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Background: Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. Methods: From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9–17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. Results: Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02–1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. Conclusions: These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls. [ABSTRACT FROM AUTHOR]

People with minor medical conditions in China tend to prefer healthcare consultation in the emergency department of tertiary hospitals and avoid public sector community health centers (PS-CHC). The reason behind this is the trust deficit in the quality of medical care at PS-CHC. On the other hand, Chinese m-health companies have a surprising number of registered users and daily healthcare queries. However, the lack of physical check-ups causes a lack of trust in the quality of prescribed treatments for m-health users. One such m-health company entered into a joint venture with a local government body. In this joint venture, the doctors from tertiary hospitals can provide healthcare consultation to m-health users at PS-CHC. This study investigates m-health users' intention to use m-health services equipped with PS-CHC, an emerging public-private joint venture in China. We extended the technology acceptance model with government support and trust to predict the adoption of such technology-based public-private joint ventures in a better way. The data were collected from 432 m-health users in Hefei and analyzed using Smart-PLS. All eight direct, but only three mediating relationships were to be found significant. This study has implications for researchers, government healthcare authorities, and m-health service providers. [ABSTRACT FROM AUTHOR]

Despite increasing research that examines language features of online medical consultation (OMC) conversations in China, limited attention has been directed to how medical professionals purposefully present themselves in their biographies on OMC websites, an emerging genre of health communication, with even fewer comparative studies on traditional Chinese medicine (TCM) and Western medicine (WM) medical professionals in this regard. To fill these gaps, this study compares the personal claims and self-presentational strategies used in TCM and WM medical professionals’ biographies on a Chinese OMC website. It is found that while Chinese TCM and WM medical professionals present themselves in similar ways, they also demonstrate some important differences. The similarities may be driven by their shared goal of building trust in the OMC context, whereas the differences may be ascribed to TCM-WM differences in clinical philosophies, education histories, clinical cultures, and medical practices. [ABSTRACT FROM AUTHOR]

Social media has become an important avenue for learning. However, the mechanisms underlying social media use and its influence on knowledge are not clear. Based on the cognitive mediation model, this study explored the pathways through which social media use was linked to health knowledge, taking into account different information acquisition patterns (e.g., media attention vs. information discussion), information processing (e.g., elaboration), and information seeking experience. With a cross-sectional survey conducted in China (N = 1,350), this study found that paying attention to health information on social media had a direct and positive relationship with health knowledge. However, discussing such information was negatively associated with knowledge. Media attention also had a positive relationship with information discussion. Both media attention and information discussion were positively related to information elaboration, which in turn, had a positive association with health knowledge. Also, the poor quality of health information seeking experience weakened the relationship between social media use and elaborative processing. This study provides important implications for health communication research and practice in the digital era. [ABSTRACT FROM AUTHOR]

Antibiotic overprescription in China has long been considered a problem on the supply side, linked to the financial incentives of physicians. Based on the conversation analysis of 187 video‐recorded naturally occurring medical consultations in Chinese paediatric primary care settings, this study finds that the driving force behind the problem of antibiotic overprescription in China has changed. Physicians use a low‐authority communication style to recommend treatment, displaying a low level of medical authority and a willingness to accommodate caregivers' preferences in antibiotic prescribing decisions. The problem is now attributed to physician–caregiver interaction, doctor–patient relationship and the antibiotic‐saturated prescribing culture. Practice implications involve deepening the understanding of the evolving nature of the antibiotic overprescription problem in China, building trust between physicians and patients/caregivers in order to facilitate the physicians' role as the gatekeeper of antibiotics and providing training programmes to help physicians develop effective communication skills. [ABSTRACT FROM AUTHOR]

According to the selective exposure hypothesis, media with the arrival of COVID-19, the output of communication and mediafocused peer-review articles have increased frenetically. As a result, this study examines the communication and media aspects, methodological characteristics and guiding theories, the geographic landscape of content, and the dominant publication avenue of peer-reviewed articles in high-impact journals (n=576). Findings show that mass communication and social media are the leading media types, while Twitter is the leading platform. The quantitative research method, survey and grounded theory are the leading methodology, research technique and guiding theory, respectively. Countries in the Global North and China dominated the geographic content of this emergent area, while the Journal of Social and Personal Relationships and Health Communication were primary publication outlets. Within communication and media-focused communications research, ‘covid,’ ‘2020,’ ‘media,’ and ‘social’ are the most popular words. [ABSTRACT FROM AUTHOR]

Leveraging substantial data from China's Weibo and datasets from Reddit and X (previously Twitter) in the United States, this research explores the disparities and complex dynamics of emotions and social connections among social media users in China and the United States during the COVID-19 pandemic. The findings indicate that the expression of three negative emotions (anxiety, sadness, and anger) and positive emotions exhibited distinctive dynamics under the impact of the pandemic, with China individuals expressing more anxiety but less sadness and anger than those in the US. Moreover, Chinese social media experienced a surge in positive emotional expressions under lockdown, whereas the US witnessed a conspicuous decline in positive emotions. Also, the expression of three types of social connections - "family", "collective", and "country"-exhibited significant differences under the impact of the pandemic, with Chinese individuals establishing deeper connections with their country and American individuals leaning towards familial connections. Further analysis on the moderating effects of social connections substantiated that the "country" connection in China and the "family" connection in the US mitigated the negative emotions affected by the pandemic. These findings facilitate a deeper understanding of how cultural contexts shape social and psychological responses in crises. Based on topic analysis and forward-looking orientation analysis, this study dissects the aforementioned findings through the dichotomy of collectivist and individualist cultures, providing new insights for social psychological support and emotional guidance in the development of public health communication strategies in the future. [ABSTRACT FROM AUTHOR]

