Main Cities Research Articles

Assessment of university students’ energy saving behavior by integrating stimulus-organism-response (SOR) and the theory of planned behavior (TPB)

Concerned about balancing issues of global warming and economic growth, the growing needs of energy consumption in contexts with limited production and resources have created a serious challenge for developing countries like Pakistan. Research approaches that focus mainly on the production or purchase of environmentally friendly products or assessment of the stance of employees and households are not seen as sufficient to present the full picture of any society regarding energy saving behaviors (ESB). The attitudes and behaviors of the student population have generally not been sufficiently presented in energy saving studies to reflect current or emerging realities. Two leading behavioral theories, stimulus-organism-response theory (SOR) and the theory of planned behavior (TPB), and their relevant variables are integrated in this study to unpack the ESB of university-going students in Pakistan. Through an online survey, 410 university students from the four main urban cities of Pakistan participated in the study. The findings revealed that media and organizational climate have significantly created both a sense of social pressure and responsibility among students to cultivate stronger intentions and actions toward saving energy. The results further indicated that these behavioral intentions do indeed have a strong impact on students reported ESB. Overall, the students appeared to have been effectively influenced to be more active in saving energy for their society and country. The findings also validate the selected energy-related constructs and predictive paths in the proposed integrated SOR and TPB model. This study shows the potential for the further testing and application of the variables and this model in other contexts with other populations as the world grapples with energy shortages and global climate change issues.

The impact and interactive effects of multi-level spatial policies on urban renewal: A case study of Shenzhen, China

Spatial policies are crucial to regulating the harmful consequences of land use change on social-ecological systems. As the urban development model transitions to urban regeneration, the efficacy of spatial policies on urban renewal remains insufficiently explored. To investigate the mechanism of multi-level spatial policies on urban renewal, we employ logit models to scrutinize the impact of four spatial policies on urban renewal in Shenzhen from 2010 to 2020, along with embedding interaction effect models to examine the interaction between multiple policies. This study comprehends the mechanism of multi-level policies in three dimensions: spatial, temporal, and interactive. (1) Small-scale spatial policies tend to have a more substantial control effect, with micro land use policies increasing the probability of urban renewal by 2.04–3.77 times. Urban renewal prioritizes inward development, demanding a higher level of spatial policy resolution. (2) Except for the planned main city centers, the effects of all policies escalate over time, with the intensity of commercial planning surging up to 139% in 2016–2020 compared to the previous period. (3) Interaction effects between policies exist between policies at different scales. The effects of the main centers and the urban renewal planning reinforce each other by 37%, while the effects of the main centers and the commercial plans counteract each other by 34%. The coordination of multisectoral policies and the diversified use of policy instruments are conducive to enhancing the interactive effects between policies.

Post-COVID-19 syndrome: Descriptive analysis based on a survivors' cohort in Colombia

BackgroundThe prevalence of post-COVID-19 Syndrome (PCS) is estimated to be between 10% and 20%. The main reported symptoms are fatigue, memory alterations, dyspnea, sleep disorders, arthralgia, anxiety, taste alterations, coughing and depression. This study aims to determine the prevalence of post-COVID-19 symptoms in a group of Colombian patients who were recruited during their outpatient appointments. MethodologyThis cross-sectional study was conducted between December 2021 to May 2022. It included patients from outpatient facilities located in five main cities in Colombia who were positive for SARS-CoV-2 infection detected by reverse transcription-polymerase chain reaction (RT-PCR) testing and reported PCS in the following 12 weeks after their COVID-19 diagnosis. ResultsA total of 1047 individuals >18 years old met the inclusion criteria and were included in the study. The median age was 46 years old. 68.2% of the participants were female, 41.5% of the patients reported having a pre-existent condition (hypertension, anxiety disorder, diabetes, hyperthyroidism, obesity and asthma). Only 22% had received at least one dose of COVID-19 vaccine prior to the COVID-19 episode registered. The more prevalent symptoms within our group are described as follows: fatigue (53.3%), dyspnea (40.3%), arthralgia and/or myalgia (43%), cephalea (40.5%), sleep disorders (35.7%) and coughing (31.3%). 72% of the patients presented four or more post-COVID 19 symptoms, 9% two symptoms, and 10% only one symptom. ConclusionThe findings of this study are consistent with international literature publicly available. The distribution and prevalence of post-COVID symptoms highlight the importance of further research to improve understanding and its potential consequences and implications in terms of quality of life and health care planning services.

