Impact of regional accessibility on urban residents' income in China: A bidirectional-fixed panel model.

The income gap between regions and its expansion are the main manifestations of the imbalanced and inadequate economic development in China. High-speed railway (HSR) construction is regarded as an important method to drive domestic demand, drive the pulse of the economy, and promote the coordinated development of regions. Based on the opening of HSR and the acceleration of ordinary railways, we used the weighted average travel time model and accessibility coefficient to estimate the changes on accessibility in 286 cities at prefecture-level and above from 2000 to 2018. Then, the influence mechanisms of improving regional accessibility on urban residents' income were estimated by using the bidirectional-fixed effects panel model and the recursive model respectively. We found that: (1) The accessibility of urban areas has been greatly improved due to the opening of HSR and the acceleration of ordinary railway, among which the improvement of HSR cities is greater. (2) The improvement of regional accessibility significantly promoted the income growth of urban residents, and the increase of the regional accessibility coefficient by 1 unit led to an average increase of 2140 yuan in the per capita disposable income of urban residents. (3) There is regional heterogeneity in the impact of improving regional accessibility on urban residents' income, and it has a significant effect on the eastern and northeastern regions. It has a greater positive effect on improving the income of residents in central cities compared with peripheral cities. (4) Regional accessibility can promote urban income growth through regional employment and fixed asset investment. In the future, the transportation network should be further improved to facilitate the regional economic cycle, strengthen the coordination and complementarity of regional economies, and promote regional economic integration so as to promote the improvement of resident income level and the common prosperity of the people.

Community support and promoting cognitive function for the elderly.

Proper cognitive functions are critical to the life of the elderly. With the rapid aging of the population, community support plays an important role in cognitive functioning. This study examines the association between community support and the level of cognitive functioning in the elderly, and the mediating effect of social participation in the relationship. Based on the panel data of China Longitudinal Healthy Longevity Survey (CLHLS) in 2005, 2008, 2011, 2014, and 2018, people aged 65 and over are selected as the research object (N = 35,479). The panel Logit model is used to analyze the influence of community support on their cognitive functioning. In addition, the stepwise regression and KHB decomposition methods are used to test the influence mechanism of community support on their cognitive function. The benchmark regression results show that there is a significant correlation between community support and cognitive function in the elderly (OR: 1.64, 95% CI: 1.41-1.91, p < 0.01). Daily care (OR: 1.75, 95% CI: 1.33-2.29, p < 0.01) has the strongest impact on the cognitive function of the elderly, followed by health care (OR: 1.70, 95% CI: 1.43-2.01, p < 0.01) and legal support (OR: 1.64, 95% CI: 1.37-1.95, p < 0.01), while psychological care (OR: 1.62, 95% CI: 1.31-2.01, p < 0.01) has the weakest impact on the cognitive function of the elderly. The results of the mediation effect test show that social participation plays a significant intermediary role in the impact of community support on the cognitive function of the elderly (mediation percentage: 16.89%), demonstrating that community support can improve the cognitive function of the elderly by promoting the social participation of the elderly. In classified community support, social participation plays a significant intermediary role in the impact of psychological care on cognition (mediation percentage: 46.10%).

Online Emotional Support Accompany Group Intervention and Emotional Change of the Public During the COVID-19 Pandemic: A Multi-Period Data Analysis From China.

COVID-19 has made it difficult to adopt traditional face-to-face psychological intervention under this situation because of the blocked down and social distancing, which brings big psychological crisis to the public among the global. To explore the emotional change of the public in China at the outburst of the pandemic at different phases, to establish an online working platform and create a new model of an online intervention to hold public emotions under pandemic, and test its effectiveness, so to give advisement for government emergency management system. We established an online organization to work for this program ad innovated a model of online group counseling with online emotional support accompany group (OESAG) right after the outburst of a pandemic. We analyzed 53 OESAGs from February 10 to April 9, including 555 application forms, 253 feedback from members, and 139 feedback from group leaders by using NVivo and SPSS to explore the evolution and characteristics of public emotion during COVID-19 and the effectiveness of OESAG. Our results showed that the emotional changes of members ranged from shock to depression to positive. The public's emotions swiftly changed from stress, anxiety, and isolation, to the hope of returning to work or finding a job during the pandemic with the help of OESAG. OESAG has effectively regulated the negative emotions of members by conducting psychological crisis intervention to provide members a space to communicate with each other, especially the female and frontline staff. Policy makers can set up an online systematic psychological crisis intervention system as soon as possible to make up for the lack of psychological assistance in the emergency management system.

