Cross-Country Discrepancies in Monkeypox Vaccine Hesitancy Among Postgraduate and Undergraduate Medical Students.

BACKGROUND: Medical students hold significant importance, as they represent the future of healthcare provision. This study aimed to explore psychological antecedents towards the monkeypox (mpox) vaccines among postgraduate and undergraduate medical students across countries. METHODS: A cross-sectional survey was conducted among medical students aged 18 years old and above in 7 countries; Egypt, Romania, Malaysia, and Yemen, Iraq, India, and Nigeria. We used social media platforms between September 27 and November 4, 2022. An anonymous online survey using the 5C scale was conducted using snowball and convenience Sampling methods to assess the 5 psychological antecedents of vaccination (i.e., confidence, constraints, complacency, and calculation, as well as collective responsibility). RESULTS: A total of 2780 participants were recruited. Participants' median age was 22 years and 52.1% of them were males. The 5C psychological antecedents of vaccination were as follows: 55% were confident about vaccination, 10% were complacent, 12% experienced constraints, and 41% calculated the risk and benefit. Lastly, 32% were willing to be vaccinated for the prevention of infection transmission to others. The Country was a significant predictor of confidence, complacency, having constraints, and calculation domains (P < 0.001). Having any idea about the mpox vaccine was linked to 1.6 times higher odds of being more confident [OR = 1.58 (95% CI, 1.26-1.98), P < 0.001] Additionally, living in a rural area significantly increased complacency [OR = 1.42 (95% CI, 1.05-1.95), P = 0.024] as well as having anyone die from mpox [OR = 3.3 (95% CI, 1.64-6.68), P < 0.001]. Education level was associated with increased calculation [OR = 2.74 (95% CI, 1.62-4.64), P < 0.001]. Moreover, being single and having no chronic diseases significantly increased the calculation domain [OR = 1.40 (95% CI, 1.06-1.98), P = 0.02] and [OR = 1.54 (95% CI, 1.10-2.16), P = 0.012] respectively. Predictors of collective responsibility were age 31-45 years [OR = 2.89 (95% CI, 1.29-6.48), P = 0.01], being single [OR = 2.76 (95% CI, 1.94 -3.92), P < 0.001], being a graduate [OR = 1.59 (95% CI (1.32-1.92), P < 0.001], having no chronic disease [OR = 2.14 (95% CI, 1.56-2.93), P < 0.001], and not knowing anyone who died from mpox [OR = 2.54 (95% CI, 1.39-4.64), P < 0.001), as well as living in a middle-income country [OR = 0.623, (95% CI, 0.51-0.73), P < 0.001]. CONCLUSIONS: This study underscores the multifaceted nature of psychological antecedents of vaccination, emphasizing the impact of socio-demographic factors, geographic location, and awareness, as well as previous experiences on individual attitudes and collective responsibility towards vaccination.

From isolation to revival: trade recovery amid global health crises.

BACKGROUND: The COVID-19 pandemic has highlighted the importance of designing effective trade recovery measures in response to global health events (GHEs). This study combines international trade risk management theory and multi-case comparative analysis of past GHEs to present a theoretical framework for designing national trade recovery measures for future events. RESULTS: The research finds that during GHEs, trade risks shift to fundamental uncertainty, requiring spatial-temporal-subject dimension recovery measures. The study suggests changing the focus of trade recovery policy design from emergency-oriented and single-dimension measures to reserve-oriented and enduring-effect measures of comprehensive dimensions at micro- and macroeconomic levels. CONCLUSION: The study contributes to the debate on managing trade risks in times of crisis, where there is a need to develop effective trade recovery measures that account for the complexities of global trade and the unique challenges of GHEs. The findings provide practical guidance for trade officials and policymakers to design measures in response to GHEs to improve a country's overall trade recovery.

International Standards and Features of Financing in the Field of Health Care and Provision of Medical Services.

The relevance of this article is due to the fact that international standards in the field of health care and medical services are central to the field of world principles of functioning and development of medical law. The aim of the article is to conduct research on the peculiarities of international standards in the field of health care and medical services, as well as to study the prospects of their implementation in Ukraine. Leading research methods are general and special research methods, including methods of logic, analysis, comparison. The results of this study are to outline recommendations for the use of international standards in the field of health care and medical services in Ukraine and to summarize the legal framework on this issue. The significance of the results is reflected in the fact that this study can serve as a basis for outlining future changes in current legislation of Ukraine on the functioning of the health care system and implementation of world practices in health care. Within the framework of this study, systematized the main international and European documents that reflect the main international standards in the field of health care and medical services and ratified in Ukraine and have a direct impact on the legal framework for this area.

