Understanding the impact of chronic diseases on COVID-19 vaccine hesitancy using propensity score matching: Internet-based cross-sectional study

AIMS AND OBJECTIVES

To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases.

BACKGROUND

Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death.

METHODS

From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases.

RESULTS

Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases.

CONCLUSIONS

Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system.

RELEVANCE TO CLINICAL PRACTICE

Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice.

PATIENT OR PUBLIC CONTRIBUTION

Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.

Twenty-month-olds categorically discriminate similar sounding vowels regardless of vocabulary level, an event related potentials (ERP) study

The current study investigated whether vocabulary relates to phonetic categorization at neural level in early childhood. Electoencephalogram (EEG) responses were collected from 53 Dutch 20-month-old children in a passive oddball paradigm, in which they were presented with two nonwords "giep" [ɣip] and "gip" [ɣɪp] that were contrasted solely by the vowel. In the multiple-speaker condition, both nonwords were produced by twelve different speakers; while, in the single-speaker condition, one single token of each word was used as stimuli. Infant positive mismatch responses (p-MMR) were elicited in both conditions without significant amplitude differences. When the infants were median split based on vocabulary level, the large and small vocabulary groups showed comparable p-MMR amplitudes yet different scalp distribution in both conditions. These results suggest successful phonetic categorization of native similar sounding vowels at 20 months, and a close relationship between speech categorization and vocabulary development.

Policy interplay among social health insurance system, pension system, delayed retirement initiative and implications for the self-rated health status of older workers

Delayed retirement initiative proposed in China attaches greater importance to the sustainability of pension systems and the labour shortage, but less to the health status of older people. The existing social health insurance and pension system are not well established to match this initiative. This study investigates the policy mix of delayed retirement, employment-based social health insurance, social pension participation for health status of older people. Results of the data from the China Health and Retirement Longitudinal Study (CHARLS-2018) show that late retirement could benefit health status among older adults. Moreover, such effect of late retirement appears more salient for those uninsured by employment-based social health insurance and those still in the pension contribution phase upon reaching the statutory retirement age. Hence, in countries with inadequate health insurance and pension systems, such as China, delayed retirement may serve as an important alternative to social security for the health of older people.

Exploring the relationship between regional tourism development and land use efficiency: A case study of Guangxi Zhuang Autonomous Region, China

The utilization efficiency of land resources is an essential embodiment of economic development, social development, and ecological development and is a critical core to measure how to maximize the efficiency of land resources under limited conditions. The land is an important content and essential carrier of the research of tourism development level. This paper selects Panel Data from 2010 to 2019 to research the Guangxi regional tourism development. The entropy weight method and stochastic frontier production function (SFA) model were used to evaluate the development level of urban-rural tourism and the utilization efficiency of land resources in Guangxi. This paper uses the Panel Vector Autoregression (PVAR) model to analyze the internal relationship between urban-rural tourism development. The results show that: (1) Guangxi has a good level of tourism development and a high land use efficiency. (2) There is a reciprocal causation relationship between the regional tourism development level and land use efficiency in Guangxi, with significant levels of 0.005 and 0.034 respectively, indicating high credibility. This indicates that there is a mutual promotion and interaction between the two, which rely on and drive each other, promoting the joint sustainability of tourism development and land use efficiency. (3) . The tourism development level is greatly influenced by itself, with impact values all above 0.99. At the same time, land use also has a significant self-impact, with impact values all above 0.87. Their internal optimization system is solid and endogenous impetus is robust, which can drive their development. Establishing an effective strategy for developing and protecting land use is beneficial to promote the long-term effectiveness of sustainable tourism development, enhancing high-quality development of the tourism economy and improving people's living standards and quality.

A Qualitative Study on Parental Experience of Involvement in the Transition from Kindergarten to Primary School for Chinese Children with Intellectual and Developmental Disabilities

Parental involvement plays a vital role in the transition from kindergarten to primary school among children with intellectual and developmental disabilities (IDDs); this study aims to explore Chinese parents' experiences of parental involvement during this period. Informed by interpretive phenomenological analysis, semi-structured, one-on-one interviews were held with 10 parents. Three major themes were identified: (1) "aggressive" involvement; (2) factors in transforming parental involvement; and (3) "rational" involvement. Participants reported their perceptions, attitudes, and parenting behaviors in different phases of involvement in the transition to primary school. These findings highlight the need to support parents of children with IDDs during this time of change.

Digital economy, green technology innovation, and productivity improvement of energy enterprises

This study aims to address the important question of whether the digital economy can be deeply integrated with the energy sector to break through the resource and environmental constraints and thus enhance the productivity of energy companies. Using a sample of Chinese energy-listed companies, we comprehensively investigate the impact of the digital economy on the productivity of energy firms using the OLS method, mediated effects model, instrumental variables method, and difference-in-differences model. Research shows that the development of digital economy can significantly improve the productivity of energy enterprises. This effect is more obvious in eastern cities, non-resource-based cities, state-owned enterprises, and enterprises with high cash holdings. Green technological innovation in alternative energy production, transportation, and administrative supervision and design is an important channel for improving productivity in the digital economy. Internet development and digital inclusive finance can also improve the productivity of energy enterprises. "National Big Data Pilot Zone" and "Broadband China" pilot cities can play a policy role in improving the productivity of energy enterprises. The findings provide important insights for promoting the integration of the digital revolution with the energy technology revolution and accelerating the green development and digital transformation of the energy sector.

Bullying victimization and depressive symptoms in Chinese adolescents: the roles of belief in a just world and classroom-level victimization

Studies have demonstrated that bullying victimization is a risk factor for depressive symptoms; however, little is known about the underlying processes that may mediate or moderate this relationship. To address this research gap, this study examined the mediating effects of personal and general belief in a just world (BJW) and the moderating effect of classroom-level victimization on the relationship between bullying victimization and depressive symptoms. Using a short-term longitudinal design, two-wave data were obtained from 2,551 Chinese adolescents (initial age = 12.99 ± 0.61, 52.2% boys) from 47 classes over 6 months. The results indicated that Time 1 personal BJW mediated the relationship between Time 1 bullying victimization and Time 2 depressive symptoms. Furthermore, the mediating effect of Time 1 personal BJW was moderated by Time 1 classroom-level victimization; this effect was stronger for adolescents in classrooms with low levels of victimization. These findings contribute to our understanding of how and when bullying victimization impacts youth depressive symptoms. Education practitioners should pay special attention to personal BJW in victimized adolescents, especially when classroom-level victimization is low.

Interaction mechanism and spatial effect of cross-regional haze pollution based on a multisectoral economy-energy-environment (3E) model and the evidence from China

The transboundary characteristics and multisectoral factor interaction mechanism of haze pollution have aroused widespread attention but remain understudied. This article proposes a comprehensive conceptual model that clarifies regional haze pollution, further establishes a theoretical framework on a cross-regional, multisectoral economy-energy-environment (3E) system, and attempts to empirically investigate the spatial effect and interaction mechanism employing a spatial-econometrics model based on China's province-level regions. The results demonstrate that (1) regional haze pollution is a transboundary atmospheric state formed by the accumulation and agglomeration of various emission pollutants; moreover, there is a "snowball" effect and a spatial spillover effect. (2) The formation and evolution of haze pollution are driven by the multisectoral factors of 3E system interaction, and the findings still hold after theoretical and empirical analysis and robustness tests. (3) Significant spatial autocorrelation exists for the 3E factors, presenting different clustering modes with a dynamic spatiotemporal evolution, particularly in the high-high (H-H) mode and low-low (L-L) mode. (4) Significant heterogeneous impacts of economic and energy factors on haze pollution are identified, namely, an inverted "U-shaped" relationship and a positive linear association, respectively. Further spatial analysis demonstrates a strong spatial spillover and obvious path dependence among local and neighboring regions. Policymakers are advised to consider multisectoral 3E system interaction and cross-regional collaboration. Integr Environ Assess Manag 2023;19:1525-1543. © 2023 SETAC.

