Journal articles on the topic 'Health attitudes China Hong Kong Statistics'

Using data from a representative sample of Chinese adults who were surveyed in the Hong Kong Panel Study of Social Dynamics (HKPSSD), we estimate the effects of neighborhood discrimination towards immigrants from Mainland China on the mental health of Chinese residents in Hong Kong. Contrary to our expectations, discrimination towards immigrants from Mainland China measured at the neighborhood level is not associated with the poor mental health of post-1997 immigrants; instead, a higher level of immigrant discrimination is associated with a lower level of psychological distress for both post-1997 Mainland immigrants and other Chinese residents in Hong Kong. A functional family also appears to be a consistent predictor of better mental health for both groups. Our findings, therefore, suggest that immigrant discrimination can signify a prejudice that leads to social distance or avoidance and that the post-1997 Mainland immigrants do not have extensive contact with other local residents in Hong Kong. Although local residents’ discriminatory attitudes may not result in aggressive behaviors that have a negative impact on newcomers’ mental health, the social distance between the immigrants and the local residents is still an issue that requires further research and practical attention.

Employed women are taking on multiple roles in the family and at work. The multiple role expectations are sources of stress and strain on working women. The attitude of working women toward their employment in socialist and capitalist societies may differ owing to the different ideological culture of the societies. This paper reports the results of a comparative study of 1,500 female respondents in the socialist cities of Beijing and Guangzhou as well as that of capitalist Hong Kong. Most respondents felt strongly about sex discrimination in the workplace. Respondents in China are more positive toward work, while respondents in Hong Kong place higher priority on the family.

Abstract Background In order to pay attention to the observation of R & D personnel, especially the changes of emotion, attitude and behavior in the process of R & D, most Asian countries will provide their own strength to improve the quality and quantity of R & D personnel. This study tracked the deviation of R & D personnel and total R & D revenue in GDP in Japan, South Korea and Singapore from 2002 to 2007. Technology is developing rapidly in Japan, Taiwan, South Korea and Singapore, as many researchers and educators obtain master's and doctoral degrees from western countries and then return to Asian countries to teach new technology, which brings rich human resources. This is why the four little dragons (Hong Kong, South Korea, Singapore and Taiwan) have strengthened high-tech and economic development. Research Objects and Methods The percentages of R & D personnel in the total population in Japan, South Korea and Singapore are expressed in full-time equivalent (FTE) and total employees (HC) respectively. The correlation between gross R & D revenue per GDP (GERD) and FTE and HC is studied. The data for this study are from the open database of the Institute for statistics of the United Nations Educational, scientific and Cultural Organization (UNESCO). This study also used DASS-21 to conduct a questionnaire survey on the samples. Subjective perceived social support questionnaire the subjective perceived social support questionnaire was revised by Zhao Xia based on the social relationship network questionnaire (NRI) compiled by Furman (1985) and others and revised by Zou Hong in 2003. The scale consists of 27 items and 5 dimensions: emotional support, instrumental support, companionship, affirmation and intimacy. The scale adopts 5-level scoring, “never” is recorded as 1 point, and “almost always” is recorded as 5 points. The higher the total score of the scale, the higher the individual's perceived level of social support. The internal consistency coefficient of the scale in this study is 0.94. Results The results are as follows: (1) statistics show that language policy is conducive to reducing the cost of education and science and technology in Singapore. (2) From 2002 to 2007, the correlation coefficient between “R & D full-time personnel in total R & D revenue per GDP (rdftep)” and “R & D personnel in total R & D revenue per GDP (rdhcp)” in Japan exceeded 0.9. In addition, the correlation coefficients of “rdftepv. Sgerd / GDP” and “rdhcpv. Sgerd / GDP” in South Korea are both 0.99. All variables are positive, i.e. R & D professionals play an active and beneficial role in these countries. Conclusion This study tracked the R & D personnel in Japan, South Korea and Singapore from 2002 to 2007 and their correlation with the total R & D revenue of each FRP. The findings are as follows: Singapore is a member of the Commonwealth. English is the first official language, which makes it easier to communicate with developed countries. The language policy has enabled her to benefit from lower costs of education, science and technology. R & D personnel in industrialized countries are very important. The study shows that R & D professionals were very valuable between 2002 and 2007, because from a statistical point of view, R & D professionals accounted for 2.44 to 7.10 of GDP per capita. The further impact of R & D personnel should be greater than the statistical data. R & D output is usually ahead of industrial technology. In short, we should pay full attention to the important role of R & D personnel in design elements, actively pay attention to the changes of their psychological emotion and behavior, as well as the impact of R & D effect and healthy behavior, and be good builders, managers, coordinators and collaborators of design methods. According to the psychological characteristics of these groups, we should actively and flexibly organize colorful activities, strive to create a relaxed and harmonious living atmosphere, create a friendly and mutually beneficial R & D relationship, encourage and guide these groups, adjust their psychology to the best state, and promote the healthy development of their good cognition and life. Acknowledgements This work was jointly supported by Natural Science Foundation of Guangdong Province under Grant 2019A1515010830 and Guangdong University of Petrochemical Technology under Grant 702-519244, Guangdong, China.

The new wave of COVID-19 in Hong Kong, China was overwhelming again by “dynamic zero” strategy and non-pharmaceutical interventions (DZ-NPIs), which makes a time challenge to control the variant of this epidemic. We describe the variant of Covid-19 in Kong Hong to the infected proportion of the population, cumulative confirmed cases, cumulative deaths and current hospitalizations by age group via statistical measure firstly, then establish time series model for fitting the accumulative confirmed cases, further to predict the trend for searching out possible turning time-points. Non-linear regression model is created to feature the deaths series, then we figure out the parameters and educe the controlling condition for this epidemic. We expect our data-driven modeling process providing some insights to the controlling strategy for the new wave of the Covid-19 variant in Hong Kong, even in the mainland of China.

Background/Objective: Limited information is available about public attitudes towards stuttering across Asia. This review considers the key factors and approaches used to measure public attitudes towards stuttering across Asia that have previously been published in order to identify potential research gaps. Methods: A scoping review was conducted using the Arksey and O’Malley’s (2005) framework. Results: A total of nine relevant articles, published between 2001 to 2019, were selected for review. Most of the studies used the Public Opinion Survey of Human Attributes (POSHA) as a survey tool. This review yielded studies from Turkey, Kuwait, China/Hong Kong, and Japan. Asian public attitudes towards stuttering were less positive in general, except in Kuwait. Conclusion: Given that limited research has focused on examining the attitudes towards stuttering among the general public in the Asian region, we call for international collaboration to increase research about public attitudes. Such data could assist speech-language pathologists in developing awareness campaigns for better intervention and increased acceptance of individuals who stutter.

The increasing prevalence of dementia has become a public health issue worldwide including China. This study aims to explore the perception of Chinese in Hong Kong towards the diagnosis, symptoms and impacts of dementia. A cross-sectional survey was conducted among outpatients (without diagnosed dementia) attending a regional public hospital using a standard questionnaire. The results from 290 respondents showed that most preferred to be told about the diagnosis of dementia as soon as possible if they got it, in order to deal with the news and to access treatment and support early. Nearly two thirds of the respondents perceived practical issues (61.3%), physical health (61.0%), and emotional distress (58.4%) as their most fearful impacts, while legal issues (7.4%) were their least concerns. Family history/genes (79.1%) and brain injury (75.9%) were the most commonly perceived causes of dementia. For symptoms, respondents were more likely to identify cognitive impairments than undesirable behaviours. The accepting and proactive attitudes of the public indicate that there is a timely need of more public education about the disease, early screening and better continuity of care to fulfil the anticipated increase of the dementia patient population.

The traditional medicine industry has undergone rapid modernization in the last 20 years, spurred on by the World Health Organization’s (WHO) Traditional Medicine Agenda to integrate traditional medicine as a complement to conventional Western medicine. While the current literature tends to visualize traditional medical systems in silos within the context of their own national interests, we aim to evaluate and explore the changing innovation landscape in traditional medicine across several selected Asian economies in order to provide a snapshot of capability in this rapidly growing field of study. Adopting an evolutionary perspective of industrial progress, this study utilizes data relating to scientific publications and trademarks to indicate the trajectory of knowledge production and commercialization in traditional medicine, and thus to assess the modernization efforts of the selected economies. For this study, we observe innovative activity in China, Hong Kong, Japan, Malaysia, Singapore, South Korea, Taiwan, and Thailand between 1993 and 2012. The results show that Hong Kong, China, Taiwan, and South Korea have the most sophisticated innovation systems in terms of capability and productivity in the fields of science and innovation. Japan and Singapore have also shown strong growth, while Thailand and Malaysia are lagging behind the other selected economies.

