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To promote the construction industry and establish a green environment, the integration of sustainable building materials is urgently required. This study presents the influences of three materials (silica fume, fly ash, and recycled ceramic powder (RCP)) and different RCP dosages (0%, 10%, 20%, and 30%) on the mechanical properties and microstructure of concrete at different temperatures. The study presents the results of comprehensive flow tests, printability assessments, mechanical evaluations under different loading directions, high-temperature analyses, digital image correlation, X-ray powder diffraction and scanning electron microscopy. The experimental findings indicate the successful printing of all samples, with wall structure failure occurring only at a height of 730 mm. Furthermore, compared to those of other materials, the RCP displays a superior heat resistance, with a significant increase in compressive strength (28.9%) to 53.9 MPa at 300 °C. Additionally, the introduction of the RCP into 3D-printed concrete results in an anisotropic behaviour, with an initial enhancement in the mechanical strength, followed by attenuation as the RCP content increases. Microstructural analysis reveals enhanced interfacial adhesion with RCP addition, albeit accompanied by the emergence of numerous pores. The optimal mixture, which is designated as RCP-2-0-1 with 20% of the cement replaced by RCP, exhibits a significant anisotropic compressive strength (55.9 MPa) and an adequate anisotropic flexural strength (12.49 MPa) and impressive heat resistance (11.7% increase in compressive strength at 300 °C). This renders it a suitable sustainable impact-resistant thermal material for use in structural applications.

BackgroundThe digital divide is the difference between individuals who use the Internet and those who do not. Under the triple social environment of urban–rural dichotomy, population aging, and the digital era in China, the existence of digital divide among rural older adults has seriously affected their access to health information through the Internet, so it is urgent to bridge the digital divide problem they face.MethodsBased on Maslow’s Hierarchy of Needs Theory and Stress Coping Theory, the impact of cultural capital on the digital divide among rural older adults was systematically analyzed using hierarchical regression and Chained Mediation Effect Tests using data from the Chinese Family Panel Studies (CFPS).ResultsCultural capital has a significant positive effect on the digital divide among rural older adults (β = 0.178, p

Abstract Background The ageing of the population has become an escalating problem in China, which has led to an increasing demand for healthcare throughout society. The care services of elderly institutions, as a more mature way of aging, can alleviate various social problems brought about by ageing to a certain extent. The aim of this paper is to explore the degree of acceptance of institutional care by rural elderly people in Shandong Province and the factors that influence whether rural elderly people accept institutional care services. Methodology Based on the theory of planned behavior, an analytical framework was constructed for the willingness of rural elderly people to receive nursing services from elderly care institutions. Using survey data from 192 rural elderly people in Shandong Province, descriptive statistics, binary logistic regression, and horizontal comparative analysis methods were used to analyze the willingness of rural elderly people to provide for the elderly and its influencing factors. Result Only 17.71% of respondents expressed willingness to receive services from elderly care institutions. Among them, education level, trust in elderly care institutions, and support from adult children have a significant positive impact on whether rural elderly people receive nursing services from elderly care institutions; The number of children, the level of understanding of elderly care institutions, neighbors' choices of elderly care methods, and their ability to contribute to the family have a significant negative impact on whether rural elderly people receive nursing services from elderly care institutions. There are significant differences in the willingness and influencing factors of rural elderly people to provide for the elderly among different regions. Conclusion The non-acceptance of institutional care by rural older people is a general phenomenon rather than a sample characteristic, thus justifying the supplementary status of institutional care services. The pension intention of the rural elderly in Shandong Province is obviously affected by personal will factors, and the influencing factors are various. The traditional concept of old-age care in Shandong province has a strong path-dependent effect on the choice of the rural elderly. There is heterogeneity in the willingness and influencing factors of the rural elderly in different regions and countries. Based on this, this paper puts forward the following suggestions: strengthen the spiritual and cultural construction of residents; The government should pay attention to the correct guidance of public opinion; And increase pension subsidies. It is hoped that reduce the burden of national elderly care through these suggestions.

