Review: Volume 33 - Chinese History

Review: Volume 33 - Chinese History

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The first complete history of Central Eurasia from ancient times to the present day, Empires of the Silk Road represents a fundamental rethinking of the origins, history, and significance of this major world region. Christopher Beckwith describes the rise and fall of the great Central Eurasian empires, including those of the Scythians, Attila the Hun, the Turks and Tibetans, and Genghis Khan and the Mongols. In addition, he explains why the heartland of Central Eurasia led the world economically, scientifically, and artistically for many centuries despite invasions by Persians, Greeks, Arabs, Chinese, and others. In retelling the story of the Old World from the perspective of Central Eurasia, Beckwith provides a new understanding of the internal and external dynamics of the Central Eurasian states and shows how their people repeatedly revolutionized Eurasian civilization.

Twentieth-Century China

Twentieth-Century China, a refereed scholarly journal, publishes new research on China’s long twentieth century. Articles in the journal engage significant historiographic or interpretive issues and explore both continuities of the Chinese experience across the century and specific phenomena and activities within the Chinese cultural, political, and territorial sphere—including the Chinese diaspora—since the final decades of the Qing. Comparative empirical and/or theoretical studies rooted in Chinese experience sometimes extend to areas outside China, as well. The journal encompasses a wide range of historical approaches in its examination of twentieth-century China: among others, social, cultural, intellectual, political, economic, and environmental. Founded as a newsletter in 1975, Twentieth-Century China has grown into one of the leading English-language journals in the field of Chinese history.

Twentieth-Century China was formerly published as Republican China (1983–1997) and as the Chinese Republican Studies Newsletter (1975–1983). Twentieth-Century China is now published by Johns Hopkins University Press for Twentieth Century China Journal, Inc., and is the journal of the Historical Society for Twentieth-Century China. Supported by an international editorial board of eminent scholars, the journal employs double-blind peer review and evaluation by the journal’s academic editors to select outstanding articles for publication.

Latest articles

Deng Fu-Guo et al 2007 Chinese Phys. 16 3553

In this paper a scheme for quantum secure direct communication (QSDC) network is proposed with a sequence of polarized single photons. The single photons are prepared originally in the same state |0〉 by the servers on the network, which will reduce the difficulty for the legitimate users to check eavesdropping largely. The users code the information on the single photons with two unitary operations which do not change their measuring bases. Some decoy photons, which are produced by operating the sample photons with a Hadamard, are used for preventing a potentially dishonest server from eavesdropping the quantum lines freely. This scheme is an economical one as it is the easiest way for QSDC network communication securely.

Wu Ya-Bo et al 2007 Chinese Phys. 16 3560

By introducing the double complex scalar field, this paper constructs the double Lagrangian with the potential V(Φ(J), Φ*(J)) = V(|Φ(J)|), which not only can describe the evolution of quintom Universe, but also can naturally give the spintessence and hessence Universe. Furthermore, the U(1, J) symmetry of the double complex Lagrangian is verified, and the total conserved charge within the physical volume is derived by means of the Noëther theorem. Moreover, it can point out that the 'imaginary motion' of the angular parameter in Ref.[14], in fact, is only a real phase displacement in our model.

Guan Jian-Yue et al 2007 Chinese Phys. 16 3566

We investigate an evolutionary snowdrift game on a square N = L × L lattice with periodic boundary conditions, where a population of n0 (n0N) players located on the sites of this lattice can either cooperate with or defect from their nearest neighbours. After each generation, every player moves with a certain probability p to one of the player's nearest empty sites. It is shown that, when p = 0, the cooperative behaviour can be enhanced in disordered structures. When p > 0, the effect of mobility on cooperation remarkably depends on the payoff parameter r and the density of individuals ρ (ρ = n0/N). Compared with the results of p = 0, for small r, the persistence of cooperation is enhanced at not too small values of ρ whereas for large r, the introduction of mobility inhibits the emergence of cooperation at any ρ < 1 for the intermediate value of r, the cooperative behaviour is sometimes enhanced and sometimes inhibited, depending on the values of p and ρ. In particular, the cooperator density can reach its maximum when the values of p and ρ reach their respective optimal values. In addition, two absorbing states of all cooperators and all defectors can emerge respectively for small and large r in the case of p > 0.

Zhao Jing et al 2007 Chinese Phys. 16 3571

Complex networks have been applied to model numerous interactive nonlinear systems in the real world. Knowledge about network topology is crucial to an understanding of the function, performance and evolution of complex systems. In the last few years, many network metrics and models have been proposed to investigate the network topology, dynamics and evolution. Since these network metrics and models are derived from a wide range of studies, a systematic study is required to investigate the correlations among them. The present paper explores the effect of degree correlation on the other network metrics through studying an ensemble of graphs where the degree sequence (set of degrees) is fixed. We show that to some extent, the characteristic path length, clustering coefficient, modular extent and robustness of networks are directly influenced by the degree correlation.

Jia Yi-Feng et al 2007 Chinese Phys. 16 3581

In this paper, the Faddeev–Jackiw approach is improved by the Wu elimination method, so a great many complicated computations in solving constraints for the finite-dimensional polynomial-type constrained dynamics can be executed easily by using computers. Moreover, based on the Faddeev–Jackiw approach, a new algorithm of solving the constrained dynamics is presented. The new algorithm is simpler and stricter than the Faddeev–Jackiw approach. Using the new algorithm, the second Cawley counterexample is solved.


Jerry H. Bentley has observed that 'the term world history has never been a clear signifier with a stable referent', and that usage of the term overlaps with universal history, comparative history, global history, big history, macro history, and transnational history, among others. [2]

The advent of world history as a distinct academic field of study can be traced to the 1960s, but the pace quickened in the 1980s. [3] [4] A key step was the creation of the World History Association and graduate programs at a handful of universities. Over the next decades scholarly publications, professional and academic organizations, and graduate programs in World History proliferated. World History has often displaced Western Civilization in the required curriculum of American high schools and universities, and is supported by new textbooks with a world history approach.

World History attempts to recognize and address two structures that have profoundly shaped professional history-writing:

  1. A tendency to use current nation-states to set the boundaries and agendas of studies of the past.
  2. A deep legacy of Eurocentric assumptions (found especially, but not only, in Western history-writing).

Thus World History tends to study networks, connections, and systems that cross traditional boundaries of historical study like linguistic, cultural, and national borders. World History is often concerned to explore social dynamics that have led to large-scale changes in human society, such as industrialization and the spread of capitalism, and to analyse how large-scale changes like these have affected different parts of the world. Like other branches of history-writing in the second half of the twentieth century, World History has a scope far beyond historians' traditional focus on politics, wars, and diplomacy, taking in a panoply of subjects like gender history, social history, cultural history, and environmental history. [3]

Organizations Edit

  • The H-World website and online network [5] is used among some practitioners of world history, and allows discussions among scholars, announcements, syllabi, bibliographies and book reviews.
  • The International Society for the Comparative Study of Civilizations (ISCSC) approaches world history from the standpoint of comparative civilizations. Founded at a conference in 1961 in Salzburg, Austria, that was attended by Othmar Anderlie, Pitirim Sorokin, and Arnold J. Toynbee, this is an international association of scholars that publishes a journal, Comparative Civilization Review, and hosts an annual meeting in cities around the world.
  • The Journal of Global History is a scholarly journal established in 2006 and is published by Cambridge University Press.
  • The World History Association (WHA) was established in 1982, and is predominantly an American phenomenon. [6] Since 1990, it publishes the Journal of World History on a quarterly basis. [7]

Pre-modern Edit

The study of world history, as distinct from national history, has existed in many world cultures. However, early forms of world history were not truly global, and were limited to only the regions known by the historian.