Background: Health rumors arbitrarily spread in mainstream social media on the internet. Health rumors emerged in China during the outbreak of COVID-19 in early 2020. Many midelders/elders (age over 40 years) who lived in Wuhan believed these rumors. Objective: This study focused on designing a serious game as an experimental program to prevent and control health rumors. The focus of the study was explicitly on the context of the social networking service for midelders/elders. Methods: This research involved 2 major parts: adopting the Transmission Control Protocol model for games and then, based on the model, designing a game named "Fight With Virus" as an experimental platform and developing a cognitive questionnaire with a 5-point Likert scale. The relevant variables for this experimental study were defined, and 10 hypotheses were proposed and tested with an empirical study. In total, 200 participants were selected for the experiments. By collecting relevant data in the experiments, we conducted statistical observations and comparative analysis to test whether the experimental hypotheses could be proved. Results: We noted that compared to traditional media, serious games are more capable of inspiring interest in research participants toward their understanding of the knowledge and learning of health commonsense. In judging and recognizing the COVID-19 health rumor, the test group that used game education had a stronger ability regarding identification of the rumor and a higher accuracy rate of identification. Results showed that the more educated midelders/elders are, the more effective they are at using serious games. Conclusions: Compared to traditional media, serious games can effectively improve midelders'/elders' cognitive abilities while they face a health rumor. The gameplay effect is related to the individual's age and educational background, while income and gender have no impact. [ABSTRACT FROM AUTHOR]

Copyright of Science & Technology of Cereals, Oils & Foods is the property of Science & Technology of Cereals, Oils & Foods Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health misinformation is a serious problem that can cause confusion and risk-taking behaviors, undermining public health efforts. Fact-checking has been highlighted as an effective tool for coping with the challenge of misinformation. However, few studies have examined the factors influencing individuals' health fact-checking behaviors. Using the comprehensive model of information seeking, we conducted a two-wave panel survey in China during the COVID-19 pandemic and explored the underlying process that might hinder COVID-19 fact-checking. The results showed that risk perception and worry about COVID-19 triggered a negative COVID-19 information-seeking experience, which reduced COVID-19 fact-checking. Moreover, the propensity to trust COVID-19 misinformation played a moderating role, such that negative information-seeking experience had a stronger negative effect on fact-checking behaviors for people with a greater propensity to trust misinformation. This study demonstrates the dark side of cognitive and affective responses to risks and health information-seeking experiences. The findings offer important implications for future health communication initiatives to effectively promote health fact-checking behaviors. [ABSTRACT FROM AUTHOR]

The present article examines how disease anthropomorphism affects compliance with recommendations for preventing the disease. We find that consumers are more likely to comply with health recommendations when the disease is described in anthropomorphic (vs. non-anthropomorphic) terms because anthropomorphism increases psychological closeness to the disease, which increases perceived vulnerability. We demonstrate the effect of disease anthropomorphism on health compliance in seven studies with several diseases (COVID-19, breast cancer), manipulations of anthropomorphism (first person and third person; with and without an image), and participant populations (the US and China). We test the proposed pathway through psychological closeness and perceived vulnerability with sequential mediation analyses and moderation-of-process approaches, and we rule out alternative accounts based on known consequences of anthropomorphism and antecedents of health compliance. This research contributes to the theory and practice of health communication and to the growing literature on how the anthropomorphism of negative entities affects consumers' judgments and behaviors. [ABSTRACT FROM AUTHOR]

In the context of the ongoing global epidemic of COVID-19 and frequent virus mutations, the implementation of vaccine is the key to the prevention and control of the epidemic at this stage. In order to provide recommendations and evidence to support global epidemic prevention and control and vaccination efforts from the perspectives of health communication and individual psychological perceptions and to improve the vaccination rate of COVID-19 vaccine among appropriate populations, this study conducted a questionnaire survey in eight districts of Beijing and collected a total of 525 valid data points. A health belief model was used to examine the predictors of COVID-19 vaccination behavior, and the relationship between different COVID-19 vaccine information dissemination channels, residents' health beliefs, and propensity to vaccinate was analyzed. This study found the following: (1) among new media, interpersonal communication and traditional media communication channels, the new media channel had the largest number of audiences; (2) the personal health beliefs of audiences in the three information channels differed significantly, with the highest perceived benefits and lowest perceived barriers in the interpersonal communication channel and the highest perceived barriers in the new media communication channel; (3) the health belief model was a significant predictor, with perceived benefits and barriers being the most effective attitudinal variables for predicting vaccination intention. This study is valuable for advancing and improving vaccine communication diffusion research and promoting wider application of the health belief model and communication media in health communication topics. [ABSTRACT FROM AUTHOR]

It is an objective reality that deaf-mute people have difficulty seeking medical treatment. Due to the lack of sign language interpreters, most hospitals in China currently do not have the ability to interpret sign language. Normal medical treatment is a luxury for deaf people. In this paper, we propose a sign language recognition system: Heart-Speaker. Heart-Speaker is applied to a deaf-mute consultation scenario. The system provides a low-cost solution for the difficult problem of treating deaf-mute patients. The doctor only needs to point the Heart-Speaker at the deaf patient and the system automatically captures the sign language movements and translates the sign language semantics. When a doctor issues a diagnosis or asks a patient a question, the system displays the corresponding sign language video and subtitles to meet the needs of two-way communication between doctors and patients. The system uses the MobileNet-YOLOv3 model to recognize sign language. It meets the needs of running on embedded terminals and provides favorable recognition accuracy. We performed experiments to verify the accuracy of the measurements. The experimental results show that the accuracy rate of Heart-Speaker in recognizing sign language can reach 90.77%. [ABSTRACT FROM AUTHOR]

