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This paper examines caregiving for sick older family members in the context of socio‐economic transformations in rural China, combining empirical investigation with normative inquiry. The empirical part of this paper is based on a case study, taken from fieldwork in a rural Chinese hospital, of a son who took care of his hospitalized mother. This empirical study highlighted family members' weiqu (sense of unfairness)—a mental status from experiencing mistreatment and oppression in family care, yet with constrained power to explicitly protest or make care‐related choices. Underpinning people's weiqu and constrained choice, as informed by the conception of structural injustice, is the impact of unjust social structures, organized by unfavourable norms, discriminatory social policies and institutions targeting rural populations. By restraining individual choices and capacities in supporting health care for aging populations, these unjust structures create additional difficulties for and discriminations against rural families and their older members. Some policy recommendations are proposed to mitigate structural injustice so as to empower families and promote care for older people in rural settings. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health‐care reform in China. This paper aimed to explore patient‐ and hospital‐level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient‐oriented health‐care system. Methods: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. Results: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse‐to‐bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. Conclusion: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well‐functioning health‐care delivery system in order to better serve patients in China. [ABSTRACT FROM AUTHOR]

Purpose: The utility efficiency of medical devices is important, especially for countries such as China, which have a large population and shortage of medical care resources. Radiotherapy devices are among the most valuable and specialized equipment categories and carry enormous treatment loads. In this study, a novel method is proposed to improve the efficiency of a radiotherapy device (linac). Although scheduling management with accurate prediction of the entire treatment time included in each appointment, arrange a reasonable time duration for appointments and save time between patient shifts effectively. Tasks belonging to the treatment and non‐treatment groups can be assigned more flexibly based on the availability of time. Material and methods: Data from 1665 patients, including patient positioning time (PT) and treatment time (TT), were collected in collaboration with the Radiotherapy Center of the Department of Oncology at the Second Affiliated Hospital of Kunming Medical University from November 2020 to August 2021. The features related to PT and TT were extracted and used to train the machine learning‐based model to predict PT and TT in independent patients. The prediction results were subsequently applied to a minute‐based scheduling tool. Conclusion: Artificial intelligence is a promising approach to solve abstract problems with a specialized knowledge background. The results of this study show encouraging prediction outcomes in relation to effective scheduling management and could improve the efficiency of the linac. This successful trial broadens the meaning of medical data and potential future research directions in radiotherapy. [ABSTRACT FROM AUTHOR]

ABSTRACT The paper looks in detail at patients that were treated at one of the most discussed companies operating in the field of untried stem cell treatments, Beike Biotech of Shenzhen, China. Our data show that patients who had been treated at Beike Biotech view themselves as proactively pursuing treatment choices that are not available in their home countries. These patients typically come from a broad variety of countries: China, the United Kingdom, the United States, South Africa and Australia. Among the patients we interviewed there seemed to be both an awareness of the general risks involved in such experimental treatments and a readiness to accept those risks weighed against the possible benefits. We interpret this evidence as possibly reflecting the emergence of risk-taking patients as 'consumers' of medical options as well as the drive of patients to seek treatment options in the global arena, rather than being hindered by the ethical and regulatory constraints of their home countries. Further, we found that these patients tend to operate in more or less stable networks and groups in which they interact and cooperate closely and develop opinions and assessments of available treatment options for their ailments. These patients also perform a multiple role as patients, research subjects, and research funders because they are required to pay their way into treatment and research activities. This new social dynamics of patienthood has important implications for the ethical governance of stem cell treatments. [ABSTRACT FROM AUTHOR]