Scoping review of international relations theories in health security: A cue for health diplomacy.

Background: Health security as a domain has gained tremendous importance in the recent past. Emerging and re-emerging diseases globally, coupled with the derailment of the determinants of health mainly the socio-political environment, has made health security a cross-cutting entity in diverse fields including International Relations (IR). With the ongoing global polycrisis, the health-related issues which were previously sidelined as a concept of less strategic importance in the IR field, are now contributing to the shift of the world order. This has instilled an increased participation of IR scholars in the discussions and debates on health security concerns. The field of IR contains numerous theoretical lenses through which scholars analyze such situations, policies, and systems of the world. Methods: In this paper, we use a scoping review method to inspect how IR theories have been applied in analyzing health security concerns. Results: We observed that various diverging IR theories have been used to deliberate on states' actions in tackling the recent pandemic and have also been prescriptive about the changing notions of multilateralism and international governing organizations. Realism, liberalism, and securitization were among the most frequently applied IR theories in the context of health security discussions. Conclusions: This work provides an impetus to enhance the interaction among interdisciplinary teams leading to evolving solutions that can address issues of global importance in the contemporary world.

Factors influencing risk perception during Public Health Emergencies of International Concern (PHEIC): a scoping review.

The unknownness and dread potential of a risk event shapes its perceived risk. A public health emergency of international concern (PHEIC) declaration by the World Health Organisation (WHO) is a signal for such an event. Understanding perceived risk then shapes risk-avoiding behaviours, important for health prevention. The review aims to consolidate the determinants of risk perception during a PHEIC, underscoring the need for grounding in context and theory. Studies published from 2010 until end-2020, searching PubMed, PsycINFO, MedlinePlus, PubPsych, and CINAHL, were included. Studies with only biological conceptualisations of risk, or no association to risk perception, were excluded. A total of 65 studies were included. Quality of the cross-sectional studies was assessed using Newcastle Ottawa Scale (NOS), yielding an average of 5.4 stars (out of 10). Factors were classified into three broad categories - individual, contextual, and media. Individual risk factors include emotions; beliefs, trust, and perceptions; immutable physical traits (sex, age, ethnicity); mutable traits (education, income, etc.); and knowledge, with no definitive correlation to risk perception. Contextual traits include pandemic experience, time, and location, with only time negatively correlated to risk perception. Media traits include exposure, attention, and framing of media, with no clear association to risk perception. One limitation is excluding a portion of COVID-19 studies due to censoring. Still, this lack of consensus highlights the need to better conceptualise "risk perception". Specifying the context and timing is also important since jurisdictions experience different outbreaks depending on outbreak histories. Using theories to ground risk perception research assists with these tasks.

Goal setting in later life: an international comparison of older adults' defined goals.

BACKGROUND: Studies of goal setting in later life tend to focus on health-related goal setting, are pre-determined by the researcher (i.e., tick box), and/or are focused on a specific geographical area (i.e., one country). This study sought to understand broader, long-term goals from the perspective of older adults (65 + years) from Australia, New Zealand (NZ), United Kingdom (UK), Ireland, Canada, and the United States of America (USA). METHODS: Through a cross-sectional, online survey (N = 1,551), this exploratory study examined the qualitative goal content of older adults. Thematic analysis was used to analyze the qualitative data, and bivariate analyses were used to compare thematic differences between regions and by participants' sex. RESULTS: Over 60% of the participants reported setting goals, and participants from the Australia-NZ and Canada-USA regions were more likely to set goals than the UK-Ireland region. The following six overarching themes were identified from the 946 goals reported: health and well-being; social connections and engagement; activities and experiences; finance and employment; home and lifestyle; and attitude to life. CONCLUSIONS: This study supports previous research that demonstrates that older adults can and do set personal goals that are wide ranging. These findings support the need for health professionals to consider different methods for elucidating this important information from older adults that builds rapport and focuses on aspects viewed as more important by the older adult and therefore potentially produces improved health outcomes.

