Background: Long COVID is prevalent in the general population. Exercise is a promising component of rehabilitation for long COVID patients.Aim: This study examined the effects of exercise interventions on managing long COVID symptoms.Methods: In this systematic review and meta‐analysis, a systematic search was conducted through June 2023 using keywords such as “long COVID” and “post‐acute COVID‐19 syndrome” among major electronic databases. Randomized controlled trials that examined the effect of exercise on patients suffering from long COVID were included. Nine studies involving 672 individuals were included in this study.Results: The main outcomes for exercise interventions in patients with long COVID were fatigue, dyspnea, anxiety, depression, and cognitive impairment. The exercise interventions comprised aerobic exercise, multimodal exercise, breathing exercise, and Taichi. Most of the included studies (6/9) were at high risk of bias. According to the meta‐analyses, exercise significantly improved long COVID fatigue (ES = 0.89, 95% CI: 0.27 to 1.50) and dyspnea (ES = 1.21, 95% CI [0.33, 2.09]), whereas no significant effect was identified on long COVID anxiety, depression, and cognitive impairment. According to subgroup analyses, multimodal exercise had the broadest spectrum of benefits on long COVID symptoms (including fatigue, dyspnea, and depression), and supervised exercise, intervention frequency ≤4 times a week, the passive control group also showed a positive effect on some long COVID symptoms.

Background: The cultivation and assessment of the professional competence of clinical undergraduates is essential to medical education. This study aimed to construct a scale to evaluate the professional competence of clinical undergraduates as well as its determinants. Methods: The competence scale was developed on the basis of four medical education standards, the literature, and expert interviews. A total of 288 undergraduates from two types of medical colleges in central and southeastern China were selected by a multistage sampling strategy. Factor analysis, correlation analysis, and internal consistency reliability were used to verify the validity and reliability of the scale. Results: A scale consisting of eight factors with 51 items was determined for factor analysis. Cronbach’α coefficients among the eight dimensions were over 0.800, with mean scores of 1.76, 1.38, 1.92, 1.54, 1.77, 1.25, 1.60, and 2.34. Clinical undergraduates with above average academic grades achieved a higher score in essential clinical knowledge (p < 0.05) and better professionalism was reported among females (p < 0.05). Conclusion: The competence scale showed excellent reliability and validity. Respondents in this study showed a moderate level of professional competence. This study could be a reference for medical educators and policy makers in order to improve medical education standards for clinical undergraduates in China and other countries with similar settings.

This study aimed to explore the health service needs of empty nest families from a household perspective. A multistage random sampling strategy was conducted to select 1606 individuals in 803 empty nest households in this study. A questionnaire was used to ask each individual about their health service needs in each household. The consistency rate was calculated based on their consistent answers to the questionnaire. We used a collective household model to analyze individuals’ public health service needs on the family level. According to the results, individuals’ consistency rates of health service needs in empty nest households, such as diagnosis and treatment service (H1), chronic disease management service (H2), telemedicine care (H3), physical examination service (H4), health education service (H5), mental healthcare (H6), and traditional Chinese medicine service (H7) were 40.30%, 89.13%, 98.85%, 58.93%, 57.95%, 72.84%, and 63.40%, respectively. Therefore, family-level health service needs could be studied from a family level. Health service needs of H1, H3, H4, H5, and H7 for individuals in empty nest households have significant correlations with each other (r = 0.404, 0.177, 0.286, 0.265, 0.220, p < 0.001). This will be helpful for health management in primary care in rural China; the concordance will alleviate the pressure of primary care and increase the effectiveness of doctor–patient communication. Health service needs in empty nest households who took individuals’ public needs as household needs (n = 746) included the H4 (43.3%) and H5 (24.9%) and were always with a male householder (94.0%) or at least one had chronic diseases (82.4%). Health service needs in empty nest households that considered one member’s needs as household needs (n = 46) included the H1 (56.5%), H4 (65.2%), H5 (63.0%), and H7 (45.7%), and the member would be the householder of the family (90.5%) or had a disease within two weeks (100.0%). In conclusion, family members’ roles and health status play an important role in health service needs in empty nest households. Additionally, physical examination and health education services are the two health services that are most needed by empty nest households, and are suitable for delivering within a household unit.

Excess healthcare utilization is rapidly rising in rural China. This study focused on excess outpatient demand (EOD) and aimed to measure its performance and sociodemographic determinants among China’s rural residents. A total of 1290 residents from four counties in central China were enrolled via multistage cluster random sampling. EOD is the condition in which the level of hospital a patient chooses is higher than the indicated level in the governmental guide. A multilevel logistic regression was used to examine the sociodemographic determinants of EOD. Residents with EOD accounted for 85.83%. The risk of EOD was 51.17% and value was 5.69. The value of EOD in diseases was higher than that in symptoms (t = −21.498, p < 0.001). Age (OR = 0.489), educational level (OR = 1.986) and hospital distance difference (OR = 0.259) were the main sociodemographic determinants of EOD. Excess outpatient demand was evident in rural China, but extreme conditions were rare. Results revealed that age, educational level and hospital distance were the main sociodemographic determinants of EOD. The capacity of primary healthcare institutions, universality of common disease judgement and understanding of institution’s scope of disease curing capabilities of residents should be improved to reduce EOD.

Background: Despite the benefits of physical activity (PA) for improving cancer-related outcomes, the majority of patients with cancer fail to meet PA guidelines. Mobile phone messaging is a scalable approach for promoting PA, but its effect on improving PA among patients with cancer has not been reviewed. Objective: This review aims to systematically evaluate the effects of mobile phone messaging–based interventions in promoting PA among patients with cancer. Methods: A systematic search in 8 English and Chinese databases (PubMed, EMBASE, Web of Science, MEDLINE, the Cochrane Library, Scopus, Wanfang, and China National Knowledge Infrastructure) was performed. Randomized controlled trials that examined the effect of mobile phone messaging–based interventions on improving PA among patients with cancer were included. Potential sources of substantial heterogeneity were investigated by subgroup analysis based on participants’ characteristics, mobile phone messaging regimens, and PA estimates. Random effects models were used to estimate the overall effect size. Risk of bias was assessed by 2 independent reviewers using the revised Cochrane Collaboration’s risk of bias tool. Sensitivity analyses were performed through leave-one-out analyses, removal of outliers, and inclusion of only studies with low or some risk of bias. Potential publication bias was explored. Results: A total of 13 studies involving 777 individuals were included in this review. After intervention, mobile phone messaging–based interventions significantly improved objective PA with a small effect size (standardized mean difference [SMD]=0.37, 95% CI 0.10-0.64; P =.007; I ² =0%), but not self-reported PA (SMD=0.20, 95% CI −0.07 to 0.47; P =.15; I ² =56%) or step count (SMD=0.27, 95% CI −0.19 to 0.73; P =.25; I ² =69%). Interventions that adopted more behavior change techniques and targeted patients who have completed active cancer treatment significantly improved step count. At follow-up, the effect of mobile phone messaging on self-reported PA, objective PA, and step count was found to be insignificant. Nine studies showed low or some risk of bias. Sensitivity analyses and trim-and-fill tests confirmed relatively stable effects of mobile phone messaging. No potential publication bias was identified. Conclusions: Mobile phone messaging–based interventions show promise as a scalable intervention to modestly improve objective PA in patients with cancer, though effects vary, with limited impact on self-reported PA or step count. Evidence for sustained long-term benefit remains limited, highlighting the need for rigorously designed trials with extended follow-up.