Are comparable studies really comparable? Suggestions from a problem-solving experiment on urban and rural great tits.

Performance in tests of various cognitive abilities has often been compared, both within and between species. In intraspecific comparisons, habitat effects on cognition has been a popular topic, frequently with an underlying assumption that urban animals should perform better than their rural conspecifics. In this study, we tested problem-solving ability in great tits Parus major, in a string-pulling and a plug-opening test. Our aim was to compare performance between urban and rural great tits, and to compare their performance with previously published problem solving studies. Our great tits perfomed better in string-pulling than their conspecifics in previous studies (solving success: 54%), and better than their close relative, the mountain chickadee Poecile gambeli, in the plug-opening test (solving success: 70%). Solving latency became shorter over four repeated sessions, indicating learning abilities, and showed among-individual correlation between the two tests. However, the solving ability did not differ between habitat types in either test. Somewhat unexpectedly, we found marked differences between study years even though we tried to keep conditions identical. These were probably due to small changes to the experimental protocol between years, for example the unavoidable changes of observers and changes in the size and material of test devices. This has an important implication: if small changes in an otherwise identical set-up can have strong effects, meaningful comparisons of cognitive performance between different labs must be extremely hard. In a wider perspective this highlights the replicability problem often present in animal behaviour studies.

Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China.

BACKGROUND: The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS: We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS: The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS: The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

The degree of population aging and living carbon emissions: Evidence from China.

Population aging and global warming have become everyday concerns of all countries. Based on the panel data of 30 provinces in China from 2003 to 2019, this paper uses the panel fixed effect model and two-stage least square method to analyze the effect of population aging on domestic energy carbon emissions of urban and rural residents. On this basis, the threshold regression model is introduced to explore the heterogeneity of the effect under different aging levels. The results show that (1) the progress of population aging at the overall level will significantly increase the level of carbon emissions from household energy consumption. At the regional level, the effect of population aging on carbon emissions from household energy consumption in rural areas is higher than in urban areas. (2) Population aging has a nonlinear effect on the carbon emissions of residential energy consumption. For urban areas, when the level of population aging crosses the threshold, its marginal impact on living carbon emissions in urban areas is further enhanced. In contrast, the opposite is true in rural areas. (3) Heterogeneity analysis results show that the impact of population aging on residential energy carbon emissions differs in different regions at the national and rural levels but does not show regional heterogeneity at the urban level.

Mortality and years of life lost due to pancreatic cancer in China, its provinces, urban and rural areas from 2005 to 2020: results from the national mortality surveillance system.

BACKGROUND: Pancreatic cancer is a growing public health concern in China, and depicting it from different perspectives would provide a comprehensive understanding of its epidemiological characteristics. METHODS: Data from the National Mortality Surveillance System (NMSS) in China was used to estimate the number of deaths, years of life lost (YLL), age-standardized mortality rate (ASMR) and age-standardized YLL rate in China, its provinces and urban-rural areas from 2005 to 2020. Joinpoint regression analysis was employed to explore the temporal trends of ASMR and age-standardized YLL rate. Decomposition analysis was conducted to assess the contribution of population growth, population aging and cause-specific mortality rate to the increment of pancreatic cancer deaths. RESULTS: A total of 100,427 pancreatic cancer deaths and 2,166,355 pancreatic cancer related YLL were estimated in China in 2020. The overall ASMR significantly increased from 6.6/100 000 in 2005 to 7.4/100 000 in 2020, and was higher in men than that in women. Age-standardized YLL rate showed a similar trend. The mortality rates of pancreatic cancer were generally higher in northeast China than in southwest China. The highest ASMRs were found in Jilin, Zhejiang, Inner Mongolia and Anhui, and the lowest ones in Guangxi, Yunnan, Tibet, and Hainan. The disease burden due to pancreatic cancer presented a significant upward trend in rural areas and a downward trend in urban areas. CONCLUSIONS: The burden associated with pancreatic cancer had been increasing in China from 2005 to 2020. The escalating disease burden of pancreatic cancer in rural areas necessitates the implementation of effective control and prevention measures. Relevant provinces should pay greater attention to the prevailing of pancreatic cancer, particularly those exhibiting higher mortality rates.

Increasing rates of cesarean birth in Bangladesh: A household-level pooled analysis.