Perceptual contrast reduces the judgments of learning of small-font words and increases the judgments of learning of large-font words compared with the no-contrast conditions

The font-size effect on judgments of learning (JOLs) refers to large-font words being rated as more memorable than small ones when required to predict memory performance during the study phase. This study examines perceptual contrast as the prerequisite for this font-size effect on JOLs and explores how perceptual contrast leads to this effect. In Experiment 1, perceptual contrast was achieved by inserting words with one font (e.g., 18 pt) into a series of words with another font (e.g., 70 pt) at a particular proportion (1:4). In Experiment 2, perceptual contrast was manipulated by presenting two different font words up and down in a pair. The results of both experiments showed that: (1) participants rated higher JOLs for large than small fonts under the contrast conditions, but the JOL difference between the two fonts was not significant under the no-contrast conditions; (2) the JOLs of small-font words under the contrast conditions was reduced compared with the no-contrast conditions, but the JOLs of large-font words under the contrast conditions was increased compared with the no-contrast conditions. These results indicated that perceptual contrast was the prerequisite for the font-size effect on JOLs. The reason for this effect is that, compared to no-contrast conditions, perceptual contrast reduces the JOLs of small-font words while increasing the JOLs of large-font words. This study may deepen researchers' understanding of the mechanism of the font-size effect on JOLs and help educators effectively guide students to learn.

Water consumption of electric power system in China: from electricity generation to consumption

Understanding the water requirement of electricity generation is critical to the development of both electricity and water systems, while the water consumption of the whole electric power system remains unrevealed. Here, we examine the water consumption driven by electricity generation, transmission, and consumption in China, finding that 14 billion m3 of freshwater is consumed by electricity generation in 2019 and that 2.5 billion m3 of freshwater was virtually transferred via electricity transmission. Nationally, the freshwater consumption per unit of electricity generation was 1.9 m3/MWh. Based on the state-of-the-art electricity transmission data, we find that 59% of the transported electric power was from water-scarce provinces and 0.7 billion m3 of freshwater was lost due to the electricity loss in transmission lines in China. It is essential to link water resources with the whole electric power system (production, transmission, and consumption) rather than only part of the power system as in previous research.

SS-GNN: A Simple-Structured Graph Neural Network for Affinity Prediction

Efficient and effective drug-target binding affinity (DTBA) prediction is a challenging task due to the limited computational resources in practical applications and is a crucial basis for drug screening. Inspired by the good representation ability of graph neural networks (GNNs), we propose a simple-structured GNN model named SS-GNN to accurately predict DTBA. By constructing a single undirected graph based on a distance threshold to represent protein-ligand interactions, the scale of the graph data is greatly reduced. Moreover, ignoring covalent bonds in the protein further reduces the computational cost of the model. The graph neural network-multilayer perceptron (GNN-MLP) module takes the latent feature extraction of atoms and edges in the graph as two mutually independent processes. We also develop an edge-based atom-pair feature aggregation method to represent complex interactions and a graph pooling-based method to predict the binding affinity of the complex. We achieve state-of-the-art prediction performance using a simple model (with only 0.6 M parameters) without introducing complicated geometric feature descriptions. SS-GNN achieves Pearson's R_p = 0.853 on the PDBbind v2016 core set, outperforming state-of-the-art GNN-based methods by 5.2%. Moreover, the simplified model structure and concise data processing procedure improve the prediction efficiency of the model. For a typical protein-ligand complex, affinity prediction takes only 0.2 ms. All codes are freely accessible at https://github.com/xianyuco/SS-GNN.

A new uncertain multi-objective programming model with chance-entropy constraint for advertising promotion

The COVID-19 outbreak has forced people to stay at home to prevent the spread of the virus. In this case, social media platforms have become the main communication venue for people. Online sales platforms have also become the main field for people's daily consumption. So, how to make full use of social media to carry out online advertising promotion, and then achieve better marketing, is one of the core issues that the marketing industry must pay attention to and solve. Therefore, this study takes the advertiser as the decision-maker, maximizes the number of full playing, likes, comments and forwarding, and minimizes the cost of advertising promotion as the decision-making goals, and Key Opinion Leader (KOL) selection as the decision vector. Based on this, a multi-objective uncertain programming model of advertising promotion is constructed. Among them, the chance-entropy constraint is proposed by combining the entropy constraint and the chance constraint. In addition, the multi-objective uncertain programming model is transformed into a clear single-objective model through mathematical derivation and linear weighting of the model. Finally, the practicability and effectiveness of the model are verified by numerical simulation, and decision-making suggestions for advertising promotion are put forward.

Is a correlation-based investment strategy beneficial for long-term international portfolio investors?

Using negative to low-correlated assets to manage short-term portfolio risk is not uncommon among investors, although the long-term benefits of this strategy remain unclear. This study examines the long-term benefits of the correlation strategy for portfolios based on the stock market in Asia, Central and Eastern Europe, the Middle East and North Africa, and Latin America from 2000 to 2016. Our strategy is as follows. We develop five portfolios based on the average unconditional correlation between domestic and foreign assets from 2000 to 2016. This yields five regional portfolios based on low to high correlations. In the presence of selected economic and financial conditions, long-term diversification gains for each regional portfolio are evaluated using a panel cointegration-based testing method. Consistent across all portfolios and regions, our key cointegration results suggest that selecting a low-correlated portfolio to maximize diversification gains does not necessarily result in long-term diversification gains. Our empirical method, which also permits the estimation of cointegrating regressions, provides the opportunity to evaluate the impact of oil prices, U.S. stock market fluctuations, and investor sentiments on regional portfolios, as well as to hedge against these fluctuations. Finally, we extend our data to cover the years 2017-2022 and find that our main findings are robust.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s40854-023-00471-9.

Investigation of Asian Dyes and Pigments from the Artifact of "Murongzhi" and the Silk Road in China

In this paper, a series of modern analysis methods, including Raman spectroscopy, X-ray diffraction, UV-vis spectrophotometry, and ultra-high-pressure liquid chromatography coupled with a thermoelectric LTQ-Orbitrap XL ETD mass spectrometer (UHPLC-MS/MS), were applied to analyze and accurately identify the chemical composition of plant dyes and the mineral pigment from the samples collected from grave goods. As a result, the textiles were dyed by the madder, Kermes, Phellodendron chinense, indigo, Lithospermum L., and so forth. In addition, the mineral pigment, charcoal, hematite, minium, cinnabar, azurite, and malachite were used to paint the exquisite artifacts in the tomb of Murongzhi. This research demonstrates the profound impact on cultural transmission and fusion in the "Tuyuhong" dynasty and explores the Silk Road in Tang dynasty.

Associations between waist circumference and executive function among Chinese Tibetan adolescents living at high altitude

Background

Associations between body composition and execution function (EF) were currently studied in low altitude (LA) areas. However, the research on the correlation between waist circumference (WC) and EF among adolescents living at high altitude (HA) was limited.

Objective

We sought to explore the association between WC and EF in Chinese Tibetan adolescents aged 13-18 years in HA areas.

Methods

After excluding invalid data and extreme values, 1,228 participants (583 boys and 645 girls) were eventually included. The areas of Lhasa (average elevation of 3650 m), Nagqu (4500 m), Qamdo (3500 m), and Nyingchi (3100 m) in China were chosen as study sites. Participants completed tasks to measure inhibitory control, working memory, and cognitive flexibility. The predictive association between WC and EF was explored by One-way ANOVA, Pearson correlation, and linear regression analysis.

Results

After controlling for concomitant variables, the reaction time (RT) of responding to inhibitory control (difference incongruent and congruent), working memory (1-back, 2-back), and cognitive flexibility (heterogeneous, difference in heterogeneous and homogeneous) stimuli in subjects with WC ≥ 85th percentile was longer than that in those with WC of the 15th percentile or below [by 1.785 ms (95% CI: 0.078, 3.491), 208.734 ms (95% CI: 96.886, 320.582), 106.679 ms (95% CI: 16.485, 196.873), 82.307 ms (95% CI: 19.171, 145.442), and 58.397 ms (95% CI: 0.343,116.452), respectively], (P < 0.05).

