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The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

This study was aimed at comparing different formats of illustrations for children's books created by modern Chinese and Ukrainian artists. At the same time, it was not focused just on determining the leading format, but on identifying the attractiveness factors of each format. To this end, the study investigated children's illustration preferences drawing from the following three age groups: 5–6 years old (preschoolers), 7–8 years old (second‐graders), and 9–10 years old (fourth‐graders). According to the survey, children were most concerned with illustration colourfulness (this is true for paper and pop‐up books) and viewing convenience. There were no statistically significant differences found between Chinese and Ukrainian books in terms of these parameters. At the same time, Chinese e‐books appeared to outperform the Ukrainian texts in terms of feature management and illustration colourfulness. Publishers and artists of children's books can use these data for effective creative activity and making constructive decisions. At the same time, these findings may be of interest to parents, informing or guiding book selection for children. [ABSTRACT FROM AUTHOR]

Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

This paper investigated a research area worthy of greater attention: foreign language classroom anxiety (hereafter FLCA) and enjoyment (hereafter FLE) of older adults learning English as a foreign language in Chinese Universities of the Third Age. Understanding the largely overlooked emotional involvement of older language learners contributes to sustaining their motivation in lifelong learning for more remarkable personal growth and successes. Based on the survey of 587 Chinese older learners of English between the age of 50 and 80, paired sample t-test showed that more FLE was reported than FLCA. The results of Welch's ANOVA suggested that those who were better educated had less FLCA and those who believed themselves healthier had more FLE. The language performance evaluation (i.e. relative standing in class and English mastery) affects both FLE and FLCA. Further interviews with 34 older participants revealed three major sources of FLE, including the language use in life situations, the favorable attitude toward FL learning in the cognitive, aesthetic cultural and pragmatic aspects and the social interactions in the U3As. FLCA occurs when the language performance is perceived as dissatisfying and when aspects of mental health (e.g. worsening memory) impede effective learning. Although FLCA and FLE had only a very weak correlation, Chinese older adult learners commented on a shared belief that anxiety usually precedes and subsequently enhances enjoyment in learning, indicating a sign of emotional resilience later in life. This paper demonstrates a need for understanding the emotions in language learning across life stages and socio-cultural contexts. [ABSTRACT FROM AUTHOR]

This study investigates the gender disparities and cohort differences in the health trajectories of older Chinese adults. Drawn on a nationally representative dataset from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey, this paper uses a growth-curve model to identify the health trajectories of older adults in functional limitations, chronic diseases, depressive symptoms and cognitive skills. Older women are found to have slightly fewer functional limitations than older men at an earlier age; however, this gap is reversed later because of women's higher deterioration rate in physical function. Compared to men, older women have more chronic diseases at younger ages, but this trend is changed after age 90 years due to a faster decline rate in chronic diseases for women. The gender gap in the depressive symptom trajectories narrows with age, whereas the gap in the trajectories of cognitive skills widens. The cohort differences favouring later-born cohorts decrease with age in the trajectory of functional limitations. The latest cohort born in 1940 or after has the fastest increase in chronic diseases and depressive symptoms among all the cohorts. These results are further verified using the random-effect model and pooled ordinary least squares. Policymakers should promote gender equality and reduce cohort differences to achieve the national goal of "Healthy China". [ABSTRACT FROM AUTHOR]