BACKGROUND: Cesarean birth (CB) rates have been increasing rapidly globally, including in Bangladesh. This study aimed to assess national trends in CB rates and to investigate associated factors in Bangladesh. METHODS: We analyzed data from the five most recent Bangladesh Demographic and Health Surveys (BDHS) between 2003 and 2018. A total of 27,328 ever-married women aged 15-49 who had a live birth in the 2 years preceding the survey were included in this study. We estimated the prevalence of CB from 2003 to 2018, as well as changes in the prevalence. Logistic regression analysis was used to measure the association between dependent and independent variables. RESULTS: The overall prevalence of CB among Bangladeshi mothers was 3.99% in 2003-04; this rate increased to 33.22% in 2017-18. The annual percentage change in CB rate was 16.34% from 2004 to 2017-18, which is alarming relative to the World Health Organization's cesarean birth recommended threshold. Several factors, such as maternal age, maternal and paternal education, working status of the mother, maternal BMI, age at first pregnancy, antenatal care (ANC) use, administrative division, and wealth status, had a significant influence on the rising rate of CB in Bangladesh. CONCLUSIONS: This study documents the alarming rate of CB increase in Bangladesh since 2003. It is critical that authorities implement more effective national monitoring measures to identify the causes of this dramatic increase and work to mitigate the rate of unnecessary CB in Bangladesh.

The impacts of urban-rural integrated medical insurance on the quality of labor supply for migrant workers in China.

BACKGROUND: The transformation from the quantity of labor supply to the quality of labor supply is an important measure to improve the self-development of migrant workers. METHOD: Based on the 2018 China Floating Population Dynamic Monitoring Survey data, this paper uses the 2SLS model based on instrumental variable estimation to analyze the impact of urban and rural integrated medical insurance on the quality of migrant workers' labor supply. RESULTS: The study found that: First, urban and rural integrated medical insurance can significantly improve the quality of labor supply for migrant workers. Even with different instrumental variables and the use of propensity score matching for counterfactual inferences, the findings remain robust. Second, the impact of urban-rural integrated medical insurance on the quality of labor supply for migrant workers has nonlinear characteristics. At the low quantile, the impact of urban-rural integrated medical insurance on the quality of labor supply for migrant workers showed a downward trend, but with the increase of the quantile, the impact of urban and rural integrated medical insurance continued to increase, showing a U-shaped trend. CONCLUSION: Urban-rural integrated medical insurance can not only directly reduce the labor time of migrant workers and ease the labor burden of migrant workers, but also indirectly improve the quality of labor supply for migrant workers through the intermediary role of promoting the availability of public services such as family contracted doctor services and health education.

Differences in the prevalence and risk factors of osteoporosis in chinese urban and rural regions: a cross-sectional study.

BACKGROUND: Bone mineral density (BMD) and prevalence of osteoporosis may differ between urban and rural populations. This study aimed to investigate the differences in BMD characteristics between urban and rural populations in Jiangsu, China. METHODS: A total of 2,711 participants aged 20 years and older were included in the cross-sectional study. Multistage and stratified cluster random sampling was used as the sampling strategy. BMD was measured by the method of dual-energy x-ray absorptiometry (DXA). Data were collected through questionnaires/interview. BMD values at the lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter were collected. Descriptive statistics were used to demonstrate the characteristics of urban and rural participants. Multivariate logistic regression analysis was utilized to analyze the factors that may be associated with osteoporosis in urban and rural populations. RESULTS: Of these participants, 1,540 (50.49%) were females and 1,363 (42.14%) were from urban. The prevalence of osteoporosis in urban and rural populations was 5.52% and 10.33%, respectively. In terms of gender, the prevalence of osteoporosis was 2.68% in males and 13.82% in females. For menopausal status, the prevalence of osteoporosis was 30.34% in postmenopausal females and 4.78% in premenopausal females. In urban populations, older age [adjusted odds ratio (AOR) = 2.36, 95%CI, 2.35-2.36), hypertension (AOR = 1.37, 95%CI, 1.36-1.37), unmarried (AOR = 4.04, 95%CI, 3.99-4.09), smoking everyday (AOR = 2.26, 95%CI, 2.23-2.28), family history of osteoporosis (AOR = 1.66, 95%CI, 1.65-1.67), dyslipidemia (AOR = 1.05, 95%CI, 1.04-1.05), and higher ß-crosslaps (ß-CTX) level (AOR = 1.02, 95%CI, 1.02-1.02) were associated with an increased risk of osteoporosis, while males (AOR = 0.04, 95%CI, 0.04-0.04), higher education level (AOR = 0.95, 95%CI, 0.95-0.95), and aquatic product intake (AOR = 0.99, 95%CI, 0.99-0.99) were related to decreased risk of osteoporosis. Similar results were also observed in rural populations, and (all P < 0.05). CONCLUSION: The prevalence of osteoporosis in rural populations was higher than that in urban populations, and the factors associated with the risk of osteoporosis were similar in urban and rural populations.

