Background: This systematic review and meta-analysis aimed to investigate and compare the passing rates of Massive Open Online Courses (MOOCs) with Traditional Courses to indicate how to improve the teaching efficiency in Medicine Education. Methods: A systematic search of relevant published literature was conducted to collect relevant retrospective cohort studies that compared the teaching efficiency of MOOCs and Traditional Courses. Results: There are three retrospective cohort studies included in the final meta-analysis. There were no significant differences in the passing rates of MOOCs and Traditional Courses. Conclusions: it is necessary for universities to invest in online education to promote the development of MOOCs, which will probably have an advantage over Traditional Courses for postgraduate medical education in the near future.

Background: It was reported that the incidence of breast cancer (BC) was the highest among cancers worldwide. The breast cancer screening (BCS) program is regarded as an effective preventive measure. However, rural women's willingness to participate in the BCS program is relatively low. To provide measures to prevent BC, it is necessary for the government to identify the influencing factors of rural women's BCS intention.Methods: A cross-sectional study was conducted among 3,011 rural women by a convenience sampling method through face-to-face interviews on a self-designed questionnaire based on the theory of planned behavior (TPB). The partial least square structural equation model (PLS-SEM) was conducted to determine the predictors of BCS intention, and a multi-group analysis (MGA) of age was performed to identify if there were differences in all hypotheses between different age groups.Results: There were still rural women who have not been screened for BC in five years (41.7%). The research model of rural women's intention to accept this prevention against BC was rational. All of the hypotheses are supported. Especially, subjective norm (SN) (β = 0.345, p < 0.001) is found to be the strongest predictor followed by the perceived behavioral control 1 (PBC 1) (personal factors, including distance, transportation, busyness, etc.) (β = 0.165, p < 0.001), attitude (β = 0.152, p < 0.001), past behavior (PB) (β = 0.150, p < 0.001), knowledge (β = 0.121, p < 0.001), and perceived behavioral control 2 (PBC 2) (pain and cultural-social factors including embarrassment from a physician, etc.) (β = 0.042, p < 0.05). The advocacy and education (A&E), medical level and service attitude (ML&SA) of township health centers and village clinics can affect behavior intention (BI) via attitude, SN, and PBC. The results of MGA of age indicate that there are significant differences among rural women of different ages regarding the relationship between A&E and PBC 2 (p < 0.01) and the effect of PB on BI (p < 0.001).Conclusion: The TPB with the addition of PB, knowledge, ML&SA, and A&E can provide the theoretical basis for the policy intervention that aims to enhance the rural women's BCS willingness. MGA of age is conducive to promoting the implementation of the BCS policy. The findings are of great significance to improve rural women's health levels.

Background: High screening coverage can effectively reduce the mortality in breast and cervical cancer. Further research on extending the coverage of breast and cervical cancer screening in China is required. This study explored factors influencing women's “two-cancer” screening service utilization using an ecological approach.Methods: Data were obtained from the National Health Services Survey (NHSS) conducted in 2018 in Jiangsu, China. A total of 3,500 women aged 18–64 years were included in the analysis. Chi-squared test, hierarchical multiple logistic regression analysis, and binary logistic regression analysis were performed.Results: In total, 44.1% of the women had been screened for breast cancer (BC) and 40.9% for cervical cancer (CC). Breast cancer screening (BCS) and cervical cancer screening (CCS) differed significantly in the following common categories: age, gestational experiences, chronic disease status, body mass index (BMI), exercise, health checkup, marital status, number of children, employment, education, family doctors, and health records. In the results of hierarchical multiple logistic regression analysis, the explanatory power of the final model was 37.5% and the area under the receiver operating characteristic curve was 0.812. The results showed that being in the age group of 35–64 years, having gestational experiences, having chronic diseases, exercising, having a health checkup, being married, having children, and being employed were statistically significant positive predictors of “two-cancer” screening adherence. The household size was a barrier. For BCS, obesity was also a negative factor, and a higher overall self-related health status was a positive factor. Being married and living in households of three or more families were not predictors. For CCS, having health records was also positively significant, while having chronic disease did not influence adherence.Conclusion: The findings provide an ecological explanation for women's BCS and CCS service utilization. Both proximal and distal factors should be considered to achieve a high coverage rate.

Predicting mask-wearing behavior intention among international students during COVID-19 based on the theory of planned behavior Yanjun Sun, Banghui Qin, Zhiqing Hu, Huanan Li, Xin Li, Yuan He, Huaxing Huang

Objective: Exploring how the theory of planned behavior (TPB), social capital theory (SCT), cervical cancer knowledge (CCK), and demographic variables predict behavioral intentions (BI) related to cervical cancer screening among Chinese women. Methods: Self-administered questionnaires were distributed to 496 women, followed by a path analysis. Results: The three-level model was acceptable, χ²(26, 470) = 26.93, p > 0.05. Subjectively overcoming difficulties, support from significant others, screening necessity, and the objective promotion factor promoted BI, with effect sizes of 0.424, 0.354, 0.199, and 0.124. SCT and CCK promoted BI through TPB, with effect sizes of 0.262 and 0.208. Monthly income, education, age, and childbearing condition affected BI through TPB, SCT, and CCK, with effect sizes of 0.269, 0.105, 0.065, and −0.029. Conclusion: The three-level model systematically predicted behavioral intentions relating to cervical cancer screening.

Prosocial behavior is essential for effective patient communication and building a positive doctor-patient relationship in medical students. Research on the factors influencing prosocial behavior in medical students is limited. This research aims to examine how perceived social support influences prosocial behavior among medical students, focusing on the mediating role of empathy and the moderating role of moral identity. This cross-sectional study included 2425 medical students from central and southern Jiangsu province. Participants were assessed using the Prosocial Behavior Scale, Interpersonal Response Index Scale, Moral Identity Scale, and Perceived Social Support Scale, with data collected through via an online questionnaire. SPSS PROCESS macro model 4.1 was used to examine the mediating effect and the moderating effect. Perceived social support showed a significant positive correlation with prosocial behavior among medical students. The indirect effects of perceived social support on prosocial behavior through perspective taking (β_indirect = 0.11, 95% Boot CI [0.09, 0.13]) and empathic concern (β_indirect = 0.08, 95% Boot CI [0.06, 0.10]) confirmed the mediating roles of these variables, accounting for 32.05% and 23.82% of the total effect, respectively. However, personal distress did not mediate this relationship (β_indirect = -0.004, 95% Boot CI [-0.01, 0.005]). Moral identity significantly moderated the effect of perceived social support on perspective taking (β = 0.05, p < 0.01) and the relationship between perspective taking and prosocial behavior (β = 0.12, p < 0.001). Additionally, moral identity also moderated the relationships between perceived social support and empathic concern (β = -0.05, p < 0.01) and between empathic concern and prosocial behavior (β = 0.08, p < 0.001). While the interaction between perceived social support and moral identity predicted personal distress (β = 0.04, p < 0.05), moral identity did not moderate the relationship between personal distress and prosocial behavior (β = 0.03, p = 0.12). This study underscores the link between perceived social support and prosocial behavior, highlighting the significant roles of perspective taking, empathic concern, and moral identity in this relationship. These findings underscore the potential of cultivating these psychological mechanisms to foster caring and prosocial behaviors among medical students, providing important references for future educational interventions and policy formulation.