Background: The increasing incidence of cancer in China has posed considerable challenges for cancer care delivery systems. This study aimed to determine the general population's preferences for cancer care, to provide evidence for building a people‐centered integrated cancer care system. Methods: We conducted a discrete choice experiment that involved 1,200 participants in Shandong Province. Individuals were asked to choose between cancer care scenarios based on the type and level of hospitals, with various out‐of‐pocket costs, waiting time, and contact working in the hospitals. Individual preferences, willingness to pay, and uptake rate were estimated using a mixed‐logit model. Results: This study included 848 respondents (70.67%). Respondents preferred county hospitals with shorter hospitalization waiting times and contact working in hospitals. Compared to the reference levels, the three highest willingness to pay values were related to waiting time for hospitalization (¥97,857.69–¥145411.70–¥212,992.10/$14512.70–$21565.16–$31587.61), followed by the county‐level hospital (¥32,545.13/$4826.58). The preferences of the different groups of respondents were diverse. Based on a county‐level general hospital with contact in the hospital, 50% out‐of‐pocket costs and a waiting time of 15 days, the probability of seeking baseline care was 0.37. Reducing the waiting time from 15 to 7, 3, and 0 days, increases the probability of choosing a county‐level hospital from 0.37 to 0.58, 0.64, and 0.70, respectively. Conclusions: This study suggests that there is a substantial interest in attending county‐level hospitals and that reducing hospitalization waiting time is the most effective measure to increase the probability of seeking cancer care in county‐level hospitals. [ABSTRACT FROM AUTHOR]

Aim: To determine the efficacy of Internet‐based interventions in decreasing the prevalence of postpartum depression in perinatal women. Design: This review was conducted according to the standards outlined in the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement. Methods: We performed a systematic meta‐analysis of randomized controlled trials on the efficacy of Internet‐based interventions for postpartum depression. Studies (2008–2018) were identified through a search conducted on PubMed, EMBASE and the Cochrane Library. Risk ratios or weighted mean differences with 95% confidence intervals were calculated using a fixed‐effects model or a random‐effects model. Stata software 11.0 was used to perform the meta‐analysis. Results: Most of the seven eligible studies were randomized controlled trials. The random‐effects model indicated that Internet‐based interventions significantly improved postpartum depression (d = 0.642, N = 7). Attrition rates ranged from 4.5%–86.9% and from 0%–87.1% for the intervention and control groups, respectively. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to determine the diagnostic and prognostic values of serum KL-6 levels in Chinese patients with interstitial lung disease (ILDs). Methods A total of 1084 subjects including 373 cases of ILDs, 584 cases of non-ILD pulmonary diseases, and 127 healthy individuals were recruited from three clinical centers in China between January 2011 and December 2013. A total of 106 patients undergoing treatments for ILDs in Shanghai Pulmonary Hospital between January 2011 and December 2013 were enrolled. Baseline and posttreatment serum KL-6 levels were determined. Results Serum KL-6 levels in patients with ILDs were significantly higher than those in patients with non-ILD pulmonary diseases or in healthy individuals (1492.09 ± 2230.08 U/mL vs 258.67 ± 268.73 U/mL or 178.73 ± 71.17 U/mL, all P < 0.05). At the cut-off value of 500 U/mL, the sensitivity and specificity of serum KL-6 as a diagnostic marker for ILDs was 77.75% and 94.51%, respectively. The Kappa value was 0.743 ( P < 0.001). The area below the receiver operating characteristic curve was 0.922 with a 95% Confidence interval of 0.904-0.941 ( P < 0.001). The posttreatment serum KL-6 levels significantly reduced in patients with improved ILDs, whereas markedly increased in patients with exacerbated ILDs (All P < 0.05). Conclusions Serum KL-6 levels might be a promising diagnostic biomarker for ILDs in Chinese patients. The prognostic value of serum KL-6 levels for ILDs remains to be verified by large-scaled studies. [ABSTRACT FROM AUTHOR]

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

Linked Articles: This article is part of a themed section on Chinese Innovation in Cardiovascular Drug Discovery. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue-23. [ABSTRACT FROM AUTHOR]

At an early stage of its foundation, new China became clear about the nature of public welfare and quickly developed medical and health services, which was well received by the World Health Organization. The marketization and the reduction of input into medical and health services from the 1980s created severe adverse consequences. After the SARS' outbreak in 2003, China started to give serious consideration to its medical and health system, and to work at developing medical and health services. The new healthcare reform launched in 2009 re-emphasizes fairness and public welfare, and China's achievements have been remarkable. Of course, there are still many problems to be solved in the reform, which also paves the way for increasing the reform in future. [ABSTRACT FROM AUTHOR]