Abstract Background It is of great practical significance to study the intrinsic relationship between cultural capital, digital divide, cognitive ability, and health of older adults in the dual social context of population aging and the digital era. Methods We analyzed data from the 2020 China Family Panel Studies (CFPS) initiated by the China Center for Social Science Surveys at Peking University. Physical health, mental health, and memory health were set as indicators of older adults, and the relationship between cultural capital, digital divide, cognitive ability, and health of older adults was examined by hierarchical regression with moderated mediated effect methods. Results Improvement in the health of older adults is associated with an increase in the level of cultural capital; cultural capital may bridge the digital divide faced by older adults, which in turn promotes the improvement of the health of older adults; the higher the level of cognitive ability, the stronger the effect of cultural capital on the digital divide, and at the same time, the stronger the mediating effect of the digital divide; cultural capital has a more pronounced effect on the health of older male adults living in the city. Conclusions The results of the study show that cultural capital can have a positive impact on the health of older adults, but there is urban-rural heterogeneity and gender heterogeneity, in which the digital divide plays a mediating role, and the enhancement of the cognitive ability of older adults will be conducive to the improvement of their health, so the health of older adults should be promoted by improving the level of their cultural capital and the ability of older adults to use digital technology, thus provide references for the protection of health of older adults.

Purpose Older adults are struggling in the digital age due to lower digital literacy and other reasons. The purpose of this study was to explore the relationship between digital social capital, digital divide, learning ability, and health of older adults. Methods This study used data from the China General Social Survey (CGSS) to systematically analyze effects of digital social capital on the health of older adults using the moderated mediated effect test. Results Digital social capital has a significant positive effect on the health of older adults and significant household and regional heterogeneity. Internet usage has a mediating impact between social capital and the health of older adults. Learning ability positively moderates the effect of internet usage on the health of older adults, but negatively moderates the impact of digital social capital on internet usage. Learning ability moderates the mediating effect of internet usage between social capital and the health of older adults. The stronger the learning ability, the stronger the mediating effect of internet usage between social capital and health of older adults. Conclusion Digital social capital can promote the health of older adults, and internet usage and learning ability can play mediating and moderating roles in the process of digital social capital affecting the health of older adults, revealing that we should cultivate the digital social capital of older adults and improve the digital ability of older adults to improve their health.

Abstract Background The study aimed to examine the influence of perceived management support on job satisfaction through the mediating role of motivation among family doctors in the Jiangsu province of China. Methods Six dimensions of motivation were employed as mediators in the association between perceived management support and job satisfaction in collecting data to analyze the hypothesized relationships in the present study. A total of 600 questionnaires were distributed to family doctors in Jiangsu province. Structural equation model (SEM) in the analysis of a moment structure (AMOS) version 26 software was used to estimate the path coefficients. Results Perceived management support has a significant positive relationship with job satisfaction. Motivation had a fully mediated relationship with the association between perceived management support and job satisfaction. Conclusions The study's findings suggest motivation is important in enhancing family doctors’ satisfaction and must not be underestimated. It, therefore, offers diverse recommendations for enhancing motivation among healthcare professionals.

BackgroundWith the perspicuous effect of COVID-19 on vaccine demand, academic and business interest in vaccine production in the BRICS nations (Brazil, the Russian Federation, India, China, and South Africa) has reached a crescendo. Aware of a “dark” past when the BRICS depended heavily on vaccines and pharmaceuticals from other parts of the world, academic curiosity on how the BRICS countries have leveraged vaccine self-sufficiency and become the hub of global vaccine production and supply is justifiable, especially in times of ineffable pandemics.MethodsThe articles were searched from November 2020 to December 2022. Within this period, an electronic search of 13 reputable healthcare and public databases was conducted. The initial searches from the designated databases yielded a total of 3,928 articles. Then, duplicated studies were removed through a two-step process, articles without titles and abstracts were excluded, and the remaining 898 articles that met the qualification assessment criteria were evaluated for article quality.ResultsThe main entrepreneurial innovations that have quickened the pace of vaccine self-sufficiency in the BRICS include investment in artificial intelligence (AI), Big Data Analytics, and Blockchain technologies. These help to speed up the drug delivery process by enhancing patient identification or optimizing potential drug candidates for clinical trials and production.ConclusionOver the past 20 years, the BRICS nations have achieved major strides in vaccine development, regulation, and production. The creation of the BRICS Vaccine Research and Development (R&D) Center will have a significant impact on vaccine cost and accessibility given the anticipated development of stronger research capability, production, and distribution technology, as well as stronger standardization to improve vaccine production quality in the near future. It is anticipated that the BRICS’ contributions to vaccine development will alter the global vaccination market and hasten the availability of vaccinations in developing nations. The challenge is turning these hopes into concrete plans of action and outcomes.

