Telehealth Care Through Internet Hospitals in China: Qualitative Interview Study of Physicians' Views on Access, Expectations, and Communication.

BACKGROUND: Internet hospitals in China are an emerging medical service model similar to other telehealth models used worldwide. Internet hospitals are currently in a stage of rapid development, giving rise to a series of new opportunities and challenges for patient care. Little research has examined the views of chronic disease physicians regarding internet hospitals in China. OBJECTIVE: We aimed to explore the experience and views of chronic disease physicians at 3 tertiary hospitals in Changsha, China, regarding opportunities and challenges in internet hospital care. METHODS: We conducted semistructured qualitative interviews with physicians (n=26) who had experience working in internet hospitals affiliated with chronic disease departments in 3 tertiary hospitals in Changsha, Hunan province, south central China. Interviews were transcribed verbatim and analyzed by content analysis using NVivo software (version 11; Lumivero). RESULTS: Physicians emphasized that internet hospitals expand opportunities to conduct follow-up care and health education for patients with chronic illnesses. However, physicians described disparities in access for particular groups of patients, such as patients who are older, patients with lower education levels, patients with limited internet or technology access, and rural patients. Physicians also perceived a gap between patients' expectations and the reality of limitations regarding both physicians' availability and the scope of services offered by internet hospitals, which raised challenges for doctor-patient boundaries and trust. Physicians noted challenges in doctor-patient communication related to comprehension and informed consent in internet hospital care. CONCLUSIONS: This study explored the experience and views of physicians in 3 tertiary hospitals in Changsha, China, regarding access to care, patients' expectations versus the reality of services, and doctor-patient communication in internet hospital care. Findings from this study highlight the need for physician training in telehealth communication skills, legislation regulating informed consent in telehealth care, public education clarifying the scope of internet hospital services, and design of internet hospitals that is informed by the needs of patient groups with barriers to access, such as older adults.

The Perception and Attitude of Farmers toward Domestic Waste Classifications: A Case Study on Wusheng County, Sichuan Province, China.

The effective treatment of rural domestic waste is the key to solving rural environmental pollution and realizing rural ecological revitalization. Giving full play to the main role of farmers' domestic waste classification can improve the efficiency and effect of domestic waste treatment. To explore the key factors affecting the farmers' perception, attitude, and behavior of domestic waste classification, this study with 318 farmers in Sichuan Province as the research object, the research framework of domestic waste classification behavior was constructed based on the theory of planned behavior, and then, the logistic regression model was used for the empirical test. The results show that the farmers' education levels, subjective norms, relatives' and neighbors' views on waste classification, farmers' awareness regarding the negative environmental impacts caused by waste, farmers' private benefits, and farmers' views on the waste management ability of local governments are significantly positively correlated with the classification behavior of farmers' domestic waste. The distance between farmers' houses and waste collection points is significantly negatively correlated with the classification behavior of farmers' domestic waste. This paper provides a certain theoretical reference for realizing the reduction, resourcization, and positive development of rural domestic waste management in China.

Rural Households' Livelihood Capital, Risk Perception, and Willingness to Purchase Earthquake Disaster Insurance: Evidence from Southwestern China.

Earthquake disaster insurance can effectively reduce the impact of earthquake disasters on rural households. Exploring rural households’ willingness to purchase earthquake disaster insurance in earthquake disaster areas provides an understanding of the motivations underlying the implementation of an insurance policy. However, few studies have examined the perspectives of rural households, in order to explore the correlations between the rural households’ livelihood capital, their disaster risk perception, and their willingness to purchase earthquake disaster insurance. A cross-sectional survey data including 241 rural households from the most severe disaster counties (cities) during the 5 • 12 Wenchuan earthquake was examined with regard to rural households’ livelihood and disaster risk perception, and ordinal logistic regression models were constructed to explore rural households’ willingness to purchase earthquake disaster insurance, as well as the driving mechanism behind this willingness. The results showed that 34.44% of rural households were very willing to purchase earthquake disaster insurance, and 7.05% of rural households were very reluctant to purchase earthquake insurance. Rural households’ livelihood capital and risk perceptions were the most important factors affecting their willingness to purchase earthquake disaster insurance. Rural households with higher scores on natural capital, physical capital, possibility, and worry were more likely to purchase earthquake disaster insurance. Specifically, keeping all other variables constant, every one unit increase in nature capital and physical capital corresponded to an increase in the odds of willingness to purchase earthquake disaster insurance by a factor of 0.14 and 0.06, respectively; every one unit increase in possibility and worry corresponded to an increase in the odds of willingness to purchase earthquake disaster insurance by a factor of 0.03 and 0.04, respectively. This study contributes to the current literature by increasing the understanding of the relationships between Chinese rural households’ livelihood capital and risk perceptions, and their willingness to purchase earthquake disaster insurance.

[Variations of microbial biomass and hydrolase activities in purple soil under different cropping modes as affected by ginger planting].