In order to guide and meet people's health needs, various resources are flowing to the health sector, and the regional health economy is bound to develop rapidly, which increases the possibility of integrating and developing the sports economy and health industry in the context of the public health sector. As the health of the population improves, life expectancy increases, science and technology develops, and lifestyles change, the health economy sector is becoming increasingly active and both sport and healthcare will contribute to the development of the regional health economy. Big data, as a new management mindset and technical tool, brings new opportunities and challenges to the integrated development of sports economy and health industry. Based on the basic characteristics of big data, this paper provides a strategy for the development of the sports and health integration industry by using research methods such as grey correlation analysis, expert interviews, and agglomeration measures, starting from the problems faced by the integration development of China's sports industry to guarantee the construction of conditions. The experiment is analysed through the big data presentation of the health industry and the big data modelling ideas of grey correlation analysis, which provides new ideas to expand the application research of grey correlation analysis in the field of integration development. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Since the COVID-19 pandemic, social media has become an important arena for the public to transmit and exchange messages, feelings, opinions, and information about the epidemic. In the era of social media, many UGC contents from self-media and various information about the epidemic on social media have strong emotional colors. These contents are not only rich in resources for text sentiment analysis but also reveal the laws and characteristics of the evolution of users' emotional tendencies in public health emergencies. It even ties together the interaction between media content and society. Objective. As the Sina Weibo platform's characteristics of communication are real-time, open, and "many-to-many," the objective of this study is to collect Weibo-blog contents tagged with the outbreak of COVID-19 in a certain metropolis in China and analyze the emotional evolution situation of Weibo-blogs of the unexpected public health emergency involved. This will provide a dynamic understanding of the mechanisms underlying the evolution of emotional conditions in the context of public health emergencies. Methods. This paper uses a Python crawler, the SnowNLP sentiment analysis model, and correlation analysis to calculate the emotional tendencies of the event "Covid-19 outbreak in a Chinese metropolis" on the Sina Weibo platform. The study was carried out in terms of the evolutionary stages of the event and the factors which induce it. Results. This paper revealed characteristics of time-varying laws and dynamic propagation of users' emotional evolution in public health emergencies. (1) This study refers to the life cycle model of COVID-19, combined with the statistics of the time series of the quantities of Weibo-blog posting, and divides the law of the quantities of Weibo-blog posting changing with the event into three stages: outbreak period, stalemate period, and resolution period. (2) Users' emotional tendencies are changeable and unstable which are easily induced by various factors. (3) There is a significant positive correlation between the reported confirmed cases and the quantities of Weibo-blog posts. (4) Individual emotional tendencies will have a positive changing trend with the public's average emotional tendencies after the event occurs. (5) There is no correlation between reposts, comments, and Weibo-blog emotional tendencies. Conclusion. The research found that, given staged evolution and repeated fluctuations of emotional tendencies, relevant departments should effectively use this law and set up different response plans according to different stages. In addition, what is highly coupled with users' emotional tendencies is not only the information about the virus but more large-scale infected by different intensities of emotions. [ABSTRACT FROM AUTHOR]

Background: It is useful to advance simulated patient (SP) participation in teaching to improve the communication skills of medical students, so this study aims to explore the current state of Chinese mainland SP education. Methods: A cross sectional survey was designed utilizing well defined quantitative research methods and descriptive statistics. The questionnaire sought information which elucidated the current status of SP-based education, the origin of SP-based learning, SP training, challenges of this learning strategy and future developments. Questionnaires were distributed to 79 medical colleges in mainland China, and 68 were returned. Of these, 64 constituted valid responses (81%). Results: The number of SP-based education activities in medical colleges offering 5-year、7-year and 8-year clinical medicine programs was significantly higher than that in medical colleges which offered only a single 5-year program (p < 0.01). Communication skills training accounted for 73% of the content of SP-based learning activities, and was expected to rise in the future to 90%, in response to a need to improve doctor-patient relationships. Persons recruited as 'simulated patients' included students (21% of the total), residents (49%), medical staff (15%) and teaching staff (14%). Colleges, planning a SP-based education program, preferred teachers (80%) and students (55%) to assume 'simulated patient' roles. In objective structured clinical education (OSCE) scenarios, co-scoring by both SPs and teachers featured more highly in the 'consultation' station and 'doctor-patient communication' station. A number of factors were identified as hindering future development and implementation of SP-based learning including budget restraints, SP selection and training. Conclusions: SP-based learning programs offer clear benefits for improving the clinical education of medical students and their communication skills. The main obstacles to achieving more widespread and higher quality SP-based education are insufficient funding and the lack of standardized training and performance evaluation processes for simulated patients. Medical colleges should consider reducing the proportion of students and teachers acting as SPs, and attract more citizens to participate in SP-based learning activities. Formalised training and evaluation of SPs performance are necessary to establish a 'standard simulated patient' for a particular medical discipline, thus improving SP-based activities and student learning. [ABSTRACT FROM AUTHOR]

The aim of our study was to identify factors associated with coronavirus disease 2019 (COVID-19)vaccine willingness in China to aid future public health actions to improve vaccination. This study was conducted in August 2020 using a mixed-method approach, including a cross-sectional self-administered anonymous questionnaire survey and in-depth interviews with community residents in China. Of the participants, 30.9% showedCOVID-19 vaccine hesitancy. Being female(OR = 1.297), having poor health(OR = 1.312), having non-health or medical-related occupations (OR = 1.129), no COVID-19 infection experience(OR = 1.523), living with vulnerable family members(OR = 1.294), less knowledge(OR = 1.371), less attention to COVID-19 information(OR = 1.430), less trust in official media(OR = 1.336), less perceived susceptibility to COVID-19(OR = 1.367), and less protective behavior(OR = 1.195) were more likely to hesitate. Qualitative research has shown that they doubt the importance and necessity, as well as the effectiveness and safety of the vaccination. The economic and service accessibility of the vaccination was an impediment to their vaccine acceptance. Nearly one-thirdof people showed hesitancy to accept COVID-19 vaccination in China. Our findings highlight that health communication and publicity should be performed for the targeted population, and immunization programs should be designed to remove underlying barriers to vaccine uptake. [ABSTRACT FROM AUTHOR]

Background: Science-driven storytelling and entertainment-education (E-E) media demonstrate potential for promoting improved attitudes and behavioral intent towards health-related practices. Months after the outbreak of coronavirus disease 2019 (COVID-19), emerging research highlights the essential role of interventions to improve public confidence in the COVID-19 vaccine. To improve vaccine confidence, we designed three short, animated videos employing three research-informed pedagogical strategies. These can be distributed globally through social media platforms, because of their wordless and culturally accessible design. However, the effectiveness of short, animated storytelling videos, deploying various pedagogic strategies, needs to be explored across different global regions.Methods/design: The present study is a multi-site, parallel group, randomized controlled trial (RCT) comparing the effectiveness of (i) a storytelling-instructional-humor approach, (ii) a storytelling-analogy approach, (iii) a storytelling-emotion-focused approach, and (iv) no video. For our primary outcomes, we will measure vaccine hesitancy, and for secondary outcomes, we will measure behavioral intent to seek vaccination and hope. Using online platforms, we will recruit 12,000 participants (aged 18-59 years) from the USA and China, respectively, yielding a total sample size of 24,000.Discussion: This trial uses innovative online technology, reliable randomization algorithms, validated survey instruments, and list experiments to establish the effectiveness of three short, animated videos employing various research-informed pedagogical strategies. Results will be used to scientifically support the broader distribution of these short, animated video as well as informing the design of future videos for rapid, global public health communication.Trial Registration: German Clinical Trials Register DRKS #00023650 . Date of registration: 2021/02/09. [ABSTRACT FROM AUTHOR]