Background Information technology and video gaming have potential advantages in the treatment of schizophrenia. However, information regarding the habits and attitudes related to internet use and video gaming in people with schizophrenia is limited. Objective The aim of this study was to explore the habits and attitudes regarding video gaming and information technology usage and their associated factors in people with schizophrenia in Hong Kong. Methods In this cross-sectional survey, service users with schizophrenia were recruited from 6 halfway hostels and 7 integrated centers for mental wellness in Hong Kong. A 79-item self-report questionnaire was utilized to explore the habits of internet use and video gaming in these people with schizophrenia. The attitude toward video gaming was assessed using the Gaming Attitudes, Motivations, and Experiences Scales. Of the 148 individuals in a convenience sample who were invited to participate in this study, 110 willingly participated (a response rate of 74.3%). The data were analyzed using descriptive statistics, a two-tailed independent t test, Pearson correlation, and principal analysis with 3 methods of rotation (varimax, equimax, and promax). Results Most participants (100/110, 90.9%) had access to the internet and half of them (54/110, 49.1%) used the internet daily mostly to watch videos (66/110, 60.0%) or read news or books, etc (42/110, 38.2%). One-third of the participants (36/110, 32.7%) used the internet to play web-based games, and most of them (88/110, 80.0%) had played a video game in the past year. The most favorable gaming platforms were cellular phones (43/88, 49%) followed by computers (19/88, 22%) and arcade cabinets (6/88, 7%). The most favorable game genre was action games (34/145, 23.4%). Those who had a bachelor’s degree or higher scored lower in social interaction than those with a lower education level (P=.03). Those who played video games daily scored higher in the category of story than those who did not play daily (t86=2.03, P=.05). The most popular gaming category was autonomy and the least popular categories were violent catharsis and violent reward. Two motives, “social playing” and “evasive playing,” were formed to describe the characteristics of playing video games. Conclusions Our data showed a high internet utilization rate among people with schizophrenia in Hong Kong. Only a few of them used the internet to search for health-related information. Our study also exemplified the unique habits of gaming among the participants. Health care professionals could utilize video games to engage people with schizophrenia and promote coping with stress and provide social skills training to such people with schizophrenia. Identification of the gaming attitudes can contribute to the development of serious games for the schizophrenic population. Further investigation is vital for the promotion of mental health through web-based platforms.

AbstractPrevious studies of East Asian welfare regimes focus on similarities between social security schemes. In contrast, this paper explores cross-national variations in public–private pension mixes in six welfare states: China, Hong Kong, Japan, Singapore, South Korea and Taiwan. Our research echoes the pension policy analysis of international organisations but takes a step forward with emphasis on the historical and institutional characteristics of the respective pension systems. The analysis identifies three institutional patterns. First, the statist pension system (Taiwan and China) primarily relies on public pensions to provide old-age security, with private pensions playing a rather minor role. Second, in the dualist pension system (Japan and Korea) both public and private pensions work in parallel to ensure retirement income, though a clear security gap exists between workers in the formal and informal economies. Finally, the individualist pension system (Hong Kong and Singapore) is characterised by genuine fully funded individual accounts, emphasising citizens’ own responsibilities for ensuring old-age security. These three types of pension systems demonstrate distinct institutional characteristics and policy outcomes, illustrated by the juxtaposition of their institutional structures as well as by the comparison of key indicators collected from government reports and Organisation for Economic Co-operation and Development statistics. The paper concludes with a theoretical reflection of East Asian pension policies and a diagnosis of the distinct challenges confronted by each of the various pension patterns.

China is experiencing the rapid development of infrastructure projects throughout the country, especially in the Guangdong-Hong Kong SAR-Macao SAR Greater Bay Area. This is placing the Chinese construction industry under tremendous pressure to transition to a sustainability orientation due to the various economic, social, and environmental challenges involved. The transition to more sustainable infrastructure projects requires the involvement of more stakeholders, while the multistakeholder context is of less importance when making project decisions, and this may create an adverse effect on the sustainability level of infrastructure projects. Based on the questionnaire data collected, this study addresses this issue by comparatively analysing stakeholder perceptions of sustainable infrastructure delivery between Guangdong province, Hong Kong SAR, and Macao SAR. Through independent sample t -tests, the disparity in perceptions between paired stakeholder groups in the Greater Bay Area (as a whole) is revealed. Three pairs, i.e., government department and supervising engineers, owners and designers, and supervising engineers and operators, are found to be the most conflicting, while contractors and supervising engineers are the least. Of the 18 sustainability items analysed, shaped local identity and international reputation (SOC, social factor 8) is the most controversial, while value-for-money of the proposed project during its lifecycle (EOC, economic factor 5) and green design and construction (ENV, environmental factor 2) have the greatest consensus towards their roles in achieving project sustainability. Significantly, different stakeholder perceptions between the three are also identified, and the contractor group is found to share the least consensus geographically, while the operators have the least conflict rating of the relevant importance of various sustainability factors. The thorough analysis of sustainability-related items of economy, society, and environment contributes to understanding the attitudes of the various stakeholder groups involved, which then helps reduce their conflicts during sustainable infrastructure delivery.

Background At the very beginning of the COVID-19 pandemic, information about fear of COVID-19 was very limited in Chinese populations, and there was no standardized and validated scale to measure the fear associated with the pandemic. Objective This cross-sectional study aimed to adapt and validate a fear scale to determine the levels of fear of COVID-19 among the general population in mainland China and Hong Kong. Methods A web-based questionnaire platform was developed for data collection; the study instruments were an adapted version of the 8-item Breast Cancer Fear Scale (“Fear Scale”) and the 4-item Patient Health Questionnaire. The internal construct validity, convergent validity, known group validity, and reliability of the adapted Fear Scale were assessed, and descriptive statistics were used to summarize the participants’ fear levels. Results A total of 2822 study participants aged 18 years or older were included in the analysis. The reliability of the adapted scale was satisfactory, with a Cronbach α coefficient of .93. The item-total correlations corrected for overlap were >0.4, confirming their internal construct validity. Regarding convergent validity, a small-to-moderate correlation between the Fear Scale and the 4-item Patient Health Questionnaire scores was found. Regarding known group validity, we found that the study participants who were recruited from Hong Kong had a higher level of fear than the study participants from mainland China. Older adults had a higher level of fear compared with younger adults. Furthermore, having hypertension, liver disease, heart disease, cancer, anxiety, and insomnia were associated with a higher fear level. The descriptive analysis found that more than 40% of the study participants reported that the thought of COVID-19 scared them. About one-third of the study participants reported that when they thought about COVID-19, they felt nervous, uneasy, and depressed. Conclusions The psychometric properties of the adapted Fear Scale are acceptable to measure the fear of COVID-19 among Chinese people. Our study stresses the need for more psychosocial support and care to help this population cope with their fears during the pandemic.

Background Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population. Objective This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period. Methods Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted. Results At Month 6, 6.9% (28/407) and 4.4% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU (β=.04; B=.002, 95% CI 0.001-0.01). Conclusions Social media and gay social networking apps may be a major source of influence on MSM’s perceptions and actual behaviors related to SDU.

According to China’s tourism statistics, the inbound tourism market is composed of eight types of travel motivations (sightseeing, leisure, business meeting (business-m), visiting relatives and friends (visiting-rf), shopping, religious worship (religious-w), culture and sports (culture-s), and health care (health-c)), and the spatial distribution of each type of travel motivation is significantly different. Four inbound sub-markets (foreigners, Hong Kong, Macao, and Taiwan) were selected as our research object. Through empirical analysis of the variable elasticity of eight different inbound motive market segments, we found that the sensitivities (elasticity) of the influencing factors (traffic conditions (traffic-c), destination image (destination-i), industry structure (industry-s), infrastructure, consumer price index (CPI), resource endowment (resource-e), and dressing index (ICL)) are different. Therefore, investment options in the target market can have differential treatment based on the rate of marginal return on investment. In accordance with the characteristics of different market segments, we suggest more feasible development paths and countermeasures, providing a decision-making basis for the accurate development of the inbound tourism market.

Economic growth has always been an economic phenomenon expected by the public, and it is also a hot topic studied by a wide range of scholars. So far, there have been a lot of domestic and foreign research literature on the phenomenon of economic growth, and it goes without saying why economic growth has always been such a hot topic. The purpose of this paper is to study the impact of human capital on economic growth by analyzing the data samples of China's 31 provinces (excluding Hong Kong, Macao and Taiwan) from 2009 to 2018 in the National Bureau of statistics and the China Statistical Yearbook. The main result of the analysis is that although educational human capital has a positive impact on China's real GDP growth, the correlation is not very significant. As for the health capital in human capital, the research shows that the relationship between health capital and economic growth is not significant. Overall, this study shows that China should reduce its dependence on physical capital investment, so as to improve the return on human capital investment and find a new path for economic growth, which can also help the economy avoid the middle-income trap.

The aims of the study were to assess sexual wellbeing knowledge and attitudes among Chinese women living in New Zealand and to investigate the factors that prevented them from seeking support from sexual wellbeing services. Seventy-nine Chinese women from Hong Kong, China and Taiwan were recruited through community and personal networks to complete a self-report survey, which included questions on socio-demographics, self-rated adjustment, knowledge of sexual wellbeing, importance of understanding sexual wellbeing, cultural influences, structural influences, and willingness to seek information and assistance. The findings in this study suggested that younger Chinese women lacked sexual wellbeing knowledge and were less likely to seek support when compared to their older age group counterparts. Three out of the eight variables assessed were found to make a significant contribution in the willingness of Chinese women seeking support from sexual wellbeing services. These were knowledge of sexual wellbeing, self-perceived importance of gaining an understanding of sexual wellbeing issues and cultural influences. Our results suggest that despite the length of residency and self-rated adjustment in New Zealand, traditional Chinese values and beliefs continue to influence the perceptions of Chinese women regarding their sexual wellbeing. Interventions to improve sexual and reproductive wellbeing in this population, particularly younger Chinese women, should be tailored to the specific enabling and reinforcing factors that include cultural views, communications between Chinese women and health and social services providers, and access to healthcare information.