Conclusion

After adjustment for concomitant variables, WC was significantly positively associated with the RT of inhibitory control, working memory, and cognitive flexibility among Chinese Tibetan adolescents in HA areas.

Exploring relationship between emotion and probiotics with knowledge graphs

Purpose

Researchers have identified gut microbiota that interact with brain regions associated with emotion and mood. Literature reviews of those associations rely on rigorous systematic approaches and labor-intensive investments. Here we explore how knowledge graph, a large scale semantic network consisting of entities and concepts as well as the semantic relationships among them, is incorporated into the emotion-probiotic relationship exploration work.

Method

We propose an end-to-end emotion-probiotics relationship exploration method with an integrated medical knowledge graph, which incorporates the text mining output of knowledge graph, concept reasoning and evidence classification. Specifically, a knowledge graph for probiotics is built based on a text-mining analysis of PubMed, and further used to retrieve triples of relationships with reasoning logistics. Then specific relationships are annotated and evidence levels are retrieved to form a new evidence-based emotion-probiotic knowledge graph.

Results

Based on the probiotics knowledge graph with 40,442,404 triples, totally 1453 PubMed articles were annotated in both the title level and abstract level, and the evidence levels were incorporated to the visualization of the explored emotion-probiotic relationships. Finally, we got 4131 evidenced emotion-probiotic associations.

Conclusions

The evidence-based emotion-probiotic knowledge graph construction work demonstrates an effective reasoning based pipeline of relationship exploration. The annotated relationship associations are supposed be used to help researchers generate scientific hypotheses or create their own semantic graphs for their research interests.

Stakeholder relationships and corporate social goal orientation: Implications for entrepreneurial psychology

As the sensitivity to corporate social responsibility (CSR) continues to grow, the goal of enterprises has expanded beyond the sole pursuit of economic value. Corporate social goal orientation has therefore come to occupy a central position in entrepreneurs' psychology and the transition away from a market-only economy. This study uses secondary data from 4,288 samples of 725 Chinese-listed companies from 2009 to 2020 to explore the driving factors in social goal orientation based on the characteristics of sample companies and their industry groups from the perspective of stakeholder relationships. The results can be summarized as follows: (1) there is an inverted U-shaped relationship between government stakeholder relationships and social goal orientation, and there is a significant positive relationship between financial stakeholder relationships, market stakeholder relationships, and corporate social goal orientation. (2) The correlation between single-dual stakeholder relationships and social goal orientation is not consistent. In light of the nature of the roles of government and the market, the correlation between the government-market dual relationship and corporate social goal orientation is not significant. However, there is a significant correlation between the finance-government dual stakeholder relationship and social goal orientation; that is, the dual stakeholder relationship maintains the existence of non-institutional capital and corporate financial capital. Moreover, there is no significant correlation between the market-finance dual relationship and corporate social goal orientation, and there is substitutability between market and financial stakeholder relationships. With the deepening of our understanding of CSR, the core goal of enterprises is no longer confined to the pursuit of economic value, and their social goal orientation has come to be regarded as a major driving force in sustainable development. This study enriches the research on the relationship between stakeholder relationships and shows that stakeholder relationships also have important significance to both achieving corporate goals and shaping entrepreneurs' psychology.

Long short-term memory neural network and improved particle swarm optimization-based modeling and scenario analysis for municipal solid waste generation in Shanghai, China

Accurate estimations of municipal solid waste (MSW) generation are vital to effective MSW management systems. While various single-point estimation approaches have been developed, the non-linearity and multiple site-specific influencing factors associated with MSW management systems make it challenging to forecast MSW generation quantities precisely. To address these concerns, this study developed a two-stage modeling and scenario analysis procedure for MSW generation and taking Shanghai as a test case demonstrated its viability. In the first stage, nine influencing factors were selected, and a hybrid novel forecasting model based on a long short-term memory neural network and an improved particle swarm optimization (IPSO-LSTM) was proposed for the forecasting of the MSW generation quantities, after which actual Shanghai data from 1980 to 2019 were used to test the performance. In the second stage, the future influencing variable values in different scenarios were predicted using an improved grey model, after which the predicted Shanghai MSW generation quantities from 2025 to 2035 were evaluated under various scenarios. It was found that (1) the proposed IPSO-LSTM had higher accuracy than the benchmark models; (2) the MSW generation quantities are expected to respectively increase to 9.971, 9.684, and 9.090 million tons by 2025 and 11.402, 11.285, and 10.240 by 2035 under the low, benchmark, and high scenarios; and (3) the MSW generation differences between the high and medium scenarios were decreasing.

Can Debunked Conspiracy Theories Change Radicalized Views? Evidence from Racial Prejudice and Anti-China Sentiment Amid the COVID-19 Pandemic

With the advent of the 'age of conspiracism', the harmfulness of conspiratorial narratives and mindsets on individuals' mentalities, on social relations, and on democracy, has been widely researched by political scientists and psychologists. One known negative effect of conspiracy theories is the escalation toward political radicalism. This study goes beyond the exploration of mechanisms underpinning the relationship between conspiracy theory and radicalization to focus on possible approaches to mitigating them. This study sheds light on the role of counter-conspiracy approaches in the process of deradicalization, adopting the case study of anti-China sentiment and racial prejudice amid the Covid-19 pandemic, through conducting an experiment (N = 300). The results suggest that, during critical events such as the Covid-19 pandemic, exposure to countermeasures to conspiracist information can reduce individual acceptance of radicalism. We investigated two methods of countering conspiracy theory, and found that: (1) a content-targeted 'inoculation' approach to countering conspiracy theory can prevent the intensification of radicalization, but does not produce a significant deradicalization effect; and (2) an audience-focused 'disenchantment' method can enable cognitive deradicalization, effectively reducing the perception of competitive victimhood, and of real and symbolic threats. This study is one of the first attempts to address causality between deradicalization and countermeasures to conspiracy theories in the US-China relations.

Effects of exercise intervention on executive function of middle-aged and elderly people: A systematic review of randomized controlled trials

Background

Executive function will gradually decline with the increase of age, which will have a negative impact on the quality of life and general health. Exercise intervention can improve executive function and prevent its deterioration, but the evidence from randomized controlled trials is not consistent.

Aim

To assess the effect of exercise intervention on executive function of healthy middle-aged and elderly people, and briefly describe its mechanism.

Methods

A search was conducted using PubMed, Web of science and EBSCO. The searches were limited to English articles published from January 2010 to January 2022. The information is extracted from searched articles included or excluded based on certain criteria.

Results

The search returned 2,746 records, of which 11 articles were included in the systematic review, and 8 articles were supplemented according to the references included and related reviews. The results show that different types of exercise intervention have positive effects on the executive function of the middle-aged and elderly people. The intervention prescriptions in most studies are executed in medium to low frequency, medium intensity and medium duration, while only 11% of the studies were followed up.

Conclusions

The intervention, which was executed twice a week with 30-60 min single intervention time and over 12 weeks total duration, showed a good intervention effect. Exercise intervention is to improve executive function by affecting the activation of brain network and the synthesis of neurotransmitters.