The Impact of Informal Social Support on Older Health: Evidence from China.

OBJECTIVES: To explore the impact of informal social support (ISS) on older health. METHODS: Multiple regression was used as the baseline regression, grouping regression was used to examine whether there were health effect differences among groups based on age and household registration, and insurance was selected to explore moderating effects of formal social support (FSS). RESULTS: First, economic support, accompanied support, and number of intimate contacts had significantly positive effects on older health except for care support's negative effects. Second, ISS had different health effects for different groups based on age and household registration. Third, FSS was a significant moderating for ISS. CONCLUSIONS: The government should emphasize and strengthen the supplementary role of ISS to FSS and promote the effective combination of the two, especially for the older who are high-age and rural, and further improve the role of care support.

Mobility-related inequality in healthcare utilization between floating and native populations and its influencing factors: evidence from China.

Our goal was to examine inequality in healthcare utilization and the factors that contribute to inequality between China's floating and native populations. Based on the China Labor-force Dynamics Surveys from 2014 to 2018, which used three rounds of data, we utilized a panel probit model that included fixed effects for time and province to estimate the probability of healthcare utilization for floating and native populations. In addition, we calculated the degree of inequality in healthcare utilization by using the method of mobility-related inequality and a decomposition approach was used to explain the contribution of each factor to the inequality. The floating population utilized healthcare at a lower rate, with a 10.5% probability of visiting a hospital and a 20.9% probability of receiving hospitalized treatment. The concentration index of mobility-related inequality in healthcare utilization shows a negative coefficient of -0.137 for hospital visits and -0.356 for hospitalized treatment. Contribution decomposition shows that self-assessed health, job category and household registration account for the largest contribution to the inequality in hospital visits, contributing -0.038, 0.021 and -0.017, respectively. Age, household registration and insurance account for the largest contribution to the inequality in hospitalized treatment, contributing -0.053, 0.024 and -0.023, respectively. The floating population was less likely to use health services and faced an inequality in treatment compared with the native population.

Mechanism of online emotional support accompany group for stress: The role of social support.

Objective: To investigate the effect of social support on stress, and to clarify the effect and mechanism of Online Emotional Support Accompany Group (OESAG). Methods: The group members who signed up for the public welfare project "Psychological Rehabilitation Group Psychological Service under the COVID-19 Pandemic" were divided into the treatment group, the control group, and the blank group with 37 members each. The treatment group received OESAG intervention, the control group received online time management group intervention, and the blank group was the waiting group. The three groups of subjects were synchronously tested before and after the intervention group. Results: After the OESAG intervention, compared with the control group and the blank group, the treatment group showed that perceived social support was improved, and loneliness and stress were decreased. Conclusion: Improving social support can effectively reduce stress. OESAG can effectively improve social support and so too decrease stress. This study could help in designing effective psychological intervention measures to reduce the degree of stress symptoms and enhance both personal and social levels of coping with stressful events.

Association of High-Speed Rail and Tuberculosis Transmission in Newly Integrated Regions: Quasi-Experimental Evidence from China.

Objectives: The spread of tuberculosis (TB) is related to changes in the social network among the population and people's social interactions. High-speed railway (HSR) fundamentally changed the integrated market across cities in China. This paper aims to examine the impact of HSR on TB transmission in newly integrated areas. Methods: By exploiting the opening and operation of the first HSR in Sichuan province as a quasi-natural experiment, we have collected and used the economic, social, and demographic data of 183 counties in Sichuan province from 2013 to 2016. Results: The new HSR line is associated with a 4.790 increase in newly diagnosed smear-positive TB cases per 100,000 people among newly integrated areas. On average, an additional increase of 34.178 newly diagnosed smear-positive TB cases occur every year in counties (or districts) covered by the new HSR. Conclusion: HSR development has significantly contributed to the transmission of TB. The public health system in China needs to pay more attention to the influences of new, mass public transportation.

