Exploring shared decision-making needs in lung cancer screening among high-risk groups and health care providers in China: a qualitative study.

BACKGROUND: The intricate balance between the advantages and risks of low-dose computed tomography (LDCT) impedes the utilization of lung cancer screening (LCS). Guiding shared decision-making (SDM) for well-informed choices regarding LCS is pivotal. There has been a notable increase in research related to SDM. However, these studies possess limitations. For example, they may ignore the identification of decision support and needs from the perspective of health care providers and high-risk groups. Additionally, these studies have not adequately addressed the complete SDM process, including pre-decisional needs, the decision-making process, and post-decision experiences. Furthermore, the East-West divide of SDM has been largely ignored. This study aimed to explore the decisional needs and support for shared decision-making for LCS among health care providers and high-risk groups in China. METHODS: Informed by the Ottawa Decision-Support Framework, we conducted qualitative, face-to-face in-depth interviews to explore shared decision-making among 30 lung cancer high-risk individuals and 9 health care providers. Content analysis was used for data analysis. RESULTS: We identified 4 decisional needs that impair shared decision-making: (1) LCS knowledge deficit; (2) inadequate supportive resources; (3) shared decision-making conceptual bias; and (4) delicate doctor-patient bonds. We identified 3 decision supports: (1) providing information throughout the LCS process; (2) providing shared decision-making decision coaching; and (3) providing decision tools. CONCLUSIONS: This study offers valuable insights into the decisional needs and support required to undergo LCS among high-risk individuals and perspectives from health care providers. Future studies should aim to design interventions that enhance the quality of shared decision-making by offering LCS information, decision tools for LCS, and decision coaching for shared decision-making (e.g., through community nurses). Simultaneously, it is crucial to assess individuals' needs for effective deliberation to prevent conflicts and regrets after arriving at a decision.

Spatial evolution and decomposition of energy-related CO2 emissions in China's mining industry: from the perspective of regional heterogeneity.

To ensure China's energy security, the mining industry faces increasing emissions reduction and energy conservation pressures. This study combined index and production-theoretical decomposition analyses to decompose the energy-related CO2 emissions in mining industry (ERCEMI) influencing factors into seven major effects and adopted a gravity model to dynamically visualize the transfer path and gravity distribution from 2000 to 2015. As investment effects were introduced into the decomposition analysis, the results fully considered the regional heterogeneity and spatiotemporal dynamics. The main findings were as follows: (i) a typical heavy emissions trend along the Heihe-Tengchong line, with a concentration of large ERCEMI values; (ii) the gravity center of ERCEMI had shifted to the southwest, and the migration trends were divided into three stages; (iii) the ERCEMI had strong regional heterogeneity, with a diffusion trend from north to south and shrinking from east to west; (iv) the potential energy intensity and investment efficiency effects had significantly inhibited the ERCEMI, while the investment scale had boosted it. Implications for regional layouts, energy intensity reductions, and investment optimization are discussed. This research provides a comprehensive regional analysis for ERCEMI reductions and the sustainable development of the mining industry and provides a reference for local industrial development planning.

Mining Eco-Efficiency Measurement and Driving Factors Identification Based on Meta-US-SBM in Guangxi Province, China.

The mining industry is one of the pillar industries of Guangxi's economic and social development. The output value of mining and related industries accounts for 27% of the whole district's total industrial output value. Therefore, the mining eco-efficiency measurement in Guangxi can be of great significance for the sustainable development of Guangxi's mining industry. This study adopted Meta-US-SBM to measure the mining eco-efficiency in Guangxi from 2008 to 2018, including economic efficiency, resource efficiency, and environmental efficiency. It used the standard deviation ellipse model to simulate the migration trend of four efficiencies in Guangxi and used GeoDetector and Tobit models to explore the internal and external factors that affect the mining eco-efficiency. The four efficiencies in Guangxi show large temporal and spatial heterogeneity, and the internal and external factors that affect the mining eco-efficiency are different. The following conclusions can be drawn. (1) Environmental efficiency and mining eco-efficiency are improving, while economic efficiency and resource efficiency are deteriorating. Cities bordering other provinces have a significantly better mining eco-efficiency than non-bordering cities. (2) The development center in Guangxi has migrated to the Beibu Gulf Economic Zone. (3) Natural resources index and mining economic scale have a great impact on the mining eco-efficiency, and with the increase of the mining economic scale, the mining eco-efficiency showed a typical "U-shaped" curve. Finally, this study put forward corresponding policy recommendations to improve the mining eco-efficiency in Guangxi from four aspects: opening-up, technological progress, regional coordination, and government control.