The influence of organizational learning and external cooperation configuration on enterprise technological innovation: A study based on fsQCA approach

This study explores the influence of organizational learning and external cooperation configuration on enterprise technological innovation and constructs a comprehensive theoretical framework of "organizational learning-external cooperation-technological innovation" based on the fuzzy set qualitative comparative analysis (fsQCA) method. The results show the following. (1) A single episode of organizational learning or external cooperation cannot affect the enterprise’s technological innovation, which requires the mutual linkage of the two to improve enterprise technological innovation performance. (2) The technological innovation model in which organizational learning and external cooperation interact is an effective way for enterprises to improve technological innovation performance. There are four technological innovation models that produce high technological innovation performance, namely consciousness-system synergy, consciousness-led, quasi-full, and all-around drive. (3) There are four models of non-high-tech innovation performance, which are not opposed to the technological innovation model of high-tech innovation performance. This research expands the technological innovation perspective of organizational learning and external cooperation matching, provides enterprises with effective technological innovation activities, and provides a theoretical reference and practical guidance for improving technological innovation performance.

Increase consumers’ willingness to pay a premium for organic food in restaurants: Explore the role of comparative advertising

Offering organic food is a new trend in the hospitality industry seeking sustainable competitiveness. Premiums and information barriers impede continued growth in organic consumption. This study aims to explore the role of comparative advertising (CA) in organic food communication. Three empirical studies were used to verify the effect of CA vs. non-comparative advertising (NCA) on consumers’ willingness to pay a premium (WTPP) for organic food, examining how benefit appeals (health vs. environmental) and consumers’ organic skepticism affects CA. The results indicate that matching CA and health appeals increase consumers’ WTPP, while environmental appeals have no significant differences between the CA and NCA groups (Study 1). Information persuasiveness mediates the interaction between CA and benefit appeal on WTPP (Study 2). CA increases WTPP among consumers with high organic skepticism, while the interaction between CA and health appeal is only effective for low skepticism consumers (Study 3). The findings unravel and explain the mechanics of how CA works in organic products, which can help restaurants, retailers and tourist destinations advertise organic food to increase consumers’ WTPP.

The association between reproductive history and the multidimensional health of older adults in rural China and its gender differences: Evidence from the Chinese longitudinal healthy longevity survey

Background

Few studies have examined the association between reproductive history and the multidimensional health of older adults with more diverse reproductive histories and poorer health status in rural China. The purpose of this study is to explore the effect of parity, sex ratio of children and late childbearing on multidimensional health and its gender differences.

Methods

The analytical sample consisted of 3,377 older adults in rural China who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. Linear regression models were applied to estimate the relationship between reproductive history and multidimensional health, with separate models for each indicator of health outcomes.

Results

Older adults in rural areas with greater parity were more likely to have better cognitive function (β = 0.409, 95% CI: 0.255–0.563), fewer Activities of Daily Living (ADL) limitations (β = −0.085, 95% CI: −0.137 to −0.034) and symptoms of depression (β = −0.396, 95% CI: −0.577 to −0.216). The social mechanism of intergenerational support from children later in life partly explained the positive effect of parity. Late childbearing had negative effects on cognitive function (β = −1.220, 95% CI: −1.895 to −0.545), ADL (β = 0.253, 95% CI: 0.028–0.478) and symptoms of depression (β = 1.025, 95% CI: 0.237–1.812). Women were more likely to be influenced by the positive effect of parity; the association between late childbearing and health was only significant in the male group.

Conclusions

Parity and late childbearing are associated with cognitive function, activities of daily living, and symptoms of depression in the older adults in rural China. Older adults with more children might be in better health, and this finding is especially significant in women. However, late childbearing had a negative effect on multidimensional health, especially for men. The social mechanism and gender differences between reproductive history and health need to be further explored.

Digital activism and collective mourning by Chinese netizens during COVID-19

This study examines the discursive practice of mourning and commenting by netizens on the final social media post made by Dr Li Wenliang, regarding it as a form of political participation and competitive discursive politics enacted in cyberspace. Discourse theory is applied to conduct discourse analysis on 4000 comments. We identified two strategies that netizens used to establish an alternative space for discourse. The first involved hidden protests expressed through multi-semantic mourning, avoiding suppression by indirectly challenging official authorities. Second, through engagement with microblogs, netizens applied personalized narratives to form a collective memory and a counter-memory space that departed from the official normative narrative. Discursive activities enacted by netizens stimulated the political agenda of resilient adjustment on the part of the authorities, leading the government to accept and incorporate public demands into policies through strategic rectification. These findings help to better understand the significant power of disorganized connective action that is reliant on affective citizens and the further development of regime resilience on the part of the Chinese political system in response to digital activities.

Corporate climate risk and stock market reaction to performance briefings in China

This study aims to enrich our understanding of the valuation consequence of climate risk in financial markets. The primary focus of our study is on the stock price reaction to firms' climate-risk-related information. We employ transcripts of Chinese listed firms' performance briefings to capture the climate risk at the firm level. Using a sample of Chinese listed firms between 2009 and 2021, we find that greater corporate climate risks lead to negative market reactions over a short time window, consistent with the market quickly comprehending corporate climate risks. This result holds for a series of robustness checks. We further find that the negative impact of corporate climate risk on the stock price reaction operates through the increased market trading activities, greater investor attention, and reduced positive media coverage. Finally, we demonstrate that industry carbon emission, local abnormal temperature, state ownership, institutional shareholding, and dividend payout are important moderators that shape the association of the corporate climate risk and the adverse market reaction. Our evidence suggests that disclosures of climate-related information can help the stock market to price climate risk more efficiently.

The influence mechanism and spatial effect of carbon emission intensity in the agricultural sustainable supply: evidence from china's grain production

Agricultural carbon mitigation is critical for China to encourage the sustainable development of agriculture and achieve the carbon peak by 2030 and carbon neutrality by 2060. By exploring the impact mechanism of the carbon emission intensity (CEI) of grain production, we can effectively promote the low-carbon transformation of agricultural production and ensure the sustainable development of the food supply. This article analyzes the temporal and spatial evolution of the total carbon emission (TCE) and CEI of staple crops and adopts a dynamic spatial model to explore the influence mechanism and spatial spillover effects of the CEI of grain production based on evidence from China's major grain-producing provinces from 2002 to 2018. The results indicate that the TCEs of rice, wheat, and maize fluctuate upward and that the CEI in most producing areas decreases with low-low agglomeration (or high-high agglomeration). Among the influencing factors, technology is the main factor reducing CEI. Technical efficiency, urbanization, industrial structure, agricultural agglomeration, and agricultural trade openness can be transmitted to neighboring areas through spatial spillover mechanisms. The spatial spillover mechanisms are resource flow, technology spillover, and policy learning, producing the demonstration effect and siphon effect. Based on our findings, agricultural technology innovation and popularization, urbanization, optimization of the agricultural structure, financial payments, and factor flow among regions should be improved to encourage the low carbon transformation of grain production.

Moving toward decoupling and collective resilience? Assessing US and Japan’s economic statecraft against China

Facing a rise in great power competition, states are increasingly paying attention to economic statecraft; that is, using economic means to pursue national security and foreign policy goals. Factors such as asymmetric interdependence in the global economy and information networks, the rapid development of dual-use technologies, and the shift of US foreign policy doctrines from liberalism to geopolitics have contributed to the rise of economic statecraft. Regarding China as an opponent in high-tech and geopolitical competition, the US is on the one hand continuously strengthening coercive economic statecraft against China, especially through technological “decoupling.” On the other hand, the US is seeking to unite the so-called like-minded countries to build technological and supply chain coalitions that exclude China. As an ally of the US, Japan is imitating and following the US, while also emphasizing the protection and development of its own “strategically indispensable” industries, striving to maintain a balance between preventing technology leakage and maintaining exports to China. While coercive economic statecraft weakens and contains opponents, it will also harm the US itself as well as its allies. In the future, the US and Japan will further strengthen economic statecraft targeting China, but implementation is likely to be rational and balanced, in an effort to secure “competitive coexistence” with China.