Background: Computational thinking (CT) has become a crucial skill for individuals in the 21st century, and while more educators are starting to recognize the importance of CT education, there is still a lack of research on how to teach young children CT, particularly outside of traditional school settings. Objectives: To fill the gap in knowledge, we aimed to investigate the effectiveness of a web‐based parent education program on improving children's CT skills. Additionally, we sought to determine if children's age, gender and family socioeconomic status had any impact on the development of CT skills. Methods: We selected 86 adult–child pairs in the K3 age group to participate in a 4‐week intervention program using a quasi‐experimental approach. Results: After 4 weeks, children in the intervention group had improved their CT skills more than their peers in the control group. This shows that the intervention was successful in enhancing children's CT skills. Age had a moderating effect on CT enhancement, with older children showing a more significant improvement than younger children. However, children's gender and family socioeconomic status did not have any moderating effects. Conclusions: These results demonstrate that CT education can be effectively implemented in the home setting through web‐mediated parent education. Encouraging the use of unplugged CT activities at home can aid children in acquiring CT skills. Lay Description: What is already known about this topic: Computational thinking (CT) education can be started at the early childhood stage.Both plugged‐in and unplugged activities can promote children's CT.Unplugged activities have many advantages and are suitable for young children. What this paper adds: Web‐mediated parent education is useful for equipping parents with the knowledge and skills to conduct CT activities at home.CT education has a positive effect on children in the home setting.Parents play an important leading role in children's CT education.Parent–child unplugged activities are beneficial to children's CT enhancement. Implications for practice and/or policy: A web‐mediated approach is an appropriate way to encourage parent participation in CT training.CT‐related parent education should be scaled up so that parents can play an active educational role at home.Unplugged CT activities should be designed more for the home settings in addition to school settings. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndromes (MetS) are clinical syndromes involving multiple pathological states with distinct gender-specific clinical patterns. As a serious disorder associated with psychiatric conditions, the prevalence of MetS is significantly higher in the population with schizophrenia (Sch). The aim of this paper is to report gender differences in the prevalence, associated factors and severity-related factors of MetS in first-treatment and drug-naïve (FTDN) patients with Sch. Methods: A total of 668 patients with FTDN Sch were included in this study. We collected socio-demographic and general clinical information on the target population, measured and evaluated common metabolic parameters and routine biochemical indicators, and assessed the severity of psychiatric symptoms using Positive and Negative Symptom Scale (PANSS). Results: In the target group, the prevalence of MetS was significantly higher in women (13.44%, 57/424) than in men (6.56%, 16/244). In the males, waist circumference (WC), fasting blood glucose (FBG), diastolic blood pressure (DBP), and triglycerides (TG) were risk factors for MetS, while systolic blood pressure (SBP), TG, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and platelet (PLT) were risk factors for the females. More importantly, for the females, we found that age, LDL-C, PANSS scores and blood creatinine (CRE) were risk factors for higher MetS scores, while onset age and hemoglobin (HGB) were protective factors. Conclusion: There are significant gender differences in the prevalence of MetS and its factors among patients with FTDN Sch. The prevalence of MetS is higher and the factors that influence MetS are more numerous and extensive in females. The mechanisms of this difference need further research and clinical intervention strategies should be formulated with gender differences. [ABSTRACT FROM AUTHOR]

This study aimed to systematically review and critically appraise the literature describing the phonetic characteristics and accuracy of the consonants, vowels and tones produced by Mandarin-speaking children with cochlear implants (CIs). The protocol in this review was designed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. EBSCOhost, PubMed, Scopus, PsycINFO, ProQuest Central databases were searched for relevant articles which met the inclusion criteria. A total of 18 journal papers were included in this review. The results revealed that Mandarin-speaking children with CIs perform consistently more poorly in their production of consonants, in particular on fricatives, have a smaller and less well-defined vowel space, and exhibit greater difficulties in tone realisation, notably T2 and T3, when compared to their normal-hearing (NH) peers. The results from acoustic and accuracy analyses are negatively correlated with CI implantation age, but largely positively correlated with hearing age. Findings of this review highlight the factors that influence consonant, vowel and tone production in Mandarin-speaking children with CIs, thereby providing critical information for clinicians and researchers working with this population. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health‐care reform in China. This paper aimed to explore patient‐ and hospital‐level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient‐oriented health‐care system. Methods: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. Results: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse‐to‐bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. Conclusion: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well‐functioning health‐care delivery system in order to better serve patients in China. [ABSTRACT FROM AUTHOR]

Over the past decade, the call to foster computational thinking (CT) in every child has received considerable attention. However, there is little understanding of whether children are developmentally ready to think computationally and what specific CT concepts and skills can be developed at various ages. This study explored the developmental and gender differences in CT skills of 197 Grade 4–6 students (aged 9–13) before being exposed to instruction and investigated the age–gender interaction effects on their CT acquisition in an intervention combining both programming and non‐programming (unplugged) activities. Results show that students' CT skills followed a developmental progression before instruction. Gender difference across ages was insignificant in conditionals, logical operators, pattern recognition and generalization skills. Additionally, students of different ages developed CT differently during the intervention, and their CT acquisition was unaffected by gender. Implications for practice and research in CT education were discussed. Lay Description: What is currently known about the topic: Learning progressions for computational thinking have been defined in K‐12 curricula globally.Engaging in programming and non‐programming (unplugged) activities can increase students' CT skills.Controversial results have been reported on the age–gender interaction effects on CT development.Lack of understanding on children's actual progressive development of CT. What this paper adds: A developmental progression was found in CT skills of students aged 9–13. Students aged 12 and above had some a priori understanding of CT.No gender difference across ages existed in conditionals, logical operators, pattern recognition and generalization skills before instruction.Students aged 9–11 benefitted the most from an intervention combining both programming and unplugged activities compared to older students. Students' CT acquisition in the intervention was unaffected by gender.Given the intervention, students aged 9 and above developed conditionals, logical operators and pattern recognition skills. However, generalization skill was developed only for students aged 12 and above. Implications for practice and policy: The findings lay the foundation for designing evidence‐based age‐appropriate CT learning progression and pedagogies.Age‐appropriate learning content: Given appropriate learning experiences, students aged 9 and above may be ready to learn certain CT concepts and skills, including conditionals, logical operators and pattern recognition.CT pedagogies: Using programming and unplugged activities to develop CT requires careful consideration of students' cognitive development and gender needs. [ABSTRACT FROM AUTHOR]