Background Existing predictive outcomes models for type 2 diabetes developed and validated in historical European populations may not be applicable for East Asian populations due to differences in the epidemiology and complications. Despite the continuum of risk across the spectrum of risk factor values, existing models are typically limited to diabetes alone and ignore the progression from prediabetes to diabetes. The objective of this study is to develop and externally validate a patient-level simulation model for prediabetes and type 2 diabetes in the East Asian population for predicting lifetime health outcomes. Methods and findings We developed a health outcomes model from a population-based cohort of individuals with prediabetes or type 2 diabetes: Hong Kong Clinical Management System (CMS, 97,628 participants) from 2006 to 2017. The Chinese Hong Kong Integrated Modeling and Evaluation (CHIME) simulation model comprises of 13 risk equations to predict mortality, micro- and macrovascular complications, and development of diabetes. Risk equations were derived using parametric proportional hazard models. External validation of the CHIME model was assessed in the China Health and Retirement Longitudinal Study (CHARLS, 4,567 participants) from 2011 to 2018 for mortality, ischemic heart disease, cerebrovascular disease, renal failure, cataract, and development of diabetes; and against 80 observed endpoints from 9 published trials using 100,000 simulated individuals per trial. The CHIME model was compared to United Kingdom Prospective Diabetes Study Outcomes Model 2 (UKPDS-OM2) and Risk Equations for Complications Of type 2 Diabetes (RECODe) by assessing model discrimination (C-statistics), calibration slope/intercept, root mean square percentage error (RMSPE), and R2. CHIME risk equations had C-statistics for discrimination from 0.636 to 0.813 internally and 0.702 to 0.770 externally for diabetes participants. Calibration slopes between deciles of expected and observed risk in CMS ranged from 0.680 to 1.333 for mortality, myocardial infarction, ischemic heart disease, retinopathy, neuropathy, ulcer of the skin, cataract, renal failure, and heart failure; 0.591 for peripheral vascular disease; 1.599 for cerebrovascular disease; and 2.247 for amputation; and in CHARLS outcomes from 0.709 to 1.035. CHIME had better discrimination and calibration than UKPDS-OM2 in CMS (C-statistics 0.548 to 0.772, slopes 0.130 to 3.846) and CHARLS (C-statistics 0.514 to 0.750, slopes −0.589 to 11.411); and small improvements in discrimination and better calibration than RECODe in CMS (C-statistics 0.615 to 0.793, slopes 0.138 to 1.514). Predictive error was smaller for CHIME in CMS (RSMPE 3.53% versus 10.82% for UKPDS-OM2 and 11.16% for RECODe) and CHARLS (RSMPE 4.49% versus 14.80% for UKPDS-OM2). Calibration performance of CHIME was generally better for trials with Asian participants (RMSPE 0.48% to 3.66%) than for non-Asian trials (RMPSE 0.81% to 8.50%). Main limitations include the limited number of outcomes recorded in the CHARLS cohort, and the generalizability of simulated cohorts derived from trial participants. Conclusions Our study shows that the CHIME model is a new validated tool for predicting progression of diabetes and its outcomes, particularly among Chinese and East Asian populations that has been lacking thus far. The CHIME model can be used by health service planners and policy makers to develop population-level strategies, for example, setting HbA1c and lipid targets, to optimize health outcomes.

ABSTRACTIn India, during the last two decades, significant developments in societal responses to address elder abuse have emerged. There is greater emphasis on recognizing that older people may be subjected to abuse and neglect by family members and the community as well. Although there is growing interest in the collection of valid statistics on the incidence and prevalence of elder abuse, there is still a need for bringing better clarity on the conceptual understanding and refining definitions of elder abuse. The government, academic community, and the civil society are working toward understanding the underlying causes of elder abuse and neglect and are focusing on appropriate interventions to address it.This paper notes the developments in recognizing elder abuse and reviews the responses in addressing the issue from a legal, social, and public health perspective in India compared with some of the Asian countries, namely China, Hong Kong, Philippines, Singapore, and Thailand. While the paper highlights the Indian experience, it is also put in an Asian context where emerging demographics are raising many concerns related to the aging of the population, and the new dynamics of relationships at the family, community, and societal levels demand fresh approaches and thoughts toward improving the quality of life of older people and reducing their vulnerability toward the risk of abuse and neglect.

Background: Adverse reactions associated with Chinese herbal medicines (CHMs) are usually the result of unpredictable active/toxic ingredients, inaccurate or mistaken beliefs, or poor supervision. The herb that most commonly induces severe adverse effects in Hong Kong and China is aconite root. More than 200 species of Aconitum plants are used for medicinal purposes, with aconite roots producing analgesic, anti-inflammatory, cardiotonic, and anti-tumor effects. The active components are alkaloids; these can be toxic, but CHM processing methods lower their toxicity and increase the pharmacological efficacy. However, aconite poisoning can result from inadequate decoction time or exceeding the recommended dose. Case Report: Here we report the case of a 92-year-old woman who presented with life-threatening bradycardia and hypotension. This started 1 h after she inappropriately consumed a herbal decoction containing Fuzi for mood fluctuation and health maintenance; Fuzi, an aconite root, has known cardiotoxicity. Electrocardiography showed supraventricular abnormalities, including sinus bradycardia and low-amplitude P waves. After an infusion of normal saline and inotropic agents for 25 h, the clinical manifestations subsided, her sinus rhythm returned to normal, and she was discharged. At follow-up 2 weeks later, she was in good health and had ceased taking any CHM. Conclusions: Standardized processing methods, stringent regulations, and cooperation between health professions can ensure medication safety and establish a fully-fledged operating process for these valuable drugs. We hope this report will help establish correct attitudes toward CHM and will assist Traditional Chinese Medicine practitioners to become more familiar with Aconitum plants.

Abstract Background In the early days of the founding of the People's Republic of China, China's higher education was very backward and could not meet the needs of the society. At that time, higher education in the Soviet Union was relatively developed and China Soviet relations were friendly, but China's relations with most western countries were not good. Therefore, the Chinese government chose and sent students to the Soviet Union for higher education. With the change of policy, the willingness of young people to study abroad has also changed. This political environment also has an impact on the anxiety sensitivity of groups studying abroad. Subjects and Methods In order to accurately grasp the motivation of Chinese students to study abroad and return home, this paper selects credible historical archives and data as the basis of the research. This paper reviews the process of selecting foreign students in the Soviet Union in the 1950s, analyzes the impact of public policy on the willingness to study abroad, and draws lessons from it. SPSS 22.0 software was used for data statistical analysis. The measurement data were expressed as mean ± standard deviation (x ± s). The statistical method was as follows: descriptive statistics was used for general demographic characteristics, t-test was used for the comparison of the mean of two independent samples, nonparametric Kruskal Wallis test was used for ordered classification data, and regression analysis was used to verify the mediating effect of RS between as and anxiety level according to the mediating effect test model. P < 0.05 was statistically significant. Results Our review of the selection process shows that the willingness to study in the Soviet Union is relatively weak, mainly for two reasons: (1) the deterioration of Sino Soviet relations in 1955; (2) Due to the uneven level of education in China, universal education is more in line with China's reality than elite education, but the selection strictly follows the standards of elite education. For China's future development, we propose to implement a comprehensive and flexible study abroad policy. The study also found that there was a negative correlation between study abroad anxiety and education level. Similarly, there is a significant negative correlation between study abroad anxiety and self-efficacy. There is a very significant positive correlation among state anxiety, trait anxiety and study abroad anxiety. The “anxiety” component of learners' personality characteristics plays a great role in the anxiety of studying abroad. The correlation coefficient between LCAS and trait anxiety was 0.408, while the correlation coefficient between LCAS and state anxiety was 0.395. Both reached a significant level (P < 0.01). There is a positive correlation between self-efficacy and willingness to study abroad. Research shows that anxiety, gender and self-efficacy can be used as comprehensive variables to measure willingness to study abroad. Conclusion In the 1950s, because most Chinese people did not have enough willingness, knowledge and funds to study abroad, it was necessary and reasonable for the Chinese government to provide financial support and students to study abroad. Although young people's willingness to study in the Soviet Union was relatively weak, and the results of the Soviet policy did not fully meet expectations, the policy at that time was probably the best. Since China implemented the market reform in the 1980s, the old education policy has become obsolete. Therefore, the role of the government in education has changed from a strict social planner to a leader in time. Although some people have the ability to study abroad, the government must provide financial support for people in certain fields according to the needs of the country. From this review, we can see that the Chinese government has timely adjusted its education strategy to stimulate the motivation to study abroad. In the 1950s, China's universal education was ahead of elite education. To sum up, through the comparative study on the impact of foreign students' ideas of studying abroad, this study found that the policy has a good role in promoting foreign students' ideas of studying abroad, which can not only effectively improve China's education level, but also enable them to face difficulties and setbacks rationally and better adapt to the society. Acknowledgements Supported by projects grant from The 2021 Guangdong Provincial College Ideological and Political Education Project “Comparative Research on National History Education after the Return of Hong Kong and Macao from the Perspective of the United Front” (Project No.: 2021GXSZ012) ,the 2020 key project of the Chinese National Cohesion Research Institute of Jinan University “Comparative Study on the Implementation of National History Education after the Return of Hong Kong” (Grant No.20ZHMZNJLZD05); the 2020 project of the Institute of Party Regulations of Jinan University “Guangdong from the Perspective of National Governance” Research on the Coupling Mechanism of Inner Party Laws, Regulations and Talents in the Hong Kong-Macao Greater Bay Area” (Grant No.JNUD2020004); Guangdong Philosophy and Social Sciences “13th Five-Year Plan” Special Commissioned Project “Research on the History of Cantonese Chinese in South Pacific Island Countries” (Grant No.GD18TW18-08)