In Ancient China, Chinese world history, that of China and the surrounding people of East Asia, was based on the dynastic cycle articulated by Sima Qian in circa 100 BC. Sima Qian's model is based on the Mandate of Heaven. Rulers rise when they united China, then are overthrown when a ruling dynasty became corrupt. [8] Each new dynasty begins virtuous and strong, but then decays, provoking the transfer of Heaven's mandate to a new ruler. The test of virtue in a new dynasty is success in being obeyed by China and neighboring barbarians. After 2000 years Sima Qian's model still dominates scholarship, although the dynastic cycle is no longer used for modern Chinese history. [9]

In Ancient Greece, Herodotus (5th century BC), as founder of Greek historiography, [10] presents insightful and lively discussions of the customs, geography, and history of Mediterranean peoples, particularly the Egyptians. However, his great rival Thucydides promptly discarded Herodotus's all-embracing approach to history, offering instead a more precise, sharply focused monograph, dealing not with vast empires over the centuries but with 27 years of war between Athens and Sparta. In Rome, the vast, patriotic history of Rome by Livy (59 BC-17 AD) approximated Herodotean inclusiveness [11] Polybius (c.200-c.118 BC) aspired to combine the logical rigor of Thucydides with the scope of Herodotus. [12]

Rashīd al-Dīn Fadhl-allāh Hamadānī (1247–1318), was a Persian physician of Jewish origin, polymathic writer and historian, who wrote an enormous Islamic history, the Jami al-Tawarikh, in the Persian language, often considered a landmark in intercultural historiography and a key document on the Ilkhanids (13th and 14th century). [13] His encyclopedic knowledge of a wide range of cultures from Mongolia to China to the Steppes of Central Eurasia to Persia, the Arabic-speaking lands, and Europe, provide the most direct access to information on the late Mongol era. His descriptions also highlight the manner in which the Mongol Empire and its emphasis on trade resulted in an atmosphere of cultural and religious exchange and intellectual ferment, resulting in the transmission of a host of ideas from East to West and vice versa.

One Muslim scholar, Ibn Khaldun (1332-1409) broke with traditionalism and offered a model of historical change in Muqaddimah, an exposition of the methodology of scientific history. Ibn Khaldun focused on the reasons for the rise and fall of civilization, arguing that the causes of change are to be sought in the economic and social structure of society. His work was largely ignored in the Muslim world. [14]

Early modern Edit

During the Renaissance in Europe, history was written about states or nations. The study of history changed during the Enlightenment and Romanticism. Voltaire described the history of certain ages that he considered important, rather than describing events in chronological order. History became an independent discipline. It was not called philosophia historiae anymore, but merely history (historia). Voltaire, in the 18th century, attempted to revolutionize the study of world history. First, Voltaire concluded that the traditional study of history was flawed. The Christian Church, one of the most powerful entities in his time, had presented a framework for studying history. Voltaire, when writing History of Charles XII (1731) and The Age of Louis XIV (1751), instead choose to focus economics, politics and culture. [15] These aspects of history were mostly unexplored by his contemporaries and would each develop into their own sections of world history. Above all else, Voltaire regarded truth as the most essential part of recording world history. Nationalism and religion only subtracted from objective truth, so Voltaire freed himself for their influence when he recorded history. [16]

Giambattista Vico (1668–1744) in Italy wrote Scienza nuva seconda (The New Science) in 1725, which argued history as the expression of human will and deeds. He thought that men are historical entities and that human nature changes over time. Each epoch should be seen as a whole in which all aspects of culture—art, religion, philosophy, politics, and economics—are interrelated (a point developed later by Oswald Spengler). Vico showed that myth, poetry, and art are entry points to discovering the true spirit of a culture. Vico outlined a conception of historical development in which great cultures, like Rome, undergo cycles of growth and decline. His ideas were out of fashion during the Enlightenment, but influenced the Romantic historians after 1800.

A major theoretical foundation for world history was given by German philosopher G. W. F. Hegel, who saw the modern Prussian state as the latest (though often confused with the highest) stage of world development.

G.W.F. Hegel developed three lenses through which he believed world history could be viewed. Documents produced during a historical period, such as journal entries and contractual agreements, were considered by Hegel to be part of Original History. These documents are produced by a person enveloped within a culture, making them conduits of vital information but also limited in their contextual knowledge. Documents which pertain to Hegel’s Original History are classified by modern historians as primary sources. [17]

Reflective History, Hegel’s second lens, are documents written with some temporal distance separating the event which is discussed in the academic writing. What limited this lens, according to Hegel, was the imposition of the writers own cultural values and views on the historical event. This criticism of Reflective History was later formalized by Anthropologists Franz Boa and coined as Cultural relativism by Alain Locke. Both of these lenses were considered to be partially flawed by Hegel. [18]

Hegel termed the lens which he advocated to view world history through as Philosophical History. In order to view history through this lens, one must analyze events, civilizations, and periods objectively. When done in this fashion, the historian can then extract the prevailing theme from their studies. This lens differs from the rest because it is void of any cultural biases and takes a more analytical approach to history. World History can be a broad topic, so focusing on extracting the most valuable information from certain periods may be the most beneficial approach. This third lens, as did Hegel’s definitions of the other two, affected the study of history in the early modern period and our contemporary period. [19]

Another early modern historian was Adam Ferguson. Ferguson’s main contribution to the study of world history was his An Essay on the History of Civil Society (1767). [20] According to Ferguson, world history was a combination of two forms of history. One was natural history the aspects of our world which god created. The other, which was more revolutionary, was social history. For him, social history was the progress humans made towards fulfilling God’s plan for humanity. He believed that progress, which could be achieved through individuals pursuing commercial success, would bring us closer to a perfect society but we would never reach one. [21] However, he also theorized that a complete dedication to commercial success could lead to societal collapse—like what happened in Rome—because people would lose morality. Through this lens, Ferguson viewed world history as humanities struggle to reach an ideal society. [22] [23]

Henry Home, Lord Kames was a philosopher during the Enlightenment and contributed to the study of world history. In his major historical work, Sketches on the History of Man, Home’s outlined the four stages of human history which he observed. [24] The first and most primitive stage was small hunter-gatherer groups. Then, in order to form larger groups, humans transitioned into the second stage when they began to domesticate animals. The third stage was the development of agriculture. This new technology established trade and higher levels of cooperation amongst sizable groups of people. With the gathering of people into agricultural villages, laws and social obligations needed to be developed so a form of order could be maintained. The fourth, and final stage, involved humans moving into market towns and seaports where agriculture was not the focus. Instead, commerce and other forms of labor arouse in a society. By defining the stages of human history, Homes influenced his successors. He also contributed to the development of other studies such as sociology and anthropology. [25]

The Marxist theory of historical materialism claims the history of the world is fundamentally determined by the material conditions at any given time – in other words, the relationships which people have with each other in order to fulfil basic needs such as feeding, clothing and housing themselves and their families. [26] Overall, Marx and Engels claimed to have identified five successive stages of the development of these material conditions in Western Europe. [27] The theory divides the history of the world into the following periods: [28] [29] [30] [31] [32] Primitive communism Slave society Feudalism Capitalism and Socialism.