Will high-speed railway influence the healthcare seeking behaviour of patients? Quasi-experimental evidence from China.

This study examines the impacts of high-speed railway (HSR) transportation on the healthcare-seeking behaviour of patients along newly integrated areas of Sichuan province, China. The opening of the Cheng-Mian-Le intercity HSR is considered as quasi-experimental evidence from China, and we make a propensity score matching the difference in differences research design, using data from the monthly report database of the Sichuan Province health statistical data collection and Decision Support System from 2014 to 2015. We find that, first, the opening of the HSR resulted in significant healthcare-seeking behaviour with great heterogeneity. Second, patients are more likely to go to areas with high-density healthcare resources, in which case HSR may mitigate the diagnostic inaccuracies that patients face locally. Third, the 'distance enhancement effect' was present, and its marginal effect is more significant for long-distance patients. Fourth, the tiered-network healthcare policy has no significant restrictive impact on patients seeking high-level medical services. Our results show that HSR establishment has a substantial impact on the behaviour of people seeking medical treatment and medicine. Furthermore, we discuss the results' policy implications for the allocation and integration of China's healthcare market, and the accessibility of medical and health services.

Trends in Dietary Patterns and Diet-related Behaviors in China.

Objectives: Determination of trends in diet-related behaviors and their interactions with cardio-metabolic diseases is an important research endeavor. Methods: We analyzed food categories, weight, eating frequency, eating location, cooking methods, time of food intake, dietary knowledge, food preference, nutritional structure over time, and their interaction with cardiometabolic risks, using t tests and χ² tests, based on the China Health and Nutrition Survey packages from 1997 to 2011. Results: Consumption of fruits, dairy products, snacks, fast food, and beverages has increased significantly, as a concomitant and marked decrease in rice consumption has occurred. Food categories, eating frequency, cooking methods, and at-home eating are gradually increasing and diversifying. Persons not only prefer to consume carbohydrate-rich foods like fruits and vegetables, but also enjoy energy-dense foods like meat, snacks, and beverages. There has been a switch from a predominantly plant-based diet to a Western style diet high in fat and animal-based foods. People have undergone significant changes in reducing the intake of energy, carbohydrates, and protein, but significantly increased their fat intake. Conclusion: Chinese dietary patterns and diet-related behaviors have undergone significant transition in the past few decades, trending towards diversification and modernization.

Differences in Overweight and Obesity between the North and South of China.

Objective: Determining geographical distribution and local dietary patterns involved in being obese is useful for designing intervention strategies. Methods: We selected residents between 18 and 65 years old from 11 Chinese provinces to compare dietary patterns and BMI from the China Health and Nutrition Survey packages in 2011. We used linear and logistic regression analyses to assess the strength of association among geographic variables, the obesity problem, and dietary patterns. Results: The overall prevalence of overweight and obesity in the North was 10.51% higher than that in the South. Northern dietary patterns feature a high intake of wheat and soybeans, whereas southern dietary patterns feature a high intake of rice, vegetables, meat, and poultry. The estimated coefficient of regional variables on dietary score is 1.49, the estimated coefficient of regional variables on the odds ratio for being overweight is 1.68 and for being obese is 2.04. Multivariate logistic regression including both variables of South-North areas and northern dietary patterns showed a significant correlation with being overweight or obese. Conclusions: Northern areas and their local dietary patterns are more likely to contribute to overweight and obesity. Our study provides empirical evidence for policies that target the ''obesogenic'' environment and promote opportunities for persons to access healthy dietary patterns and nutritional balance.

The Impact of Mothers' Dietary Patterns on Children's Nutritional Status in China.