Operational resilience towards a global alignment.

Operational resilience lies between operational risk and business continuity. This paper provides a view on the implementation of the operational resilience framework, and its relationship with operational risk and business continuity. It analyses the similarities and differences between these exercises and how management information from these exercises can be leveraged and aligned. The paper also provides answers to three important questions: (1) What pushed the international regulators to add additional oversight? (2) What benefits and challenges are brought by operational resilience? (3) Why is it important to harmonise operational resilience within the international regulatory landscape?

Economic globalization-energy diversification nexus and implications for environmental management in China.

Every nation on earth has the responsibility to implement effective environmental management measures for sustainable environmental quality. In doing so, this study scrutinizes the relationship between economic globalisation and energy diversification in the Chinese economy from 1995 to 2022 for designing and implanting policies for environmental management. It uses industrialization, foreign direct investment, foreign remittances, and information & communication technology as supplementary factors into augmented energy diversification demand function. This empirical analysis shows cointegration between the variables, with economic globalisation positively impacting energy diversification. Factors such as foreign direct investment, foreign remittances, and information & communication technology contribute to energy diversity. However, industrialization has an adverse relationship with energy diversification. The relationship forms an inverted-U shaped between economic globalization and energy diversification. Our causality analysis indicates that economic globalization positively causes energy diversification. This study also reveals a reciprocal and beneficial cause-and-effect association between foreign direct investment and energy diversification. Lastly, foreign remittances and information & communication technologies positively cause energy diversification.

International comparison of China's digitalization level and its enlightenment.

The global digital wave has flourished in recent years, and the digital technology revolution has emerged. Digitalization plays an undeniable role in promoting modern economic and social development in multiple aspects such as economy, society, innovation, public services and sustainable development, China's digitalization application is also developing rapidly. In order to better measure the current situation of China's digitalization development level, this paper constructs a comprehensive evaluation index system of digitalization development from four dimensions of talents in the digital field, digital infrastructure construction, digitalization innovation ability and international competitiveness, and tests the index system. The entropy method is used to measure the level of digitalization development between China and the United States, the United Kingdom, France and other major developed countries in the world, and the coefficient of variation method, kernel density estimation and Dagum Gini coefficient method are used to analyze the temporal and spatial characteristics and regional differences of digitalization development level of seven countries. This paper makes a comparative analysis between China and major developed countries from the historical perspective of the evolution of the techno-economic paradigm. With a view to summarizing and exploring from it and drawing on the advanced experiences accumulated by the developed countries over a long period of time, so as to provide China with useful insights and bases for further enhancing its digitalization development level.

Characteristics and outcomes of the drug patent linkage system in China.

BACKGROUND: On July 4, 2021, China officially introduced the drug patent linkage system, which has made more localized adjustments than have similar systems in the US and South Korea. This study describes the characteristics and outcomes of China's patent linkage system. METHODS: For this study, we used the database of China's patent information registration platform for marketed drugs to capture all listed patents and patent certifications from June 25, 2021, to June 30, 2023. We used descriptive statistics for the above data to assess the impact of patent linkage on branded drug manufacturers, generic drug manufacturers, and the public's access to medicines. RESULTS: During the study period, the patents of 632 branded drugs were listed, and 5058 ANDAs submitted patent certifications to the Registration Platform. Of these 632 branded drugs, 462 (73.1%) drugs were approved before the year of patent registration, and the average number of listed patents per drug was 1.8, with a standard deviation of 1.4. However, of these 5058 ANDAs, P1 certifications accounted for 85.1%, and P3 and P4 certifications accounted for 16% combined. In addition, according to the detailed statistics of P2 certifications, we found that the proportion of patent invalidation cases was 46.4%. The remaining validity of the patents corresponding to P3 certifications was longer, with a median value of 17 months, and the IQR was 10-30.75, ranging from - 2 to 204 months. CONCLUSIONS: China's patent linkage aims to promote the balance of multiple interests -innovation, imitation and public health-and has its own system characteristics. Patent listing and patent certification are the key indicators reflecting the implementation effect of the system. From the perspective of system outcomes, ANDAs have been connected to the patent linkage system in an orderly manner, but the growth of patent challenges is not obvious. Moreover, manufacturers of foreign branded drugs that have not yet entered the Chinese market need to pay more attention to the role of patent listing.