Purpose The purpose of this study is to examine the relationship between financial strength or condition and managerial practices in preparing financial statements of public limited companies. The objectives of this study are threefold – to measure the financial strength, to measure integrity index and to examine the relationship between management practices and financial strength. Design/methodology/approach Financial ratios, Altman’s Z-Score, integrity index, ranking approach and chi-square test are used to achieve the objectives. A multi-year cross-country analysis is done by considering sample of seven Asian countries, namely, Malaysia, Singapore, Thailand, Indonesia, Hong Kong, China and Japan. Findings The study catches the relationship between management practices and financial strength across sample countries. Management practices is one of the responsible factors for this relationship. They use discretionary power in preparing financial statements to control the trading results. The principles of accounting do not support the alteration of financial data to look the company better on paper. The cost of financial statement fraud is higher than other occupational fraud. Research limitations/implications This study does not cover factors other than management practices and further study could be conducted to look for the other reasons that may also responsible for the deviations. Practical implications Conflict of interest between shareholders and board of directors is not a new phenomenon. Auditing system is introduced to minimize this conflict of interest, but they failed to uphold their position in reality. Management also needs to prove their integrity in financial statements. Ethical consideration is the highest priority. Social implications Stakeholders, especially regulators, professional bodies and academics, should concentrate on the issue on ‘how to reduce the manipulation in financial statements’ to create a safe investments avenue for the nation. Originality/value This study provides empirical evidences regarding the influence of management practices on financial statements and financial strength of listed companies across countries. The culture, attitudes, beliefs, perceptions, etc., are different from country to country. The aim is to contribute empirical evidence about the relationship between management practices and financial health in different settings. This study is first of its kind.

“The family” has long been a focus of cross-party attention. While family is perceived as foundational to society’s success, how parents rear their children is perhaps the most conservative or persistent part of concern. While Chinese immigrant families and Chinese families in Asia – in Hong Kong, Macau, Taiwan, mainland China, and elsewhere – are struggling with a socialization process that has emphasized support for traditional values, they are also simultaneously being confronted by modern ideologies and technologies. Professionals have a growing interest in addressing the culturally diverse needs and the gender issues of Chinese families. The theme of this issue of The Open Family Studies Journal, then, is “Gender, family and parenting in the Chinese context”. The heart of this special issue lies in a concern for families, in particular for the challenges posed to families and parenting practices in a changing world. The family, like any social group, is a product of history, culture and context. Because of economic and technological changes, and the increasingly pluralistic nature of our society, both gender relations and family structures have undergone tremendous change, and many challenges await elucidation. The seven papers in this special issue thus feature new perspectives on family, gender and parenting issues. The issue opens with a paper on scale validation. Since intimacy is a construct that has received limited attention in the Chinese context, the first paper, “Intimacy as a distinct construct: validating the intimacy scale among older adults of residential care homes in Hong Kong”, aims to develop a valid measurement for the quality of the relationship between older adults and family caregivers in the Hong Kong Chinese context. The study results demonstrate the reliability and validity of the instrument across samples of older adults. Paper 2 and 3 that follow are qualitative studies adopting cultural perspectives to understand Chinese American immigrant adults and older female survivors of intimate partner violence in Taiwan. In paper 2, “Understanding family connections and help-seeking behavior in Chinese parental lives. These findings illustrate how existentialism provides a new frame of reference and new practice directions for conducting parent-education programs. The final paper titled “Internet supervision and parenting in the digital age: The case of Shanghai” echoes the technological advancement and its impact on parenting. In a changing world, and in a society permeated by the Internet and by nearly instantaneous communication, families constantly need to adapt to different and changing ways of parenting. The paper explores the issue of parenting confidence in supervision of children’s Internet use in Shanghai, China. Multiple-regression models are used to identify factors affecting parents’ confidence about their own parenting. The findings suggest that efforts to assist parents should help them review their attitudes towards the Internet. American immigrant adults who attempt suicide”, the authors investigate beliefs, values and norms in the Chinese family culture and examine Chinese cultural influences on attitudes and beliefs about mental health and mental health services in the immigrant context. Paper 3, “Older female survivors of intimate partner violence in the Taiwanese cultural context” examines the needs of older female IPV survivors in another Chinese cultural context. The findings of both studies reflect the importance of family and the influence of Chinese family culture; they make it clear that traditional family beliefs are still highly valued and hold a prominent position in Chinese culture. The authors of these two papers question the efficacy of service-delivery models based on Western cultures, and they call for ethnically sensitive intervention approaches that incorporate cultural premises into developing viable options for service recipients. Paper 4 is titled “The Macau family-in-transition: the perceived impact of casino employment on family relationships among dealer families”. This paper draws on findings from a qualitative study to explore the impacts of casino employment on family life and family relationships. The family, like other social group, is a product of culture and context, and the specific socio-economic context of Macau poses challenges to dealer families and casino workers in performing their parental role. The paper sheds much-needed light on our understanding of Macau dealer families. The final three papers in this special issue all address the issue of parenting. Paper 5, “Reflective inquiry on professionals’ view on parents and about parenting”, examines professionals’ views of parents, their attitudes and beliefs about parenting, and the values underpinning their practice. The study’s findings on the theme of parent blaming provide an impetus for professionals to reflect on the attitudes and assumptions they hold, and their impact on parents. The paper calls for reflection on parenting work to recognize the difficulties and challenges faced by contemporary families. Paper 6, “Reviving parents’ life momentum: A qualitative evaluation of a parent education program adopting an existential approach”, reports the results of a qualitative analysis of the participants’ perceptions of a parent-education program. The findings of this study demonstrate that a program of this nature can make parents aware of the existential dimensions of being a parent and help them understand the significance of creating meaning in their In fact, family, parenting and gender are vastly contested terms which encompass a range of topics. The seven varied papers recommended for publication in this special issue reflect the considerable attention that we have placed on family, parenting and gender, and also the vision of this special issue. These papers add to the growing body of research and literature, and they provide both food for thought and a platform for discussion. In the last, I offer both my sincere thanks to the authors who have contributed to this special issue, and my gratitude to those who have participated as blind peer reviewers. Their thoughtful comments and criticisms have certainly improved the quality of each and every paper in this special issue.

Background The COVID-19 pandemic increased attention to digital tools to support governmental public health policies in East and South-East Asia. Mobile apps related to the COVID-19 pandemic continue to emerge and evolve with a wide variety of characteristics and functions. However, there is a paucity of studies evaluating such apps in this region, with most of the available studies conducted in the early days of the pandemic. Objective This study aimed to examine free apps developed or supported by governments in the East and South-East Asian region and highlight their key characteristics and functions. We also sought to interpret how the release dates of these apps were related to the commencement dates of other COVID-19 public health policies. Methods We systematically searched for apps in Apple App Store and Google Play Store and analyzed the contents of eligible apps. Mobile apps released or updated with COVID-19–related functions between March 1 and May 7, 2021, in Singapore, Taiwan, South Korea, China (mainland), Japan, Thailand, Hong Kong, Vietnam, Malaysia, Indonesia, and the Philippines were included. The CoronaNet Research Project database was also examined to determine the timeline of public health policy commencement dates in relation to the release dates of the included apps. We assessed each app’s official website, media reports, and literature through content analysis. Descriptive statistics were used to summarize relevant information gathered from the mobile apps using RStudio. Results Of the 1943 mobile apps initially identified, 46 were eligible, with almost 70% of the apps being intended for the general public. Most apps were from Vietnam (n=9, 20%), followed by Malaysia, Singapore, and Thailand (n=6 each, 13%). Of note, most apps for quarantine monitoring (n=6, 13%) were mandatory for the target users or a population subset. The most common function was health monitoring (32/46, 70%), followed by raising public health awareness (19/46, 41%) through education and information dissemination. Other functions included monitoring quarantine (12/46, 26%), providing health resources (12/46, 26%). COVID-19 vaccination management functions began to appear in parallel with vaccine rollout (7/46, 15%). Regarding the timing of the introduction of mobile solutions, the majority of mobile apps emerged close to the commencement dates of other public health policies in the early stages of the pandemic between March and April 2020. Conclusions In East and South-East Asia, most governments used mobile health apps as adjuncts to public health measures for tracking COVID-19 cases and delivering credible information. In addition, these apps have evolved by expanding their functions for COVID-19 vaccination.