Objective: We studied the effect of mothers' dietary patterns on their children's nutritional status. Methods: Based on the China Health and Nutrition Survey (CHNS) packages in 2004, 2006, 2009, and 2011, mothers' dietary quality scores were calculated using the Dietary Balance Index-07. We further explored the influence of maternal dietary patterns on children's nutritional status using a series of regression analyses with time and province fixed effects in longitudinal study, simultaneouly considering the differential impact of child's age, multigenerational co-residence, and categories of maternal food consumption. Results: Maternal food consumption was slightly higher than what is required, and each food group positively correlated between mothers and their children. Furthermore, the maternal dietary quality score on the children's energy intake was significant. The influence of maternal dietary patterns on children's nutritional intake increases gradually with the child's age, but multigenerational co-residence has the opposite effect. Furthermore, maternal food intake of cereals, vegetables, beans, and meat has a positive impact on children's nutritional intake. Conclusions: Maternal dietary patterns have a significant impact on children's nutritional status. The consumption of meat and multigenerational co-residence should be given high priority.

Building an innovation system of medical devices in China: Drivers, barriers, and strategies for sustainability.

OBJECTIVES: This article aimed to discuss the emergence of medical device sector in China from a sectoral innovation system perspective, to explore the drivers and barriers to the successful building of an innovation system of medical devices, and to highlight the policy implications and suggestions for sustainable innovation of medical devices. METHODS: A theoretical framework of sectoral systems of innovation was applied in the analysis of data, and materials were collected from multiple sources with particular attention paid to the evolutionary phases, structure, and function of the innovation system. RESULTS: The evolution of medical device sector in China could be divided into four phases: initialization (1960s-1970s); exploration (1980s); steady growth (1990s); and rapid growth (since 2000). Through analyzing the innovation system's structural components of technology, actors, and networking, as well as institutions, this study indicated that the government policy decision was the most important driver that affected the virtuous cycle of the Chinese medical device innovation system, followed by market demand and entrepreneurial activities. However, barriers against the innovation cycle such as knowledge base development and diffusion, legitimacy, and resource mobilization still remained. CONCLUSION: In its endeavor to build an innovation system, the Chinese medical device sector had made some progress in meeting the local medical demands and improving its industrial competence. Although a Chinese innovation system for medical devices was initiated under the guidance of the government, knowledge advancement and diffusion had become the main challenges for the sustainability of innovation in this sector. The future development depends on China's effort and ability to establish education and health research systems specific to medical devices.

Are parental dietary patterns associated with children's overweight and obesity in China?

BACKGROUND: It is believed that parents have a great influence on their children's dietary behaviours. However, it is not clear whether parental food patterns are associated with children's nutritional status in China, which includes a vast territory with rich, diverse cultures. The goal of this project is to systematically study the associations between parental food intake and children's overweight and obesity in China, according to children's ages and regional differences. METHODS: Based on individual food consumption data from the China Health and Nutrition Survey (CHNS) package in 2011, cross-sectional studies have previously been conducted to analyse the association between different categories of food intake of parents and children. The current study extends this research by directly. RESULTS: Our analysis results show that parental food intake is highly correlated with children's food intake, with the estimated coefficients of most food intake categories being greater than 0.5. Furthermore, this association between parental food intake and children's overweight and obesity is most significant in young children, but it begins to weaken in relation to children aged between 13 and 18. Additionally, the associations between parental food intake and children's overnutrition are more significant in rural areas than they are in urban areas. CONCLUSIONS: The association between parental food intake and childhood overweight and obesity is significant, although it varies considerably according to food categories, children's ages and area differences. These results show promise for intervening in the overnutrition of children by controlling household dietary patterns according to children's developmental stages and regional differences.

What Entrepreneurial Followers at the Start-Up Stage Need From Entrepreneurship Cultivation: Evidence From Western China.