Regna Darnell and Frederic Gleach argue that, in the Soviet Union, the Marxian theory of history was the only accepted orthodoxy, and stifled research into other schools of thought on history. [33] However, adherents of Marx's theories argue that Stalin distorted Marxism. [34]

Contemporary Edit

World history became a popular genre in the 20th century with universal history. In the 1920s, several best-sellers dealt with the history of the world, including surveys The Story of Mankind (1921) by Hendrik Willem van Loon and The Outline of History (1918) by H.G. Wells. Influential writers who have reached wide audiences include H. G. Wells, Oswald Spengler, Arnold J. Toynbee, Pitirim Sorokin, Carroll Quigley, Christopher Dawson, [35] and Lewis Mumford. Scholars working the field include Eric Voegelin, [36] William Hardy McNeill and Michael Mann. [37] With evolving technologies such as dating methods and surveying laser technology called LiDAR, contemporary historians have access to new information which changes how past civilizations are studied.

Spengler's Decline of the West (2 vol 1919–1922) compared nine organic cultures: Egyptian (3400 BC-1200 BC), Indian (1500 BC-1100 BC), Chinese (1300 BC-AD 200), Classical (1100 BC-400 BC), Byzantine (AD 300–1100), Aztec (AD 1300–1500), Arabian (AD 300–1250), Mayan (AD 600–960), and Western (AD 900–1900). His book was a smashing success among intellectuals worldwide as it predicted the disintegration of European and American civilization after a violent "age of Caesarism," arguing by detailed analogies with other civilizations. It deepened the post-World War I pessimism in Europe, and was warmly received by intellectuals in China, India, and Latin America who hoped his predictions of the collapse of European empires would soon come true. [38]

In 1936–1954, Toynbee's ten-volume A Study of History came out in three separate installments. He followed Spengler in taking a comparative topical approach to independent civilizations. Toynbee said they displayed striking parallels in their origin, growth, and decay. Toynbee rejected Spengler's biological model of civilizations as organisms with a typical life span of 1,000 years. Like Sima Qian, Toynbee explained decline as due to their moral failure. Many readers rejoiced in his implication (in vols. 1–6) that only a return to some form of Catholicism could halt the breakdown of western civilization which began with the Reformation. Volumes 7–10, published in 1954, abandoned the religious message, and his popular audience slipped away, while scholars picked apart his mistakes., [39]

McNeill wrote The Rise of the West (1963) to improve upon Toynbee by showing how the separate civilizations of Eurasia interacted from the very beginning of their history, borrowing critical skills from one another, and thus precipitating still further change as adjustment between traditional old and borrowed new knowledge and practice became necessary. McNeill took a broad approach organized around the interactions of peoples across the Earth. Such interactions have become both more numerous and more continual and substantial in recent times. Before about 1500, the network of communication between cultures was that of Eurasia. The term for these areas of interaction differ from one world historian to another and include world-system and ecumene. Whatever it is called, the importance of these intercultural contacts has begun to be recognized by many scholars. [40]

United States Edit

As early as 1884, the American Historical Association advocated the study of the past on a world scale. [41] T. Walter Wallbank and Alastair M. Taylor co-authored Civilization Past & Present, the first world-history textbook published in the United States (1942). With additional authors, this very successful work went through numerous editions up to the first decade of the twenty-first century. According to the Golden Anniversary edition of 1992, the ongoing objective of Civilization Past & Present "was to present a survey of world cultural history, treating the development and growth of civilization not as a unique European experience but as a global one through which all the great culture systems have interacted to produce the present-day world. It attempted to include all the elements of history – social, economic, political, religious, aesthetic, legal, and technological." [42] Just as the first world war strongly encouraged American historians to expand the study of Europe than to courses on Western civilization, the second world war enhance the global perspectives, especially regarding Asia and Africa. Louis Gottschalk, William H. McNeill, and Leften S. Stavrianos became leaders in the integration of world history to the American College curriculum. Gottschalk began work on the UNESCO 'History of Mankind: Cultural and Scientific Development' in 1951. McNeill, influenced by Toynbee, broadened his work on the 20th century to new topics. Since 1982 the World History Association at several regional associations began a program to help history professors broaden their coverage in freshman courses world history became a popular replacement for courses on Western Civilization. Professors Patrick Manning, at the University of Pittsburgh's World History Center and Ross E. Dunn at San Diego State are leaders in promoting innovative teaching methods. [43]

In related disciplines, such as art history and architectural history, global perspectives have been promoted as well. In schools of architecture in the U.S., the National Architectural Accrediting Board now requires that schools teach history that includes a non-west or global perspective. This reflects a decade-long effort to move past the standard Euro-centric approach that had dominated the field. [44]

In recent years, the relationship between African and world history has shifted rapidly from one of antipathy to one of engagement and synthesis. Reynolds (2007) surveys the relationship between African and world histories, with an emphasis on the tension between the area studies paradigm and the growing world-history emphasis on connections and exchange across regional boundaries. A closer examination of recent exchanges and debates over the merits of this exchange is also featured. Reynolds sees the relationship between African and world history as a measure of the changing nature of historical inquiry over the past century. [45]


Two ways of generating mental imagery Edit

There are two fundamental ways by which mental imagery is generated: voluntary and involuntary.

The involuntary and spontaneous generation of mental images is integral to ordinary sensory perception, and cognition, and occurs without volitional intent. Meanwhile, many different aspects of everyday problem solving, scientific reasoning, and creative activity involve the volitional and deliberate generation of mental images. [18]

Involuntary Edit

The generation of involuntary mental imagery is created directly from present sensory stimulation and perceptual information, such as when someone sees an object, creates mental images of it, and maintains this imagery as they look away or close their eyes or when someone hears a noise and maintains an auditory image of it, after the sound ceases or is no longer perceptible.

Voluntary Edit

Voluntary mental imagery may resemble previous sensory perception and experience, recalled from memory or the images may be entirely novel and the product of fantasy. [19] [20] [21]

Technique Edit

The term guided imagery denotes the technique used in the second (voluntary) instance, by which images are recalled from long-term or short-term memory, or created from fantasy, or a combination of both, in response to guidance, instruction, or supervision. Guided imagery is, therefore, the assisted simulation or re-creation of perceptual experience across sensory modalities. [22] [23]

Mental imagery can result from both voluntary and involuntary processes, and although it comprises simulation or recreation of perceptual experience across all sensory modalities, [24] including olfactory imagery, gustatory imagery, haptic imagery, and motor imagery. [25] Nonetheless, visual and auditory mental images are reported as being the most frequently experienced by people ordinarily as well as in controlled experiments, [26] with visual imagery remaining the most extensively researched and documented in scientific literature. [27]

In experimental and cognitive psychology, researchers have concentrated primarily on voluntary and deliberately generated imagery, which the participant or patient creates, inspects, and transforms, such as by evoking imagery of an intimidating social event, and transforming the images into those indicative of a pleasant and self-affirming experience.