Background Older adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups. Methods and findings We conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged ≥65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research (GRADE–CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case–control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors—healthcare provider and system related, patient related, and policy and operational—and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia. Conclusions In this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.

During physical distancing, children do not meet their peers to play or talk together. Peer relationships have a crucial influence on all child development, especially for social skills or behaviour during early childhood. This study aims to determine changes in children's social behaviour during physical distancing during the Covid-19 pandemic. This research method is a descriptive quantitative study designed with the percentage value was used as a score for measuring the results of parental observations of children concerning the child's social behaviour instrument. Quota sampling (150 parents) was used to reach participants from various cities in Indonesia to see cultural differences. Data on children's social behaviour was obtained using the Preschool and Kindergarten Behaviour Scale (PKBS) tests. The data were then analysed using descriptive statistics. The results show that there are changes in children's social behaviour during physical distancing. Children who are less independent (58.9%) are the biggest decline in social behaviour reported by parents, while the one who changes the least is cleaning up the mess that has been made (38.7%). The implication of the results of this study is that parents should continue to pay attention to their children's social behaviour by providing opportunities for children to interact with peers in the house while still paying attention to health protocols. Keywords: Early Childhood, Social Behaviour, Physical Distancing References: Aksoy, P., & Baran, G. (2010). Review of studies aimed at bringing social skills for children in preschool period. Procedia - Social and Behavioural Sciences, 9, 663–669. https://doi.org/10.1016/j.sbspro.2010.12.214 Al-Tammemi, A. B. (2020). The Battle Against COVID-19 in Jordan: An Early Overview of the Jordanian Experience. Frontiers in Public Health, 8(May), 1–6. https://doi.org/10.3389/fpubh.2020.00188 Arkorful, V., & Abaidoo, N. (2015). 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STEAM-based learning is a global issue in early-childhood education practice. STEAM content becomes an integrative thematic approach as the main pillar of learning in kindergarten. This study aims to develop a conceptual and practical approach in the implementation of children's education by applying a modification from STEAM Learning to R-SLAMET. The research used a qualitative case study method with data collection through focus group discussions (FGD), involving early-childhood educator's research participants (n = 35), interviews, observation, document analysis such as videos, photos and portfolios. The study found several ideal categories through the use of narrative data analysis techniques. The findings show that educators gain an understanding of the change in learning orientation from competency indicators to play-based learning. Developing thematic play activities into continuum playing scenarios. STEAM learning content modification (Science, Technology, Engineering, Art and Math) to R-SLAMETS content (Religion, Science, Literacy, Art, Math, Engineering, Technology and Social study) in daily class activity. Children activities with R-SLAMETS content can be developed based on an integrative learning flow that empowers loose part media with local materials learning resources. Keyword: STEAM to R-SLAMETS, Early Childhood Education, Integrative Thematic Learning References Ali, E., Kaitlyn M, C., Hussain, A., & Akhtar, Z. (2018). the Effects of Play-Based Learning on Early Childhood Education and Development. Journal of Evolution of Medical and Dental Sciences, 7(43), 4682–4685. https://doi.org/10.14260/jemds/2018/1044 Ata Aktürk, A., & Demircan, O. (2017). A Review of Studies on STEM and STEAM Education in Early Childhood. Journal of Kırşehir Education Faculty, 18(2), 757–776. Azizah, W. A., Sarwi, S., & Ellianawati, E. (2020). 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Embedding play-based learning into junior primary (Year 1 and 2) Curriculum in WA. Australian Journal of Teacher Education, 43(1), 112–126. https://doi.org/10.14221/ajte.2018v43n1.7 Kennedy, A., & Barblett, L. (2010). Supporting the Early Years Learning Framework. Research in Practise Series, 17(3), 1–12. Keung, C. P. C., & Cheung, A. C. K. (2019). Towards Holistic Supporting of Play-Based Learning Implementation in Kindergartens: A Mixed Method Study. Early Childhood Education Journal, 47(5), 627–640. https://doi.org/10.1007/s10643-019-00956-2 Keung, C. P. C., & Fung, C. K. H. (2020). Exploring kindergarten teachers’ pedagogical content knowledge in the development of play-based learning. Journal of Education for Teaching, 46(2), 244–247. https://doi.org/10.1080/02607476.2020.1724656 Krogh, S., & Morehouse, P. (2014). The Early Childhood Curriculum : Inquiry Learning Through Integration. Liao, C. (2016). 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Covid 19 – living the experience As I sit at my desk at home in suburban Brisbane, following the dictates on self-isolation shared with so many around the world, I am forced to contemplate the limits of human prediction. I look out on a world which few could have predicted six months ago. My thoughts at that time were all about 2020 as a metaphor for perfect vision and a plea for it to herald a new period of clarity which would arm us in resolving the whole host of false divisions that surrounded us. False, because so many appear to be generated by the use of polarised labelling strategies which sought to categorise humans by a whole range of identities, while losing the essential humanity and individuality which we all share. This was a troublesome trend and one which seemed reminiscent of the biblical tale concerning the tower of Babel, when a single unified language was what we needed to create harmony in a globalising world. However, yesterday’s concerns have, at least for the moment, been overshadowed by a more urgent and unifying concern with humanity’s health and wellbeing. For now, this concern has created a world which we would not have recognised in 2019. We rely more than ever on our various forms of electronic media to beam instant shots of the streets of London, New York, Berlin, Paris, Hong Kong etc. These centres of our worldly activity normally characterised by hustle and bustle, are now serenely peaceful and ordered. Their magnificent buildings have become foregrounded, assuming a dignity and presence that is more commonly overshadowed by the mad ceaseless scramble of humanity all around them. From there however the cameras can jump to some of the less fortunate areas of the globe. These streets are still teeming with people in close confined areas. There is little hope here of following frequent extended hand washing practices, let alone achieving the social distance prescribed to those of us in the global North. From this desk top perspective, it has been interesting to chart the mood as the crisis has unfolded. It has moved from a slightly distant sense of superiority as the news slowly unfolded about events in remote Wuhan. The explanation that the origins were from a live market, where customs unfamiliar to our hygienic pre-packaged approach to food consumption were practised, added to this sense of separateness and exoticism surrounding the source and initial development of the virus. However, this changed to a growing sense of concern as its growth and transmission slowly began to reveal the vulnerability of all cultures to its spread. At this early stage, countries who took steps to limit travel from infected areas seemed to gain some advantage. Australia, as just one example banned flights from China and required all Chinese students coming to study in Australia to self-isolate for two weeks in a third intermediate port. It was a step that had considerable economic costs associated with it. One that was vociferously resisted at the time by the university sector increasingly dependent on the revenue generated by servicing Chinese students. But it was when the epicentre moved to northern Italy, that the entire messaging around the event began to change internationally. At this time the tone became increasingly fearful, anxious and urgent as reports of overwhelmed hospitals and mass burials began to dominate the news. Consequently, governments attracted little criticism but were rather widely supported in the action of radically closing down their countries in order to limit human interaction. The debate had become one around the choice between health and economic wellbeing. The fact that the decision has been overwhelmingly for health, has been encouraging. It has not however stopped the pressure from those who believe that economic well-being is a determinant of human well-being, questioning the decisions of politicians and the advice of public health scientists that have dominated the responses to date. At this stage, the lives versus livelihoods debate has a long way still to run. Of some particular interest has been the musings of the opinion writers who have predicted that the events of these last months will change our world forever. Some of these predictions have included the idea that rather than piling into common office spaces working remotely from home and other advantageous locations will be here to stay. Schools and universities will become centres of learning more conveniently accessed on-line rather than face to face. Many shopping centres will become redundant and goods will increasingly be delivered via collection centres or couriers direct to the home. Social distancing will impact our consumption of entertainment at common venues and lifestyle events such as dining out. At the macro level, it has been predicted that globalisation in its present form will be reversed. The pandemic has led to actions being taken at national levels and movement being controlled by the strengthening and increased control of physical borders. Tourism has ground to a halt and may not resume on its current scale or in its present form as unnecessary travel, at least across borders, will become permanently reduced. Advocates of change have pointed to some of the unpredicted benefits that have been occurring. These include a drop in air pollution: increased interaction within families; more reading undertaken by younger adults; more systematic incorporation of exercise into daily life, and; a rediscovered sense of community with many initiatives paying tribute to the health and essential services workers who have been placed at the forefront of this latest struggle with nature. Of course, for all those who point to benefits in the forced lifestyle changes we have been experiencing, there are those who would tell a contrary tale. Demonstrations in the US have led the push by those who just want things to get back to normal as quickly as possible. For this group, confinement at home creates more problems. These may be a function of the proximity of modern cramped living quarters, today’s crowded city life, dysfunctional relationships, the boredom of self-entertainment or simply the anxiety that comes with an insecure livelihood and an unclear future. Personally however, I am left with two significant questions about our future stimulated by the events that have been ushered in by 2020. The first is how is it that the world has been caught so unprepared by this pandemic? The second is to what extent do we have the ability to recalibrate our current practices and view an alternative future? In considering the first, it has been enlightening to observe the extent to which politicians have turned to scientific expertise in order to determine their actions. Terms like ‘flattening the curve’, ‘community transmission rates’, have become part of our daily lexicon as the statistical modellers advance their predictions as to how the disease will spread and impact on our health systems. The fact that scientists are presented as the acceptable and credible authority and the basis for our actions reflects a growing dependency on data and modelling that has infused our society generally. This acceptance