Entrepreneurial followers are defined as the crucial members of a specific entrepreneurial team and do not include the leader or normal employees in the present paper. This population can be viewed as indispensable factors in the success of entrepreneurship, especially in the start-up stage. In addition, according to the following time, they can be divided into two groups, namely long-term entrepreneurial followers and short-term entrepreneurial followers. However, studies focusing on entrepreneurship cultivation for entrepreneurial followers are relatively few. The main purpose of this paper is to determine the needs of Chinese entrepreneurial followers in entrepreneurship cultivation from the early stage of entrepreneurship. In this paper, a sample of 200 long-term entrepreneurial followers from Tianfu New Area in China was investigated. To enable the researchers to explore the unique opinions of entrepreneurial followers, a mixed data collection approach that combined interviews and questionnaires was chosen in this study. The results revealed following findings: (a) high levels of social capital, good entrepreneurial opportunities and projects, and highly cooperative teams were viewed as the most important factors for entrepreneurship by entrepreneurial followers in China; (b) most entrepreneurial followers believed that the primary difficulty in the cultivation process was the inefficiency in talent training mechanism; and (c) nearly 40% of samples suggested that the cultivation and enhancement of local talents should be firstly carried out by the Chinese government, indicating a gap between the supporting force for local and returned talents in China. In addition, various types of incentive policies and good environments for talent growth were also considered as important suggestions by entrepreneurial followers. We found that unlike entrepreneurial leaders, entrepreneurial followers focus more on income expectation, and personal development rather than supporting the development of companies in China. These findings should be viewed as priorities when enhancing current entrepreneurship cultivation in China.

Exploratory study on development challenges of maternal and child healthcare institutions in China: a qualitative study combining interviews and focus groups.

OBJECTIVES: To manage the development of the maternal and child healthcare institution (MCHI) in China, it is important to understand the key challenges and the influencing factors for sustainable development of MCHIs. However, these areas have not been fully investigated previously. This qualitative study aims to systematically explore the perceived development challenges for MCHIs from the perspectives of MCHI staff and government officials. DESIGN: Qualitative approaches, including focus group, semistructured interview and documentary analysis, were employed to identify development challenges encountered by the MCHIs in Chengdu city, China. PARTICIPANTS: Totally 16 medical staff of MCHIs and officials from local government. MEASURES: Participants' opinions about the development challenges for MCHI. RESULTS: The study revealed the main development challenges for MCHIs included: (1) incapability to provide differentiated medical service (including differentiated maternal and child health maintenance, integrative model of health maintenance and disease treatment, lack of innovation capability); (2) insufficient financial support; (3) shortage of gynaecologists and paediatricians; (4) insufficient facilities and medical equipment; (5) weakness in adopting information technology and (6) constraints of law and regulations. CONCLUSIONS: The study recommends that MCHI should take governance reform to promote healthcare innovation to ensure the sustainable development of MCHI. Public-private partnership needs to be considered for the sustainable development of MCHIs.

Health status of children left behind in rural areas of Sichuan Province of China: a cross-sectional study.

BACKGROUND: In recent decades, many workers from rural areas in China migrated to urban cities in search of a better livelihood. Due to the household registration policy and other financial barriers, more than 40 million of children were left behind in their rural home by their migrated parents in 2015. In this cross-sectional study, we aimed to investigate the influence of being left behind on these children's physical and mental health. METHODS: A self-administered questionnaire was completed by participants about their demographic background and health status. Chi-square Test was conducted to investigate the influence. RESULTS: A total of 1662 participants responded and completed all the questions in the questionnaire. Significant differences existed between left-behind children group and non-left-behind children group on several health issues such as not going to school due to sickness (p = 0.080), completeness of the vaccination scheme (p = 0.036) and feeling of loneliness (p = 0.039). However, regarding symptoms like fever, cough or respiratory difficulties, diarrhea and twitch, as well as mental health problems like unhappiness and insomnia, no significant difference was found. Gender difference was also demonstrated showing that girls were more vulnerable than boys to certain symptoms and emotional problems. CONCLUSION: This study indicated that both being left-behind and gender had an impact on the children's health. It is necessary to further reform the household registration system to improve rights of equal access to employment, education and health resources for workers and their children from rural areas in China.

The Use of Microblog "Weibo" by Chinese Patent Medicine Companies in China.