Introduction: The 1-year mortality rate after femoral intertrochanteric fracture is higher than that of femoral neck fracture, which also belongs to hip fracture (Cui et al. in Arch Osteoporos 14(1):55, 2019). With the application of the concept of co-management model of orthopedics and geriatrics, the short-term and long-term mortality of all types of hip fractures has decreased (Van Heghe et al. in Calcif Tissue Int, 2021, https://doi.org/10.1007/s00223-021-00913-5). However, the mortality of Chinese femoral intertrochanteric fracture patients under this model has not been reported in the literatures. Aim: This paper aims to study the risk factors of postoperative all-cause mortality in aged patients with femoral intertrochanteric fracture under the co-management model of orthopedics and geriatrics. Materials and methods: This is a single-center prospective cohort study based on the real world, under the co-management of orthopedics and geriatrics, 363 patients aged ≥ 65 years with femoral intertrochanteric fracture were enrolled and followed up for 2–3 years; 52 patients were lost to follow up. Age, gender, body mass index (BMI), history of comorbidities, hip Bone Mineral Density (BMD), fracture history, 25(OH)D level, hemoglobin level, anti-osteoporosis treatment were risk factors to be tested. Kaplan–Meier survival curves and multivariate Cox proportional hazards models were constructed to analyze the impact of factors on all-cause mortality. Results: (1) Most of the dead patients were older (the mean age was 83.4 years, compared with 79.8 years for surviving patients), with more complications and without anti-osteoporosis medication; gender, pre-fracture history, BMI, total hip BMD, hemoglobin, 25(OH)D had no difference between the dead and the living patients. (2) Elderly patients with Intertrochanteric fracture can benefit from the early treatment of Zoledronic Acid (within 3 days after the operation). Conclusion: Under the co-management of orthopedics and geriatrics, to Chinese patients with Femoral Intertrochanteric fracture, Doctors should pay more attention to their age and chronic disease, and give anti-osteoporosis treatment if allowed. [ABSTRACT FROM AUTHOR]

Background: The goal of this paper was to assess the quality of primary healthcare services at community health centres (CHCs) from the demand (patient) and supplier (healthcare service institution) angles. Methods: This study was conducted at six CHCs in the Greater Bay Area of China. Between August and October 2019, 1,568 patients were recruited (55.8% women and 44.2% men). We evaluated the service quality of CHCs using the National Committee for Quality Assurance Patient-Centred Medical Home (NCQA-PCMH) recognition questionnaire. We assessed patients' experiences with medical and health services using the Primary Care Assessment Tools (PCAT). Results: PCAT total and sub-domains scores were significantly difference at the six CHCs (P < 0.001). Among the six CHCs, Shayuan CHC had the highest PCAT total and sub-domain scores and the highest NCQA-PCMH total and sub-domain scores, as well. Older (> 60 years), female, lower education, and employee medical-insured individuals had better patient experiences. Conclusions: Our results indicate that CHCs could improve their service quality by improving both institutional health service quality based on NCQA-PCMH assessment and patient experiences based on PCAT scales. These findings can help inform patient-centred primary healthcare policy and management. [ABSTRACT FROM AUTHOR]

Background: Most existing research on rural–urban health inequalities focuses on disparities in service access and health outcomes based on region. This paper examines rural–urban disparities in maternal healthcare utilization and delivery modes based on household registration (hukou) status to understand the role of state institutions in producing healthcare disparities in China. Methods: Utilizing administrative data from the Public Maternal Health Insurance scheme, we analyzed 54,733 live births in City A (2015–2019) and 25,849 live births in City B (2018–2019) in Guangdong Province in China. We constructed regression models using hukou status (rural versus urban) as the explanatory variable. Results: While there is no statistically significant difference in rural and urban mothers' probability of obtaining the minimum recommended number of prenatal care checkups in City A (OR = 0.990 [0.950, 1.032]), mothers with rural hukou status have a lower probability of obtaining the minimum recommended number of visits in City B than their counterparts with urban hukou (OR = 0.781 [0.740, 0.825]). The probability of delivering in tertiary hospital is lower among mothers with rural hukou than among those with urban hukou in both cities (City A: OR = 0.734 [0.701, 0.769]; City B: OR = 0.336 [0.319, 0.354]). Mothers with rural hukou are more likely to have a Cesarean section than those with urban hukou in both cities (City A: OR = 1.065 [1.027, 1.104]; City B: OR = 1.127 [1.069, 1.189]). Compared with mothers with urban hukou, mothers with rural hukou incurred 4 % (95 % CI [-0.046, -0.033]) and 9.4 % (95 % CI [-0.120, -0.068]) less in total medical costs for those who delivered via Cesarean section and 7.8 % (95 % CI [-0.085, -0.071]) and 19.9 % (95 % CI [-0.221, -0.177]) less for those who delivered via natural delivery in City A and City B, respectively. Conclusions: Rural hukou status is associated with younger age, no difference or lower probability of having a minimum number of prenatal checkups, higher likelihood of delivering in nontertiary hospitals, increased Cesarean delivery rates, and lower medical cost for delivery in these two Chinese cities. Evaluating how hukou status influences maternal healthcare in Chinese cities is important for devising targeted public policies to promote more equitable maternal health services. [ABSTRACT FROM AUTHOR]