Background. From Ebola, Zika, to the latest COVID-19 pandemic, outbreaks of highly infectious diseases continue to reveal severe consequences of social and health inequalities. People from low socioeconomic and educational backgrounds as well as low health literacy tend to be affected by the uncertainty, complexity, volatility, and progressiveness of public health crises and emergencies. A key lesson that governments have taken from the ongoing coronavirus pandemic is the importance of developing and disseminating highly accessible, actionable, inclusive, coherent public health advice, which represent a critical tool to help people with diverse cultural, educational backgrounds and varying abilities to effectively implement health policies at the grassroots level. Objective. We aimed to translate the best practices of accessible, inclusive public health advice (purposefully designed for people with low socioeconomic and educational background, health literacy levels, limited English proficiency, and cognitive/functional impairments) on COVID-19 from health authorities in English-speaking multicultural countries (USA, Australia, and UK) to adaptive tools for the evaluation of the accessibility of public health advice in other languages. Methods. We developed an optimised Bayesian classifier to produce probabilistic prediction of the accessibility of official health advice among vulnerable people including migrants and foreigners living in China. We developed an adaptive statistical formula for the rapid evaluation of the accessibility of health advice among vulnerable people in China. Results. Our study provides needed research tools to fill in a persistent gap in Chinese public health research on accessible, inclusive communication of infectious diseases' prevention and management. For the probabilistic prediction, using the optimised Bayesian machine learning classifier (GNB), the largest positive likelihood ratio (LR+) 16.685 (95% confidence interval: 4.35, 64.04) was identified when the probability threshold was set at 0.2 (sensitivity: 0.98; specificity: 0.94). Conclusion. Effective communication of health risks through accessible, inclusive, actionable public advice represents a powerful tool to reduce health inequalities amidst health crises and emergencies. Our study translated the best-practice public health advice developed during the pandemic into intuitive machine learning classifiers for health authorities to develop evidence-based guidelines of accessible health advice. In addition, we developed adaptive statistical tools for frontline health professionals to assess accessibility of public health advice for people from non-English speaking backgrounds. [ABSTRACT FROM AUTHOR]

Public health emergencies, especially major infectious diseases, may cause global crises. Timely and effective communication is essential for response to such incidents. However, the emergency response to such incidents usually lasts longer and break out repeatedly, and the existing static emergency communication network (ECN) analysis cannot fully reflect the dynamic information interaction between organizations during the emergency process. Therefore, this article takes the recent COVID-19 epidemic in Hubei, China as a case, and uses social network analysis to reveal the dynamic evolution of communication networks, positions, roles, and tasks of organizations from the time dimension. The results show that: (1) the ECN has changed from concentrated to decentralized over time; (2) the positions and roles of participating organizations in the ECN has changed, but there are still a few key organizations that at the central position in all phases of emergency communication; (3) the core tasks have changed due to emergency needs at each stage; (4) under the concentrated management system, the core organization of the ECN mainly comes from government organizations. The research results reveal the dynamic evolution of communication networks between different types of emergency organizations, which is beneficial to guide emergency management of public health emergencies. In actual emergency, the emergency communication mode should be dynamically adjusted based on the characteristics of the emergency situation at different stages, comprehensively using the advantages of the concentrated and decentralized emergency network. In addition, communication between different types of organizations such as governments, research institutions, and enterprises should be strengthened, and channels for diversified organizations to participate in emergency communication should be set up. The research helps to improve communication between emergency response organizations and is of great significance to controlling and reducing the harm caused by public health emergencies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic provoked public attention to medical treatments across the world. In China, a debate on the efficacy of traditional Chinese medicine (TCM) took place amid the government's active promotion of it for COVID-19 patients. Rather than addressing such a debate from the perspective of medical science or health communication, this paper explores how TCM was politicised on Chinese social media. The research is based on a case study, collecting data from the most popular Chinese community question-answering (CQA) site – Zhihu. By triangulating content analysis (CA) and thematic analysis (TA), we reveal how nationalist sentiments and dissenting opinions are expressed through approval or criticism of TCM among the Zhihu community. The research findings uncover the political momentum behind the debate by shedding light on how Zhihu users engage with public affairs through medical commentaries. This paper thus contributes to understanding the politicised discourse of TCM in China in the wake of the global pandemic. [ABSTRACT FROM AUTHOR]

Obesity has become a major health concern in China, as it is elsewhere, and so health communication on obesity in Chinese discourse deserves more scholarly attention. In this paper, to investigate how obesity is metaphorically framed in the People's Daily, one of China's major official media outlets, we use the Discourse Dynamics Approach to identify evaluative positionings towards obesity in 98 obesity-related editorials. Based on our analysis, we posit three groupings of linguistic metaphors in the editorials that frame different aspects of obesity: JOURNEY, WAR and MONEY. Within the groupings, our analysis finds three systematic metaphors surrounding weight-loss, i.e., LOSING WEIGHT IS A NATIONAL JOURNEY TOWARDS HEALTH; LOSING WEIGHT IS A FIGHT FOR NATIONAL SECURITY; LOSING WEIGHT IS AN INVESTMENT BOTH AT THE INDIVIDUAL AND NATIONAL LEVELS. All represent obesity and obese individuals negatively and are embedded in specific Chinese sociocultural contexts, jointly framing obesity as a matter of national collective social character rather than just an individual health issue. While JOURNEY and WAR express a collectivist view of the issue, the MONEY grouping seems to indicate a neoliberal, individualist perspective emphasising the maintenance of health as part of citizenship. By comparison, similar stories on health issues surrounding obesity in Western media show differences in their discourse models. [ABSTRACT FROM AUTHOR]