Indoor air quality in Saudi residential homes

This study aimed to assess the level of IAQ (indoor air quality) through monitoring of several air pollutants inside selected homes in the Eastern Province of Saudi Arabia, and to study the most affecting factors on IAQ. Continuous 8-hour monitoring at each home during six months of 2019–2020 was conducted for six air pollutants inside and outside 200 homes, representing three main Saudi cities (Dammam, Al-Hofuf and Qatif). Measurements of six air pollutants were conducted in the kitchen, the living room and the bedroom inside each home and simultaneously outside these homes in their immediate vicinity. The highest mean levels of PM10 (50.3 ± 20.0 µg/m3), CO2 (822.9 ± 195.1 ppm) and NO2 (0.044 ± 0.009 ppm) were found in kitchens, while the highest mean level of CO (1.27 ± 0.25 ppm) was found in living rooms. As for total volatile organic compounds (TVOC) and SO2, their levels were nearly the same at three sites (0.21 ± 0.04 ppm and 0.018 ± 0.002 ppm, respectively). Levels of PM10 exceeded their air quality guidelines (AQGs) in homes that are located near industrial and agricultural areas, while levels of other air pollutants were lower than their AQGs in all regions. The increase in concentrations of air pollutants outdoors was accompanied by an increase in concentrations indoors.

SARS-CoV-2 incidence and hospitalisation in South Tyrol (Italy): a population-based ecological study

Abstract Background Literature associating SARS-CoV-2 spread to environmental variables such as altitude, tourism, vaccination adherence and demographics, is inconclusive and contrasting. This study aimed at studying these relationships during the first unrestricted winter in South Tyrol, a multicultural Italian alpine province. Methods An ecological study was performed, based on the 20 districts of the area. Data about incidence and hospitalization between November ’21 and February ’22 was collected and associated to geographical, demographic and health-related characteristics via bivariate analyses. Results Incidence (range: 15% - 22%) and hospitalization (range: overall = 0.09% - 0.26%/ intensive care unit (ICU) = 0 - 0.06%) varied widely among districts. Incidence showed positive correlations with average altitude (Rho=0.62, p < 0.001), tourist amount (0.54, p < 0.04) and average family size (0.66, p < 0.005); whereas negative ones with vaccination coverage (-0.62, p < 0.04) and population density (-0.44, p < 0.05). Similar trends were observed for ICU admissions. Incidence was significantly higher in Ladin speaking districts and lower in Italian ones, while ordinary wards admission appeared lowest in Ladin districts and higher in the Italian ones, as well as close to main cities and hospitals. Conclusions Living in urban districts, geographically and linguistically closer to the Health Authorities, may have played a protective role against infection and severe disease, through an increased adherence to public health preventive measures. The concomitant higher rate of admissions might be due to the easier access to the structures. By contrast, infection spread was higher in rural and sparsely populated districts, associated with greater winter tourism and family sizes, but also characterized by lower herd immunity and institutional closeness. More attention should be paid to communities with special needs (geographical and cultural) to ensure equitable means for future pandemics. Key messages • Living in urban districts may protect against infection spread through increased adherence to public health preventive measures, and facilitate hospitalisations due to easier access to the structures. • More attention should be paid to communities geographically and culturally distant from Public Health Institutions to ensure equitable means for future pandemics.

Informal Traffic Controller: Study on Shadow Economy in Indonesia

The urban low-income segment of society survived on their earnings in the informal sector. This study examines the informal traffic controllers in the shadow economy framework who assist incoming cars at traffic-congested intersections and turning lanes in the main cities to earn income. This paper originates from the preliminary study of “Pak Ogah”: the Portrait of Shadow Economy in the Greater Area of Jakarta. The field study was conducted at 60 congested intersections and turning lanes on roadways where the informal traffic controller groups operated. The study employs a mixed method of qualitative and quantitative procedures and conducts a triangulation strategy. The study's implications suggest that the shadow economy was created by institutional failure to anticipate the negative impact of urban development policy.JEL Classification: O17, E26, R41, I32How to Cite:Chalid, P., & Kuswini, I. (2023). Informal Traffic Controller: Study on Shadow Economy in Indonesia. Signifikan: Jurnal Ilmu Ekonomi, 12(2), 399-412. https://doi.org/10.15408/sjie.v12i2.33434.

