after receiving individualized online intervention.Likewise,the mental health literacy of the control group has also improved after receiving individualized online intervention.In addition,we compared the mental health literacy level of the experimental group at Time 3 to those at Time 2 and found that the mental health literacy level at Time 3 had not decreased one month later.This shows that individualized online intervention was not only momentarily effective,but also had long-term efficacy.Conclusion:This study illustrates that the individualized online intervention has both great momentary and long-term effectiveness in improving community residents’mental health literacy.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Comparative Study of the Socioeconomic Characteristics and Digital Literacy Level of Agricultural Extension Personnel in Imo and Ebonyi States, South-East, Nigeria

The study comparatively analysed the socioeconomic characteristics and digital literacy level of Agricultural Extension personnel (AEP) in Ebonyi and Imo States, South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in Ebonyi and Imo States, and to ascertain the digital literacy level of AEP in the studied states. Purposive sampling technique was used to select 312 Agricultural Extension personnel (132 from Ebonyi State Agricultural Development Program and 180 from Imo State Agricultural Development Program) for the study. Data were collected through the use of validated and structured questionnaire, and administered through the help of well-trained enumerators. Data were analysed using simple descriptive statistical tools such as percentages mean score, standard deviation and weighted mean. Findings indicated that they were more male in the both States (55.3% and 57.8%) for Ebonyi and Imo State respectively and that the average age of AEP in Ebonyi and Imo States were 44.7 years and 49.2 years respectively. It was further revealed that the majority (77.3% and 82.8%) had B.Sc./HND as their highest academic qualifications, belonged to professional organisations (62.1% and 75%), and were earning an average monthly income of N58,798 and N62,648 for Ebonyi and Imo State respectively. Also, it was revealed that their mean years of service were 12.4 years and 13.4 years for Ebonyi and Imo State respectively. Almost all of them (87.9% and 95.0%) own a smartphone, had access to the internet (80.3% and 90.0%), but do not own a laptop/ipad (82.6% and 72.8%) for Ebon-yi and Imo State respectively. Results further revealed that Agricultural extension personnel in both Ebonyi and Imo State respectively had low digital literacy level ( = 2.41 and 2.32). The study concluded that AEP in Ebonyi and Imo State respectively had similar socioeconomic characteristics and low level of digital literacy. The study recommended that the management of ADPs in both Ebonyi and Imo State should ensure the training of AEP in digital skills to enhance their digital literacy level to enable them use digital technologies in their work.

Digital Literacy in the Rural Environment of Rivers State, Nigeria

While literacy can generally be defined as the basic ability to read,write,and also count,digital literacy can be described as the ability to perform all these tasks using electronic means.These means would include modern electronic gadgets,such as mobile phones,tablets,computers,kindle books,and the like.To be digitally literate would therefore require the existence of modern technologies such as internet facilities that would make it possible to access online reading and writing.The rural environment,particularly in developing areas,is usually characterised by a seeming lack of modern amenities and even worse,digital internet networks.Yet,those who live in the rural areas of Rivers State belong to the modern digital era and deserve to be digitally literate.This paper examines the prerequisites for digital literacy and explores how these can be achieved for citizens who inhabit the rural areas of an industrially-nascent state like Rivers State.

A Study on the Values and Strategies of English Picture Book Reading for Improving Pupils’ English Reading Literacy

Reading is one of the core skills in English learning.It is indispensable for EFL learners to develop good English reading literacy in primary schools.English picture books are consistent with pupils’cognitive and thinking modes,which is valuable to improve their English reading literacy.However,at present,most Chinese pupils have some problems in English reading.The paper aims at analyzing the current problems in Chinese pupils’English reading and digging out the values and strategies of English picture book reading,so as to stimulate their reading interests,cultivate their intercultural awareness,and improve their English reading literacy.

Paths to Enhance Teacher Digital Literacy Under Educational Digital Transformation in China

In the context of the digital transformation of education in the new era,digital literacy for teachers is a new requirement for professional development.Teacher digital literacy encompasses four main aspects:attitudinal literacy,knowledge and skills literacy,instructional application literacy,and innovation and development literacy.Currently,there are several issues with teacher digital literacy,such as a lack of digital responsibility,insufficient digital knowledge and skills,weak digital application skills,and low digital innovation capability.Enhancing teachers’digital literacy is a complex and critical task.Based on the current state of teachers’digital literacy,this paper proposes the following approaches:(1)adherence to digital norms;(2)development of a robust training mechanism;(3)improvement of the evaluation system;(4)strengthening of digital innovation.

Exploring International Media and Information Literacy Initiatives: Insights From DW Akademie’s MIL Model

Media and Information Literacy(MIL)is one of the most important topics in today’s mediatized world.Under the leadership of United Nations Educational,Scientific and Cultural Organization(UNESCO),many international organizations in the world,as foreign donors,annually announce many projects and grants for the promotion and development of the field of MIL in the countries of the world.One of the main actors of this movement is DW Akademie with different media and MIL projects several countries of the world.This research paper delves into the role of DW Akademie’s MIL model in shaping a media-savvy generation.The study explores the theoretical underpinnings and practical applications of Deutsche Welle(DW)Akademie’s MIL model,analysing its effectiveness in fostering media literacy skills.The research employs a multi-faceted approach,incorporating case studies to assess the model’s impact across diverse demographics.The paper also considers the model’s alignment with global educational policies and proposes recommendations for its integration into broader frameworks.By investigating DW Akademie’s MIL model,this research contributes to the ongoing discourse on media literacy education,providing valuable insights for educators,policymakers,and researchers.The findings offer a nuanced understanding of the model’s position in cultivating a media-savvy generation poised to navigate the complexities of the information age.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

English Writing Autonomy and Literacy among Chinese College Students

The purpose of this study is to examine the current situation of English writing autonomy and literacy among Chinese college students,to analyze their performance,scale,and distribution as well as influencing factors,and to explore the correlation between English writing autonomy and literacy.This study will provide an in-depth analysis of the current situation of Chinese college students’English writing autonomy and literacy,reveal the scale,distribution,and influencing factors,as well as put forward strategies to enhance them,so as to provide a reference for the reform and development of college English education.