The role of green finance in eradicating energy poverty: ways to realize green economic recovery in the post-COVID-19 era

Realizing green economic recovery and eradicating energy poverty have become China’s strategic priorities in the post-COVID-19 era. In the context of the active advocacy of green finance, to empirically investigate whether green finance can help eradicate energy poverty, this study utilizes provincial sample data to explore the energy poverty eradication effect of green finance. Our study also examines the regional heterogeneity and mediating effect. The main findings are as follows: (1) Green finance is a powerful weapon to alleviate China’s energy poverty and accelerate green economic recovery, indicating that the green evolution of financial institutions is effective means to facilitate green economic recovery in the post-COVID-19 era; (2) green finance only eradicates energy poverty in low energy poverty regions and the eastern areas, and green finance can alleviate energy poverty in both high and low green finance areas; and (3) improved green finance not only directly eradicates China’s energy poverty, but also alleviates current energy poverty by accelerating technical innovation and optimizing the industrial structure. Following the above main findings, this study advances a series of policy implications in terms of facilitating the green transition of the financial industry and realizing green economic recovery.

How natural disasters affect carbon emissions: the global case

The outbreak of the COVID-19 pandemic has once again made the impacts of natural disasters a hot topic in academia. The environmental impacts of natural disasters, however, remain unsettled in the existing literature. This study aims to investigate the impact of natural disasters on CO₂ emissions. For this purpose, we employ a panel dataset covering 138 countries over the period 1990-2018 and two dynamic panel estimation methods. Then, considering the differences in CO₂ emissions across various countries, we run a panel quantile regression to examine the asymmetry in the nexus between natural disasters and CO₂ emissions. We also discuss the mediating effects of energy consumption between natural disasters and CO₂ emissions. After conducting a series of robustness checks, we confirm that our results are stable and convincing. The empirical results indicate that natural disasters significantly reduce CO₂ emissions. Nevertheless, the impact of natural disasters on CO₂ emissions is asymmetric across different quantiles of CO₂ emissions. Furthermore, the technology level serves as an important moderating factor between natural disasters and CO₂ emissions. The mediating effect results reveal that natural disasters not only directly reduce CO₂ emissions but also indirectly promote carbon reduction by restraining energy consumption. Finally, several policy implications are provided to reduce CO₂ emissions and the damage caused by natural disasters.

Exploring the Mediating Role of Situation Awareness and Crisis Emotions Between Social Media Use and COVID-19 Protective Behaviors: Cross-Sectional Study

Background

In an outbreak of an infectious disease especially, online media would usually be an important channel for people to get first-hand knowledge and evaluate risks of the specific emergency. Although there has been increasing attention to the effect of social media use during epidemics and outbreaks, relatively little is known about the underlying mechanism by which social media plays a role in people's cognitive, affective and preventive responses.

Objective

With an objective to advance current knowledge surrounding social media effects on people's cognition, affection and health protective behaviors during epidemics, we aim to examine the associations between social media exposure to COVID-19 risks related information and preventive behavior of the public, and also the role that situation awareness and crisis emotions including anxiety and fear played.

Methods

An online cross-sectional survey was conducted in China a total of 632 participants were recruited. Measures included exposure to COVID-19 information through social media, situation awareness, anxiety, fear and protective behaviors that participants have taken. We have performed the descriptive statistical analysis, correlation and mediation analysis to test the research hypotheses.

Results

Findings indicated that situation awareness was positively associated with social media use (B = 0.54, p < 0.001), anxiety (B = 0.95, p < 0.001) and fear (B = 0.87, p < 0.001), and preventive behavior (B = 0.68, p < 0.001). Social media use would also have an indirect effect on anxiety (indirect effect = 0.40; 95% CI = [0.34, 0.46]) and fear (indirect effect = 0.35; 95% CI = [0.29, 0.42]) through situation awareness. The serial mediation effect of situation awareness and fear in the correlation between social media use and preventive behavior has been testified (indirect effect = 0.04, 95% CI = [0.01, 0.08]).

Conclusions

Social media use might influence the adoption of preventive behaviors through triggering situation awareness and fear. Therefore, health communication regarding COVID-19 prevention should target people with less internet access and low eHealth literacy. Understanding the positive role of negative crisis emotions during outbreaks could also help communicators and policymakers develop appropriate strategies to make people proactive to avoid the remaining health hazard.

Space-Focused Stereotypes About People Living With HIV/AIDS and the Effects on Community-Approaching Willingness

Targeting people living with Human Immunodeficiency Virus (HIV), this research examined the prevalence of space-focused stereotypes and their underlying mechanism on behavioral inclinations. Study 1 adopted the explicit nomination and implicit Go/No-Go association tests to explore the existence of space-focused stereotypes of people living with HIV/AIDS. The results demonstrated that space-focused stereotypes were only manifested explicitly with characteristics such as messy, dirty, and gloomy. Study 2 demonstrated a more negative evaluation and community-approaching willingness for communities that include people living with HIV/AIDS than those without HIV/AIDS. Additionally, space-focused stereotypes were found to have an indirect influence on community-approaching willingness; the influence was mediated by both emotional (threat perception) and cognitive factors (community evaluation). These results indicate the deviation of explicit and implicit space-focused stereotypes. More importantly, it revealed that space-focused stereotypes decreased community evaluation and influenced behavioral inclination. This research suggested the existence of space-focused stereotypes on another stigmatized social group. Characteristics of space (e.g., geographical segregation) might be the key to forming space-focused stereotypes.

Association between resident status and patients' experiences of primary care: a cross-sectional study in the Greater Bay Area, China

OBJECTIVES

Patients' experiences are important part of health services quality research, but it's still unclear whether patients' experiences are influenced by resident status. This study aimed to evaluate the association between resident status and patients' primary care experiences with the focus on migrants vs local residents.

DESIGN

A cross-sectional study using multistage cluster random sampling was conducted from September to November 2019. The data were analysed using general linear models.

SETTING

Six community health centres in Guangzhou, China.

PARTICIPANTS

1568 patients aged 20 years or older.

MAIN OUTCOME MEASURES

Patients' primary care experiences were assessed using the Primary Care Assessment Tool. The 10 domains included in Primary Care Assessment Tool (PCAT) refers to first contact-utilisation, first contact-access, ongoing care, coordination (referral), coordination (information), comprehensiveness (services available), comprehensiveness (services provided), family-centredness, community orientation and cultural competence from patient's perspective.

RESULTS

1568 questionnaires were analysed. After adjusting for age, sex, education, annual family income, self-perceived health status, chronic condition, annual medical expenditure and medical insurance, the PCAT total scores of the migrants were significantly lower than those of local residents (β=-0.128; 95% CI -0.218 to -0.037). Migrants had significantly lower scores than local residents in first contact utilisation (β=-0.245; 95% CI -0.341 to -0.148), ongoing care (β=-0.175; 95% CI -0.292 to -0.059), family-centredness (β=-0.112; 95% CI -0.225 to 0.001), community orientation (β=-0.176; 95% CI -0.286 to -0.066) and cultural competence (β=-0.270; 95% CI -0.383 to -0.156), respectively.

CONCLUSION

Primary care experiences of migrants were significantly worse off than those of local residents, especially in terms of primary care utilisation, continuity and cultural competence. Given the wide disparity in primary care experiences between migrants and local residents, Chinese healthcare system reform should focus on improving quality of primary care services for migrants, overcoming language barriers and creating patient-centred primary care services.

Multimodal Irregular Self-Selection in Chinese Postgraduate English as a Foreign Language Learners’ Conversation: When, How, and Why

Irregular self-selection is a demonstration of active involvement in interaction. English as a foreign language (EFL) learners’ talk-in-interaction is one of such cases. Yet, little research has explored when, how, and why learners implement this action. The aim of this article is to address these issues in Chinese postgraduate EFL learners’ conversations from the perspective of multimodal interaction. To this end, we provide descriptive statistics and use multimodal conversation analysis to investigate the detailed process of irregular self-selection. The results show the interactional sensitivity of learners, and all the successful irregular self-selection can be divided into the following three types: turn interruption (TI), turn competition TC), and turn holding abortion (THA). Learners implement this action by using multimodal resources, including lexis, syntax, pitch reset, intensity enhancement, gaze, and so forth. However, their body movements lack diversity, causing behaviors to be constrained and inactive. The main purpose of irregular self-selection is to provide knowledge that contributes to topical development. This study reveals that Chinese postgraduate EFL learners are interactionally competent members. They are able to achieve communicative goals but in a low diversity of body movements. The findings help to understand the detailed process of speakership claiming in EFL learners’ conversations.