BACKGROUND: In order to introduce regulatory measures to regulate social media use by the Chinese patent medicine (CPM) companies, it needs better understanding of CPM companies' promotional activities using social media. Thus, this study aimed to analyze the nature of the information conveyed to the public by the CPM companies through microblog (Weibo) in China. METHODS: The content of 17 CPM Weibo accounts was analyzed. These accounts were established by 13 CPM companies, each of which had more than 10,000 followers, over 1000 posts and updated posts in 2016. RESULTS: Of the 40,798 original posts identified in the 17 Weibo accounts, 98.39% (n = 40,142) were classified into 6 main themes: (1) social living (36%); (2) health science (26%); (3) health maintenance (14%); (4) direct product promotion (11%); (5) corporate branding (7%); and (6) medical and industrial information (6%). Among the posts directly related to product promotion, more than half (n = 2550) focused on customer interactions followed by product efficacy (n = 945). Among the posts about corporate branding, about half of them (n = 1,443) focused on company image. CONCLUSIONS: Weibo is being used by CPM companies widely for strategic product promotion. With one of the key strategies being overt marketing driven by covert marketing, a large amount of health-related information is disseminated through this platform. Regulatory policies to ensure the credibility of information disseminated in the social media used by the CPM companies for promotion purposes are warranted to help protect the public's interests.

Consumers' Perceptions About Pharmaceutical Care Provided by Community Pharmacists in China in Relation to Over-the-Counter Drugs: A Qualitative Study.

While patient-centered care is highly anticipated nowadays, investigation of consumers' perceptions and expectations about pharmacist's pharmaceutical care when providing over-the-counter (OTC) drugs is sparse. This article aimed to explore consumers' perceptions regarding the pharmaceutical care that community pharmacists provide in relation to OTC drugs. Semistructured interviews were conducted with consumers recruited (N = 97) in Yinchuan City, China. The 4 main themes that emerged were expectations on pharmaceutical care, attitude toward pharmacist's competence, experience of self-medication, and suggestions for improving pharmaceutical care. Most participants had high expectations on community pharmacists to recommend the right medicines, to advise them about the effective use of drug, to advise them about the safe use of drug, and to recommend economic drugs. However, their previous experiences at community pharmacy were far from satisfaction reportedly, leading to a general distrust in pharmacist's certification and qualification, knowledge, communication skills, and attitude. As a result, the participants turned to self-medication based on their personal experiences, their relatives' experiences, the information on drug label, and the information distributed in the mass media. Realizing the need to improve pharmaceutical care, the participants also made improvement suggestions specific to community pharmacist, community pharmacy, and the government.

The trend and features of physician workforce supply in China: after national medical licensing system reform.

BACKGROUND: The annual number of newly licensed physicians is an important indicator of medical workforce supply, which can accurately reflect an inflow into the health care market over a period. In order to both regulate medical professions and improve the quality of health care services, China established its medical licensing system from the point of the implementation of 'Law on Practising Doctors' in 1999. The objective of this study is to depict the trend and structure of newly licensed physicians thereafter. METHODS: This study analyses a unique census data set that provides the headcount of newly licensed physicians from 2005 to 2015 in China. We also review a short history of medical licensing system reform in China since the 1990s. RESULTS: The annual number of first-time licensed physicians in China increased from 159 489 in 2005 to 221 639 in 2015. Up to 2015, over half of newly licensed physicians had not received a medical education equivalent to a bachelor degree or higher. Around 51% of China's newly licensed physicians were female in 2005, while the same ratio for females in 2015 was 56%. CONCLUSION: This article first provides an exploratory analysis of physician inflow into health care market in China using physician licensing data. The medical licensing system in China allows entering physicians with a broad range of educational levels. Moreover, the feminisation of the physician supply in China has become increasingly apparent and its impacts on health care provision still require more rigorous examination.

Trends involving monoclonal antibody (mAb) research and commercialization: A scientometric analysis of IMS Lifecycle R&D Focus Database (1980-2016).

This article aims to explore the trends of monoclonal antibodies (mAbs) research and commercialization, mainly to examine the development trajectories by a contrastive exploration of successful and unsuccessful mAb. This work is based on two sets of R&D project reports, consisting of 517 discontinued mAb project reports and 64 marketed mAb project reports, from IMS Lifecycle R&D Focus. The analysis of drug development processes will provide the basic evidences of mAb technology commercialization. We examined the mAb research and commercialization from three perspectives: (1) Countries with mAb research activity; (2) Organizations participating in mAb research and development; and (3) Clusters of keywords (indication and class description) regarding mAb. The technology factor, the market factor and the abilities of participating firms to pursue commercialization were analyzed. Through data analysis, we have discovered that the research and development on mAb has reached a mature and diversified stage.