This paper studied the variations of soil microbial biomass C, N, and P contents and soil hydrolase activities under different cropping modes, i.e., corn + sweet potato intercropping (CS), soybean mono-cropping (SM), continuous cropping of ginger (CG), and rice-milk vetch rotation (RM) , after ginger planting in the purple soil area at the lower reaches of Minjiang River. Ginger planting decreased the soil microbial biomass C, N and P contents significantly. The decrement of the soil microbial biomass C and N contents after ginger planting was lesser under CS and RM than under SM and CG, but the soil microbial biomass P content was in adverse. Ginger planting also decreased the soil acid phosphatase activity significantly, and the decrement was the greatest under CS but the least under RM. The soil invertase activity decreased significantly under CG, and the soil urease activity had a significant decrease under SM, CG and RM. After ginger planting, the soil urease and intervase activities under CS were higher, as compared with those under the other cropping modes.

Abundance and composition dynamics of soil ammonia-oxidizing archaea in an alpine fir forest on the eastern Tibetan Plateau of China.

Real-time qPCR and clone library sequencing targeting amoA genes were used to investigate the seasonal dynamics of an ammonia-oxidizing archaea (AOA) community in an alpine fir forest in western China. AOA were detected at all sampling dates, and there were significant variations in archaeal amoA gene copy numbers (7.63 × 10(5) to 8.35 × 10(8) per gram of dry soil) throughout the nongrowing season. Compared with ammonia-oxidizing bacteria (AOB), the AOA displayed a higher abundance on the majority of sampling dates during the freeze-thaw period. All of the AOA sequences fell within soil and sediment lineages and were affiliated with 7 clusters. Compared with the other clusters, cluster 1 was more sensitive to low temperature and was the dominant group in August. In contrast, cluster 3 dominated the AOA community in winter and probably represents a group of cold-adapted archaea. Redundancy analysis (RDA) revealed that the seasonality of the AOA community was mainly attributed to changes in soil temperature and nutrient availability (e.g., dissolved organic nitrogen and carbon). Our results indicate that AOA exist in frozen soils in the alpine coniferous forest ecosystem of the eastern Tibetan Plateau. Moreover, soil temperature may directly and (or) indirectly affect AOA abundance and composition and may further influence the soil N cycle during the winter.

First detection of OKP-A ß-lactamase in two Serratia marcescens isolates in China.

Two strains of Enterobacteriaceae producing prodigiosin were isolated from meat in the Sichuan province of China in 2010. The strains were identified by Vitek system, 16S rDNA, rpoB, pfs and luxS genes. Minimum inhibitory concentrations were determined using the broth microdilution method. The two strains were screened for the presence of ß-lactamase genes (blaTEM, blaSHV, blaOKP, and blaCTX-M genes). Based on PCR amplification and 16S rDNA sequencing the analysed strains were identified as Serratia marcescens. In addition, morphological and biochemical identification showed that the two stains were definitely S. marcesens. Antimicrobial susceptibility test showed that both strains were resistant to ampicillin and first-generation cephalosporins while being susceptible to cefotaxime, ceftiofur, ceftriaxone, imipenem and aztreonam. It was found that blaOKP had been identified first from the two S. marcescens strains, ch1 and ch2. The isolates were closely related as shown by pulsed-field gel electrophoresis (PFGE). The narrow-spectrum OKP-A ß-lactamase gene blaOKP-A-13 was found to be chromosomally located in S. marcescens. The isolates produced a ß-lactamase with a pI of approximately 8.2, which corresponds to the OKPA family. Findings indicate that OKP enzymes are not Klebsiella pneumoniae-specific chromosomal ?-lactamases, and the first isolation of S. marcescens producing OKP-A ?-lactamase suggests that the blaOKP gene may be disseminated between different species.

[Effects of cadmium stress on the microbial biodiversity in purple soil and alluvial soil potted with a poplar (Populus deltoides x Populus nigra)].

Effects of current Cd contamination levels on microbial biodiversity were studied under the typical Cd contaminated soils in the Yangtze Basin. Purple soil and alluvial soil potted with a poplar (Populus deltoides x Populus nigra) were selected, and the culturable soil microbial amounts by flat method, microbial biomass and bacterial community structure by PCR-DGGE were investigated. Cd supplies significantly increased the culturable amounts of bacteria and actinomyces in purple soil, but decreased the culturable amounts of fungi and the content of microbial biomass N. Fingerprint of DGGE also showed that bacterial community structure have obviously changed under different Cd supplies. In contrast, the lower Cd supplies slightly increased the culturable amounts of bacteria and fungi in alluvial soil, but higher Cd supply treatment decreased the culturable amounts of bacteria, actinomyces and fungi, and the content of microbial biomass N. However, only a slight change was observed under different Cd supplies by DGGE fingerprint. Additionally, there were few effects of Cd supplies on the content of microbial biomass C in both purple soil and alluvial soil. The results provided basic data to understand the effects of present Cd contamination levels on soil microbial characteristics.