Background: During a public health emergency, social media is a major conduit or vector for spreading health misinformation. Understanding the characteristics of health misinformation can be a premise for rebuking and purposefully correcting such misinformation on social media. Methods: Using samples of China's misinformation on social media related to the COVID-19 outbreak (N=547), the objective of this article was to illustrate the characteristics of said misinformation on social media in China by descriptive analysis, including the typology, the most-mentioned information, and a developmental timeline. Results: The results reveal that misinformation related to preventive and therapeutic methods is the most-mentioned type. Other types of misinformation associated with people's daily lives are also widespread. Moreover, cultural and social beliefs have an impact on the perception and propaganda of misinformation, and changes in the crisis situation are relevant to the type variance of misinformation. Conclusion: Following research results, strategies of health communication for managing misinformation on social media are given, such as credible sources and expert sources. Also, traditional beliefs or perceptions play the vital role in health communication. To sum up, combating misinformation on social media is likely not a single effort to correct misinformation or to prevent its spread. Instead, scholars, journalists, educators, and citizens must collaboratively identify and correct any misinformation. [ABSTRACT FROM AUTHOR]

Copyright of Electronic Turkish Studies is the property of Electronic Turkish Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the effect of ISBAR (Introduction, Situation, Background, Assessment, Recommendation) handover mode combined with optimized graded transport on the safe transport of patients undergoing emergency interventional surgery. Methods 166 cases of patients undergoing emergency interventional surgery transferred in Xuzhou Mining Group General Hospital from July 2019 to June 2020 were selected. They were divided into two groups according to the transfer time in hospital, with 83 cases each. The patients of the control group were carried out routine transfer. The patients of the observation group were carried out ISBAR handover mode combined with optimized hierarchical transfer. The transport time, incidence of transport adverse events and nursing satisfaction were compared between the two groups. Results The transport time of the observation group was shorter than that of the control group (P<0. 05). The total incidence of transport adverse events in the observation group was lower than that in the control group (P <0. 05). Nursing satisfaction scores in the dimensions of pipeline management, disease focus, comprehensiveness and organization of the observation group were significantly higher than those of the control group (all P < 0. 05). Conclusion The implementation of ISBAR handover mode combined with optimized graded transport can shorten the transport time of patients undergoing emergency interventional surgery and prevent the occurrence of adverse events during the transport. It can improve the overran nursing satisfaction. [ABSTRACT FROM AUTHOR]

Background: In the light of "Internet plus", hospitals are following the trend of using mobile internet and adopting a strategy of spreading public health knowledge through mobile terminals. WeChat is a social media with the largest number of users in China. Its public account has become the most popular service among the public.Methods: We examine the health communication of medical institutions on social media platforms. The WeChat public accounts of Zhejiang Provincial Chinese Traditional Medicine Hospital and Jiangxi Provincial Chinese Traditional Medicine Hospital were taken as cases to measure the communication effect from the following dimensions: update interval, content positioning and design, numbers of clicks and likes as well as topic types.Results: The update interval of WeChat public account of Jiangxi Provincial Hospital of Traditional Chinese Medicine was regular, compared with that of the other hospital. The accounts of the two hospitals both set up special sections to facilitate patients to obtain medical services online. There is an extremely significant difference between the two hospitals' mean numbers of clicks (p < 0. 001), compared with no significant difference between their mean numbers of likes. One-way analysis of variance suggests the type of topic on posts is significantly correlated with the number of clicks. Moreover, there is an extremely significant difference between public health knowledge and news propaganda.Conclusion: The development of hospitals' WeChat public accounts can promote people's health and equity in accessing medical information and service, and also boost "Internet plus health care" service. The topic type of hospital's news publicity is paid a relatively lower attention by users. Therefore, hospitals' WeChat public accounts need to adjust their strategy from propaganda-oriented to users-centered, with topic planning and posts designed to fulfill users' needs. [ABSTRACT FROM AUTHOR]

Background: Online health communities (OHCs) are one of the developments related to online health. Patient compliance plays a vital role in improving health treatment outcomes. Patient activation is associated with patient activities in OHCs, such as physician–patient communication and health information seeking. In other words, OHCs influence patient compliance. Therefore, identifying the relationship between patient activation in OHCs and patient compliance is important for improved health outcomes. Methods: This study established a research model consisting of one independent variable (patient activation), four mediators (physician–patient communication, health information seeking, perceived information asymmetry, and e-health literacy), one dependent variable (patient compliance) and four control variables (gender, age, education level, and status). Data were obtained through a web-based survey, involving a total of 387 valid participants in China. These data were analyzed and tested through structural equation modeling and partial least squares. Results: Patient activation positively affects patient compliance through the mediation of physician–patient communication, health information seeking, perceived information asymmetry, and e-health literacy. Perceived information asymmetry has no direct effect on patient compliance. However, perceived information asymmetry affects patient compliance through the mediation of e-health literacy. Conclusions: Patient compliance is significantly affected by patient activation. Thus, physicians can achieve higher patient compliance by improving patient activation. Guaranteeing and improving the information quality in OHCs is essential for physicians and OHCs operators. Physicians should pay extra attention in cultivating patients' e-health literacy through communications and health information-seeking behaviors to further improve patient compliance. [ABSTRACT FROM AUTHOR]

The recommendation system in the online medical consultation website is a system to assist patients to find appropriate doctors. Based on the analysis of the current situation of the development of an online medical community (Haodf.com) in China, this paper puts forward recommendation suggestions of finding the right hospital and doctor to promote the rapid integration of Internet technology and traditional medical services. A new recommendation model called Probabilistic Matrix Factorization integrated with Convolutional Neural Network (PMF-CNN) is proposed in the paper. Doctors' data in Haodf.com were used to evaluate the performance of our system. The model improves the performance of medical consultation recommendations by fusing review text and doctor information based on CNN (Convolutional Neural Network). Specifically, CNN is used to learn the feature representation of the review text and the doctors' information. Furthermore, the extended matrix factorization model is exploited to fuse the review information feature and the initial value of the doctors' information for recommendation. As is shown in the experimental results on Haodf.com datasets, the proposed PMF-CNN achieves better recommendation performances than the other state-of-the-art recommendation algorithms. And the recommendation system in an online medical website improves the utilization efficiency of doctors and the balance of public health resources allocation. [ABSTRACT FROM AUTHOR]