Assessing the technical efficiency performance of Chinese ports logistics: Evidence from the DEA and fsQCA.

Ports are critical centers of international trade and global logistics now that economic globalization has taken hold. The efficiency performance of port logistics is crucial to building an emerging pattern of development in which domestic and foreign dual cycles are complementary for China. This paper examines the efficiency performance of 19 ports within five major economic circles in China. It explores how their efficiency is distributed, and the configurations of efficiency improvement during the new normal of China's economy. First, the DEA-BCC model is employed to calculate the technical efficiency performance and distribution of each port from 2011 to 2020. Then, fuzzy-set qualitative comparative analysis (fsQCA) was applied to integrate and analyze the influencing factors. The results show as follows: (1) Each port group performed differently on efficiency rankings, as well as regional distributions. Among these, the port groups of the Bohai Rim region, the Yangtze River Delta region, and the Bohai Rim region continue to rank highly. (2) From the perspective of configuration analysis, the results suggest that government support is not necessary for port logistics with better economic endowments. However, it is critical for backward ones. (3) A rational industrial structure can enhance levels of infrastructure, openness, and information technology, improving port performance. The findings can provide theoretical and practical references for better promoting the development of Chinese port management.al references for better promoting the development of Chinese port management.

The effectiveness of emerging markets' legal structure in explaining financial development.

This article examines the role of legal structure in explaining financial development in twenty-three emerging markets, which has not been explored in institutional economics literature before. This study relied on Pedroni, and Kao cointegration tests, which is followed by the renowned panel cointegration technique. The results of the Pedroni and Kao cointegration tests show that the variables understudy is cointegrated in the long-run. These findings are confirmed by the panel cointegration showing that legal structure (LS) has positive impact on financial development (FIND) in long-run that support Law and Finance, and New Institutional Economics theories in emerging markets. This study is the first to directly examine the long-run impact of LS on FIND in emerging markets, and the result remains consistent across alternative measure of FIND. The findings of this study have important policy implications for emerging markets. Policymakers should focus on creating a legal environment that is conducive to financial development. This includes strengthening the legal framework, improving regulatory regimes, and promoting market autonomy. Additionally, policymakers should work to attract foreign investment, which can help spur economic growth and development in emerging markets. The findings of the study are consistent across battery of robustness testing.

[The long 1992 year in medicinal (non-)security of Russia. Report I. Market trial].

The year 1992 is an important landmark in the history of Russian pharmaceutical market. It began not in January, but in December 1991, when orders of the President and the Government to open free market of medications were promulgated. The Yeltsin advisers conceived that market economy was infallible means to combat medication shortages, corruption and bureaucratic monopoly. However, panacea did not work. Moreover, it gave rise to completely new problems. The human and state security implies protection from threats of dependence. The unprepared dive into market plunged Russians and the country into deep dependence on imported medications and foreign pharmaceutical companies. The proposed study proceeds our publications in this journal and in journal "Pharmacia" in 2022. At that time, analysis of medication "famine" was implemented on basis of published sources and relied on journalistic evidences. The current study was carried out on the basis of archive documents of the Ministry of Health of the Russian Federation and authors interviews of representatives of the regulator. The first report reveals administrative mechanism that engendered crisis of medication supply in the first post-Soviet year of our country.

Impact of sanitary and phytosanitary measures on agri-products quality upgrading and environmental protection.

Protecting human, animal, and plant life or health from additives, toxins, and contaminants in agri-products and promoting green free trade are the main components of Sanitary and Phytosanitary (SPS) measures. However, the SPS measures are heterogeneous. This study examines the impact of SPS measures on the measured export quality and discusses their influence on the environmental protection of the exporting country. International heterogeneous measures do not necessarily promote quality upgrading but greatly increase transaction costs. By contrast, China's agri-product' quality upgrading and environmental pollution are in sharp contrast. Based on a heterogeneous firm-trade model, this study obtains three hypothetical propositions and conducts empirical regressions using the Tobit method. This study finds that heterogeneous SPS measures hinder quality upgrading because firms present a different quality upgrading trend, which in turn impedes the environmental protection of the exporting country; the quality upgrading made by diversified SOEs is higher than that of foreign firms and private firms; the quality upgrading made by general firms is higher than that of processing firms; and protective SPS measures have a stronger negative effect on quality upgrading and environmental protection.