China’s Perspectives on the Modern Educational Value of Critical Information Literacy

Critical information literacy is a new and important direction of information literacy education for university students in the new media era.By comparing critical information literacy between China and the West,combining with the research on information literacy education in China in the past 20 years,and based on the three major relationships that Chinese philosophy is concerned about that people need to face in the world of life,i.e.,the individual and the self,the individual and nature,and the individual and the society,this paper defines critical information literacy as that individuals,as information subjects,discover,select,confirm,and evaluate the information they are exposed to by obtaining and discriminating the content elements of the information world(information sources,information,and information assets)and using critical thinking skills and methods,creatively interpret or solve the relevant problems arising from the interaction between individuals and self,individuals and nature,individuals and society,and form the literacy that represents the knowledge,ability,attitude,habit,and level of the information subject through continuous reflection and practice.In order for human beings to better understand the world and construct it responsibly,critical information literacy can play a greater role and educational value.It not only helps contemporary college students build knowledge of“good questioning”and enhance their“reasoning”skills,but also encourages them to maintain a“firm standpoint,”cultivate a habit of“healthy skepticism,”and enhance their“decision-making”skills.

Improving Statistical Literacy through Evidence-Based Strategies Among First-Year Education Students in a State University

Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.

A Study on Extracurricular Literary Classics Reading in High School English Based on Core Literacy

Reading teaching is the core content of high school English teaching,and extracurricular literary classics reading is a supplement to in-class reading,which can deepen students’understanding and memorization of English-related knowledge,and cultivate students’core literacy.This paper outlines the problems in high school English reading teaching,analyzes the significance of extracurricular literary classics reading in high school English,and explores the teaching strategies of extracurricular literary classics reading in high school English based on core literacy,with a view to providing valuable reference information for teachers.

Evaluation and Empirical Research on Teachers’ Information Literacy in the Context of Smart Education

The development of smart education has led to the integration of emerging technologies such as artificial intelligence with education.It is a prerequisite for teachers to have high information literacy for conducting education and teaching work.This study conducted a questionnaire survey on 412 teachers in a certain area.The results showed that teachers’information literacy is above the middle level,and there are significant differences in information literacy between teaching experience and educational background.The evaluation showed that information ethics,information awareness,and information application have a significant positive impact on professional development,and information knowledge and information awareness have a positive predictive effect on information ethics.

Research on the Lifting Path of Data Literacy Ability of Applied University Teachers under the Perspective of Organizational Learning

With the arrival of the big data era, the modern higher education model has undergone radical changes, and higher requirements have been put forward for the data literacy of college teachers. The paper first analyzes the connotation of teacher data literacy, and then combs through the status quo and dilemmas of teachers’ data literacy ability in applied universities. The paper proposes to enhance the data literacy ability of teachers from the perspective of organizational learning. Through building a digital culture, building a data-driven teaching environment, and constructing an interdisciplinary learning community to further promote the application of the theory and practice of datafication inside and outside the organization, and ultimately improve the quality of teaching.

The influence of CEO’s financial literacy on SMEs technological innovation:the mediating effects of MCS and risk‑taking

Previous literature showed mixed results about the impact of CEOs’financial literacy(CFL)on small and medium-sized enterprises’(SMEs)innovation.This relationship can be motivated by relevant variables,which are missing in the previous literature and make a difference as mediators.In this sense,based on the theoretical framework related to upper echelon theory and resource-based view,this study focuses on the mediating effect of risk-taking attitude and management control systems(MCS)varia-bles.Empirical data from 310 SMEs gathered using a qualitative research questionnaire are analyzed using structural equation modeling methodology.Specifically,estimations are carried out considering the partial least square method.Findings show that MCS and managers’risk attitudes fully mediate the relationship between financial literacy(FL)and innovation.Between these two mediating variables,the implementation of MCS stands out because it also enables the mediating effect of CEOs’risk-taking in the CFL–technological innovation relationship.As the results do not support the significant direct relationship between FL and risk attitude,they confirm an indirect effect through MCS.Furthermore,based on the study findings,SMEs’directors and owners,business associations,and public authorities can improve SMEs’technological innovation by implementing training programs and policies to foster CFL.They can also acknowledge the interdependency between organizational factors and individual characteristics to enhance SMEs’technological innovation.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Financial literacy,behavioral traits,and ePayment adoption and usage in Japan

This study investigates how financial literacy and behavioral traits affect the adoption of electronic payment(ePayment)services in Japan.We construct a financial literacy index using a representative sample of 25,000 individuals from the Bank of Japan’s 2019 Financial Literacy Survey.We then analyze the relationship between this index and the extensive and intensive usage of two types of payment services:electronic money(e-money)and mobile payment apps.Using an instrumental variable approach,we find that higher financial literacy is positively associated with a higher likelihood of adopting ePayment services.The empirical results suggest that individuals with higher financial literacy use payment services more frequently.We also find that risk-averse people are less likely to adopt and use ePayment services,whereas people with herd behavior tend to adopt and use ePayment services more.Our empirical results also suggest that the effects of financial literacy on the adoption and use of ePayment differ among people with different behavioral traits.