Social networking sites offer an important means for increasing the accessibility and enabling new forms of health communication between the public and medical social influencers (MSIs). MSIs have a social presence and are perceived as a credible source of health-related information. A research gap, however, exists in understanding the communication strategies employed by MSIs and the factors driving the public to engage in health communication with MSIs. This study, therefore, developed a new conceptual framework incorporating health communication, dialogic and interpersonal communication by employing quantitative content analysis to examine public engagement with MSI communication on the largest microblogging site in China, Sina Weibo. The analysis yielded insights into how the usefulness of health-related information provided alongside the interactive dialogue and affective practices played an active role in engaging the public. The public sought health-related information primarily to address issues of concern for well-being and a high level of engagement in terms of online shares, likes, and comments was found. The use of multimedia made the site more appealing, resulting in likes while the expression of emotions by MSIs generated likes and comments. The need to connect with other online users and have a sense of community was reflected in engagement through sharing useful MSI posts by the public. By identifying influential MSIs on social networking sites, health information providers such as organizations and the government can raise awareness of health issues to foster a healthy lifestyle and contribute to better living in the community. [ABSTRACT FROM AUTHOR]

Multilingual crisis communication has emerged as a global challenge during the COVID-19 pandemic. Global public health communication is characterized by the large-scale exclusion of linguistic minorities from timely high-quality information. The severe limitations of multilingual crisis communication that the COVID-19 crisis has laid bare result from the dominance of English-centric global mass communication; the longstanding devaluation of minoritized languages; and the failure to consider the importance of multilingual repertoires for building trust and resilient communities. These challenges, along with possible solutions, are explored in greater detail by the articles brought together in this special issue, which present case studies from China and the global Chinese diaspora. As such, the special issue constitutes not only an exploration of the sociolinguistics of the COVID-19 crisis but also a concerted effort to open a space for intercultural dialogue within sociolinguistics. We close by contending that, in order to learn lessons from COVID-19 and to be better prepared for future crises, sociolinguistics needs to include local knowledges and grassroots practices not only as objects of investigation but in its epistemologies; needs to diversify its knowledge base and the academic voices producing that knowledge base; and needs to re-enter dialogue with policy makers and activists. [ABSTRACT FROM AUTHOR]

While an increasing literature on multilingualism addresses the key role of language in access to social resources, including crisis communication, little attention has been paid to practices of English-mediated multilingualism. Based on semi-structured interviews with 10 international students from South Asia and Southeast Asia receiving their higher education in China, the study reveals what language-related challenges international students encounter, how they mobilize their multilingual resources to enhance their access to crisis communication and build a shared community, and how their multilingual competences are valorized and enacted in the shifting paradigm of the China-oriented new economy addressing mutual accountability in South-South cooperation. The study suggests that English-mediated multilingualism in China fails to bridge the needs of international students of diverse backgrounds. The study also calls attention to the shifting paradigm of multilingual studies and the necessity of addressing the real world problems of health communication in a diverse context. [ABSTRACT FROM AUTHOR]

This paper investigated the use of information communication technology (ICT) to seek antiretroviral therapy (ART)-related knowledge among people living with HIV (PLHIV) taking antiretroviral treatment in Guangxi, China. A total 1902 participants who undertook ART and had used ICT were recruited from 12 sites with the highest cumulative HIV incidence. A questionnaire survey was used to collect data on the participants' sociodemographic characteristics, clinical outcomes, infections in the family and comorbidity, access to healthcare resources, ICT using behavior in HIV management, and ART-related knowledge. The results showed that 15% of the participants had searched HIV-related information online, fewer participants had contacted healthcare providers via computer (1.6%) or text messaging (11.9%), and only 7.7% of the participants had contacted other PLHIV using ICT. Education had a positive impact on the knowledge level of all three categories of ART-related knowledge. Participants with better medication and mechanisms knowledge were more likely to search HIV-related information online and less likely to contact healthcare providers using text messages. Findings of this study suggested that ICT was used as an effective approach to acquire some type of ART-related knowledge. ICT was underutilized in health communication among the PLHIV in this study due to low education level and insufficient eHealth literacy. Future intervention programs should address the customization of the communication tools and focus on improving the education level and eHealth literacy of the PLHIV to better promote ICT as an efficient platform for ART-related knowledge seeking. [ABSTRACT FROM AUTHOR]

Objective: Apply Chinese VR-CoDES in ophthalmic setting and describe patients' worries and the doctor's responses. Explore cultural differences in coding.Methods: 102 audio-taped consultations of 84 patients were coded by Chinese version of VR-CoDES. The intra-class correlation coefficient (ICC) was used to test inter/intra-rater reliability, and inductive content analysis was conducted.Results: The ICCs of inter-rater reliability for cues/concerns and responses were 0.78 and 0.81, and intra-rater reliability were 0.87 and 0.99, respectively. Cues were more frequent than concerns and elicited often by patients. Explicit Reduce Space (ER) was the most frequent response. Interruptions and the doctor's repetitions were evident. Some expressions were not specified in the coding manual. Patients concerned about treatment effect (22 %), expenses (18 %), risk of operation (14 %), and pain (10 %).Conclusion: The Chinese VR-CoDES can be applied to clinical consultations in China. Ophthalmic patients often expressed cues which were frequently elicited by themselves. The ophthalmologist preferred to give ER response. Interruptions and the ophthalmologist's repetitions were difficult to code. More Chinese expressions should be collected to reduce cultural difference when coding.Practice Implication: VR-CoDES will be helpful in doctor-patient communication and medical education. VR-CoDES should undergo cultural adaptions in China. [ABSTRACT FROM AUTHOR]