Since the medical reform implemented by the Chinese government in 2016, more attention has been paid to family doctors and the key role they play in safeguarding citizens’ health. Therefore, it is necessary to explore the factors that affect the motivation of family doctors to provide contracted services. In this study, factors influencing the motivation of family doctors to provide contract services are divided into intrinsic motivation and extrinsic motivation. Intrinsic motivation includes family doctors’ sense of professional belonging, occupational motivation, and occupational efficacy, while extrinsic motivation includes the attraction, support, and promotion of contract services, as well as pressure from government and community health service institutions. And the environment in which family doctors operate during their contracted services. The questionnaire was designed with a sample size of 536 family doctors in Jiangsu Province using logical reasoning method. Stata16 software is used for empirical analysis using linear regression method. The empirical analysis is conducted using the linear regression method. A family physician’s motivation is categorized into two perspectives: intrinsic and extrinsic motivation. Significant findings unveiled that; (i) Family physicians’ sense of professional belonging ( β = .026, p

BackgroundThe development of Internet information technology will generate an Internet use gap, which will have certain adverse effects on health, but internet information dependence can alleviate these negative effects.ObjectiveThis article is to demonstrate the negative impact of the internet use gap on population health in developing countries and to propose improvement paths.MethodsThis article used the 2018 China Family Tracking Survey database (N = 11086). The research first used Latent class analysis (LCA) to identify potential categories of users with different Internet usage situations, then used the Bolck, Croon, and Hagenaars (BCH) method to perform latent class modeling with a continuous distal outcome, and finally built an intermediary model about Internet information dependence based on the model constraint function in Mplus software.Results(1) The Internet users can be divided into light-life users (C1: N = 1,061, 9.57%), all-around users (N = 1,980, 17.86%(C2: N = 1,980, 17.86%), functional users (C3: N = 1,239, 11.18%), and pure-life users (C4: N = 6,806, 61.39%). (2) We examined individual characteristics, social characteristics and different living habits, and health differences between the latent classes. For example, there are certain structural differences on the effect of different categories of Internet use on health (C1: M = 3.089, SE = 0.040; C2: M = 3.151, SE = 0.037; C3: M = 3.070, SE = 0.035; C4: M = 2.948, SE = 0.016; P < 0.001). (3) The Internet use gap can affect health through the indirect path of Internet information dependence, and some of the mediation effects are significant. When the functional user group (C3) was taken as the reference group, the mediating effect values of light-life users (C1) and all-around users (C4) on health were −0.050 (SE = 0.18, Est./SE = −3.264, P = 0.001) and −0.080 (SE = 0.010, Est./SE = −8.412, P = 0.000) through Internet information dependence, respectively. However, the effect of categories on health was not significant after adding indirect paths.ConclusionThe Internet use gap has a significant effect on health, and Internet information dependence plays an intermediary role in this effect path. The study proposes that attention should be paid to the diversified development of Internet use, the positive guiding function of Internet information channels should be made good use of, and the countermeasures and suggestions of marginalized groups in the digital age should also be paid attention to and protected.

Nurses’ turnover intention has become a concern for medical institutions because nurses are more needed than ever under the prevalence of COVID-19. This research sought to investigate the effects of the four dimensions of organizational justice on COVID-19 frontline nurses’ turnover intention through the mediating role of job engagement. We also tested the extent to which perceived job alternatives could moderate the relationship between job engagement and turnover intention. This descriptive cross-sectional study used an online survey to collect data from 650 frontline nurses working in appointed hospitals in Jiangsu province, China. Hierarchical regression was used to analyze the hypothesized relationships. Findings revealed that all organizational justice components significantly influenced job engagement and turnover intention. Job engagement also significantly affected nurses’ turnover intention and mediated the relationships between organizational justice components and turnover intention. Besides, perceived job alternatives moderated the relationships between job engagement and turnover intention. The implications of this study include demonstrating that healthcare authorities should respect human rights through effective organizational justice as this approach could encourage nurses to appreciate their job and be more devoted to staying and achieving their institutional duties, especially under challenging circumstances.

Abstract Background The family doctors’ contract service problem is not about government management alone, but an interaction of a complex social environment. Consequently, the effect of contracted services of family doctors not only depends on policy incentives but also needs to win the participation, acknowledgement, and confidence of community residents. The purpose of this integrative review is to examine whether there is any significant evidence that social capital in the form of social networking groups and other forms of social groups have any positive impact on the acceptance and the effectiveness of family doctors' contractual services. Method Research on qualitative, quantitative and hybrid methods published in peer-reviewed journals on the social capital role in the process of contract service of family doctors were eligible for inclusion. In view of the increasing attention paid to the contract service effect of family doctors during this period, a 10-year time scale was selected to ensure full coverage of relevant literature in the same period. In total, 809 articles were determined in the database retrieval results which were downloaded and transferred to the Mendeley reference application software. Results Twelve articles met the inclusion criteria for this integrative review and the quality of the included studies were assessed using the published criteria for the critical appraisal of quantitative and qualitative research methods. Majority of the articles assessed reported that there was evidence of a positive link between social support, especially a sense of belonging and the presence of regular family doctors. The influencing factors of patients' contract behavior of studies conducted in China were social interaction of social capital, acceptance of the first contact in the community, year of investigation, and exposure to the public. Conclusion The study affirms previous studies that suggest that social resources have the propensity to improve relationship between patients and clients and between doctors and peers for the benefit of the patients and the stability of the overall healthcare system. Through the integration of various social resources family doctor systems accelerate the development of community construction. These social capital (social network groups) can guide residents to use family doctor services to maintain health. Social capital can also help residents have a regular and reliable family doctor.