Seismic structure beneath the Avacha and Koryaksky volcanoes in Kamchatka based on the data of permanent and temporary networks

Avacha and Koryaksky are active volcanoes located in the vicinity of Petropavlovsk-Kamchatsky, the main city of Kamchatka, and they represent a serious hazard to the surrounding population and infrastructure. Here we investigate the upper-crustal structure beneath these volcanoes by implementing local earthquake tomography based on data from permanent seismic stations and from a temporary network installed in 2018–2019. Although the total amount of seismic rays recorded by the temporary network dataset is much lower, adding this data and attributing an appropriate weight lead to considerable increase of the resolution compared to the case of using merely the permanent network data. The resulting distributions of the P and S wave velocities, and especially the Vp/Vs ratio, reveal two magma reservoirs located below Avacha and Koryaksky volcanoes. Different depths of their upper limits explain differences in the eruption activity styles of these volcanoes. Below the Avacha Pass, we observe a thick layer of low-velocity soft volcaniclastic sediments formed due to the activity of both volcanoes. A conservative numerical estimate of a steady-state conductive temperature field around the magma source below Avacha demonstrates that the high temperature zone can be reached by drilling a well to a reasonable depth, thus suggesting that the area might be exploited as a source of geothermal energy.

ФОРМУВАННЯ МІСТ СУПУТНИКІВ В КРИЗОВИХ УМОВАХ ІНТЕНСИВНОЇ МІГРАЦІЇ

The article explores the world experience of creating satellite cities. A satellite city is a conceptual unit of urban development located in the zone of influence of a large city. Previously, the satellite city was conceptually described by the English philosopher Ebenezer Howard as the optimal environment for life - the "garden city." The concept was adopted by urban planners as an approach to reduce population concentration and optimize socio-economic activities in the center of large cities. These cities are designed to provide housing and employment for people who work in the city but want to live in a more suburban or rural environment. In addition, satellite cities can have their own base of employment and production and interact with the main city in a different scenario. The relevance of the topic is determined by the migration surge that is expected after the end of martial law in Ukraine. The satellite city is considered as an urban planning tool for regulating migration flows within the country in conditions of a critical shortage of settlements with an established socio-economic infrastructure. There is a need to revise the existing concept for implementation in the specific conditions of post-war Ukraine. The satellite city concept already has theoretical validity and practical implementation in other states. Implementation of the concept requires careful analysis from the point of view of general planning and socio-economic realities of modern Ukraine. Adaptation and implementation of world experience can be an optimal solution to the problems associated with future reverse migration, which will have unprecedented volumes after the end of martial law.

Do Locations of Employment and Residence Influence whether People Use Virtual Social Networks? A Case Study of Residents in Wuhan, China

High-speed information technology development has made virtual social networking (VSN) a social interaction trend. Studies have been carried out to investigate the spatial clustering characteristics of the locations where there is online social interaction, but they have not yet concentrated on the geographic phenomenon associated with the distribution of occupational and residential locations of citizens who use VSN. According to usage statistics gathered from China Unicom for people living in the Wuhan metropolitan development area, there are geographical characteristics for the sites of employment and residence of virtual social application (VSA) users. Compared with people who live or work in the central city, suburban citizens are more willing to conduct virtual social networking, and those who are most likely to do so are concentrated in the suburbs 20–30 km from the main city. Additionally, we used geographically weighted regressions to evaluate the relationship between the density of physical social facilities and the possibility of the usage of VSAs, revealing the influence of various conventional social conveniences on the propensity to use the VSA. Residents are more inclined to engage in VSN in places where traditional social interaction is inconvenient, particularly in suburbs, indicating that VSN is an addition to traditional social interaction. Nonetheless, neither an improvement in, nor the replacement of, VSN activities is apparent in places where conventional socializing is practical. This study identified the clustering of virtual social users’ places of employment and residence in metropolitan areas and concluded that virtual social interaction offers new social channels for people who lack access to adequate physical social facilities; that is, it complements traditional social interaction. These results can deepen the understanding of the relationship between traditional social interaction and VSN. They also offer a fresh viewpoint on facility planning for the potential future creation of a more balanced and diverse social interaction environment through the joint planning of virtual and physical social facilities.