Per capita CO2 emission inequality of China's urban and rural residential energy consumption: A Kaya-Theil decomposition.

With the increasing affluence, the differences in CO2 emission between urban and rural residential sectors are remarkable and show an increasing trend. In case of China, residential sector accounts for a substantial share of the national CO2 emission, bringing greater pressure to achieve the goal of carbon peak. Analyzing the emission inequality trend and its drivers is essential for formulating effective CO2 emission reduction policies. However, the existing literature lacks relevant analysis from the viewpoint of urban-rural disparity. Hence, this study decomposes the CO2 emission inequality of China's urban and rural residential consumption into four factors by combining the Theil index and Kaya decomposition. The results suggest that, in 2005-2020, the per capita CO2 emission of rural residential consumption increased to a higher extent than those of urban households, with large differences in spatial distribution. Decomposition of the per capita CO2 emission inequality for residential sector shows that the primary source is the inequality within the groups, mainly from the urban intra-group inequality. Based on the static decomposition, energy intensity appears as the main factor of urban-rural inequality. The dynamic decomposition shows that there have been differences in the factors of the change in the Theil index between urban and rural areas across sub-periods.

[Quality of Life and Its Influencing Factors Among Schizophrenia Patients Living in Urban and Rural Areas].

Objective: To investigate the status quo of the quality of life of schizophrenia patients in a city in Sichuan Province and to explore, thereof, the urban-rural differences in the factors influencing their quality of life. Methods: A total of 824 schizophrenia patients were selected for the study through multistage stratified cluster random sampling method. All the subjects were selected from a pool of patients covered by the Sichuan Provincial Information System for the Comprehensive Management of Severe Mental Disorders. Questionnaire surveys were conducted with the Schizophrenia Quality of Life Scale (SQLS), the Social Support Rating Scale (SSRS), the general circumstance questionnaire, and the lifestyle questionnaire. In addition, univariate and multiple linear regression models were used to analyze the influencing factors of quality of life among schizophrenia patients living in urban areas and those in rural areas. Results: Rural patients had poorer quality of life than urban patients did in all measurement domains ( P<0.05). Marital status, vocational skills, physical exercise, and social support were influencing factors of the quality of life among urban patients ( P<0.05). Age, marital status, annual household income, vocational skills, participation in community rehabilitation activities, and the time required to walk to the nearest medical institution were influencing factors of the quality of life among rural patients ( P<0.05). Conclusion: Targeted measures for the enhancement of the quality of life of schizophrenia patients should be formulated on the basis of urban and rural characteristics in terms of economic support, vocational skills training, input in mental health services, community rehabilitation services, and social support.

[Comparative Analysis of Influencing Factors of Health Service Utilization Among Urban and Rural Residents in Tibet].

Objective: To examine the differences and commonalities of factors influencing the utilization of health services among urban and rural residents in Tibet and to identify vulnerable populations in the utilization of health services, thereby providing references for the formulation of local health policies and the allocation of health resources. Methods: Using the Tibetan area data from the Sixth National Health Service Survey, we conducted statistical analysis of the health service utilization status of 8 297 residents of agro-pastoral areas and 2 179 residents of urban areas with χ 2 test and logistic regression model. Results: The two-week outpatient visit rates of residents in agro-pastoral areas and that of the urban residents were 65.3% and 57.1%, respectively, and the one-year hospitalization rates were 8.3% and 8.9%, respectively. The influencing factors of two-week outpatient visits for rural and pastoral residents included urban and rural health insurance coverage, Three Guarantees in One coverage, distance to medical facilities, chronic disease status, physical examination, family doctor contract status, employment status, and health status self-assessment. The influencing factors of two-week outpatient visit for urban residents included chronic disease status, urban and rural medical insurance coverage, health status self-assessment, health records, and physical examination. The factors influencing hospitalization for agro-pastoral residents were sex, age, marital status, urban and rural medical insurance coverage, Three Guarantees in One coverage, critical illness insurance, health self-assessment, mobility, health records, physical examination, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status. Conclusion: The urban and rural residents in Tibet have relatively poor health and their awareness of seeking early medical help after they fall ill is relatively weak. The health institutions concerned should dedicate more attention to the vulnerable populations who have difficulty accessing health services, focus on the commonly shared influencing factors of health service utilization among urban and rural residents, take into account the differences, rationally allocate health resources, and improve the effective utilization rate of health services among residents in Tibet.