In psychopathology, clinicians have typically focused on involuntary imagery which "comes to mind" unbidden, such as in a depressed person's experience of intrusive unwelcome negative images indicative of sadness, hopelessness, and morbidity [28] or images that recapitulate previous distressing events that characterize posttraumatic stress disorder. [29]

In clinical practice and psychopathology, involuntary mental images are considered intrusive when they occur unwanted and unbidden, "hijacking attention" to some extent. [30] [31]

The maintenance of, or "holding in mind" imagery, whether voluntary or involuntary, places considerable demands upon cognitive attentional resources, including working memory, redirecting them away from a specific cognitive task or general-purpose concentration and toward the imagery.

In clinical practice, this process can be positively exploited therapeutically by training the participant or patient to focus attention on a significantly demanding task, which successfully competes for and directs attention away from the unbidden intrusive imagery, decreasing its intensity, vividness, and duration, and consequently alleviating distress or pain. [32] [33]

Mental imagery, especially visual and auditory imagery, can exacerbate and aggravate a number of mental and physical conditions. [34]

This is because, according to the principles of psychophysiology and psychoneuroimmunology, the way an individual perceives his or her mental and physical condition in turn affects biological processes, including susceptibility to illness, infection, or disease and that perception is derived significantly from mental imagery. That is to say that in some cases, the severity of an individual's mental and physical disability, disorder, or illness is partially determined by his or her images, including their content, vividness or intensity, clarity, and frequency with which they are experienced as intrusive and unbidden. [35]

An individual can aggravate the symptoms and intensify the pain or distress precipitated by many conditions through generating, often involuntarily, mental imagery that emphasizes its severity.

For example, mental imagery has been shown to play a key role in contributing to, exacerbating, or intensifying the experience and symptoms of posttraumatic stress disorder (PTSD), [36] compulsive cravings, [37] eating disorders [38] such as anorexia nervosa [39] and bulimia nervosa, [40] spastic hemiplegia, [41] incapacitation following a stroke or cerebrovascular accident, [42] restricted cognitive function and motor control due to multiple sclerosis, [43] social anxiety or phobia, [44] bipolar disorder, [45] schizophrenia, [46] attention deficit hyperactivity disorder, [47] and depression. [48] [49]

The aforementioned challenges and difficulties are some of those for which there is evidence to show that an individual can aggravate the symptoms and intensify the pain or distress precipitated by the condition through generating mental imagery that emphasizes its severity.

The following elaborates the way in which such mental imagery contributes to or aggravates four specific conditions:

Posttraumatic stress disorder Edit

Posttraumatic stress disorder often proceeds from experiencing or witnessing a traumatic event involving death, serious injury, or significant threat to others or oneself [50] and disturbing intrusive images, often described by the patient as 'flashbacks', are a common symptom of this condition across demographics of age, gender, and the nature of the precipitating traumatic event. [51] This unbidden mental imagery is often highly vivid, and provokes memories of the original trauma, accompanied by heightened emotions or feelings and the subjective experience of danger and threat to safety in the present "here and now". [52]

Social anxiety Edit

Individuals with social anxiety have a higher than normal tendency to fear situations that involve public attention, such as speaking to an audience or being interviewed, meeting people with whom they are unfamiliar, and attending events of an unpredictable nature. [53] As with posttraumatic stress disorder, vivid mental imagery is a common experience for those with social anxiety, and often comprises images that revive and replay a previously experienced stressful, intimidating or harrowing event that precipitated negative feelings, such as embarrassment, shame, or awkwardness. [54] [55] Thereby, mental imagery contributes to the maintenance and persistence of social anxiety, as it does with posttraumatic stress disorder. [56] [57]

In particular, the mental imagery commonly described by those suffering from social anxiety often comprises what cognitive psychologists describe as an "observer perspective". This consists of an image of themselves, as though from an observing person's perspective, in which those suffering from social anxiety perceive themselves negatively, as if from that observing person's point of view. [58] [59] Such imagery is also common among those suffering from other types of anxiety, who often have depleted ability to generate neutral, positive, or pleasant imagery. [60]

Depression Edit

The capacity to evoke pleasant and positively affirming imagery, either voluntarily or involuntarily, may be a critical requisite for precipitating and sustaining positive moods or feelings and optimism and this ability is often impaired in those suffering from depression. [61] Depression consists of emotional distress and cognitive impairment that may include feelings of hopelessness, pervasive sadness, pessimism, lack of motivation, social withdrawal, difficulty in concentrating on mental or physical tasks, and disrupted sleep. [62]

Whilst depression is frequently associated with negative rumination of verbal thought patterns manifested as unspoken inner speech, [63] ninety percent of depressed patients reporting distressing intrusive mental imagery that often simulates and recollect previous negative experiences, [64] [65] and which the depressed person often interprets in a way that intensifies feelings of despair and hopelessness. [66] [67] In addition, people suffering from depression have difficulty in evoking prospective imagery indicative of a positive future. [68] The prospective mental imagery experienced by depressed persons when at their most despairing commonly includes vivid and graphic images related to suicide, which some psychologists and psychiatrists refer to as "flash-forwards". [69] [70]

Bipolar disorder Edit

Bipolar disorder is characterized by manic episodes interspersed with periods of depression [71] 90% of patients experience comorbid anxiety disorder at some stage [72] and there is a significant prevalence of suicide amongst sufferers. [73] [74] Prospective mental imagery indicative of hyperactivity or mania and hopelessness contributes to the manic and depressive episodes respectively in bipolar disorder. [75]

The therapeutic use of guided imagery, as part of a multimodal treatment plan incorporating other suitable methods, such as guided meditation, receptive music therapy, and relaxation techniques, as well as physical medicine and rehabilitation, [76] and psychotherapy, aims to educate the patient in altering their mental imagery, replacing images that compound pain, recollect and reconstruct distressing events, intensify feelings of hopelessness, or reaffirm debilitation, with those that emphasize physical comfort, functional capacity, mental equanimity, and optimism.

Whether the guided imagery is provided in person by a facilitator, or delivered via media, the verbal instruction consists of words, often pre-scripted, intended to direct the participant's attention to imagined visual, auditory, tactile, gustatory or olfactory sensations that precipitate a positive psychologic and physiologic response that incorporates increased mental and physical relaxation and decreased mental and physical stress.