Curriculum Leadership of Rural Teachers: Status Quo, Influencing Factors and Improvement Mechanism-Based on a Large-Scale Survey of Rural Teachers in China

Revealing the general status quo of teacher curriculum leadership has great theoretical, policy, and practical significance. However, large-scale empirical investigations in this area are rare, and there is even less attention to the current situation of rural teacher curriculum leadership. Based on the survey of 2,966 rural teachers in 20 provinces of China, this paper presented the status quo of rural teacher curriculum leadership and examined influencing factors through multiple linear regression analysis. It was found that curriculum leadership of rural teachers was at a low level with backward leadership views, lack of practical ability, and low sense of identity. Regression analysis demonstrated that individual field factors had a significant impact on teachers’ curriculum leadership. Specifically, the higher the teachers’ leadership willingness, trust in others, and self-efficacy, the higher the curriculum leadership. The school field was also an important influential aspect. In particular, the formation of a common vision and teacher community by the school and the appropriate empowerment of the principal had a significant positive impact on the curriculum leadership of rural teachers. Based on these key findings, several improvement suggestions are put forward at the end, which can be used as references for other countries to develop improvement plans on rural teacher curriculum leadership.

Research Trends and Development Patterns in Language Testing Over the Past Three Decades: A Bibliometric Study

This study used bibliometric data from Language Testing, a prestigious international peer-reviewed journal in the language testing field, to investigate research trends and development patterns in language testing. The bibliometric information included the number of publications, the most frequently researched test types and topics, the most cited publications and authors (as measured by references), the most prolific countries/regions and institutions and the most frequently collaborating countries/regions. The results showed that interest in language testing has increased over time and that regional tests and international tests have been major concerns, while classroom tests/assessments have received less attention. Research topics were wide-ranging and addressed almost all language testing related issues, among which validity/validation received the highest interest across periods. Moreover, the publications were produced by a wide range of countries/regions and institutions and included collaborative research spanning various institutions and regions, although collaborative publications across countries were relatively scarce. Based on the findings of this study, implications and suggestions have been highlighted for future research, academic agencies and this journal.

Market impact shapes competitive advantage of investment strategies in financial markets

The formation of an efficient market depends on the competition between different investment strategies, which accelerates all available information into asset prices. By incorporating market impact and two kinds of investment strategies into an agent-based model, we have investigated the coevolutionary mechanism of different investment strategies and the role of market impact in shaping a competitive advantage in financial markets. The coevolution of history-dependent strategies and reference point strategies depends on the levels of market impact and risk tolerance. For low market impact and low risk tolerance, the majority-win effect makes the trend-following strategies become dominant strategies. For high market impact and low risk tolerance, the minority-win effect makes the trend-rejecting strategies coupled with trend-following strategies become dominant strategies. The coupled effects of price fluctuations and strategy distributions have been investigated in depth. A U-shape distribution of history-dependent strategies is beneficial for a stable price, which is destroyed by the existence of reference point strategies with low risk tolerance. A δ-like distribution of history-dependent strategies leads to a large price fluctuation, which is suppressed by the existence of reference point strategies with high risk tolerance. The strategies that earn more in an inefficient market lose more in an efficient market. Such a result gives us another explanation for the principle of risk-profit equilibrium in financial markets: high return in an inefficient market should be coupled with high risk in an efficient market, low return in an inefficient market should be coupled with low risk in an efficient market.

Influencing factors of urban innovation and development: a grounded theory analysis

Urban innovation and development are a core driver for promoting the industrial, economic, and social development of cities. However, the factors that affect the innovation and development of cities lack systematic analysis as well as interaction analysis. Based on a multidimensional perspective, this study suggests that natural, economic, and social factors are three major factors conditioning urban innovation and development. A grounded theoretical qualitative method is further adopted to code relevant research literatures, news reports and interview materials, resulting in an onion factors model. We find that natural factors-including environmental quality, geographic location, and city scale-are prerequisite for conditioning urban innovation and development. Economic factors are also key, including economic level, industrial structure, industrial agglomeration, and technological innovation. Social factors are guarantee factors, including administrative hierarchy, cultural environment, population structure, and government management and services, i.e., they are essential for cities to become adaptable in the current dynamic situation. The study provides theoretical support and practical directions for the formulation of policies for urban innovation development.

Quality Perceptions and Choice of Public Health Facilities: A Mediation Effect Analysis of Outpatient Experience in Rural China

PURPOSE

Outpatients have choices of providers in the hierarchical health service delivery system of China. Understanding how quality perceptions and outpatient experience affect the choice of health facility would help inform decisions about priorities for action aimed at guiding the use of primary care. This study examines how quality perceptions of outpatient service affect the facility level choice in rural China.

METHODS

Household surveys were conducted in 2011, 2012 and 2015 in Ningxia Hui Autonomous Region, China. We selected 968 respondents as the study sample, who had at least two outpatient visits to the public health facilities during each survey period. Prior quality perceptions of the outpatient service at the village clinics, township centers, and county hospitals were reported on an 8-item Quality Indicator questionnaire. Experienced quality perception from the first outpatient visit was also reported. The outcome of interest was outpatients' facility level choices. We used regression and mediation analysis to explore whether and how outpatient experience at a specific health facility would mediate the relationship between prior quality perceptions and the facility level choice.

RESULTS

Overall, the quality perception was positively and significantly associated with outpatients' staying at the same or lower levels of care (β=0.265, P=0.007). This effect was fully mediated by experienced quality perception (z=2.985, P=0.003). The indirect effect was significant for three particular dimensions, including quality perceptions of the environment (β=0.075, P=0.025), doctor-patient communication (β=0.065, P=0.022), and physician ability (β=0.062, P=0.021).

CONCLUSION

Outpatient quality perceptions-especially positive perceptions regarding environment, doctor-patient communication, and physician ability-could contribute to minimizing upward referral via improvement in outpatient experience. Policymakers and health care providers may need to therefore optimize outpatient experience as they push to develop a more locally responsive primary care system.

Individualism Versus Collectivism and the Early-Stage Transmission of COVID-19

We propose a perspective based on the individualism versus collectivism (IC) cultural distinction to understand the diverging early-stage transmission outcomes of COVID-19 between countries. Since individualism values personal freedom, people in such cultures would be less likely to make the collective action of staying at home and less likely to support compulsory measures. As a reaction to the public will, governments of individualistic societies would be more hesitant to take compulsory measures, leading to the delay of necessary responses. With processed COVID-19 data that can provide a fair comparison, we find that COVID-19 spread much faster in more individualistic societies than in more collectivistic societies. We further use pronoun drop and absolute latitude as the instruments for IC to address reverse causality and omitted variable bias. The results are robust to different measures. We propose to consider the role of IC not only for understanding the current pandemic but also for thinking about future trends in the world.

Shadow banking contraction and innovation efficiency of tech-based SMEs-based on the implementation of China’s New Asset Management Regulation

Tech-based SMEs are important subjects for achieving national innovation-driven development, and it is crucial to study whether and how changes in the macro-institutional environment affect their innovation efficiency. New Asset Management Regulation (NAMR) is a policy promulgated by the Chinese government to address the chaotic expansion of shadow banking in China, and this study treats it as a quasi-natural experiment, selecting a sample of Chinese GEM-listed firms from 2015 to 2019, adopting the event study method and the generalized double difference method, and empirically testing the impact of shadow banking contraction on the innovation efficiency of Chinese tech-based SMEs and its mechanism. This study finds that shadow banking contraction under the NAMR significantly improves innovation efficiency of tech-based SMEs. The mechanism test finds that the NAMR can optimize the debt financing structure of tech-based SMEs, reduce their financing costs and financing risks, and ultimately accelerate their innovation efficiency by improving their financing efficiency, which supports the hypothesis of “financing efficiency view”; it is further found that, to tech-based SMEs, the more they rely on shadow banking and the severer financing constraints they endure, the more obvious NAMR’s effect is on improving innovation efficiency. The findings not only provide some empirical evidence to clarify the controversy of shadow banking in China from the perspective of firm innovation, but also have some implications for the subsequent financial regulatory reform.