[The comparative evaluation of heterogeneity of urban and rural population aging at the regional level].

The article considers the process of population aging, which is evidently specific in economically developed countries for last quarter of the XX century. The increasing of population size older than able-bodied age in urban and rural population in the Irkutsk Oblast that is demonstrated by aging coefficient dynamic. In all studied territories increasing of this coefficient is revealed that characterizes transition of aging process in most areas of residence of urban and rural population to the level of III-IV stages (old and deeply old population). The dynamics of average age indicator is characterized by its stabilization at the level of stage II as aging population. The pensionary load on urban and rural population is increasing and it is higher in rural population. The increasing of this indicator is reflected in transformation of aging population (stage II) to old and deeply old population (stage III-IV). In most areas, coefficient of longevity is characterized by its increase in urban and rural population. The heterogeneity of aging differences between urban and rural population is smoothing out.

[The inclusive tourism: main approaches and directions of investigation: publications review].

The article presents review of research publications concerning inclusive tourism, i.e. tourism of individuals with health limited capacities or disability. The Russian scientific electronic library (eLibrary) was used as a basis of this theoretical methodological study. The content analysis methodology was applied to more than 36 million publications. The sampling for studying included 242 publications considering economical, medical and psychological pedagogical aspects of inclusive tourism as sociocultural phenomenon.

Association amongst social support inside or outside the family and depression symptoms: longitudinal study of urban-rural differences in China.

PURPOSE: The purpose is to analyze the longitudinal association between social support inside and outside the family and depression and the differences between urban and rural areas. METHODS: A total of 11,150 respondents were included from Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS). The baseline data and the subsequent two surveys were used to describe the basic characteristics and social support in the urban and rural. The growth curve model was used to analyse the longitudinal association between social support inside and outside the family and depression. RESULTS: People participating in social activities were less likely to suffer from depression while those who had public transfer were more likely to suffer from depression. Respondents who had weekly contact with their children were less likely to suffer from depression. Respondents with larger families were also less likely to suffer from depression, but this effect was significant in rural. As time changes, the association between social activities and depression does not change significantly, only public transfer and family size show a gradually weakening impact on depression in rural areas. The association between the contact with children and depression scores weakens in rural areas but increases in urban areas. CONCLUSIONS: Future dynamic intervention for depression can include holding various beneficial social activities, carrying forward the filial piety culture and improving the level of rural social welfare, protecting the excellent traditional culture, and providing public services for rural special families.

Urban-rural disparities in the association between long-term exposure to high altitude and malnutrition among children under 5 years old: evidence from a cross-sectional study in Tibet.

OBJECTIVE: To assess urban-rural disparities in the association between long-term exposure to high altitude and malnutrition among children under 5 years old. DESIGN: A three-stage, stratified, cluster sampling was used to randomly select eligible individuals from July to October 2020. The data of participants, including demographic characteristics, altitude of residence, and nutritional status, were collected via questionnaire and physical examination. SETTING: Tibet, China. PARTICIPANTS: Children under 5 years old in Tibet. RESULTS: Totally, 1975 children under 5 years old were included in this study. We found that an additional 1000 m increase in altitude was associated with decreased Z-scores of height-for-age (ß = -0·23, 95 % CI: -0·38, -0·08), Z-scores of weight-for-age (ß = -0·24, 95 % CI: -0·39, -0·10). The OR for stunting and underweight were 2·03 (95 % CI: 1·51 to 2·73) and 2·04 (95 % CI: 1·38 to 3·02) per 1000 m increase in altitude, respectively; and OR increased rapidly at an altitude above 3500 m. The effects of long-term exposure to high altitudes on the prevalence of underweight in rural children were higher than that in urban children (P < 0·05). CONCLUSIONS: High-altitude exposure is tightly associated with malnutrition among children under 5 years old. Improving children's nutrition is urgently needed in areas above 3500 m, especially in rural ones.

Diet cost and quality using the Healthy Eating Index-2015 in adults from urban and rural areas of Mexico.