Guided imagery is one of the means by which therapists, teachers, or practitioners seek to achieve this outcome, and involves encouraging patients or participants to imagine alternative perspectives, thoughts, and behaviors, mentally rehearsing strategies that they may subsequently actualize, thereby developing increased coping skills and ability. [77]

According to the computational theory of imagery, [78] [79] [80] which is derived from experimental psychology, guided imagery comprises four phases: [81]

  1. Image generation
  2. Image maintenance
  3. Image inspection
  4. Image transformation

Image generation Edit

Image generation involves generating mental imagery, either directly from sensory data and perceptual experience, or from memory, or from fantasy. [82]

Image maintenance Edit

Image maintenance involves the volitional sustaining or maintaining of imagery, without which, a mental image is subject to rapid decay with an average duration of only 250 ms. [83] This is because volitionally created mental images usually fade rapidly once generated in order to avoid disrupting or confusing the process of ordinary sensory perception. [84] [85] [86]

The natural brief duration of mental imagery means that the active maintenance stage of guided imagery, which is necessary for the subsequent stages of inspection and transformation, requires cognitive concentration of attention by the participant. This concentrative attentional ability can be improved with the practice of mental exercises, including those derived from guided meditation and supervised meditative praxis. [87] [88] [89] Even with such practice, some people can struggle to maintain a mental image "clearly in mind" for more than a few seconds [90] [91] [92] not only for imagery created through fantasy [93] but also for mental images generated from both long-term memory [94] and short-term memory. [95]

In addition, while the majority of the research literature has tended to focus on the maintenance of visual mental images, imagery in other sensory modalities also necessitates a volitional maintenance process in order for further inspection or transformation to be possible. [96]

The requisite for practice in sustaining attentional control, such that attention remains focused on maintaining generated imagery, is one of the reasons that guided meditation, which supports such concentration, is often integrated into the provision of guided imagery as part of the intervention. Guided meditation assists participants in extending the duration for which generated mental images are maintained, providing time to inspect the imagery, and proceed to the final transformation stage of guided imagery. [97] [98]

Image inspection Edit

Once generated and maintained, a mental image can be inspected to provide the basis for interpretation, and transformation. [99] For visual imagery, inspection often involves a scanning process, by which the participant directs attention across and around an image, simulating shifts in perceptual perspective. [100]

Inspection processes can be applied both to imagery created spontaneously, and to imagery generated in response to scripted or impromptu verbal descriptions provided by the facilitator. [101] [102] [103]

Image transformation Edit

Finally, with the assistance of verbal instruction from the guided imagery practitioner or teacher, the participant transforms, modifies, or alters the content of generated mental imagery, in such a way as to substitute images that provoke negative feelings, are indicative of suffering, or that reaffirm disability or debilitation for those that elicit positive emotion, and are suggestive of resourcefulness, ability to cope, and an increased degree of mental and physical capacity. [104] [105]

This process shares principles with those that inform the clinical psychology techniques of "imagery restructuring" or "imagery re-scripting" as used in cognitive behavioral therapy. [106] [107] [108]

While the majority of research findings on image transformation relate to visual mental imagery, there is evidence to support transformations in other sensory modalities such as auditory imagery. [109] and haptic imagery. [110]

Outcome of image generation, maintenance, inspection, and transformation Edit

Through this technique, a patient is assisted in reducing the tendency to evoke images indicative of the distressing, painful, or debilitative nature of a condition, and learns instead to evoke mental imagery of their identity, body, and circumstances that emphasizes the capacity for autonomy and self-determination, positive proactive activity, and the ability to cope, whilst managing their condition.

As a result, symptoms become less incapacitating, pain is to some degree decreased, while coping skills increase. [111] [112] [113] [114]

In order for the foregoing process to take place effectively, such that all four stages of guided imagery are completed with therapeutic beneficial effect, the patient or participant must be capable of or susceptible to absorption, which is an "openness to absorbing and self-altering experiences". [115] [116] This is a further reason why guided meditation or some form of meditative praxis, relaxation techniques, and meditation music or receptive music therapy are often combined with or form an integral part of the operational and practical use of the guided imagery intervention. For, all those techniques can increase the participant's or patient's capacity for or susceptibility to absorption, thereby increasing the potential efficacy of guided imagery. [117] [118]

The United States National Center for Complementary and Integrative Health (NCCIH), which is among twenty-seven organizations that make up the National Institutes of Health (NIH), classifies guided imagery and guided meditation, as mind–body interventions, one of five domains of medical and health care systems, practices, and products that are not presently considered part of conventional medicine. [119]

The NCCIH defines mind-body interventions as those practices that "employ a variety of techniques designed to facilitate the mind's capacity to affect bodily function and symptoms", and include guided imagery, guided meditation and forms of meditative praxis, hypnosis and hypnotherapy, prayer, as well as art therapy, music therapy, and dance therapy. [120]

All mind–body interventions, including the aforementioned, focus on the interaction between the brain, body, and behavior and are practiced with intention to use the mind to alter physical function and promote overall health and wellbeing. [121] [122]

There are documented benefits of mind-body interventions derived from scientific research firstly into their use in contributing to the treatment a range of conditions including headaches, coronary artery disease and chronic pain secondly in ameliorating the symptoms of chemotherapy-induced nausea, vomiting, and localised physical pain in patients with cancer thirdly in increasing the perceived capacity to cope with significant problems and challenges and fourthly in improving the reported overall quality-of-life. In addition, there is evidence supporting the brain and central nervous system's influence on the immune system and the capacity for mind-body interventions to enhance immune function outcomes, including defense against and recovery from infection and disease. [123] [124] [125] [126] [127]

Guided imagery has also demonstrated efficacy in reducing postoperative discomfort as well as chronic pain related to cancer, arthritis, and physical injury. [128] [129] [130] Furthermore, the non-clinical uses for which the efficacy of guided imagery has been shown include managing the stress of public performance among musicians, enhancing athletic and competitive sports ability, and training medical students in surgical skills. [131] The evidence that it is effective for non-musculoskeletal pain is encouraging but not definitive. [132]

Evidence and explanations for the effectiveness and limitations of creative visualization come from two discreet sources: cognitive psychology and psychoneuroimmunology.

Cognitive psychology Edit

Guided imagery is employed as an adjunctive technique to psychological therapies in the treatment of many conditions, including those identified in the previous sections. It plays a significant role in the application of cognitive approaches to psychotherapy, including cognitive behavioral therapy, rational emotive behavior therapy, schema therapy, and mindfulness-based cognitive therapy. [133]

These therapies derive from or draw substantially upon a model of mental functioning initially established by Aaron T. Beck, a psychiatrist and psychoanalyst who posited that the subjective way in which people perceive themselves and interpret experiences influences their emotional, behavioral, and physiological reactions to circumstances. He additionally discovered that by assisting patients in correcting their misperceptions and misinterpretations, and aiding them in modifying unhelpful and self-deprecating ways of thinking about themselves and their predicament, his patients had more productive reactions to events, and developed a more positive self-concept, self-image, or perception of themselves. [134] [135]

This use of guided imagery is based on the following premise. Everyone participates in both the voluntary and involuntary spontaneous generation of visual, auditory and other mental images, which is a necessary part of the way in which a person solves problems, recollects the past, predicts and plans the future, and formulates their self-perception, self-image, or the way they 'view' and perceive themselves. [136] [137] [138]