Serravallo Bark and Iron Wine Tonic, 1890 to 1930s

Abstract At the end of 19th century, Trieste, then the main city port of the Austro-Hungarian Empire, produced and exported alcoholic beverages all over the world, including to Islamic countries where alcohol consumption was forbidden. For the latter, beverages were disguised as “medicines”. The Serravallo pharmaceutical plant of Trieste took the lead, sending their medical liquors everywhere, up to the late 1930s. The present essay examines the network of distributors in the Levant and Asia, as well as the astonishingly vast set of supporting advertising instruments, precisely prepared in local languages.

Role of Work-Family Conflict on Work Performance Among Employees in Chinese National AMCS

Purpose: The objective of this study was t to investigate the impact of work-family conflict on work performance, with a particular focus on the mediating role of employee innovative behavior and the moderating role of creative self-efficacy, based on the principles of the Stimulus-Organism-Response (SOR) theory among employees in Chinese national AMCs. Theoretical framework: Recent literature has reported good results in work-family conflict in work performance (Hendra and Made, 2019). However, there is still much to investigate and learn about WP because it is a recent development. Design/Methodology/Approach: This study adopted SEM (Structural Equation Modeling) research method and using the software PLS 3.0 processing data collected from 548 questionnaires distributed through email-box to the general employees of four main cities of the four national AMCs in China. Findings: Based on this study, it can be concluded that work-family conflict has a significant negative impact on work performance in the AMC industry. Higher levels of work-family conflict leading to lower work performance. However, employee’s creative self-efficacy and innovative behavior can improve their performance. Research, Practical & Social implications: This study contributes to the existing literature exploring the role of work-family conflict as a negative factor affecting employees' work performance within the framework of the Stimulus-Organism-Response (SOR) theory. Practically, this study provides valuable guidance for managers in noticing and addressing specific challenges within China's national AMCs. We suggest a future research of framework in this research in other industries or countries with different cultural, economic, and organizational contexts with longitudinal or experimental designs. Originality/Value: The results highlight the relevance of the SOR framework in guiding managerial considerations, addressing practical problems, and fostering positive work environments that lead to improved work performance in national asset management companies.

Population mobility change for controlling the transmission of COVID-19: mobile phone data analysis in nine cities of China

ABSTRACT Mobility restriction measures were the main tools to control the spread of COVID-19, but the extent to which the mobility has decreased remained unsure. We investigated the change in local population mobility and its correlation with COVID-19 infections, using 1185 billion aggregated mobile phone data records in nine main cities in China from 10 January to 24 February 2020. The mobility fell by as much as 79.57% compared to the normal days in 2020 and by 58.13% compared to the same lunar period in 2019. The daily incidence of COVID-19 was significantly correlated with local daily mobility (R2 = 0.77, P < 0.001). The instantaneous reproduction number R(t) declined by 3% when mobility was reduced by 10% in the GLM analysis (P < 0.05). Our study indicated that the decreased mobility level, driven by a mixture effect of holiday and public health interventions, could substantially reduce the transmission of COVID-19 to a low level. Our study could provide evidence of mobility restriction to control local transmission for other places facing COVID-19 outbreaks or potential next waves.

Comparison of Seismic Response of Multi-Storey Building Having Shear Walls Without Opening on STAAD-PRO and ETAB

In India’s main cities, high-rise reinforced concrete residential buildings with more than 15, 16, or 17 stories are widespread these days, which are aligned parallel to the Indian government’s “Pradhan Mantri Awas Yojna”. The development of an economical and eco-friendly R-C building by providing a limited area of shear walls at the diagonal corners of the structure is evaluated in STAAD-PRO and ETAB in this paper. This work also focuses on the location and minimal area of shear walls along with maximum strength, and its 3-D analysis gives conclusions. The paper concludes that the design of 20-story buildings in STAAD and ETAB with minimum shear walls gives safe results, and Horizontal forces increase the structure’s strength and stiffness requirements.