has been used to strengthen the actions on behalf of the human lives first and foremost position. For those who pursue the livelihoods argument even bigger figures are available to be thrown about. These relate to concepts such as numbers of jobless, increase in national debt, growth in domestic violence, rise in mental illness etc. However, given that they are more clearly estimates and based on less certain assumptions and variables, they do not at this stage seem to carry the impact of the data produced by public health experts. This is not surprising but perhaps not justifiable when we consider the failure of the public health lobby to adequately prepare or forewarn us of the current crisis in the first place. Statistical predictive models are built around historical data, yet their accuracy depends upon the quality of those data. Their robustness for extrapolation to new settings for example will differ as these differ in a multitude of subtle ways from the contexts in which they were initially gathered. Our often uncritical dependence upon ‘scientific’ processes has become worrying, given that as humans, even when guided by such useful tools, we still tend to repeat mistakes or ignore warnings. At such a time it is an opportunity for us to return to the reservoir of human wisdom to be found in places such as our great literature. Works such as The Plague by Albert Camus make fascinating and educative reading for us at this time. As the writer observes Everybody knows that pestilences have a way of recurring in the world, yet somehow, we find it hard to believe in ones that crash down on our heads from a blue sky. There have been as many plagues as wars in history, yet always plagues and wars take people equally by surprise. So it is that we constantly fail to study let alone learn the lessons of history. Yet 2020 mirrors 1919, as at that time the world was reeling with the impact of the Spanish ‘Flu, which infected 500 million people and killed an estimated 50 million. This was more than the 40 million casualties of the four years of the preceding Great War. There have of course been other pestilences since then and much more recently. Is our stubborn failure to learn because we fail to value history and the knowledge of our forebears? Yet we can accept with so little question the accuracy of predictions based on numbers, even with varying and unquestioned levels of validity and reliability. As to the second question, many writers have been observing some beneficial changes in our behaviour and our environment, which have emerged in association with this sudden break in our normal patterns of activity. It has given us the excuse to reevaluate some of our practices and identify some clear benefits that have been occurring. As Australian newspaper columnist Bernard Salt observes in an article titled “the end of narcissism?” I think we’ve been re-evaluating the entire contribution/reward equation since the summer bushfires and now, with the added experience of the pandemic, we can see the shallowness of the so-called glamour professions – the celebrities, the influencers. We appreciate the selflessness of volunteer firefighters, of healthcare workers and supermarket staff. From the pandemic’s earliest days, glib forays into social media by celebrities seeking attention and yet further adulation have been met with stony disapproval. Perhaps it is best that they stay offline while our real heroes do the heavy lifting. To this sad unquestioning adherence to both scientism and narcissism, we can add and stir the framing of the climate rebellion and a myriad of familiar ‘first world’ problems which have caused dissension and disharmony in our communities. Now with an external threat on which to focus our attention, there has been a short lull in the endless bickering and petty point scoring that has characterised our western liberal democracies in the last decade. As Camus observed: The one way of making people hang together is to give ‘em a spell of the plague. So, the ceaseless din of the topics that have driven us apart has miraculously paused for at least a moment. Does this then provide a unique opportunity for us together to review our habitual postures and adopt a more conciliatory and harmonious communication style, take stock, critically evaluate and retune our approach to life – as individuals, as nations, as a species? It is not too difficult to hypothesise futures driven by the major issues that have driven us apart. Now, in our attempts to resist the virus, we have given ourselves a glimpse of some of the very things the climate change activists have wished to happen. With few planes in the air and the majority of cars off the roads, we have already witnessed clearer and cleaner air. Working at home has freed up the commuter driven traffic and left many people with more time to spend with their family. Freed from the continuing throng of tourists, cities like Venice are regenerating and cleansing themselves. This small preview of what a less travelled world might start to look like surely has some attraction. But of course, it does not come without cost. With the lack of tourism and the need to work at home, jobs and livelihoods have started to change. As with any revolution there are both winners and losers. The lockdown has distinguished starkly between essential and non-essential workers. That represents a useful starting point from which to assess what is truly of value in our way of life and what is peripheral as Salt made clear. This is a question that I would encourage readers to explore and to take forward with them through the resolution of the current situation. However, on the basis that educators are seen as providing essential services, now is the time to turn to the content of our current volume. Once again, I direct you to the truly international range of our contributors. They come from five different continents yet share a common focus on one of the most popular of shared cultural experiences – sport. Unsurprisingly three of our reviewed papers bring different insights to the world’s most widely shared sport of all – football, or as it would be more easily recognised in some parts of the globe - soccer. Leading these offerings is a comparison of fandom in Australia and China. The story presented by Knijnk highlights the rise of the fanatical supporters known as the ultras. The origin of the movement is traced to Italy, but it is one that claims allegiances now around the world. Kniijnk identifies the movement’s progression into Australia and China and, in pointing to its stance against the commercialisation of their sport by the scions of big business, argues for its deeper political significance and its commitment to the democratic ownership of sport. Reflecting the increasing availability and use of data in our modern societies, Karadog, Parim and Cene apply some of the immense data collected on and around the FIFA World Cup to the task of selecting the best team from the 2018 tournament held in Russia, a task more usually undertaken by panels of experts. Mindful of the value of using data in ways that can assist future decision making, rather than just in terms of summarising past events, they also use the statistics available to undertake a second task. The second task was the selection of the team with the greatest future potential by limiting eligibility to those at an early stage in their careers, namely younger than 28 and who arguably had still to attain their prime as well as having a longer career still ahead of them. The results for both selections confirm how membership of the wealthy European based teams holds the path to success and recognition at the global level no matter what the national origins of players might be. Thirdly, taking links between the sport and the world of finance a step further, Gomez-Martinez, Marques-Bogliani and Paule-Vianez report on an interesting study designed to test the hypothesis that sporting success within a community is reflected in positive economic outcomes for members of that community. They make a bold attempt to test their hypothesis by examining the relationship of the performance of three world leading clubs in Europe - Bayern Munich, Juventus and Paris Saint Germain and the performance of their local stock markets. Their findings make for some interesting thoughts about the significance of sport in the global economy and beyond into the political landscape of our interconnected world. Our final paper comes from Africa but for its subject matter looks to a different sport, one that rules the subcontinent of India - cricket. Norrbhai questions the traditional coaching of batting in cricket by examining the backlift techniques of the top players in the Indian Premier league. His findings suggest that even in this most traditional of sports, technique will develop and change in response to the changing context provided by the game itself. In this case the context is the short form of the game, introduced to provide faster paced entertainment in an easily consumable time span. It provides a useful reminder how in sport, techniques will not be static but will continue to evolve as the game that provides the context for the skilled performance also evolves. To conclude our pages, I must apologise that our usual book review has fallen prey to the current world disruption. In its place I would like to draw your attention to the announcement of a new publication which would make a worthy addition to the bookshelf of any international sports scholar. “Softpower, Soccer, Supremacy – The Chinese Dream” represents a unique and timely analysis of the movement of the most popular and influential game in the world – Association Football, commonly abbreviated to soccer - into the mainstream of Chinese national policy. The editorial team led by one of sports histories most recognised scholars, Professor J A Mangan, has assembled a who’s who of current scholars in sport in Asia. Together they provide a perspective that takes in, not just the Chinese view of these important current developments but also, the view of others in the geographical region. From Japan, Korea and Australia, they bring with them significant experience to not just the beautiful game, but sport in general in that dynamic and fast-growing part of the world. Particularly in the light of the European dominance identified in the Karog, Parim and Cene paper this work raises the question as to whether we can expect to see a change in the world order sooner rather than later. It remains for me to make one important acknowledgement. In my last editorial I alerted you to the sorts of decisions we as an editorial and publication team were facing with regard to ensuring the future of the journal. Debates as to how best to proceed while staying true to our vision and goals are still proceeding. However, I am pleased to acknowledge the sponsorship provided by The University of Macao for volume 42 and recognise the invaluable contribution made by ISCPES former president Walter Ho to this process. Sponsorship can provide an important input to the ongoing existence and strength of this journal and we would be interested in talking to other institutions or groups who might also be interested in supporting our work, particularly where their goals align closely with ours. May I therefore commend to you the works of our international scholars and encourage your future involvement in sharing your interest in and expertise with others in the world of comparative and international sport studies, John Saunders, Brisbane, May 2020

The aim of this study was to examine nurses’ attitudes about the importance of family in nursing care from an international perspective. We used a cross-sectional design. Data were collected online using the Families’ Importance in Nursing Care—Nurses’ Attitudes (FINC-NA) questionnaire from a convenience sample of 740 registered nurses across health care sectors from Sweden, Ontario, Canada, and Hong Kong, China. Mean levels of attitudes were compared across countries using analysis of variance (ANOVA). Multiple regression was used to identify factors associated with nurses’ attitudes and to test for interactions by country. Factors associated with nurse attitudes included country, age, gender, and several practice areas. On average, nurses working in Hong Kong had less positive attitudes compared with Canada and Sweden. The effects of predictors on nurses’ attitudes did not vary by country. Knowledge of nurses’ attitudes could lead to the development of tailored interventions that facilitate nurse-family partnerships in care.