Abstract Background Emerging countries continue to suffer gravely from insufficient healthcare funding, which adversely affects access to quality healthcare and ultimately the health status of citizens. By using panel data from the World Development Indicators, the study examined the determinants of health care expenditure among twenty-two (22) emerging countries from the year 2000 to 2018. Methods The study employed cross-section dependence and homogeneity tests to confirm cross-sectional dependence and to deal with homogeneity issues. The Quantile regression technique is employed to test for the relationship between private and public health care expenses and its determinants. The Pooled mean group causality test is used to examine the causal connections among the variables. Results The outcome of the quantile regression test revealed that economic growth and aging population could induce healthcare costs in emerging countries. However, the impact of industrialization, agricultural activities, and technological advancement on health expenses are found to be noticeably heterogeneous at the various quantile levels. Unidirectional causality was found between industrialization and public health expenses; whereas two-way causal influence was reveled amongst public health expenditure and GDP per capita; public health expenditure and agricultural activities. Conclusion It is therefore suggested that effective and integrated strategies should be considered by industries and agricultural sectors to help reduce preventable diseases that will ultimately reduce healthcare costs among the emerging countries.

Abstract Background Family practice and family doctors are critical part of China’s primary healthcare delivery in a constantly evolving society. As the first point of contact with the medical system, family practices require physically and psychologically sound and a well-motivated family doctors at all times. This is because an error can lead to loss of lives as gatekeepers of the medical system. Our study explored the extent to which positive psychological capital promotes higher performance among family doctors. Methods A questionnaire was used to collect data from family doctors in Shanghai, Nanjing, and Beijing. We applied a structural equation analysis to analyze the causal relationship among the variables. Results We found out that psychological well-being and job involvement significantly influences the performance of family doctors in China. The study also noted that psychological capital moderates the relationship between psychological well-being attainment, job involvement, and performance. Conclusions Studies have shown that these pressures affect their well-being considerably. For this reason, a healthcare professional who experiences positive emotions affects the total behavior which culminates into performance.

BackgroundThe game of interest is the root cause of the non-cooperative competition between urban and rural medical and health institutions. The study investigates competition and cooperation among urban and rural medical institutions using the evolutionary game analysis.MethodsWith the evolutionary game model, analysis of the stable evolutionary strategies between the urban and rural medical and health facilities is carried out. A numerical simulation is performed to demonstrate the influence of various values.ResultsThe result shows that the cooperation mechanism between urban and rural medical Institutions is relevant to the efficiency of rural medical institutions, government supervision, reward, and punishment mechanism.ConclusionsSuggestions for utilizing the government's macro regulation and control capabilities, resolving conflicts of interest between urban and rural medical and health institutions is recommended. In addition, the study again advocates mobilizing the internal power of medical institutions' cooperation to promote collaboration between urban and rural medical and health institutions.

BackgroundUser selection is an important guarantee for the sustainable development of mobile medical businesses. Under the background of increasingly fierce competition, the decision-making behavior of mobile medical businesses will directly affect the choice of the behavior of users.MethodsThe study constructs the decision-making behavior model of mobile medical business based on the user choice and adds the role of people in government. It uses the game method to explore the relationship between the government, mobile medical business, and users. Finally, it makes an example analysis. Empirical research is conducted to demonstrate the influence of different parameter changes on the results.ResultsThe results show that in the absence of government intervention, users’ choice of filtering information will create a bad environment for mobile medical businesses, and further will be reduced, and the expected utility of businesses will not be affected causing a reduction in expected utility of companies. Similarly, government regulations can effectively improve the mobile medical environment and enhance the expected utility of mobile medical companies.ConclusionThe government needs to formulate relevant laws and regulations to ensure the orderly operation of the mobile medical market and strengthen government supervision. It is necessary to conduct publicity and education to protect the fundamental interests of users and businesses.