Many factors influence a mother's decision to breastfeed. We investigated whether the melamine scandal involving infant formula influenced the decision to breastfeed. News of the melamine scandal was revealed in September 2008 and rapidly spread via the internet. We illustrate that this scandal significantly and rapidly impacted the pattern of newborn feeding among Chinese women who delivered at a hospital in the eastern district of Paris. This area is home to one of the largest groups of Chinese people in France. The breastfeeding rate increased sharply in September 2008 from 14% to a peak of 31% ( p = 0.014) before decreasing over a 6-month period at a rate slower than the diminishing media frenzy. The effect of the melamine news coverage on the internet was temporary and strongly associated to ethnicity and language ( p = 0.015, p = 0.004, respectively). Numerous patients utilize the internet to access medical information, and these findings highlight the internet's role in the healthcare equation. [ABSTRACT FROM AUTHOR]

Objective To describe and analyse factors associated with the duration of disease onset to hospital admission, admission to discharge and admission to death for severe acute respiratory syndrome (SARS), using the recently developed comprehensive database covering all regions of mainland China, and compare the results within and outside China. Methods The database included all probable 5327 SARS cases, of whom 343 died. Linear regression (uni- and multivariate analysis) was performed for all three durations to test the impact of the following variables: sex, age, occupation, geographic location and period of the SARS epidemic (time since the first case, i.e. 16 November 2002). Results The average duration of onset of symptoms to hospital admission was 3.8 days, of admission to discharge for those who survived was 29.7 days, while admission to death for casualties was 17.4 days. Health care workers, patients from Tianjin and patients infected towards the end of the epidemic had the shortest duration of onset to admission. Regarding admission to discharge, particularly young patients and patients from Guangdong had the shortest duration. Older age was the sole factor associated with shorter duration of admission to death. Conclusions The average duration and pattern (with time of epidemic and age) of onset of symptoms to hospital admission of SARS patients in mainland China were comparable to other affected areas. The duration of hospital admission to discharge was shorter than elsewhere, possibly because of different hospitalisation policies. The duration of hospital admission to death in mainland China, however, appeared to be shorter than in other areas, which is in striking contrast to the much lower case fatality in mainland China. [ABSTRACT FROM AUTHOR]

Background The next influenza pandemic will create a surge in demand for health resources in China, with its current population of >1·3 billion persons and under-developed medical care and public health system. However, few pandemic impact data are available for China. Objectives We estimated the effects of a future influenza pandemic in China by examining pandemic scenarios of varying severity and described the time distribution of cases during a first wave. Methods  We used a Monte-Carlo simulation model and death rates, hospitalizations and outpatient visits for 1918- and 1968-like pandemic scenarios and data from the literature or experts’ opinion to estimate four health outcomes: deaths, hospitalizations, outpatient medical visits and clinical illness for which medical care was not sought. For each of the two scenarios we estimated outcomes by week using a normal distribution. Results We estimated that a 1968 scenario in China would result in 460 000–700 000 deaths, 1·94–2·27 million hospitalizations, 111–117 million outpatient visits and 192–197 million illnesses for which medical care was not sought. Fifty-two percent of hospitalizations occurred during the two-peak weeks of the first wave. We estimated that patients at high-risk of influenza complications (10–17% of the population) would account for 61–75% of all deaths. For a 1918 scenario, we estimated that 4·95–6·95 million deaths, 20·8–22·7 million hospitalizations and 101–108 million outpatient visits could occur. Conclusion Even a 1968 pandemic scenario will pose substantial challenges for the medical and public health system in China, and planning to manage these challenges is essential. [ABSTRACT FROM AUTHOR]

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

Discusses the application of professional values in traditional Chinese medicine. Accomplishments of Chinese health care; Medical ethics in China since 1949; Aspects of the efforts to develop professional values in medical practice.