Abstract Background Although dormitory residents have been identified as a high-risk group for alcohol misuse in Chinese university settings, the factors associated with their drinking behaviors has not be characterized. Methods A cross-sectional study was conducted among hostel residents in two Hong Kong universities (n = 1455) using self-administered, anonymous surveys. In addition to examining the knowledge levels and drinking-related attitudes, we examined the factors associated with binge drinking in this population using multivariable regression analysis. Results Among university dormitory residents, the prevalence of past-month binge drinking was 26.8% among males and 12.8% among females. It was noted that although respondents demonstrated attitudes conducive towards alcohol-free socialization, they exhibited low levels of alcohol-related knowledge (mean knowledge score: 3.3/ 10, SD = 2.0). While about 59% were aware that alcohol is a carcinogen and that some medications should not be taken with alcohol, only 10.4% were familiar with symptoms of alcohol poisoning and only 23% were familiar with relative amounts of alcohol in different beverage categories. Of the respondents the factors independently associated with past-month binge drinking were: male sex, older age, full-time hostel residence, drinking roommates, drinking romantic partner, participation in drinking games, and having pro-alcohol attitudes (OR ranging from 1.33-3.69). Alcohol-related knowledge was not associated with binge drinking. Conclusions Although southern China is a low alcohol consumption area, binge drinking is common among university residents and requires multi-prong interventions. Heavy drinking is a neglected health problem among urban Chinese university students. Interventions targeting binge drinkers need to counteract pro-alcohol attitudes and peer effects. Increasing alcohol knowledge may additionally help to reduce alcohol-related harms in this age group. Key messages Urban Chinese university dormitory residents demonstrate low levels of alcohol knowledge. Pro-alcohol attitudes and peers effects need to be addressed in university anti-binge drinking interventions.

Mental Health Survey of Junior Medical Officers. Gene Silencing Tools Released by CSIRO. China Participated in Global Sleeping Disorder Survey. Beijing Opens Liver Cancer Prevention Center. Hong Kong Bird Flu Virus Strikes Again. Emergency BP Drug Could be Potentially Fatal. Vitamin Prices Spirals in India Amidst Fears of Supply Cuts. India's Healthcare Industry Likely to Get Tax Concessions. Egg Bank Opens in Japan. AstraZeneca Under Investigation for Research Suppression on Lung Cancer Drug Irresa. Paper Review for Genetically Modified Crops. Harmful Corticosteroid Dosage in Asthma Inhalers.

AbstractThis paper explores attitudes toward dating people with disability amongst young people in Australia and Hong Kong. Data relating to disability were extracted from an e-survey that investigated young people’s (n = 2208) experiences of and attitudes toward dating. Quantitative data were analysed using descriptive statistics while open ended responses were subjected to interpretive content analysis. When asked about preferred characteristics for potential dates, young people identified factors that were unlikely to be negatively influenced by disability, such as loyalty, honesty, dedication, humour, and kindness. Yet when asked whether disability would influence their dating choices, most said that it would and expressed an unwillingness to date people with disability. Young adults in Hong Kong expressed less openness to dating people with disability than those in Australia. Physical disability and mental health issues were seen as less of a barrier to dating than intellectual or developmental disability. Despite recent gains in public attitudes toward people with disability, improvements are needed in terms of young people in the general population viewing people with disability as suitable partners and thus, allowing them to enjoy equal rights to relationships and sexuality. Culture is an important determinant, indicating a potential for change.

Research Facility at Macquarie University Joins International Proteomic Alliance. Public Databases have Errors and no Quick Fix. Genetic Viability of Australian Grasslands and Heathlands. China Drafts Biotechnology Accord with Brazil. China Calls for Closer Cooperation with US in Biomedical Research. Opportunities in China's Biomedicine Industry. China Aims to Be Leading Pharmacy Processing Center. Geneticist Tsui Lap Chee Appointed as Vice Chancellor of University of Hong Kong. India to Start Growing Pest-resistant Cotton. Health Ministry Confirms Fourth Mad Cow Case. Importance of Japanese Funding to Rice Genomics. Bio Expo Korea 2002 Scheduled for September. Korea Establishes an Arctic Science Base. The Sciences not Popular among Korean Students. Soya Bean the Only GM Food in the Malaysian Market. Fear Prevents AIDS Patients from Getting Cheaper Treatment. Biotech Industry Receives Big Funding. Genome Institute of Singapore Moves to New Facility. Scientist Lays out his Vision for the Life Sciences in Singapore. Industry Conference on Lab Design and Management. Singapore and University of Washington form Bioengineering Alliance. Taiwan Hsinchu Science Park's March Trade Highest in One Year. New Drug for ED Going on Sale Soon. Traders Urged to Market Higher Quality Rice. Hybrid Rice Meeting in Vietnam.

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Reading in a Foreign Language (Honolulu, HI, USA) 17.1 (2005), 23–59.05–284Jackson, Sue & Susan Gee (Victoria U of Wellington, New Zealand; sue.jackson@vuw.ac.nz), ‘Look Janet’, ‘No you look John’: constructions of gender in early school reader illustrations across 50 years. Gender and Education (Abingdon, UK) 17.2 (2005), 115–128.05–285Kaplan, B. Robert (U of Southern California, USA) & Richard B. Baldauf, Jr., Editing contributed scholarly articles from a language management perspective. Journal of Second Language Writing (Amsterdam, the Netherlands) 14.1 (2005), 47–62.05–286Keen, John (Manchester U, UK; john.keen@man.ac.uk), Sentence-combining and redrafting processes in the writing of secondary school students in the UK. Linguistics and Education (Amsterdam, the Netherlands) 15.1–2 (2004), 81–97.05–287Liu, Lu (Purdue U, USA), Rhetorical education through writing instruction across cultures: a comparative analysis of select online instructional materials on argumentative writing. 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BackgroundOral health literacy (OHL) has been recognized as a component of oral health disparities; however, the precise relationship between literacy and oral health outcomes has not been established. To explore the role of parents' OHL for their own subjective oral health, related behavior, and for the proxy assessment of their child's oral health, oral health-related behavior.MethodsSurvey data were collected from 406 parents of 4- to 7-year-old children in Beijing, China. The background characteristics, oral health assessment, oral health-related behavior, knowledge and attitudes, and diet-related questions of parents and their children were surveyed by a questionnaire. OHL was assessed with the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREAL-30) Scale and a revised version that asked the respondents to indicate if they understood the words (HKREALD-30-Understand).ResultsThe HKREALD-30 responses correlated with the HKREALD-30-Understand responses. The higher the parents' HKREALD-30-Understand scores, the better they described the health of their own teeth and gums, the greater their child's diet was influenced by the protein, sugar and calories of the food, and the more positive their oral health-related attitudes were. The higher the parent's HKREALD-30 scores, the healthier they described their child's teeth and gums.ConclusionsBoth the HKREALD-30 and HKREALD-30-Understand Scores correlate with parents' self and proxy oral health-related responses. Chinese parents could understand that the word would add predictive value to the prediction of how parents' oral health literacy affects their own oral health care, children's oral health and other related aspects.

Abstract Mosquito-borne viruses such as Zika virus, Japanese Encephalitis virus and Dengue virus present an increasing global health concern. However, in-depth knowledge of the distribution and diversity of mosquito-associated viruses and their related vectors remains limited, especially for China. To promote their understanding, we present the first comprehensive dataset of the distribution and diversity of these viruses and their related vectors in China (including Taiwan, Hong Kong and Macau). Data was drawn from peer-reviewed journal articles, conference papers and thesis publications in both English and Chinese. Geographical data on mosquito-associated viruses’ occurrence and related mosquito vector species was extracted, and quality-control processes employed. This dataset contains 2,428 accounts of mosquito-associated viruses’ and mosquito species geo-referenced occurrences at various administrative levels in China. The prevalent mosquito-associated virus includes Japanese encephalitis virus, Dengue virus, Banna virus and Culex flavivirus, whereas the abundant mosquito vectors are Culex tritaeryohynchus, Aedes albopictus and Culex pipiens pallens. This geographical dataset delivers a distribution and diversity outline of mosquito-associated viruses in China, and also applicable in various spatial and risk-assessment analysis.

