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Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

This study empirically examines the impact of climate change and agricultural research and development (R&D) as well as their interaction on agricultural productivity in 12 selected Asian and Pacific countries over the period of 1990–2018.

Various estimation methods for panel data, including Fixed Effects (FE), the Feasible Generalized Least Squares (FGLS) and two-step System Generalized Method of Moments (SGMM) were used.

Results show that both proxies of climate change – temperature and precipitation – have negative impacts on agricultural productivity. Notably, agricultural R&D investments not only increase agricultural productivity but also mitigate the detrimental impact of climate change proxied by temperature on agricultural productivity. Interestingly, climate change proxied by precipitation initially reduces agricultural productivity until a threshold of agricultural R&D beyond which precipitation increases agricultural productivity.

The findings imply useful policies to boost agricultural productivity by using R&D in the context of rising climate change in the vulnerable continent.

This study contributes to the literature in two ways. First, this study examines how climate change affects agricultural productivity in Asian and Pacific countries – those are most vulnerable to climate change. Second, this study assesses the role of R&D in improving agricultural productivity as well as its moderating effect in reducing the harmful impact of climate change on agricultural productivity.

This paper aims to offer insight into how strategies within the accounting profession, which has been becoming more global, might be changed by the recent outbreak of the Second Cold War between the West and the Rest of the World.

We explore the strategies of those who called themselves “Confucian accountants” in China, a country which has recently discouraged its state-owned enterprises from using the services of the Big 4. We do this by employing qualitative research methods, including reflexive photo interviews, in which Big-4 accountants, recognised as the most Westernised accounting actors in China, and Confucian accountants are asked to take and explain photographs representing their professional lives. Bourdieu’s notions of “economy of practices” and “vision-of-division strategy” are drawn upon to understand who the Confucian accountants are and what they do strategically in their pursuit of a higher revenue stream and improved social standing in the Chinese social space.

The homegrown Confucian accountants share cultural-cognitive characteristics with neighbouring social actors, such as their clients and government officials, who have been inculcated with Confucianism and the state’s cultural confidence policy in pursuit of a “socialist market economy with Chinese characteristics”. Those accountants try to enhance their social standing and revenue stream by strategically demonstrating their difference from Big-4 accountants. For this purpose, they wear Confucian clothes, have Confucian props in their office, employ Confucian phrases in their everyday conversations, use Confucian business cards and construct and maintain guanxi with government officials and clients.

This paper is the first attempt to explore Confucian accountants’ strategies for increasing their revenue and social standing at the start of the Second Cold War.