Research on the impact of equity incentive model on enterprise performance: A mediating effect analysis based on executive entrepreneurship.

In implementing the equity incentive system, this paper delves into the listed enterprises' selection of equity incentive models. While previous research has extensively covered the effects, models, and influencing factors of equity incentives, there needs to be more in-depth literature focusing on the diverse incentive models and their impact on corporate performance. Notably, there needs to be more literature on considering entrepreneurial spirit as a mechanism. It aims to explore the relationship between executives' choices under different incentive models, the entrepreneurial spirit fostered by these models, and their combined impact on corporate performance. The findings reveal that adopting the restricted stock incentive model by listed enterprises implementing the equity incentive system significantly positively affects enterprise performance. Mechanistic tests show that when a company implements the restricted stock incentive model, executives prioritize maximizing their interests, leading them to embrace more risk in their investment decisions. This behavior, in turn, stimulates the adventurous spirit of executives, positively impacting enterprise performance, particularly pronounced in companies with more concentrated executive power. Moreover, executives may be more inclined to invest in high-risk, high-reward innovative projects, a behavior indicative of innovation and more prevalent in firms with higher research and development (R&D) investment. However, the limitation of this paper is that the study evaluates the operation of the equity incentive system in China by taking listed companies in China as an example, which is not necessarily suitable for foreign developed capitalist countries. This study contributes to the study of principal-agent problems by exploring the relationship between executives, entrepreneurship and firm performance.

The adoption of renewable energy towards environmental sustainability: Evidence from Partial Least Square Structural Equation Modelling (PLS-SEM).

The effect of carbon emissions on the environment has made some of the Sustainable Development Goals difficult to achieve. Despite the efforts of international bodies, there is still a need to address the problem since the transition is not complete. Therefore, this study investigates the effect of globalization, economic growth, financial inclusion, renewable energy, and government institutions on carbon emissions from the period of 1998 to 2021. To be able to assess both the direct and indirect effects of the variables, the Partial Least Square Structural Equation Modelling is employed, where renewable energy serves as the mediator, and the Two-Stage Least Squares is employed as the robustness check. The findings of the study reveal that globalization promotes the use of renewable energy, but financial inclusion has a negative effect on renewable energy use. Renewable energy has a direct positive and significant effect on carbon emissions. Financial inclusion has an indirect negative and significant effect on carbon emissions. The results imply that more enlightenment on financial inclusion will help a smooth transition, and globalization should be embraced when all environmental regulations are enforced.

Characteristics of strong midwifery leaders and enablers of strong midwifery leadership: An international appreciative inquiry.

OBJECTIVES: This research aimed to identify the characteristics of strong midwifery leaders and explore how strong midwifery leadership may be enabled from the perspective of midwives and nurse-midwives globally. DESIGN: In this appreciative inquiry, we collected qualitative and demographic data using a cross-sectional online survey between February and July 2022. SETTING: Responses were received from many countries (n = 76), predominantly the United Kingdom (UK), Australia, the United States of America (USA), Canada, Uganda, Saudi Arabia, Tanzania, Rwanda, India, and Kenya. PARTICIPANTS: An international population (n = 429) of English-speaking, and ethnically diverse midwives (n = 211) and nurse-midwives (n = 218). MEASUREMENTS: Reflexive thematic analysis was used to make sense of the qualitative data collected. Identified characteristics of strong midwifery leadership were subsequently deductively mapped to established leadership styles and leadership theories. Demographic data were analysed using descriptive statistics. FINDINGS: Participants identified strong midwifery leaders as being mediators, dedicated to the profession, evidence-based practitioners, effective decision makers, role models, advocates, visionaries, resilient, empathetic, and compassionate. These characteristics mapped to compassionate, transformational, servant, authentic, and situational leadership styles. To enable strong midwifery leadership, participants identified a need for investment in midwives' clear professional identity, increased societal value placed upon the midwifery profession, ongoing research, professional development in leadership, interprofessional collaborations, succession planning and increased self-efficacy. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study contributes to understandings of trait, behavioural, situational, transformational and servant leadership theory in the context of midwifery. Investing in the development of strong midwifery leadership is essential as it has the potential to elevate the profession and improve perinatal outcomes worldwide. Findings may inform the development of both existing and new leadership models, frameworks, and validated measurement tools.