Abstract Objective Health professionals in China tend to avoid open communication with terminally ill cancer patients concerning their diagnosis and prognosis. This review aims to explore Chinese cultural beliefs and attitudes concerning disclosure and death among health professionals and cancer patients in China and to investigate preferences of terminally ill cancer patients for a “good death.” Method A narrative literature review was conducted in May 2020 on MEDLINE, EMBASE, and WEB OF SCIENCE to include all studies with clear study design which presented its own study data or referred to data within underlying studies, published between January 2000 and May 2020, having cancer patients and/or healthcare professionals as participants, conducted in Mainland China, Hong Kong, or Taiwan and containing relevant data concerning “medical disclosure” or “good death.” Quality assessment of publications was conducted using the NIH and CASP checklists. Results Primary database search revealed a total of 108 papers of which 9 were ultimately included. The additional hand search led to the inclusion of eight further papers. In total, there were 11 quantitative studies, 4 qualitative studies and 2 literature reviews included in this review. Our findings indicated that most terminally ill cancer patients in China want to know the truth about their diagnosis and prognosis and preferred to be informed by their doctors. Terminally ill cancer patients valued a good relationship with family and medical staff as well as being respected as an individual and wanted to be able to prepare for death. Significance of results Terminally ill cancer patients in China often have a substantial need for information about their condition while their preferences are widely consistent with those in Western societies. Training for health professionals needs to focus on communication skills in order to overcome barriers in patient interaction.

Abstract Background Microscale environmental features are usually evaluated using direct on-street observations. This study assessed inter-rater reliability of the Microscale Audit of Pedestrian Streetscapes, Global version (MAPS-Global), in an international context, comparing on-street with more efficient online observation methods in five countries with varying levels of walkability. Methods Data were collected along likely walking routes of study participants, from residential starting points toward commercial clusters in Melbourne (Australia), Ghent (Belgium), Curitiba (Brazil), Hong Kong (China), and Valencia (Spain). In-person on the street and online using Google Street View audits were carried out by two independent trained raters in each city. The final sample included 349 routes, 1228 street segments, 799 crossings, and 16 cul-de-sacs. Inter-rater reliability analyses were performed using Kappa statistics or Intraclass Correlation Coefficients (ICC). Results Overall mean assessment times were the same for on-street and online evaluations (22 ± 12 min). Only a few subscales had Kappa or ICC values < 0.70, with aesthetic and social environment variables having the lowest overall reliability values, though still in the “good to excellent” category. Overall scores for each section (route, segment, crossing) showed good to excellent reliability (ICCs: 0.813, 0.929 and 0.885, respectively), and the MAPS-Global grand score had excellent reliability (ICC: 0.861) between the two methods. Conclusions MAPS-Global is a feasible and reliable instrument that can be used both on-street and online to analyze microscale environmental characteristics in diverse international urban settings.

Medical and health researchers have shown that fatalities during heat waves are most commonly due to respiratory and cardiovascular diseases, primarily from heat's negative effect on the cardiovascular system. In an attempt to control one's internal temperature, the body’s natural instinct is to circulate large quantities of blood to the skin. However, to perform this protective measure against overheating actually harms the body by inducing extra strain on the heart. This excess strain has the potential to trigger a cardiac event in those with chronic health problems, such as the elderly, Cui et al. Frumkin showed that the relationship of mortality and temperature creates a J-shaped function, showing a steeper slope at higher temperatures. Records show that more casualties have resulted from heat waves than hurricanes, floods, and tornadoes together. This statistic’s significance is that extreme heat events (EHEs) are becoming more frequent, as shown by Stone et al. Their analysis shows a growth trend of EHEs by 0.20 days/year in U.S. cities between 1956 and 2005, with a 95% confidence interval and uncertainty of ±0.6. This means that there were 10 more days of extreme heat conditions in 2005 than in 1956. Studies held from 1989 to 2000 in 50 U.S. cities recorded a rise of 5.7% in mortality during heat waves. The research of Schifano et al. revealed that Rome’s elderly population endures a higher mortality rate during heat waves, at 8% excess for the 65–74 age group and 15% for above 74. Even more staggering is findings of Dousset et al. on French cities during the 2003 heat wave. Small towns saw an average excess mortality rate of 40%, while Paris witnessed an increase of 141%. During this period, a 0.5 °C increase above the average minimum nighttime temperature doubled the risk of death in the elderly. Heat-related illnesses and mortality rates have slightly decreased since 1980, regardless of the increase in temperatures. Statistics from the U.S. Census state that the U.S. population without air conditioning saw a drop of 32% from 1978 to 2005, resting at 15%. Despite the increase in air conditioning use, a study done by Kalkstein through 2007 proved that the shielding effects of air conditioning reached their terminal effect in the mid-1990s. Kan et al. hypothesize in their study of Shanghai that the significant difference in fatalities from the 1998 and 2003 heat waves was due to the increase in use of air conditioning. Protective factors have mitigated the danger of heat on those vulnerable to it, however projecting forward the heat increment related to sprawl may exceed physiologic adaptation thresholds. It has been studied and reported that urban heat islands (UHI) exist in the following world cities and their countries and/or states: Tel-Aviv, Israel, Newark, NJ, Madrid, Spain, London, UK, Athens, Greece, Taipei, Taiwan, San Juan, Puerto Rico, Osaka, Japan, Hong Kong, China, Beijing, China, Pyongyang, North Korea, Bangkok, Thailand, Manila, Philippines, Ho Chi Minh City, Vietnam, Seoul, South Korea, Muscat, Oman, Singapore, Houston, USA, Shanghai, China, Wroclaw, Poland, Mexico City, Mexico, Arkansas, Atlanta, USA, Buenos Aires, Argentina, Kenya, Brisbane, Australia, Moscow, Russia, Los Angeles, USA, Washington, DC, USA, San Diego, USA, New York, USA, Chicago, USA, Budapest, Hungary, Miami, USA, Istanbul, Turkey, Mumbai, India, Shenzen, China, Thessaloniki, Greece, Rotterdam, Netherlands, Akure, Nigeria, Bucharest, Romania, Birmingham, UK, Bangladesh, and Delhi, India. The strongest being Shanghai, Bangkok, Beijing, Tel-Aviv, and Tokyo with UHI intensities (UHII) of 3.5–7.0, 3.0–8.0, 5.5–10, 10, and 12 °C, respectively. Of the above world cities, Hong Kong, Bangkok, Delhi, Bangladesh, London, Kyoto, Osaka, and Berlin have been linked to increased mortality rates due to the heightened temperatures of nonheat wave periods. Chan et al. studied excess mortalities in cities such as Hong Kong, Bangkok, and Delhi, which currently observe mortality increases ranging from 4.1% to 5.8% per 1 °C over a temperature threshold of approximately 29 °C. Goggins et al. found similar data for the urban area of Bangladesh, which showed an increase of 7.5% in mortality for every 1 °C the mean temperature was above a similar threshold. In the same study, while observing microregions of Montreal portraying heat island characteristics, mortality was found to be 28% higher in heat island zones on days with a mean temperature of 26 °C opposed to 20 °C compared to a 13% increase in colder areas.

Jarrow, Gail. Bubonic Panic: When Plague Invaded America. Calkins Creek, 2015.If public health seems like it would be one of those topics that would send you to sleep, then Bubonic Plague: When Plague Invaded America by Gail Jarrow will change your mind. This is the final book in her trilogy about Deadly Diseases for middle grades and higher.Jarrow is fairly succinct in presenting the history, transmission, and trajectory of various waves of plague around the world. She briefly charts its first appearance in 541 in Turkey, then vividly describes the second wave that started in 1346 and at its most virulent was named the Black Death, killing millions in Europe and parts of Asia and North Africa. The majority of the book focuses on the third wave, when it reached North America.The third pandemic began in the mid-1800s when China became ground zero for this next wave, which spread to Hong Kong by 1894. Hong Kong was a busy port town and trade and travel on steamships allowed for rapid dispersion of the disease. Researchers from a number of countries sought feverishly to identify the source of the epidemic and learn how it was spread. By the late 1890s two of them had proven it was rat fleas. Unfortunately almost nobody believed them, which became problematic when in 1900 San Francisco saw its first deaths in Chinatown.Jarrow provides a fascinating look at the political and social climate of this period in relation to the attitudes of Americans towards Chinese immigrants and the impact quarantining San Francisco’s Chinatown would have on businesses reliant on trade and tourism. It became a complicated and fraught tug-o-war between politicians, businessmen, doctors and public health officials, fighting about whether to recognize and publicize the deaths and quarantine when the evidence seemed inconclusive as to their cause. Even after proof was offered action was surprisingly slow to follow and the disease was able to spread, although the number of deaths was comparatively low, being in the low hundreds.This well researched book also includes information about contemporary cases in the United States, ongoing research and treatments for all three strains of plague. There are extensive source notes and bibliography, a glossary, timeline, index and an author’s note explaining her keen interest in public health and the importance it had in the past,and will have when the next global pandemic hits. Also included are numerous photographs (some a little gruesome), newspaper clippings, cartoons, posters and illustrations to engage readers’ interest.This will pair perfectly with a middle grade novel, Chasing Secrets by Gennifer Choldenko, 2015 that gives a fictional account of the outbreak in San Francisco.This is a strong finish to a fascinating series that combines history, social issues, scientific research, technological developments and culture in America, showing long term implications for today’s government policies towards health.Highly Recommended: 4 out of 4 starsReviewer: Tammy FlandersTammy is the Reference Coordinator in the Doucette Library of Teaching Resources at the University of Calgary. She also reviews juvenile resources with an eye to classroom use in her blog, Apples with Many Seeds.