INTERNATIONAL PROCESSES IN THE NEAR AND MIDDLE EAST IN THE MID-1940S - MID-1960S IN THE ASSESSMENTS OF CONTEMPORARIES-RUSSIAN EMIGRANTS

The purpose of the article is to analyze the perception by Russian emigrants of the international processes of the Cold War era in the Middle East. The author focuses on the situation in the region in the mid-1940s - mid-1960s, when the foundations of inter-bloc confrontation were being formed. The source base for the study was the materials of the Russian émigré press published in Paris, Frankfurt am Main, New York and other cities of the world. An analysis of historical sources makes it possible to single out two main groups of Russian emigrants from the Cold War era. Some representatives of the Russian emigration sympathized with the Soviet Union and supported its efforts in the international arena, including in the Near and Middle East. However, the most active were those emigrant publicists who belonged to the anti-communist camp. It has been proven that they blamed the Soviet Union for the escalation of tension in various regions of the world, negatively assessed those political regimes of the countries of the region that were oriented towards the USSR. The conclusion is substantiated that the Russian emigration did not ignore the factor of contradictions within the Western bloc in the Cold War, showing how they were embodied in the policies of the USA, Great Britain and France in the Middle East.

Massive testing in the Galapagos Islands and low positivity rate to control SARS-CoV-2 spread during the first semester of the COVID-19 pandemic: a story of success for Ecuador and South America.

During the first months of the COVID-19 pandemic in Latin America, countries like Ecuador, Peru and Colombia experienced chaotic scenarios with public health systems collapsing and lack of testing capacity to control the spread of the virus. In main cities like Guayaquil in Ecuador, dramatic situations such as corpses in the streets were internationally broadcasted. While the COVID-19 pandemic was devastating South America, SARS-CoV-2 transmission was successfully managed in the Galapagos Islands due to the implementation of a massive screening strategy including hospitalized and community-dwelling populations, and travel restrictions facilitated by its geographical location (972 km from the Ecuadorian continental territory). Floreana Island was one of the few locations in the world that remained COVID-19 free during 2020. In this study, we retrospectively analyzed the data related to SARS-CoV-2 massive testing campaigns from April to September 2020 in the Galapagos Islands, and found this territory to have the lowest positivity rate in South America (4.8-6.7%) and the highest testing ratio among Ecuadorian provinces (9.87% of the population, which is 2480 out of 25 124 inhabitants) during the first wave of the COVID-19 pandemic. This story of success was possible because of the interinstitutional collaboration between the regional government of Galapagos Islands (Consejo de Gobierno), the local authorities (Gobiernos Autonomos Descentralizados de Santa Cruz, San Cristobal and Isabela), the regional authorities from Ecuadorian Ministry of Health, the Agencia de Regulaci&oacute;n y Control de la Bioseguridad y Cuarentena para Gal&aacute;pagos and Universidad de Las Am&eacute;ricas.

From South Asia to Southern Europe: a comparative analysis of Sri Lankans’ residential segregation in the main Italian cities using high-resolution data on regular lattice geographies

The present work proposes a spatial analysis of the residential segregation and settlement models of Sri Lankans in the eight main Italian municipalities. Hosting more than half of the total Sri Lankan population residing in Italy, the selected urban areas allow Sri Lankans’ residential model to be globally framed across the country. The purpose of this work is threefold. First, it provides a general assessment of the allocation pattern of a foreign community that has seldom been studied and yet is characterized by peculiar settlement choices. Second, it attempts to compare the settlement patterns of Sri Lankans across different urban contexts. Third, it aims to detect the possible spatial polarization of Sri Lankans in specific neighbourhoods and to verify its spatial correlation with other key variables that constitute proxies of urban neighbourhoods’ socioeconomic inequalities. The study runs multiple aspatial linear models to assess the global variation in concentrations of Sri Lankans related to several socioeconomic predictors. Furthermore, it implements geographically weighted regressions to explicitly model the spatial dependence between Sri Lankans’ location quotients and several predictors. It refers all the considered variables to a single geographic reference grid, enabling the homogenization of different areal unit arrangements and comparisons across space. Except for Milan and Rome, the findings suggest that Sri Lankans tend to reside in central neighbourhoods characterized by a high foreign presence and a decreased trend of Italian population. Conversely, the impact of the cost of living and the state of the built environment is heterogeneous across space, with a sort of centre-periphery duality in Southern cities and more fragmented situations in the other urban contexts. This evidence proves the relevance of local scale analysis and the need to build up urban observatories on spatial inequalities and segregation processes.

