Objective: To evaluate the awareness of College Students (CSs) of HPV vaccine in China and provide evidence-based recommendations for HPV vaccine’s publicity and promotion. Methods: Web of Science, PubMed, Science of Direct, EBSCO, China National Knowledge Infrastructure and Wanfang Data were searched. A random effects meta-analysis was conducted to determine pooled estimates of Awareness Rate (AR) for HPV vaccine. Results: Of the 36 studies included, the estimated AR of HPV vaccine was 40.27% (95% CI: 30.86%, 50.06%) among Chinese CSs. The AR of HPV vaccine was stratified by factors as gender, major, area, city, survey time, and sampling method of the study. The pooled AR of HPV vaccine among CSs was as follows: 44.17% (95% CI: 31.65%, 57.09%) and 31.93% (95% CI: 13.25%, 54.30%) for females and males; 44.47% (95% CI: 29.90%, 59.55%) and 12.02% (95% CI: 7.69%, 17.15%) for medical-related and nonmedical majors; 44.47% (95% CI: 28.71–60.82%) and 41.16% (95% CI: 26.48–56.64%) for Eastern and Midwestern region; 48.86% (95% CI: 30.63–67.25%) and 33.19% (95% CI: 22.27–45.12%) for first-tier and second- and third-tier city; 29.67 (95% CI: 11.44–52.16%) and 38.81 (95% CI: 27.14–51.21%) for AR before and after HPV vaccine entered in China; 51.51% (95% CI: 32.21%, 70.53%) and 26.21% (95% CI: 17.41%, 36.10%) for nonrandom and random sampling. Conclusion: This review indicates that awareness of HPV vaccine among CSs remains relatively low in China compared with European countries. Our findings may provide useful information to better understand the HPV vaccine awareness status among Chinese CSs.

This study seeks to measure the efficiency disparity and productivity change of tertiary general public hospitals in Wuhan city, central China from the perspective of administrative affiliations by using panel data from 2013 to 2017. Sample hospitals were divided into three categories, namely provincial hospitals, municipal hospitals, and other levels of hospitals. Data envelopment analysis with bootstrapping technique was used to estimate efficiency scores, and a sensitive analysis was performed by varying the specification of model by considering undesirable outputs to test robustness of estimation, and efficiency evolution analysis was carried out by using the Malmquist index. The results indicated that the average values of provincial hospitals and municipal hospitals have experienced efficiency improvement over the period, especially after the initiation of Pilot Public Hospital Reform, but hospitals under other affiliations showed an opposite trend. Meanwhile, differences of administrative subordination in technical efficiency of public hospitals emerged, and the disparity was likely to grow over time. The higher efficiency of hospitals affiliated with municipality, as compared with those governed by province and under other administrative affiliations, may be attributed to better governance and organization structure.

<!-- *** Custom HTML *** --> The configuration of a multifunctional rural landscape is critical for its protection. Although studies on multifunctional rural landscapes have been conducted, there is a lack of information regarding the spatiotemporal characteristics and tradeoff/synergy relationships of rural landscape functions in the time series on the administrative unit scale. The purposes of this study were to (1) analyze the spatial-temporal distribution characteristics of the tradeoff and synergy from the perspective of multifunctionality for efficient use of rural landscape resources and (2) formulate regional sustainable development policies to minimize the conflict between people and nature. Aiming at the scientific representation of landscape function and the quantification of landscape multifunctional relationships, and by taking Qingpu District of Shanghai as an example, six kinds of rural landscape functions were constructed according to the functional framework of “productive function, living function and ecological function”. Based on the data for 1980 to 2018, the characteristics of variations of multifunctional tradeoff and synergy relationships of the rural landscape in 184 administrative villages were studied by the methods of Spearman rank correlation coefficient analysis and bivariate spatial autocorrelation. The following results were obtained. 1) The fine division of rural landscape function types was realistic and necessary for analyzing the regional multi-function relationships in the regions with rapid development. In the process of rapid urbanization, the rural landscape functions of urban suburban areas changed under the combined action of natural resource endowment, social and economic conditions and other internal and external factors. As a result, the agricultural production function could not replace the economic development function and become the function of rural landscape production. The research results of Qingpu District showed that the agricultural production function was no longer the primary functional form, yet the economic development function became the dominant function in this area. 2) Temporal and spatial analysis methods of rural landscape functions can accurately and comprehensively reflect the evolution of the characteristics of multifunction tradeoffs and synergies. According to the Spearman rank correlation analysis of the multifunction value of the rural landscape in the time dimension, the results masked the differences of resource and environment carrying capacity caused by the differences of regional landscape resource endowment in the spatial dimension. 3) The spatial and temporal differences of the multi-functional tradeoffs and synergies of the rural landscape in Qingpu District from 1980 to 2018 were significant. There was significant heterogeneity of tradeoffs and synergies between functions in the spatial pattern, with clustering characteristics. Meanwhile, as for the temporal pattern, the tradeoffs and synergies of functions changed differently in terms of Moran's I and the correlation coefficient. The results of this study can provide scientific references for urban-suburban-rural space reconstruction and regional sustainable development.

Background: During the pandemic, a third dose of the COVID-19 vaccine effectively reduces the proportion of severe cases in those infected, but vaccine hesitancy impedes this reasonable prevention method. Epidemic control in China is being tested due to the large population base, especially in crowded places like college campuses. This study aimed to explore the configuration paths of psychological antecedents for college students to receive a third COVID-19 vaccine.Methods: An anonymous cross-sectional survey was carried out in five universities in Wuhan using convenience sampling. A long version of the 5C 7-point Likert scale was used to measure college students' intention and psychological antecedents on the third dose of the COVID-19 vaccine. A fuzzy-set Qualitative Comparative Analysis (QCA) approach was performed to explore the configuration of conditions to the vaccination willingness.Results: 31.67% of respondents surveyed did not receive their third dose of the COVID-19 vaccine. The score of intention to get the vaccine for college students who did not receive the booster vaccine was 4.93 (±1.68). Average scores of 5.19 (±1.24), 4.35 (±1.75), 4.02 (±1.45), 5.84 (±1.23), and 4.61(±1.32) were reported for confidence, complacency, constraints, calculation, and collective responsibility in them. QCA showed high confidence and collective responsibility playing a central role in third dose vaccination intention. Meanwhile, low confidence and collective responsibility are the core conditions of low vaccination willingness.Conclusion: Eliminating vaccine hesitancy necessitates focusing on the psychological antecedents of vaccination intentions to identify critical targets for policy and interventions. This study identified trust and collective responsibility are core elements of the psychological antecedents of college students' intention to receive the booster vaccine for COVID-19. To achieve herd immunity as soon as possible, health administration and campus can start with vaccine confidence-building and collective responsibility cultivation to take appropriate actions and measures to improve coverage of the booster vaccination.