Purpose: The purpose of this paper is to explore consumers’ intention to purchase genetically modified (GM) food from the perspective of risk information. Design/methodology/approach: A conceptual model was proposed in which intention to purchase GM food is stimulated by the combination and complex effects of knowledge, risk perception, information need, information seeking and attitude. A face-to-face questionnaire survey was conducted in Jinan, Shandong Province. A total of 757 valid samples (55.6 percent of women vs men) were involved to conduct structural equation model analysis. Findings: Results demonstrated that attitude is the most important predictor of intention to purchase GM food. Attitude, in turn, is predicted by risk perception and information seeking. Risk perception is a significant determinant of information need and information seeking. Moreover, information need influences information seeking. Finally, knowledge plays a critical role in risk perception and intention. Overall, the explained variance of the model is 66 percent. Originality/value: The study provides new insights explaining intention to purchase GM food by constructing a conceptual model from the perspective of risk information. In this model, knowledge, risk perception, information need and information seeking are all based on information related to GM food, resulting in attitude and intention to purchase.

Shared decision-making (SDM) has been institutionally recognized as clinically effective by many Western healthcare systems. Nevertheless, it appears culturally unattractive in China, a country that adheres to Confucian familism which strongly prefers collective family decisions. This study examined this conflict and assessed the influence of Confucian familism on SDM in end-of-life (EOL) care for advanced cancer patients. Between August and November 2018, 188 EOL advanced-cancer patients were randomly recruited from 640 cancer hospital medical records at a Tertiary A-level hospital in Shandong province. Eventually, 164 (87.23%) sample patients were included in the statistical analysis after the non-responsive cases (4.79%) and missing value (7.98%) were removed. SDM was measured through SDM-Q-9, and the patient’s siblings were used as indicators of Confucian Familism. Of the 164 patients, the mean SDM score was 38/100; 47.6% were thoroughly unfamiliar with their treatment plans and fell outside the decision-making procedure. Each patient had four siblings on average. Ceteris paribus, more siblings led to lower SDM. Moreover, being 56–65 years old and open-minded were associated with higher SDM, while higher satisfaction of the quality of EOL care yielded lower SDM. In conclusion, Confucian familism weakened patient–clinician SDM in EOL care for advanced cancer patients.

China’s environmental problems have long been criticized. The Communist Party of China (CPC) and the government have increasingly paid attention to developing environmental protection and included the construction of an ecological civilization in the “Five-in-One” development strategy. The improvement of regional eco-efficiency is an important way to realize the coordinated development of the entire society, and environmental policy instruments are a powerful means to enhance regional eco-efficiency. This paper categorizes environmental policy instruments into mandatory, hybrid, and voluntary types. Based on panel data from 31 provinces in China from 2005 to 2015, the paper discusses the impact of environmental policy instruments on regional eco-efficiency and the means of the impact. The research shows that (1) mandatory and hybrid environmental policy instruments play a significant role in promoting regional eco-efficiency, while the role of voluntary instruments is not significant in promoting regional eco-efficiency; (2) hybrid and mandatory environmental policy instruments have negative interactions; and (3) the level of economic development will positively affect the role of hybrid environmental policy instruments in promoting regional eco-efficiency but negatively affect the role of mandatory instruments in promoting regional efficiency.

Based on policy instrument theory and a case of low-carbon city development (Qihe County in Shandong), this study examined the policy instruments adopted for low-carbon city development in China and the effectiveness of these instruments. All the policies adopted by the piloted city from 2008 and 2014 were collected, coded, and analyzed. A two-dimensional analytical framework was developed based on a trichotomous policy instrument categorization and low-carbon city connotation. The results showed that the key goal of China’s low-carbon city construction is to develop low-carbon technology and low-carbon energy. Compulsory policy instruments are the most used and most effective, while voluntary policy instruments are rarely used. Further results indicated that when the ratio of compulsory instruments and mixed instruments comes to 2:1, the combination of policy instruments can lead to the optimal completion degree. It seems difficult to balance the stability of various policy instruments with the overall high completion degree. Chinese local governments are more accustomed to compulsory policy instruments. This reminds policymakers to pay more attention to the potential of voluntary instruments and mixed instruments in building low-carbon cities.

Public sectors typically learn from crises, providing them the opportunity to improve the performance of crisis management. Through thematic analysis, this study maps out the evolution process of China’s pandemic response and emergency management systems and summarizes the characteristics of China’s crisis learning process, crisis learning subject, and crisis learning content. The findings indicate that China’s pandemic response and emergency management systems have the characteristics of crisis learning with gradual adjustments and continuous innovation. Specifically, under the impetus of China’s political factors, its pandemic response and emergency management systems have been able to learn from crises and have a complete crisis learning process. This crisis learning process includes adaptive learning, as well as single, double, and triple-loop learning. There is also a clear selection preference at various government levels, corresponding crisis learning processes and stages, and the path dependence of crisis learning content. Moreover, political accountability, attention, and pressure are the key factors opening the window of crisis learning, but the decision-making authority is the decisive factor of crisis learning in China’s centralized context. This study provides a theoretical framework for understanding the evolution and changes in the government’s crisis learning model and puts forward policy implications.

Objective: Understanding the preferences of old -age adults for their long-term caregivers can improve person -centred health care and the quality of long-term care (LTC). This study examines Chinese older adults ' preferences for long-term caregivers. Study design: This is a cross-sectional study. Methods: A national representative discrete choice experiment (DCE) surveyed 2031 adults aged 50-70 across 12 provinces in China. Each DCE scenario described five attributes: type of caregivers, place of LTC, contents of LTC, out-of-pocket payments, and quality of life (QoL). Preferences and the marginal willingness to pay (WTP) were derived using mixed-logit and latent class models. Results: Older adults displayed higher preferences for long-term caregivers who improve their QoL, incur lower out-of-pocket payments, and provide medical LTC services at home, with the maximum WTP of $22.832 per month. QoL was rated as the most important LTC factor, followed by the place of LTC and the type of caregivers. When the level of QoL improved from poor to good, respondents would be willing to pay $18.375 per month more (95% con fidence interval: 16.858 to 20.137), and the uptake rate increased by 76.47%. There was preference heterogeneity among older people with different sex, education, family size, and knowledge of LTC insurance. Conclusion: QoL was the most important factor in older Chinese adults' preference for caregivers. Home care and medical care from formal caregivers was preferred by older adults. We recommend training family caregivers, raising older people's awareness of LTC insurance, and guiding policymakers in developing people -oriented LTC and a multi -level LTC system. (c) 2024 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.