Does China’s green economic recovery generate a spatial convergence trend: an explanation using agglomeration effects and fiscal instruments

China’s urbanization process has entered a period of rapid development, and cities have become key to driving regional economic development. This paper uses data from 286 cities in China in the period 2005–2018 to construct an urban economic growth quality index system and examine the influence of spatial factors on the convergence trend of China’s urban economic growth quality. It is found that there is a β absolute convergence trend of economic growth quality in Chinese cities across the whole country. After controlling for the initial conditions of individual economies, spatial factors strengthen the spatial convergence trend of urban economic growth quality and significantly increase the corresponding convergence rate. Among the areas studied, the western region has the fastest convergence rate, followed by the central and eastern regions, and the convergence rates of both the central and western regions are higher than the national average. Agglomeration economies and fiscal policy tools are important for the promotion of the urban economic growth quality. The agglomeration of productive service industries significantly improves the spatial convergence rate of urban economic growth quality. This effect is mainly due to the spatial spillover of industrial agglomeration. The expansion of government fiscal expenditure also contributes to the spatial convergence trend of urban economic growth quality. Local economic growth quality is also affected by government fiscal expenditure in neighboring cities.

Contact network analysis of Covid-19 in tourist areas--Based on 333 confirmed cases in China

The spread of infectious diseases is highly related to the structure of human networks. Analyzing the contact network of patients can help clarify the path of virus transmission. Based on confirmed cases of COVID-19 in two major tourist provinces in southern China (Hainan and Yunnan), this study analyzed the epidemiological characteristics and dynamic contact network structure of patients in these two places. Results show that: (1) There are more female patients than males in these two districts and most are imported cases, with an average age of 45 years. Medical measures were given in less than 3 days after symptoms appeared. (2) The whole contact network of the two areas is disconnected. There are a small number of transmission chains in the network. The average values of degree centrality, betweenness centrality, and PageRank index are small. Few patients have a relatively high contact number. There is no superspreader in the network.

Pastoral subsistence and mounted fighting in the Eastern Tianshan Mountain region: New insights from the Shirenzigou worked bone assemblage

Situated at a geographic crossroads, the eastern Tianshan Mountain region in northwest China is crucial to understanding various economic, social, and cultural developments on the Eurasian Steppes. One promising way to gain a better knowledge of ancient subsistence economy, craft production, and social change in the eastern Tianshan Mountain region is to study the artifact assemblages from archaeological contexts. Here, we present an analysis of 488 worked animal bones from the large site of Shirenzigou (ca. 1300-1 BCE), to date the largest assemblage of this kind uncovered in the eastern Tianshan Mountain region. We classified these worked bones into six categories, including "ritual objects", "ornaments", "tools", "worked astragali", "warfare and mobility", and "indeterminate". The identification of animal species and skeletal elements indicates that worked bones from Shirenzigou are characterized by a predominance of caprine products, particularly worked astragali, which is consistent with the large proportion of caprine fragments found in animal remains associated with food consumption. This demonstrates the contribution of caprine pastoralism to bone working activities at Shirenzigou. The making of most worked bones does not appear to have required advanced or specialized skills. Considering the absence of dedicated bone working space, alongside the variability in raw material selection and in dimensions of certain types of artifacts, we infer that worked bone production at Shirenzigou was not standardized. In terms of raw material selection and mode of production, Shirenzigou differed from their settled, farming counterparts in the Yellow River valley of northern China. In addition, along with the evidence for violence and horseback riding, the increasing use of bone artifacts associated with warfare and mobility during the late occupation phase of Shirenzigou reflects growing social instability and implies the likely emergence of single mounted horsemen, equipped with light armors, in the region during the late first millennium BCE. Our results provide new insights into animal resource exploitation and changing lifeways of early pastoral societies in the eastern Tianshan Mountain region, expanding our knowledge of the economic, social, and political milieu of late Bronze Age and early Iron Age eastern Eurasia.

Prevalence of Colorectal Polyps Based on Cardiorespiratory Fitness, Muscle Strength, Health Behavior, and Abdominal Obesity in Asymptomatic Elderly

Colorectal polyps are precursor lesions of colorectal cancer and are known to be associated with obesity, low physical activity, and unhealthy behavior. This cross-sectional study analyzed the prevalence of colorectal polyps based on cardiorespiratory fitness (CRF), muscle strength, and health behavior in older adults. Participants were asymptomatic and included 1024 men and 472 women aged 65-80 years who visited the health care center. Colonoscopy was performed under conscious sedation, and cardiorespiratory fitness was measured as the maximum oxygen uptake using gas analysis. Muscle strength was determined using isokinetic equipment, and physical activity, alcohol consumption, and smoking status were investigated using questionnaires. Waist circumference was measured at the thickest part of the middle of the abdomen. Logistic regression analysis was used to calculate the prevalence of colorectal polyps using odds ratios (ORs) based on the variables. The incidence of colorectal polyps was 65.2% in men and 48.5% in women. The ORs of colorectal polyps for obesity were 1.151 (95% confidence interval [CI], 1.010-2.291) and 1.178 (95% CI, 1.015-2.612) in men and women, respectively. The OR for colorectal polyps in male current smokers was 1.884. The ORs for low CRF were 1.985 and 1.841 in men and women, respectively, compared with high CRF. The prevalence of polyps increased with low muscle strength (men's OR 1.343 women's OR 1.440) and physical activity in both men (OR 1.693) and women (OR 1.861). In conclusion, lower CRF and muscle strength were associated with an increased prevalence of colorectal polyps in men and women. In both sexes, high waist circumference and low physical activity increased the prevalence of colorectal polyps.

Health service utilisation among African migrants in China: a nationwide cross-sectional study

OBJECTIVES

To assess the health utilisation status and associated factors among African migrants in China.

DESIGN

A national cross-sectional study was conducted among African migrants in China in 2019.

SETTING

Participants were recruited online and offline to participate in a self-report survey. Online participants were recruited through WeChat across China, and offline participants were recruited in Guangzhou.

PARTICIPANTS

We recruited participants who were from an African country; had spent at least 1 month cumulatively in China; were at least 18 years old; were willing to provide informed consent. A total of 1025 participants were recruited online and offline, 19 of them were excluded due to invalid response and 1006 people were finally included in the analysis.

OUTCOME MEASURES

The primary outcome was health service utilisation and associated factors among African migrants during their stay in China in the past 12 months. The potential factors include the predisposing factors (demographic characteristics and social structure variables), enabling factors (annual income, health insurance in China) and need factors (non-communicable chronic and infectious diseases, depression) which determined by Anderson framework were measured.

RESULTS

Eight hundred and seven online and 218 offline participants completed the survey, including 624 males and 382 females, with an average age of 26.4±8.9 years. Around 28.5% reported health utilization in the past 12 months. Results showed that longer duration in China, migration to China for business (aOR=2.23, 95% CI:1.13-4.40) and study (aOR=5.00, 95% CI:2.74-9.11), living in apartment (aOR=2.59, 95% CI:1.62-4.14) or dormitory (aOR=3.22, 95% CI:2.17-4.80) in China, suffering from chronic diseases, communicable diseases, and greater depressive symptoms (aOR=1.91, 95% CI:1.42-2.56) facilitated health service utilization.