Vaccination has emerged as the most cost-effective public health strategy for maintaining population health, with various social and economic benefits. These vaccines, however, cannot be effective without widespread acceptance. The present study examines the effect of media attention on COVID-19 vaccine hesitancy by incorporating fear of COVID-19 as a mediator, whereas trust in leadership served as a moderator. An analytical cross-sectional study is performed among rural folks in the Wassa Amenfi Central of Ghana. Using a questionnaire survey, we were able to collect 3079 valid responses. The Smart PLS was used to estimate the relationship among the variables. The results revealed that media attention had a significant influence on vaccine hesitancy. Furthermore, the results showed that fear of COVID-19 played a significant mediating role in the relationship between media and vaccine hesitancy. However, trust in leadership had an insignificant moderating relationship on the fear of COVID-19 and vaccine hesitancy. The study suggests that the health management team can reduce vaccine hesitancy if they focus on lessening the negative impact of media and other antecedents like fear on trust in leadership.

Electronic health record (EHR) systems have become a basic need in most health care facilities worldwide. However, little can be said about the developing nations’ use of it. Nevertheless, Ghana is one of the very few countries in Africa to start using EHRs. Nursing is a field that has been substantially influenced by the use of hospital electronic information management systems (HEIMS). More importantly, the successful implementation of any mHealth and EHRs critically depends on user acceptance. Therefore, as nurses in Ghana work at the frontline of the health care system in the country with access to vital records about the patients, it is important to assess what motivates them to use the system. This study applied a non-experimental survey design. An electronic platform questionnaire on smartphones was used to collect data on 660 nurses. Statistically, AMOS structural equation modeling (SEM) was employed to examine the research model. “Behavioral intention” (BI) to HEIMS use was significantly predicted by effort expectancy (EE) ( p

Background Medical care facilities in both developed and developing countries around the world continue to invest in hospital information technologies (HITs). Nevertheless, it has been discovered that user acceptance of these technologies is one of the imperative issues during their implementation and management in developing countries such as Ghana. Purpose Notably, the technology acceptance assessment of nurses is a timely one since they play a very important role in the medical sector. Based on the model of “Unified Theory of Acceptance and Use of Technology,” this study explored the factors that affect Ghanaian nurses’ acceptance of HIT. Design/Method/Approach: A descriptive nonexperimental research design was employed in this study to recruit 660 nurses (404 females and 256 males) from 3 teaching and 2 regional hospitals in Ghana. A standardized electronic platform questionnaire (based on the Unified Theory of Acceptance and Use of Technology model) was designed on smartphones and was self-administered, while the data collected were analyzed via the SmartPLS Structural Equation Modeling path analysis. The “Social Influence” ( t = 3.656, p

Abstract Background While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China’s Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Methods Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. Results We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. Conclusions The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

Abstract Background While the demand for the health service keeps escalating at the grass root or rural areas of China, a substantial portion of healthcare resources remains stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, the Deepening Health Care Reform in 2012 China was intended to flush out these discrepancies and promote a more equitable and efficient distribution of health resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Methods We divided Jiangsu Province into 3 zones according to the level of economic and social development i.e. developed, developing, and undeveloped areas. Using a hybrid of Panel data analysis and an augmented Data Envelopment Analysis (DEA), we model human resources, capital inputs of Community Health Centers to comprehensively determine the technical and scale efficiency of community health resources in 3 zones in Jiangsu Province. Results We sampled data and analysed efficiency and productivity growth of 75 Community Health Centers in 13 cities of Jiangsu Province from 2011 to 2015, which shows that a significant productive growth among Community Health Centers between 2011 and 2015. Mirroring the behavior of Community Health Centers, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. This can be credited partly to the Deepening Health Care Reform measures aimed at improving technology availability in health centers in sub-urban areas. The regional summary of the DEA result shows that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand among the 3 zones of Jiangsu. Conclusions The government of China in general and Jiangsu province in particular could improve the efficiency of health resources allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources and enhancing the level of health of financial resources allocation.

We propose a one-time blind signature scheme based on coding theory, which is improved on the basis of the SHMWW protocol. By adding two blinding factors, the anonymity of users is protected. The analysis proves that the scheme is secure and meets the requirements of completeness, blindness, and one-more unforgeability. Under the 128-bit security level, our scheme can achieve a signature length of 2.1 kB. The experimental results show that our scheme has a short signature length and high execution efficiency. Our scheme can also be applied to electronic forensics of traffic accidents on the Internet of Vehicles, which can protect users’ privacy.