With the increasing popularity and accessibility of online healthcare service and the continuous development of interactive digital communication, online medical consultation is prevalent in contemporary China. As a new genre, online medical consultation deserves in-depth exploration from a non-English discursive perspective in order to better understand the pragmatic features of this genre. This will help to map out the harmonious rapport management between doctors and patients in online medical consultation and describe the localization of the social practice in Chinese cyberspace. As such, this paper attempts to report on the forms and functions of mitigation strategies used by Chinese doctors in online medical consultation. The findings suggest that doctors prefer perlocutionary and locutionary mitigation to illocutionary ones, while mitigations are used to maintain a professional image, construct solidarity and relieve patients' anxiety. The study demonstrates that the investigation into mitigation in Chinese online medical consultation could not only provide insights into cross-cultural uses of mitigation in the new genre but also provide doctors with appropriate strategies for harmonious rapport management with the patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effects of patient-centered communication, patient participation, and patient preference on patient trust in the context of China. A cross-sectional survey was conducted involving 217 cancer patients in China. Mediation and moderation analyses were performed to examine the relationships among the study variables. First, patient-centered communication increased patient participation in decision-making, which, in turn, enhanced patient trust. Second, patient-centered communication did not have a direct effect on patient trust. Third, patient preference for a passive role in decision-making weakened the relationship between patient participation and patient trust. The results underscore the significant effect of facilitating patient participation in linking patient-centered communication to patient trust. However, medical communication should also respond to patients' preferred roles in the decision-making process. Doctors should provide patients with opportunities to ask questions and express their concerns. In addition, they should evaluate patients' preferred degree of involvement before inviting them to contribute so as to respect their preferences and values. • Examined the effects of patient-centered communication, patient participation, and patient preference on patient trust. • The research involved a cross-sectional survey of 217 cancer patients in China. • Patient-centered communication increased patient participation in decision-making, which, in turn, enhanced patient trust. • Patient preference for a passive role in decision-making weakened the relationship between participation and trust. • Medical communication should also respond to patients' preferred roles in the decision-making process. [ABSTRACT FROM AUTHOR]

Patient-provider communication is an important factor influencing patients' health-related outcomes. This study examined how the quality of face-to-face communication with providers is associated with their subsequent Internet use for patient-provider communication. With an analysis of two-wave panel data collected in China, results showed that face-to-face patient-provider communication had a positive and direct effect on online patient-provider communication at a later time point. In addition, patient trust and patient satisfaction both positively moderated the relationship between face-to-face and online patient-provider communication. The results of this study emphasized the important roles of patient-centered communication and patient-provider relationship in the process of eHealth and mHealth movement, particularly in the Chinese health care system. [ABSTRACT FROM AUTHOR]

The rise of wemedia in China has brought challenges to public health communication (PHC), such as the change in doctor--patient relations and the vulnerability of trust. As few researchers have touched upon the issue of identity construction during PHC in Weibo, this study aims to fill this gap and investigate one health information provider's discursive construction of multiple identities in Weibo and its pragmatic effect on trust building. Through this study the author attempts to contribute to the existing scholarship on the dynamics of identityrelation construction in wemedia and the pragmatic construction of trustworthiness in a PHC context. [ABSTRACT FROM AUTHOR]

Abstract Conflict is inevitable in public-private partnership (PPP) due to the long-term agreement and multiplicity of stakeholders with varying beliefs and interests. However, a thorough understanding of the root causes of conflict beforehand helps to minimize conflict occurrence, thereby ensuring a smooth PPP process. This paper aims to explore and evaluate the root causes of conflicts in PPPs through a comparative study between Ghana and China. Further, the most suitable conflict resolution mechanisms are explored from the Ghanaian and Chinese perspectives. Results show that causes of conflict ranked higher in Ghana directly relate to poor governance and contract arrangement, whereas causes related to poor risk management and communication are ranked higher in China. Further, arbitration and negotiation are the most suitable conflict resolution mechanisms for PPPs in Ghana and China respectively. The outputs of this study inform international private investors interested in PPPs in Africa and China of the possible sources of disputes and resolution mechanisms in PPPs. This will enable international investors to develop strategic measures before entering into the PPP markets of both regions. Highlights • Conflict is inevitable in public-private partnership arrangements • This paper explores the root causes of conflicts and conflict resolution mechanisms in PPPs • Causes of conflicts related to poor governance and contractual arrangements emerged as critical in Ghana, whereas causes related poor risk management and communication emerged as critical in China • Arbitration and Negotiations are the most suitable resolution mechanisms for conflicts in PPPs in Ghana and China respectively. [ABSTRACT FROM AUTHOR]

In Singapore, the institutional preference for biomedicine and the cultural importance of traditional Chinese medicine (TCM) have created tensions between the two medical systems and erected barriers to a more collaborative health-care system. This study foregrounds TCM physicians' voice to reveal ideological struggles and power imbalances that underlie the interprofessional tensions and accompanying marginalization of TCM. Through in-depth interviews with 22 TCM physicians in Singapore, this study reveals the incongruences in ideological underpinnings between biomedicine and TCM, reflected in their different worldviews and epistemological approaches to knowledge formation and evaluation. Power differentials between the two medical systems are manifest in TCM physicians' inferior position in relation to their biomedical peers, the patients' internalization of biomedical standards to question the TCM profession and their own interest in seeking TCM treatments, and the state's limited support for TCM research, subsidies, and service provision in hospital settings. The results suggest that more open dialogue about the dichotomous framings of biomedicine and TCM is key to disrupting the mutual reinforcement of ideology and power, as well as to creating increased mutual understanding between the two medical systems. [ABSTRACT FROM AUTHOR]

Participants from the Netherlands (n = 52), China (n = 50), and South Africa (n = 166) either read a self-targeted or a family-targeted fear appeal message about chlamydia. Seven aspects of individual cultural orientation were measured, and six effects of the different messages. Interactions between nationality and target of threat were found on perceived severity, perceived susceptibility, and danger control. Only for perceived susceptibility, a difference in cultural orientation partly explained this interaction. The outcomes add to the doubts about claims in earlier literature about the relevance of receivers' nationality and cultural orientation for developing a fear appeal message. [ABSTRACT FROM AUTHOR]

Background:It has become a new lifestyle of using social media (SM) to acquire all kinds of information. The objectives of this study were to determine general practitioner (GP) trainers' current use of SM and their beliefs and attitudes regarding use of SM. Methods:A cross-sectional questionnaire survey was taken during a 1-week GP trainers' training program. Data probing GP trainers' use of SM and attitudes toward SM use in clinical work and education were collected and analyzed. Results:Four hundred seven respondents participated in the survey, and the response rate was 61.4%. All the respondents reported that they have at least an SM account. A total of 99.3% of respondents replied that they would add a colleague as a friend via SM; however, only 68.6% of them would add a patient. More than half of the respondents have been contacted by a patient more than five times per year, whereas 67.2% of them attempted to contact a patient by SM less than three times per year. One hundred forty of 407 (34.4%) respondents used SM daily to explore medical information, whereas 42 of 407 (10.3%) contributed new information via SM on a daily basis. Nearly 50% of respondents believed that SM was useful and beneficial. Conclusions:SM is widely used among GP trainers from 11 provinces of China. Most of the participants believed that SM is useful and beneficial to their work. However, there are still some problems for them to use SM in healthcare and medical education, including separating personal and professional use of SM, SM policy, and the quality of information from SM. [ABSTRACT FROM AUTHOR]