Urban Youth of the European Sector of the Russian Arctic Zone: Behavior in the Information Space, Values and Political Orientations in 2021–2022 (case of Pomorie)

The article summarizes the data of sociological surveys of young people, mainly aged 18– 24 years, held in the European sector of the Arctic zone of Russia (main cities of the Arkhangelsk region) in 2021 and 2022. Survey was aimed to identifi cation of indicators of the behavior and preferences of the target group in the information space, trust in various sources of information, as well as its personal values and political orientations in the context of Special Military Operation in Ukraine. It has been revealed that the main source of information is the Internet, while information of a political nature is not the main object of interest for urban youth. A constant decline in the youth audience of TV as a channel for obtaining information, as well as a consistently low level of trust in the official media, were noted. In terms of personal values, the basic traditional institutions such as labor, family, love, friendship still retain relevance for the urban youth of the Russian Arctic (in the case of Arkhangelsk and Severodvinsk). The amount of income is significant, but not the only main motive that determines the choice of a job. In the special political and international conditions after February 2022, young citizens of the Russian Federation in Pomorie, for the most part, remain optimistic about the future development of Russia and trust in state institutions, prospects for relations with Western countries. In general, the data obtained do not create grounds for assessing the urban youth of the European sector of the Russian Arctic (in the case of Pomorye) as a source of negative social potential that threatens political stability in the macroregion.

Surface Radiative Forcing as a Climate-Change Indicator in North India due to the Combined Effects of Dust and Biomass Burning

This study estimates the radiative forcing by biomass burning and dust aerosols over the Indian subcontinent, with emphasis on the Indo-Gangetic Plains (IGP) during the period from January 2021 to April 2021, based on multiple satellite and reanalysis datasets. In this respect, we used retrievals from the Moderate Resolution Spectroradiometer (MODIS) and the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observation (CALIPSO) system, as well as reanalysis data from the Goddard Earth Observing System, version 5 (GEOS-5), the Modern-Era Retrospective analysis for Research and Applications, version 2 (MERRA-2), the Copernicus Atmosphere Monitoring Service (CAMS), and ERA-Interim. According to the MERRA-2 and the CAMS, the highest black carbon (BC) concentrations in January 2021 were 7–8 µg m−3, which were significantly lower than measurements performed in main cities along the IGP, such as Patiala, Delhi, and Kanpur. The meteorological data analysis accompanied by the CALIPSO lidar measurements showed that the vertical distribution of total attenuated backscatter (TAB) could reach altitudes of up to ~4–5 km and could be transported over the central Himalayan region. The spatial-averaged daily aerosol radiative forcing (ARF) values over the Indian subcontinent from January 2021 to April 2021 were found to range from −51.40 to −6.08 W m−2 (mean of −22.02 ± 9.19 W m−2), while on a monthly basis, the ARF values varied widely, from −146.24 to −1.63 W m−2 (mean of −45.56 ± 22.85 W m−2) over different parts of the study region. Furthermore, the spatial-averaged daily BC radiative forcing ranged from −2.23 to −0.35 (−1.01 ± 0.40 W m−2), while it varied from −15.29 to −0.31 W m−2 (−2.46 ± 2.32 W m−2) over different regions of southern Asia, indicating a rather small contribution to the total aerosol radiative effect and a large presence of highly scattering aerosols. Our findings highlight the importance of growing biomass burning, in light of recent climate change and the rapid decline in air quality over North India and the Indian Ocean.