OBJECTIVE: To assess the association between diet cost and quality by place of residence. DESIGN: We analysed cross-sectional data of the National Health and Nutrition Survey-2012. Diet cost was estimated by linking dietary data, obtained from a 7-d SFFQ, with municipality food prices, which were derived from a national expenditure survey. Diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015). Association between quintiles of diet cost and HEI-2015 was assessed using linear regression analysis. SETTINGS: Mexico. PARTICIPANTS: 2438 adults (18-59 years). RESULTS: Diet cost was positively associated with diet quality (HEI-2015) in urban but not in rural areas. Compared with quintile (Q1) of cost, the increment in diet quality score was 1·17 (95 % CI -0·06, 4·33) for Q2, 2·14 (95 % CI -0·06, 4·33) for Q3, 4·70 (95 % CI 2·62, 6·79) for Q4 and 6·34 (95 % CI 4·20, 8·49) for Q5 (P-trend < 0·001). Individuals in rural v. urban areas on average have higher quality diets at lower cost with higher intakes of whole grains and beans and lower intakes of Na, added sugars and saturated fats. Living in the South, being indigenous and having low socio-economic status were also associated with higher quality diets. CONCLUSIONS: Diet cost was positively associated with diet quality, but only in urban areas. Further studies are needed to understand the relation between diet cost and quality in rural areas. To improve overall diet quality in Mexico, strategies that aim to reduce the cost of high-quality diets should consider the heterogeneity by place of residence.

The Fujian eye cross sectional study: objectives, design, and general characteristics.

PURPOSE: To describe the objective and design of the Fujian Eye Study and to introduce the general characteristics and vision condition of this study. METHODS: The Fujian Eye Study (FJES) is a population-based cross-sectional survey on the public eye health status of residents over 50 years old in the entire Fujian Province of Southern China, which contains both urban and rural areas and coastal and inland regions. 10,044 participants were enrolled using a two-stage cluster sampling design and underwent a questionnaire and a series of standard examinations both physical and ocular. The main subgroups of data collection included age, sex, region, refractive error, education background, income, eating habits, smartphone usage in the dark, complaints of eye discomfort, history of chronic diseases, consumption of tobacco, alcohol, or tea. RESULTS: 8211 (81.8%) participants were finally included and were divided into urban populations (4678 subjects) and rural populations (3533 subjects) and coastal residents (6434 subjects) and inland residents (1777 subjects); 4836 participants were female. The mean age was 64.39 (SD 8.87) years (median 64 years; range 50-98 years). 227 (3.33%) had vision impairment (VI), 195 (2.87%) had low vision and 14 (0.21%) were blind. The mean presenting near visual acuity (PNVA) was 0.28 (0.17), the mean presenting distance visual acuity (PDVA) was 0.61 (0.30), and the mean best corrected visual acuity (BCVA) was 0.82 (0.28). CONCLUSIONS: The FJES collected detailed questionnaire information and overall ocular and physical examinations, which provide the opportunity to identify risk factors and images of VI and eye diseases and to evaluate their associations with chronic diseases and basic personal information.

Urban-rural disparities in the healthy ageing trajectory in China: a population-based study.

PURPOSE: The aim of this study is to measure the trajectory of healthy ageing among Chinese middle-aged and older population, and explore the disparity of the trajectory, as well as contributing factors, between urban and rural areas in China. METHODS: A total of 9402 respondents aged 45 years and older interviewed in four waves (2011, 2013, 2015 and 2018) were selected from the China Health and Retirement Longitudinal Study. Healthy ageing score was calculated through item response theory. A latent growth mixture model (LGMM) was applied to distinguish the trajectory of healthy aging. A multinomial logistics regression model (MLRM) was used to explore the relationship between urban-rural areas and healthy aging trajectories, and further to explore associated factors in rural and urban areas separately. RESULTS: The healthy ageing score was lower in rural areas than urban areas in each survey wave. Five classes ("continuing-low", "continuing-middle", "continuing-middle-to-high", "significantly-declining", "continuing-high") were grouped through LGMM. The MLRM results showed that urban living was significantly associated with a higher likelihood of being healthy (for [continuing-low/continuing-high]: ß = - 1.17, RRR = 0.31, P < 0.001, 95% CI = 0.18-0.53; and for [continuing-middle/continuing-high]: ß = - 0.53, RRR = 0.59, P < 0.001, 95% CI = 0.49-0.71). CONCLUSION: Healthy ageing is a prominent objective in the development of a country, and rural-urban disparities are an essential obstacle to overcome, with the rural population more likely to develop a low level of healthy ageing trajectory. Prevention and standardized management of chronic diseases should be enhanced, and social participation should be encouraged to promote healthy ageing. The policy inclination and resource investment should be enhanced to reduce disparity in healthy ageing between urban and rural areas in China.