However, this self-image can be altered and self-regulated with the aid of mind-body interventions including guided imagery, by which an individual changes the way he or she visualizes, imagines, and perceives themselves generally, and their physical condition, body image, and mental state specifically. [139]

Psychoneuroimmunology Edit

The term "psychoneuroimmunology" was coined by American psychologist Robert Ader in 1981 to describe the study of interactions between psychological, neurological, and immune systems. [140]

Three years later, Jean Achterberg published a book called Imagery in Healing that sought to relate and correlate contemporaneous evidence from the then emerging scientific study of the way mental processes influence physical and physiological function, with particular emphasis on mental imagery, to the folklore she extrapolated from a set of diverse ancient and geographically indigenous practices previously described as 'shamanism' by the historian of religion and professor at the University of Chicago, Mircea Eliade and a number of anthropologists and ethnologists. [141] [142]

The fundamental hypothesis of psychoneuroimmunology is concisely that the way people think and how they feel directly influences the electrochemistry of the brain and central nervous system, which in turn has a significant influence on the immune system and its capacity to defend the body against disease, infection, and ill health. Meanwhile, the immune system affects brain chemistry and its electrical activity, which in turn has a considerable impact on the way we think and feel. [143]

Because of this interplay, a person's negative thoughts, feelings, and perceptions, such as pessimistic predictions about the future, regretful ruminations upon the past, low self-esteem, and depleted belief in self-determination and a capacity to cope can undermine the efficiency of the immune system, increasing vulnerability to ill health. Simultaneously, the biochemical indicators of ill health monitored by the immune system feeds back to the brain via the nervous system, which exacerbates thoughts and feelings of a negative nature. That is to say, we feel and think of ourselves as unwell, which contributes to physical conditions of ill health, which in turn cause us to feel and think of ourselves as unwell. [144]

However, the interplay between cognitive and emotional, neurological, and immunological processes also provides for the possibility of positively influencing the body and enhancing physical health by changing the way we think and feel. For example, people who are able to deconstruct the cognitive distortions that precipitate perpetual pessimism and hopelessness and further develop the capacity to perceive themselves as having a significant degree of self-determination and capacity to cope are more likely to avoid and recover from ill health more quickly than those who remain engaged in negative thoughts and feelings. [145]

This simplification of a complex interaction of interrelated systems and the capacity of the mind to influence the body does not account for the significant influence that other factors have on mental and physical well-being, including exercise, diet, and social interaction.

Nonetheless, in helping people to make such changes to their habitual thought processes and pervasive feelings, mind-body interventions, including creative visualization, when provided as part of a multimodal and interdisciplinary treatment program of other methods, such as cognitive behavioral therapy, have been shown to contribute significantly to treatment of and recovery from a range of conditions.

In addition, there is evidence supporting the brain and central nervous system's influence on the immune system and the capacity for mind-body interventions to enhance immune function outcomes, including defense against and recovery from infection and disease. [146]

The integration of traditional Chinese medicine and Western medicine

Traditional Chinese Medicine (TCM) is one of the world's oldest medical systems, having a history of several thousands of years. It is a system of healing based upon the Chinese philosophy of the correspondence between nature and human beings. Its theories refer to yin and yang , the Five Elements, zang-fu , channels-collaterals, qi , blood, body fluid, methods of diagnosis, the differentiation of symptom-complexes, etc. TCM has two main features: a holistic point of view and treatment according to a differentiation of syndromes. The therapeutic methods of TCM involve different approaches, such as acupuncture, moxibustion, tuina bodywork, herbal medicine and qi gong , in order to allow the body to heal itself in a natural way. Western medicine was first introduced into China from the middle of the 17th century. During the first two centuries several different views, related to the future of TCM and the relation between TCM and Western medicine, emerged. Some advocated ‘complete westernization’ of Chinese medicine, others were in favour of keeping it intact, whereas again others recommended the ‘digestion and assimilation of TCM and Western medicine’. Nowadays, more and more people realize that each of the two medical traditions has its own merits and advise that the two systems should benefit from each other's strong points. We offer an argument for integrating Western medicine with TCM. In the 20th century China has maintained and developed three kinds of medical science, that is, TCM, Western medicine, and ‘integrated medicine’. Much has been achieved in clinical, experimental and theoretical research. The development of any science can be furthered by cross-fertilization based on absorption and fusion of whatever useful theory and experience. It is our dream that, in the future, diverse modalities – including TCM, Western medicine and possibly other variants – can work in conjunction with each other as part of a unified team rather than in competition. This integrated approach will ultimately lead to safer, faster and more effective health care.

History of Diabetes Insipidus

Under physiological conditions, fluid and electrolyte homoeostasis is maintained by the kidney adjusting urine volume and composition according to body needs. Diabetes Insipidus is a complex and heterogeneous clinical syndrome affecting water balance and characterized by constant diuresis, resulting in large volumes of dilute urine. With respect to the similarly named Diabetes Mellitus, a disease already known in ancient Egypt, Greece and Asia, Diabetes Insipidus has been described several thousand years later. In 1670s Thomas Willis, noted the difference in taste of urine from polyuric subjects compared with healthy individuals and started the differentiation of Diabetes Mellitus from the more rare entity of Diabetes Insipidus. In 1794, Johann Peter Frank described polyuric patients excreting nonsaccharine urine and introduced the term of Diabetes Insipidus. An hystorical milestone was the in 1913, when Farini successfully used posterior pituitary extracts to treat Diabetes Insipidus. Until 1920s the available evidence indicated Diabetes Insipidus as a disorder of the pituitary gland. In the early 1928, De Lange first observed that some patients with Diabetes Insipidus did not respond to posterior pituitary extracts and subsequently Forssman and Waring in 1945 established that the kidney had a critical role for these forms of Diabetes Insipidus resistant to this treatment. In 1947 Williams and Henry introduced the term Nephrogenic Diabetes Insipidus for the congenital syndrome characterized by polyuria and renal concentrating defect resistant to vasopressin. In 1955, du Vigneaud received the 1955 Nobel Prize in chemistry for the first synthesis of the hormone vasopressin representing a milestone for the treatment of Central Diabetes Insipidus.

History of diabetes mellitus

Clinical features similar to diabetes mellitus were described 3000 years ago by the ancient Egyptians. The term "diabetes" was first coined by Araetus of Cappodocia (81-133AD). Later, the word mellitus (honey sweet) was added by Thomas Willis (Britain) in 1675 after rediscovering the sweetness of urine and blood of patients (first noticed by the ancient Indians). It was only in 1776 that Dobson (Britain) firstly confirmed the presence of excess sugar in urine and blood as a cause of their sweetness. In modern time, the history of diabetes coincided with the emergence of experimental medicine. An important milestone in the history of diabetes is the establishment of the role of the liver in glycogenesis, and the concept that diabetes is due to excess glucose production Claude Bernard (France) in 1857. The role of the pancreas in pathogenesis of diabetes was discovered by Mering and Minkowski (Austria) 1889. Later, this discovery constituted the basis of insulin isolation and clinical use by Banting and Best (Canada) in 1921. Trials to prepare an orally administrated hypoglycemic agent ended successfully by first marketing of tolbutamide and carbutamide in 1955. This report will also discuss the history of dietary management and acute and chronic complications of diabetes.

Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis

Introduction: In the beginning of 2020, an unexpected outbreak due to a new corona virus made the headlines all over the world. Exponential growth in the number of those affected makes this virus such a threat. The current meta-analysis aimed to estimate the prevalence of underlying disorders in hospitalized COVID-19 patients.

Methods: A comprehensive systematic search was performed on PubMed, Scopus, Web of science, and Google scholar, to find articles published until 15 February 2020. All relevant articles that reported clinical characteristics and epidemiological information of hospitalized COVID-19 patients were included in the analysis.

Results: The data of 76993 patients presented in 10 articles were included in this study. According to the meta-analysis, the pooled prevalence of hypertension, cardiovascular disease, smoking history and diabetes in people infected with SARS-CoV-2 were estimated as 16.37% (95%CI: 10.15%-23.65%), 12.11% (95%CI 4.40%-22.75%), 7.63% (95%CI 3.83%-12.43%) and 7.87% (95%CI 6.57%-9.28%), respectively.

Conclusion: According to the findings of the present study, hypertension, cardiovascular diseases, diabetes mellitus, smoking, chronic obstructive pulmonary disease (COPD), malignancy, and chronic kidney disease were among the most prevalent underlying diseases among hospitalized COVID-19 patients, respectively.

Keywords: COVID-19 Comorbidity Meta-analysis severe acute respiratory syndrome coronavirus 2.

The Impacts on Health, Society, and Economy of SARS and H7N9 Outbreaks in China: A Case Comparison Study

3 MPH, Associate Professor, Department of Public Health Information Research, Institute of Medical Information, Chinese Academy of Medical Sciences, 3 Yabao Road, Chaoyang District, Beijing 100020, China

4 Vice Director, Chinese Centre for Health Education, 12 Anhua Xili 1 Qu, Anding men Wai, Chaoyangqu, Beijing 100011, China


Background. Epidemics such as SARS and H7N9 have caused huge negative impacts on population health and the economy in China. Aims. This article discusses the impacts of SARS in 2003 and H7N9 in 2013 in China, in order to provide a better understanding to government and practitioners of why improving management of response to infectious disease outbreaks is so critical for a country’s economy, its society, and its place in the global community. Methods. To provide the results of an analysis of impacts of SARS and H7N9 based on feedback from documents, informants, and focus groups on events during the SARS and H7N9 outbreaks. Results. Both outbreaks of SARS and H7N9 have had an impact on China, causing significant negative impacts on health, the economy, and even national and even international security. Conclusions. Both SARS coronavirus and H7N9 viruses presented a global epidemic threat, but the social and economic impacts of H7N9 were not as serious as in the case of SARS because the response to H7N9 was more effective.

1. Introduction

In the past 15 years China has experienced numerous public health crises caused by disease outbreaks including Severe Acute Respiratory Syndromes (SARS) in 2003 and Influenza A Virus Subtype H7N9 (H7N9) in 2013. Epidemics such as SARS and H7N9 have caused huge negative impacts on population health and the economy. If not controlled well, they can become pandemics, threatening national and even international security. SARS, in particular, highlighted global connectedness and the great threat that pandemic and potential pandemic present.

Since the SARS outbreak in 2003, China has established and strengthened its national and local surveillance systems to prevent and control diseases and has also expanded its laboratory capacity [1, 2]. China’s experiences of emergency management for epidemics have varied. Although the SARS coronavirus and H7N9 virus share some similarities, the control efforts for SARS were problematic and the disease spread globally [3], while the H7N9 response was highly praised and the disease did not spread widely [4]. This article discusses the impacts of SARS in 2003 and H7N9 in 2013 in China, in order to provide a better understanding to government and practitioners of why improving management of response to infectious disease outbreaks is so critical for a country’s economy, its society, and its place in the global community.

2. Methods

We followed the methods of Qiu W. et al., 2017 [5]. This research uses a qualitative case study approach including literature review, document analysis, and in-depth interviews.

The review drew on a wide range of data sources, including books, journal articles, government documents, policy reports, and conference papers. Most books were searched for in the Griffith University Library Catalog. Journal article searches were made in the Library Catalog and reference lists of retrieved articles and textbooks, and electronic literature databases, such as ScienceDirect, PubMed, Medline, Health and Medical Complete (ProQuest), and Web of Science. Government documents and policy reports came from the national and local Centers for Disease Control and Prevention (CDC), government departments, and published research literature.

In-depth interviews using a semistructured style were conducted with 26 key stakeholders, including officers from various national and international agencies as well as experts from local health departments, agriculture departments, Centers for Disease Control and Prevention (CDCs), hospitals, and journalists who have experience of SARS and/or H7N9 in the key cities of Beijing, Shanghai, Guangzhou, and Hangzhou, which were most affected by SARS and/or H7N9. We interviewed key informants about their experience of and reflections on the emergency management of the SARS and H7N9 events, with the same questions about the impacts on health, society, and economy of SARS and H7N9. Each interview lasted about 60 minutes.

3. Results

3.1. Impacts of SARS in China in 2003
3.1.1. Health Effects

The SARS outbreak infected thousands of people, causing widespread serious illness across a large population and many deaths. According to WHO, from Nov 1, 2002, to July 31, 2003, 648 of the 8082 probable cases of SARS in mainland China and Hong Kong died. Worldwide, in just 6 months, there were more than 8000 infected individuals, with over 700 deaths (almost 9% of infected cases) [6]. The psychological impact of SARS was also very serious. The distress was more prominent among the groups of nurses who were working with patients with SARS [7]. Studies show that the SARS outbreak also fostered negative impacts on people’s mental health [8], as mentioned by two hospital doctors:

These SARS cases caused extreme emotional sadness. Psychologically it is entirely possible that an event destroyed a person. They needed psychological counselling.

When the SARS cases lived in the hospital, they could not see their family, and feared the treatment. They developed a mental disorder.

3.1.2. Social Impacts

SARS caused a very large impact on society, particularly in China. During the early period of the SARS outbreak, tension surged in the community. Due to a lack of trustworthy official information, folk tales about the epidemic situation spread through word of mouth, mobile phone short messages, social media transmission, and other ways. The spread of all kinds of rumors exacerbated the spread of social panic, reflected in an escalation of panic buying of drugs in Guangdong province [9]. One rumor was that Banlangen (Radix isatidis) and vinegar could prevent and control SARS, but whether they were effective for SARS was not scientifically established at this time. In early January 2003, the first wave to purchase antiviral drugs occurred in Heyuan city. After half a month, the drug purchasing spree had spread to Zhongshan city then the buying spree gradually spread through Guangdong province [10, 11], as mentioned by a community resident:

Everybody was panic buying Banlangen (Radix isatidis). Banlangen was completely sold out.

In February 2003, people were wearing masks everywhere on the streets in Guangzhou. Panic was also spreading from Guangzhou to Shenzhen, Zhuhai, and other areas and then spread to Hainan, Fujian, Jiangxi, Guangxi, Hong Kong, and other adjacent areas. A media journalist said the following:

During SARS, we were more likely to panic. I had the impression that Banlangen (Radix isatidis) was sold out. Like every family, I also went to buy Banlangen (Radix isatidis) and vinegar, which they thought can cure SARS. Now I think that was a very funny thing to do.