Glaxo Smith Kline's Cervarix was the first human papillomavirus (HPV) vaccine licensed for use in China and officially launched there on 31 July 2017. Since news media content can influence people's vaccine-related knowledge, understanding, and intentions, a content analysis was used to examine Chinese newspapers' coverage of the HPV vaccine. A total of 253 articles published from 2000 to 2016 met the inclusion criteria and were coded. The results show that HPV and the HPV vaccine received very little newspaper coverage in China both before and after vaccine licensure. Most of the coverage came from China Party press newspapers, with the stories predominantly using thematic rather than episodic framing. Application of the Health Belief Model to the content analysis revealed that benefits, self-efficacy, and cues to action were found in most news stories. Overall, given the relative lack of Chinese newspaper coverage, public health officials and health-care providers in China should assume most people, including those for whom HPV vaccination is recommended, have little or no knowledge about HPV, HPV vaccine, and the reasons for the vaccination recommendation. If news media are to be a source of HPV information for the Chinese public, significant efforts will be needed to increase attention. [ABSTRACT FROM AUTHOR]

The physician-patient relationship in China is highly strained. This study examined the professional identity of physicians and their perceptions of the physician-patient relationship against the backdrop of the rise of health consumerism in China. Structured interviews with 29 physicians found that the marketization of medical care and the rise of health consumerism caused physicians to have a conflicted professional identity. The traditional bureaucratic relationship between physicians and patients based on implicit trust was gradually replaced by an arm's length relationship characterized by self-interest, opportunism, and mistrust. In addition, the transition from physician-centered communication to patient-centered communication in China was tenacious. Theoretical and practical implications of the current study are discussed. [ABSTRACT FROM AUTHOR]

The Chinese pharmaceutical regulatory landscape and medical publication policies have gone through drastic changes in recent years and they continue to evolve. These changes provide great opportunities and many challenges to medical writers in China, and they affect the global medical comm - unications strategy of multinational pharma - ceutical companies and global medical communications agencies. Seasoned medical writers who are fluent in both English and Chinese are becoming essential to multi - national pharmaceutical companies interested in the Chinese market as well as to Chinese companies striving to enter the global market. Meanwhile, the demand for ethical medical writing and editorial services remains high. In this article, I share my observations on the current trends, opportunities, and challenges facing medical communications professionals in China. [ABSTRACT FROM AUTHOR]

Background The emergence of online health communities (OHCs) broadens and diversifies channels for patient-doctor interaction. In recent times, patient satisfaction has gained new attention within the context of OHCs where unique patterns are provided: a variety of services with unique attributes are available in OHCs for patients and doctors have the options of providing and pricing for different services. OHCs are given high hopes on improving medical efficiency and patient satisfaction. Knowing how these patterns in OHCs affect patient satisfaction is crucial for the development of OHCs and medical practices.Methods: An empirical research is conducted to examine the effects of provision and pricing of online services on patient satisfaction by analyzing data from 2309 doctors in a Chinese OHC.Results: The results from this study provided empirical support, suggesting that service quantity positively influenced patient satisfaction. A non-linear correlation between service price and satisfaction was explored and results suggested an inverted U-shaped relationship. At the low price level, service price led to an increase in patient satisfaction, whereas the high price level (over 330 CNY/US$49) could have just the opposite effect. Importantly, we found that price difference between a doctor's different services significantly decreased patient satisfaction. A mediating effect was tested in post-hoc analyses, and results revealed that the impact of price difference on patient satisfaction was partially mediated by flexibility of service selection, and the mediating effect accounted for 28.6% of the total effect.Conclusions: Our results indicate that patient satisfaction can be improved by effectively providing and pricing services in OHCs. Specifically, doctors can offer different type services and charge within a reasonable range. [ABSTRACT FROM AUTHOR]

In 2015, South Korea experienced the largest outbreak to date of the Middle East Respiratory Syndrome (MERS-CoV) outside the Middle East. Fears related to a potential spread of the disease led to an increased alert level as well as heightened media coverage in the neighboring Hong Kong. A cross-sectional survey (N = 533) among residents of Hong Kong was conducted to assess the relationships between the effects of outbreak-related mass media coverage, interpersonal communication, the perceived level of concern in one's close environment, and the uptake of preventive measures. A serial multiple mediator model finds that interpersonal communication and higher perceived concern indirectly influence the effects of media coverage on the engagement in preventive actions. These results expand previous research on the mediating role of interpersonal communication and support assumptions about a modified two-step flow of communication in the context of a public health emergency. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) case detection in China has improved remarkably, partly benefiting from the reducing delay to TB care, whereas the timeliness of TB care in Malawi remains problematic. Methods: This study investigates barriers hindering timely TB diagnosis in Malawi and China, and attempts to share the experience in high burden countries. A cross-sectional study on TB diagnostic delay was conducted among 254 Malawian and 146 Chinese TB patients. Results: The medians of patient's delays were 22 and 20 days (p>0.05), and provider delays were 12 and 11.5 days (p>0.05) in Malawi and China, respectively. Malawian patients had a higher proportion (72.05% vs 67.12%) of patient's delay longer than 14 days (p=0.042), which was significantly associated with initial visits to lower-level health providers in the villages (aOR=1.989, 95% CI: 1.075-3.682), and patients conducting casual/piece work (aOR=3.318, 95% CI: 1.228-8.964). Initial healthcare visits at village level also led to longer provider delay in both Malawi (aOR=2.055,1.211-3.487) and China (aOR=5.627, 2.218-14.276). Conclusion: Establishing a good communication and referral mechanism between different levels of health facilities is crucial to timely TB diagnosis. China's experience on pro-poor interventions could be useful to its Malawian counterpart and other similar settings with high TB burden. [ABSTRACT FROM AUTHOR]