Research on the design of serious illness insurance scheme in Shanghai based on micro-simulation.

BACKGROUND: Urban and rural residents' basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai. METHODS: We developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai's current policies. RESULTS: The payment of SIMIS according to high expenses, the total medical expenses of seriously ill patients show an increasing trend, with an average annual growth rate of 3.56%. The URRBMI fund payment covers 56%-58% of total medical expenses, and the SIMIS fund covers 5%-7% of the total medical expenses. Both cover 62%-63% of total medical expenses. Self-payment under SIMIS covers 22%-23% of the total medical expenses, total self-payment covers 14%-15% of the total medical expenses, and the medical expenses borne by individuals cover 36%-38% of the total medical expenses.The fund expenditure is 213 million yuan and average annual cost borne by individual patients ranges from 40 000 to 60 000 yuan. CONCLUSIONS: The policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.

Construction and validation of a revised satisfaction index model for the Chinese urban and rural resident-based basic medical insurance scheme.

BACKGROUND: Quality is the most important factor in satisfaction. However, the existing satisfaction index model of urban and rural resident-based basic medical insurance scheme (SIM_URRBMI) lacks the segmentation of perceived quality elements, it couldn't provide a reference for quality improvement and satisfaction promotion. This study aims to construct a revised SIM_URRBMI that can accurately and detailly measure perceived quality and provide feasible and scientific suggestions for improving the satisfaction of urban and rural residents' basic medical insurance scheme (URRBMI) in China. METHODS: Based on the theoretical framework of the American Customer Satisfaction Index, the elements of perceived quality were refined through literature review and expert consultation, and a pool of alternative measurement variables was formed. A three-stage randomized stratified cluster sampling was adopted. The main decision makers of URRBMI in the families of primary school students in 8 primary schools in Changsha were selected. Both the classic test theory and the item response theory were used for measurement variables selection. The reliability and validity of the model were tested by partial least squares (PLS)-related methods. RESULTS: A total of 1909 respondents who had URRBMI for their children were investigated. The SIM_URRBMI1.0 consists of 11 latent variables and 28 measurement variables with good reliability and validity. Among the three explanatory variables of public satisfaction, perceived quality had the largest total effect (path coefficient) (0.737). The variable with the greatest effect among the five first-order latent variables on perceived quality was the quality of the medical insurance policy (0.472). CONCLUSIONS: The SIM_URRBMI1.0 consists of 28 measurement variables and 11 latent variables. It is a reliable, valid, and standard satisfaction measurement tool for URRBMI with good prediction ability for public satisfaction. In addition, the model provides an accurate evaluation of the perceived quality, which will greatly help with performance improvement diagnosis. The most critical aspects of satisfaction improvement are optimizing the scope and proportion of reimbursement as well as setting appropriate level of deductible and capitation of URRBMI.

Gentle or rude? A study on China's publicity of epidemic prevention and governance of urban and rural areas based on anti-epidemic slogans.

COVID-19 has swept through the world, challenging countries' ability to respond to crises and their public governance. One of the difficulties of public governance in China is the knowledge gap caused by the urban-rural dual structure. This study takes anti-epidemic slogans in China, a traditional means of information governance as its research object in the context of COVID-19. Independent sample tests and cluster analysis were conducted to measure the knowledge gap between urban and rural residents in acquiring epidemic information, and compare the different slogans posted in urban and rural areas, as well as the feedback they received. Based on this, the study explores the different logic of urban and rural governance in China. The results show that, although slogans cannot convey the latest information, they can make the public aware of the severity of the epidemic. Urban residents were found to give lower evaluations to slogans, although they acknowledged that slogans had the effect of rendering an anti-epidemic atmosphere, whereas rural residents were more accepting of rude and threatening slogans and control measures. Slogans with scientific guidance were more likely to trigger changes in their awareness and behavior. The study is significant as it can be a reference for other regions' and countries' publicity work and governance approaches in the prevention and control of infectious diseases.