CONCLUSIONS

The healthcare service that African migrants received in China is low. The existing public health policies and intervention measures need to be improved to make health utilisation more accessible and feasible for African migrants.

Cross-cultural adaptation and validation of the caregiver contribution to self-care of chronic illness inventory in China: a cross-sectional study

OBJECTIVE

Caregiver contribution (CC) is important for the self-care behaviors of chronic disease individuals, as it could enhance patient outcomes. Therefore, it is necessary to assess this CC by using a good validity and reliability instrument. The Caregiver Contribution to Self-Care Chronic Illness Inventory (CC-SC-CII) was designed to assess CC to self-care behaviors of patients with chronic illness in Italy. However, it was unclear whether this tool had sound psychometrics properties in the context of Chinese culture. Therefore, we performed the cross-cultural adaption of the CC-SC-CII and we tested its psychometric properties among Chinese caregivers of patients with chronic disease.

DESIGN

A cross-sectional observational design.

SETTINGS

Participants were recruited from communities and institutions in Pingdingshan, Henan Province, China.

PARTICIPANTS

301 caregivers of care recipients with chronic disease completed the Chinese version of the CC-SC-CII (C-CC-SC-CII).

PRIMARY AND SECONDARY OUTCOME MEASURES

The content validity index of items (I-CVI), the scale content validity index-average (S-CVI/Ave), exploratory factor analysis, confirmatory factor analysis (CFA), internal consistency and item analysis were tested.

RESULTS

The range of I-CVI was between 0.833 and 1.00, and the score of S-CVI was 0.991. In CFA, the C-CC to self-care monitoring scale had satisfactory fit indices. However, the C-CC to self-care maintenance and management scales had unsupported fit indices. The reliability coefficients of C-CC-SC-CII were 0.792, 0.880 and 0.870 for its three scales. Item-total correlations were all over 0.590. Test-retest reliability showed that the range of intraclass correlation coefficients was from 0.728 to 0.783.

CONCLUSION

The C-CC-SC-CII has sound psychometrics characteristics and is a culturally appropriate and reliable instrument for assessing CC to the self-care behaviours of patients with chronic disease in China.

Applying resource bricolage theory to the city integration of new-generation migrant workers in China

New-generation migrant workers in Chinese cities are struggling with a lack of urban resources, such as capital, skills, and relationships. To cope with the pressure of these resource constraints, new-generation migrant workers obtain urban development opportunities through resource bricolage. Based on a questionnaire survey of 365 new-generation migrant workers, we used a multiple regression analysis to study the mechanism underlying the effects of resource bricolage on the city integration of new-generation migrant workers. There were four findings: (1) resource bricolage had a significant positive effect on career growth and city integration; (2) career growth had a mediation effect on the relationship between resource bricolage and city integration; (3) environmental dynamism had a positive moderating effect on the relationship between resource bricolage and city integration for new-generation migrant workers; and (4) resource bricolage and environmental dynamism had a moderating effect on city integration through the mediation effect of career growth. The results suggest that resource bricolage promotes the career growth of new-generation migrant workers and further promotes their city integration, and that the environmental dynamism faced by workers is the external condition for promoting integration through resource bricolage. The study emphasizes the importance of resource bricolage in new-generation migrant workers' city integration.

An options pricing method based on the atmospheric environmental health index: an example from SO2

Environmental finance has gradually become an important tool for solving atmospheric pollution problems. The creation of options based on an atmospheric environmental health index (AEHI) is designed to support a rational pricing of financial products related to the health of the atmospheric environment. To begin with, the improved Ornstein-Uhlenbeck model is established to predict the change in air pollutant concentrations, and then we construct the AEHI by using exposure-response Poisson regression model. In addition, an options pricing method for AEHI is proposed based on Esscher transform theory, and the universal investment strategy for enterprises is formulated to hedge operational risk by using the AEHI option. Finally, we use Beijing city of China, as a case study to demonstrate how to determine the AEHI options prices for two diseases in three age groups, and propose the investment strategy for an insurance enterprise. The AEHI options should therefore be used to compensate for the damage to human health caused by air pollution, and to hedge against the operational risks of related industries.

Hukou-based rural-urban disparities in maternal health service utilization and delivery modes in two Chinese cities in Guangdong Province

BACKGROUND

Most existing research on rural-urban health inequalities focuses on disparities in service access and health outcomes based on region. This paper examines rural-urban disparities in maternal healthcare utilization and delivery modes based on household registration (hukou) status to understand the role of state institutions in producing healthcare disparities in China.

METHODS

Utilizing administrative data from the Public Maternal Health Insurance scheme, we analyzed 54,733 live births in City A (2015-2019) and 25,849 live births in City B (2018-2019) in Guangdong Province in China. We constructed regression models using hukou status (rural versus urban) as the explanatory variable.

RESULTS

While there is no statistically significant difference in rural and urban mothers' probability of obtaining the minimum recommended number of prenatal care checkups in City A (OR = 0.990 [0.950, 1.032]), mothers with rural hukou status have a lower probability of obtaining the minimum recommended number of visits in City B than their counterparts with urban hukou (OR = 0.781 [0.740, 0.825]). The probability of delivering in tertiary hospital is lower among mothers with rural hukou than among those with urban hukou in both cities (City A: OR = 0.734 [0.701, 0.769]; City B: OR = 0.336 [0.319, 0.354]). Mothers with rural hukou are more likely to have a Cesarean section than those with urban hukou in both cities (City A: OR = 1.065 [1.027, 1.104]; City B: OR = 1.127 [1.069, 1.189]). Compared with mothers with urban hukou, mothers with rural hukou incurred 4 % (95 % CI [-0.046, -0.033]) and 9.4 % (95 % CI [-0.120, -0.068]) less in total medical costs for those who delivered via Cesarean section and 7.8 % (95 % CI [-0.085, -0.071]) and 19.9 % (95 % CI [-0.221, -0.177]) less for those who delivered via natural delivery in City A and City B, respectively.

CONCLUSIONS

Rural hukou status is associated with younger age, no difference or lower probability of having a minimum number of prenatal checkups, higher likelihood of delivering in nontertiary hospitals, increased Cesarean delivery rates, and lower medical cost for delivery in these two Chinese cities. Evaluating how hukou status influences maternal healthcare in Chinese cities is important for devising targeted public policies to promote more equitable maternal health services.

Registered nurses' role experiences of caring for older stroke patients: a qualitative study

BACKGROUND

With China's population ageing rapidly, stroke is becoming one of the major public health problems. Nurses are indispensable for caring for older patients with acute and convalescent stroke, and their working experiences are directly linked to the quality of care provided. The study aims to investigate registered nurses' experiences of caring for older stroke patients.

METHODS

A qualitative descriptive design was adopted. Data were collected via semi-structured interviews with 26 registered nurses about their lived experiences of caring for older stroke patients. Thematic analysis was used to analyze the data.

RESULTS

Two main themes were identified. First, the nurses identified an obvious gap between their ideal role in elderly care and their actual practice. The unsatisfactory reality was linked to the practical difficulties they encountered in their working environment. Second, the nurses expressed conflicting feelings about caring for older stroke patients, displaying a sense of accomplishment, indifference, annoyance, and sympathy. Caring for older stroke patients also affects nurses psychologically and physically. The nurses were clear about their own roles and tried their best to meet the elderly people's needs, yet they lack time and knowledge about caring for older stroke patients. The factors influencing their working experiences extend beyond the personal domain and are linked to the wider working environment.

CONCLUSIONS

Sustaining the nursing workforce and improving their working experiences are essential to meet the care needs of older people. Understanding nurses' lived working experiences is the first step. At the individual level, nurse mangers should promote empathy, relieve anxiety about aging, and improve the job satisfaction and morale of nurses. At the institutional level, policymakers should make efforts to improve the nursing clinical practice environment, increase the geriatric nursing education and training, achieve a proper skill mix of the health workforce, and overall attract, prepare and sustain nurses regarding caring for older people in a rapidly aging society.