By the middle of March, because the epidemic was spreading but no information had been officially confirmed, people began to believe the rumors, and the panic and purchasing of antiviral drugs that had appeared in Guangdong also began in Beijing, as mentioned by an officer of international organization:

During SARS, I was working in a unit outside of Beijing. Beijing was in a panic. When I arrived at Beijing, (my colleagues) gave me a box of masks and they made me wear a mask. To tell the truth, I felt a bit nervous.

The lack of understanding of SARS by authorities or the media caused a number of experts to become dissatisfied. For example, a 72-year-old retired surgeon from the People’s Liberation Army 301 Hospital, wrote to the media criticizing the health department for hiding the SARS epidemic situation. On April 12, he also wrote a letter to the MOH, urging them to publish accurate numbers as soon as possible. On the same day, an academic from the Chinese Academy of Engineering, the leader of the team guiding the prevention and cure of SARS in Guangdong province, also questioned the information provided by government about the control of the epidemic. He questioned whether SARS really was under control. These published questions brought the SARS epidemic situation in China to the attention of the international community [12].

3.1.3. The Economic Impacts

The SARS epidemic brought great harm not only to peoples’ physical and mental health, but also to the economy. It was estimated that Asian states lost USD 12–18 billion as the SARS crisis depressed travel, tourism, and retail sales [13]. SARS had a large impact on tourism and its related industries, and due to the spread of SARS, population movement in China and many counties decreased. Families reduced their demand for food, clothes, travel, and entertainment, and the numbers of guests in hotels declined sharply. As observed by officers from the Agricultural and Health Departments,

I think it was certainly panic at beginning, as it was not clear what SARS was. I remember (there were) almost no people in a restaurant when I had dinner. And the tourism had few people too.

During SARS in Shanghai, there were not many people on the street and almost no people in entertainment clubs, restaurants and gymnasiums, which caused a very large impact on the whole social and economic life.

After WHO announced that Beijing was an epidemic area and issued more stringent advice to international travelers and airlines, including recommendations on screening at certain airports, the international tourism, transport, and business sectors were seriously affected. For example, the mid-April Chinese enterprise summit in Beijing, hosted by the World Economic Forum, was delayed and the Rolling Stones concert planned for Beijing was cancelled.As observed by an international officer and a media journalist,

During SARS, it was very obvious to see the status of Beijing which became a ghost city. We all know that Beijing has traffic jams every day, but [then] you worried whether you were speeding. It’s never been seen before.

During SARS, you could find that Beijing traffic was so good, (there were) not many people on the road. There were no traffic jams, and you felt great to take the bus (with few people) in Beijing. But I was deeply impressed that when I took a bus, and a man behind had a cough, I was scared and I got off quickly at the next stop.

The global macroeconomic impact of SARS was estimated at USD 30–100 billion or around USD 3–10 million per cases [14]. The 2003 SARS outbreak caused losses of USD 12.3-28.4 billion and an estimated decrease of 1% in GDP in China and 0.5% in Southeast Asia [15]. The social burden of SARS in Guangzhou meant less income and spending, with a rough estimate of the total economic burden of RMB 11 billion [16].

The influence of SARS also spread to the manufacturing industry. It was reported that in Asia’s largest manufacturing base, Dongguan in Guangdong province, because of the reduced orders from Hong Kong, the shipments from Dongguan to Hong Kong decreased by one-third [17].

At the same time personnel exchanges were reduced for fear of infection, and income decreased. There was also increased spending on prevention and healthcare, which had negative economic impacts on families. Interviews with 71 households in Qinling Mountain in Shaanxi Province indicated that in the second quarter of 2003 SARS caused the average annual household income to decline to US$175.44, 22.36% below what was expected [18].

3.2. Impacts of H7N9 in China in 2013
3.2.1. Health Effects

H7N9 avian influenza is another infectious disease that has caused severe illness and death in humans in China. It has a high fatality rate [19]. The first H7N9 case was found in China in February 2013. By November 13, 2015, a total of 681 laboratory-confirmed cases of human infection with H7N9, including 275 deaths were reported to WHO. The case fatality rate of H7N9 was 40.1% [20]. According to Disease Outbreak News issued by the WHO on February 22, 2017, a total of 1223 laboratory-confirmed cases of human infection with avian influenza A (H7N9) virus had been reported since early 2013. The number of human cases developing since October 1, 2016, accounted for nearly one-third of all human cases of H7N9 infection reported since 2013. As of February 23, 2017, at least 425 cases had been reported during the fifth outbreak in China, which began in October and spiked suddenly in December in 2016. This increase in the number of new cases of H7N9 infection has caused domestic and international concern [21]. According to National Statutory Epidemic Situation in 2017 by the China National Health Commission on February 26, 2018, there are 589 laboratory-confirmed cases of H7N9 that had been reported, with 259 deaths in China in 2017. Today, there is no H7N9 vaccine available, although some vaccine manufacturers are conducting clinical evaluations of a H7N9 vaccine [22].

The influenza H7N9 virus remains a large threat due to its virulent nature in poultry. The major factors that influence the epidemic potential of an influenza virus, including its ability to cause human disease, are the immunity of the population to the virus and the transmission potential of the virus [23]. Although there is no evidence that H7N9 spreads easily from human to human and the population had little immunity to H7N9, the virus was easily transmitted. The significance still remains over whether H7N9 could be the next pandemic strain of influenza [24].

3.2.2. Social Impacts

Although there were rumors that people could be infected with H7N9 from eating chicken and that pickled peppers and onions can prevent H7N9 [25], compared with SARS, the H7N9 epidemic did not lead to large-scale social panic, and the management of the problem satisfied both the Chinese and international community, as mentioned by one media journalist and one CDC expert

During H7N9, the impact on people’s lives was very limited. In fact, the panic is derived from what people don’t know. There wasn’t any panic, as we knew something with H7N9.

There were no impacts on the city life in Beijing during H7N9. The only [impacts] was to further strengthen the poultry market management.

The National 12320 Telephone Management Center carried out an opinion survey regarding the government’s response to the H7N9 event from April 27 to May 4 through the 12320 Health Hotline, which was reported in Guangming Daily in May 2013. In it, more than 80% of respondents expressed satisfaction with the government’s prevention and control of human infection with H7N9 avian influenza, thought that the government announced the information regarding the epidemic situation in a timely manner, expressed satisfaction with the government’s release of information about prevention and control measures, and felt confident in the government’s ability to fully control the epidemic, as mentioned by a community resident:

As we could know the information of H7N9 by TV, newspaper, internet, it was clearer for us to know the dangers of H7N9 than SARS.

More than 50% of the respondents believed that the prevention of human infection with H7N9 avian influenza had changed their health habits, indicating that the release of the knowledge of prevention and control of human infection with H7N9 avian influenza was effective [26].

The timeline for the beginning of the outbreak of H7N9 is presented in Figure 1.