Research on the spatiotemporal characteristics and influence mechanism of the integration of the health industry and tourism industry in the Chengdu-Chongqing economic circle of China.

Given the background of the "Healthy China" strategy and the aging population, the high-quality integration of the health industry and tourism industry is of great significance to meet the national health tourism needs and promote regional coordinated development. Taking the Chengdu-Chongqing economic circle as an example, this paper uses the coupling coordination degree method and geographic detectors to explore the spatiotemporal characteristics and influence mechanism of the integration of the health industry and tourism industry in the Chengdu-Chongqing region. (1) The integration level of the Chengdu-Chongqing economic circle as a whole, four major regional sectors, and 36 cities is relatively low, and the regional differences in the degree of coupling coordination are relatively large, showing a three-level change. Overall, the spatial differentiation characteristics are high in the west and low in the east, radiating from the two nuclei to the periphery. (2) There are obvious regional differences in the spatial connection strength of the integration of the two major industries, which form a radial non-equilibrium structure with the Chengdu and Chongqing main cities as the connection centers. The overall spatial connection network structure is relatively loose, the point-degree centrality has the spatial distribution characteristics of dominated by two poles, led by multiple cores, and weak at the edges, and the division of cohesive subgroups is greatly affected by geographical factors and administrative divisions. (3) The temporal and spatial characteristics of the integration of the two industries are the result of the mutual coupling of market demand, industrial development, policy support, and economic development. The high-quality integrated development of the health industry and the tourism industry is a complex systematic project, which requires the assistance of government departments at all levels and health tourism enterprises in the Chengdu-Chongqing economic circle to strengthen coordination and cooperation.

The impact of COVID-19 on patient engagement with primary healthcare: lessons from the saudi primary care setting

BackgroundThere have been significant achievements in controlling COVID-19 in Saudi Arabia (SA), but as in most healthcare settings worldwide, health services have been seriously disrupted. Also, with pandemic control measures such as lockdowns and curfews, and innovations such as digital health services, the delivery of primary healthcare (PHC) services has dramatically changed. However, little is known about patients’ experiences of PHCs during the pandemic, their views on the pandemic-related interventions in SA, and patient views on impact on their medical care.MethodsQualitative semi-structured online interviews were conducted for twenty-four Saudi patients across SA aged 18 and above who were diverse in terms of age, gender, education and health status. Data were analysed using thematic analysis yielding four major themes as an impact of COVID-19 on patient engagement with PHCs.ResultsThe COVID-19 pandemic has had profound mixed impacts on patient engagement with PHC in SA. Fear of infection or of breaking lockdown rules has negatively impacted the utilisation of PHCs but positively changed patients’ attitudes towards seeking medical help for self-limiting conditions. The pandemic has also negatively impacted routine preventive care at PHCs, especially for patients with long-term health conditions. The mandatory use of some digital health services in SA that existed pre-pandemic has provided patients with a perception of better care during the pandemic. Yet, a lack of awareness of optional digital health services, such as virtual clinics, hindered optimal use. Despite pandemic-related disruption of patient engagement with PHCs, the reduced waiting time in PHC centres and healthcare providers’ communication and empathy during the pandemic contributed to patients’ perceptions of better care compared to pre-pandemic. However, patients living outside the main cities in SA perceived care quality as less good during the pandemic compared to PHCs in the main cities in SA.ConclusionThe lessons learned from patients’ experiences and views of PHCs during the pandemic were beneficial in promoting patient engagement with PHCs. The digital health services mandated in response to the pandemic have accelerated digital health innovation in SA and allowed patients to recognise the benefits of digital health. This has huge potential for increasing continuous patient engagement with PHCs. Yet, patients’ experiences of digital health services during the pandemic are essential for informing appropriate implementation and utilisation of e-health services. Patients’ positive experiences of PHCs during the pandemic, such as the reduction in waiting times and the perception of improved healthcare providers’ professionalism, communication and empathy, can be built on to sustain engagement with PHC services. These findings might have significance for clinicians and policymakers to support patient engagement with PHCs, particularly in healthcare systems like SA that struggle with the overuse of emergency departments (EDs) for PHC-treatable conditions.