Health Literacy (HL) is an important determinant of health. Many scholars have conducted a large number of studies on the level of Chinese students’ HL and its associated factors. However, previous studies on HL level and the factors that influence it have been contradictory. Therefore, this systematic review and meta-analysis was conducted to estimate the level of Chinese students’ HL and its three dimensions (knowledge, behavior and skills) and to identify factors associated with HL in Chinese students. Two investigators independently searched literature, selected research and extracted data through comprehensively searching of four international electronic databases and three Chinese electronic database to identify all relevant observational studies on affecting factors for HL in Chinese students published in English and Chinese from database January, 2010 to September, 2020. In total, 61 articles were extracted in the study. The results showed that the level rates of HL and its three dimensions were 26%, 35%, 26%, 51%, respectively. For Chinese students, the significant factors were urban residents, senior class students, well performance at school, the Han nationality, focus on health knowledge, less exposure to video games, highly educated parents, income of one-child families, receiving health education, having medical background. This study provides some inspirations for improving the level of Chinese students’ HL and their health. First, the findings may help Chinese policy makers understand the overall HL of Chinese students and their levels across three dimensions (knowledge, behavior and skills). Second, protective factors for Chinese students’ HL were found in this research, which will help to improve the level of Chinese students’ HL, stimulate students’ awareness of prevention, and lay the foundation for a healthy China.

With a surge of conflicts between healthcare workers and patients in recent years, the therapeutic relationship (TR) in China is presently in tension. Meanwhile, consequent issues have begun to emerge, such as the distrust between healthcare workers and patients and the decline in the quality of medical services. Although many empirical studies about the TR have been conducted in China, previous studies on TR and its influencing factors have been contradictory. Therefore, this study conducted a systematic review and meta-analysis to assess the current situation of the TR and to identify factors associated with the TR in Chinese hospitals from three perspectives (healthcare worker, patient, and therapeutic interaction). Two reviewers independently searched the literature, selected researches, and extracted data through comprehensively searching of three international electronic databases and three Chinese electronic databases to identify all relevant observational studies on influencing factors for TR in China published in English and Chinese from January 2000 to January 2020. Among the 3290 records initially identified, 11 studies met the selection criteria. A total of 96,906 individuals were included in the review. The results showed that 55.73% of healthcare workers consider the TR to be tense, and 33.7% of patients hold this view. The meta-analysis indicated that healthcare workers who were male, older, less educated, working in a non-surgical department, and had a senior title were more likely to be pessimistic about the TR. Patients who were rural residents, highly educated, and had no medical insurance were more likely to be pessimistic about the TR. Furthermore, the mutual trust could improve rapport between healthcare workers and patients. The 25 other related factors related to the TR were analyzed and described using a narrative approach. The findings might deserve consideration in the design of relative policies to promote harmony between doctors and patients.

To analyse the prevalence of severe and critical COVID-19 cases and its determinants, a systematic review and meta-analysis were conducted using Review Manager. Four English and two Chinese databases were used to identify and explore the relationships between the severity of COVID-19 and its determinants, with no restrictions on publication date. The odds ratio and 95% CI were combined to assess the influencing level of all factors. Twenty-three articles containing a total of 15,828 cases of COVID-19 were included in this systematic review. The prevalence of severe and critical COVID-19 cases was 17.84% and 4.9%, respectively. A total of 148 factors were identified, which included behavioural, symptom, comorbidity, laboratory, radiographic, exposure, and other factors. Among them, 35 factors could be included in the meta-analysis. Specifically, for example, the male (OR 1.55, 95% CI 1.42–1.69) and elderly (OR 1.06, 95% CI 1.03–1.10) populations tended to experience severe and critical illness. Patients with cough, dyspnea, fatigue, fever, and gastrointestinal symptoms could have severe and critical diseases. Regarding laboratory results, albumin, aspartate aminotransferase, creatinine, D-dimer, fibrinogen, neutrophils, procalcitonin, platelets, and respiratory rate were potential factors that could be used to predict the severity of COVID.

Objective: The purpose of this study is to explore the relationship between parents’ phubbing behavior and children’s online gaming time. More importantly, we investigated the mediating role of electronic health literacy in this association. Methods: A total of 1200 questionnaires were sent out and 1130 effective questionnaires were returned, an effective recovery of 94.17%. As some students did not answer part of the EHL survey, eventually only 867 students were included in this study based on the selected independent variables and the degree of questionnaire completion. Both tools used for measuring parental phubbing and electronic health literacy passed confirmatory factor analyses. To analyze the mediating effect of electronic health literacy on parental phubbing behavior and online gaming time, 5000 datapoints were sampled using the Bootstrapping method. Results: The results indicated that parents’ phubbing was positively related to their children’s online gaming time, which was mediated by electronic health literacy, parental phubbing is positively and significantly correlated with electronic health literacy, and electronic health literacy is negatively and significantly correlated with online gaming time among adolescents. Conclusions: Electronic health literacy partially mediates the relationship between parental phubbing behavior and adolescent online gaming time, and Chinese students’ electronic health literacy is a two-dimensional structure consisting of health information acquisition and application. This study is the first empirical study to explore the relationship between parental phubbing behavior and the amount of time adolescents spend playing games online.

As a southwestern province of China, Sichuan is confronted with geographical disparities in access to healthcare professionals because of its complex terrain, uneven population distribution and huge economic gaps between regions. With 10-year data, this study aims to explore the county-level spatial disparities in access to different types of healthcare professionals (licensed doctors, registered nurses, pharmacists, technologists and interns) in Sichuan using temporal and spatial analysis methods. The time-series results showed that the quantity of all types of healthcare professionals increased, especially the registered nurses, while huge spatial disparities exist in the distribution of healthcare professionals in Sichuan. The local Moran’s I calculations showed that high–high clusters (significantly high healthcare professional quantity in a group of counties) were detected in Chengdu (capital of Sichuan) and relatively rich areas, while low–low clusters (significantly low healthcare professional quantity in a group of counties) were usually found near the mountain areas, namely, Tsinling Mountains and Hengduan Mountains. The findings may deserve considerations in making region-oriented policies in educating and attracting more healthcare professionals to the disadvantaged areas.