Abstract Child nutritional health has always been a research focus and an essential indicator reflecting children's health and living conditions in developing countries. This study investigates how household income and other individual and family factors influence child nutritional status. The Chinese Health and Nutrition Survey data are used to analyze changing patterns of child malnutrition status, and to compare the gap between genders, rural and urban areas etc., and the WHO new child growth standards are used in this paper as the reference for each specific age and gender. The findings in this paper include three aspects. First of all, the headcount ratio of undernourished children in both stunting and underweight has declined over years from 1991 to 2009 in China. Second, regional disparity in child nutritional status was significant, and the economic growth was a key driver to improve the nutritional conditions of the poor children. Furthermore, this paper also employs the stepwise logistic regression models to illustrate the influencing mechanisms of family income and other factors on child nutrition, and finds that household income affected child nutritional status significantly through the mechanisms of community, household, parental and individual factors. Highlights • This paper studies stunting and underweight rates of Chinese children and finds both malnutritional indicators have declined from 1991 to 2009. • This paper studies the regional and demographic differences in child nutrition and finds certain heterogeneity in malnutritional indicators. • This paper studies the relationship between family income and child nutrition and reveals significant and positive correlation between the two. • This paper finds significant impact mechanisms of individual, parental, family and community factors on child nutrition. [ABSTRACT FROM AUTHOR]

Background: China initiated a reform of the health insurance system in the late 1990s. The new insurance, Urban Employee Basic Medical Insurance (UEBMI), is employment-based, which makes it more difficult than it used to be for those unemployed or informal employed (most of whom are women) to be covered by health insurance. Methods: Based on three large sample of micro datasets, we first use statistical methods to identify gender differences in health insurance. Next, we construct a logistic regression model to capture the differences in insurance coverage across age groups using the parameter of interaction terms for gender and age groups. Results: Based on data from a demographic survey that covers a large sample, we find that in the below 50 (in 2005) or 60 (in 2015) years age group, the coverage gap of UEBMI between men and women was relatively smaller, while a larger disparity existed in the above 50 (in 2005) or 60 (in 2015) group. Moreover, gender differences in health insurance were more significant in the low-education group, while no gender differences were found in the high-education group. Conclusions: This paper explains the gender gap in health insurance and the reason for the wider gap among older people. Our study indicates that because the UEBMI in China mainly covers people with formal jobs, a lower labor participation rate (even much lower in formal jobs) of women has led to their greater difficulty in obtaining health insurance. Since the older women's greater difficulty in obtaining jobs or susceptibility to lay-offs during the period of the UEBMI's implementation, the possibility of being covered was even much lower. In fact, it was because of the combined effects of the UEBMI system and the labor market condition at that time that older women had a lower proportion of being covered under the UEBMI. [ABSTRACT FROM AUTHOR]

Objectives: Characterized by infrequent contact, low emotional intensity, and limited intimacy, weak ties are found to be associated with better subjective well-being and other health outcomes. Drawing on the theory of weak ties and the convoy model of social relations, this paper aims to examine the association between weak ties and cognitive function among older adults in China. Methods: We used multilevel growth modeling to analyze panel data for adults aged 60 years and over (N = 2,650) selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011–2015). Weak ties were measured based on the frequency of social activity participation and the number of social activities. Results: Weekly or irregular social activity participation in at least one social activity was significantly associated with better mental status and memory. The number of participated social activities was also significantly and positively associated with mental status and memory. After controlling for age, gender, marital status, educational attainment, geographic residence, household expenditures, and health conditions (i.e., depressive symptoms and self-reported health), we found that participation in a greater number of social activities protected memory from declining by 4% for every 2 years (p < 0.001). Conclusion: These findings suggest that social interactions with peripheral members of a diverse social network may help prevent cognitive decline for older Chinese adults. Greater attention on weak ties might yield practical implications for non-pharmacological dementia prevention and health promotion for the general older population. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Schizophrenia is a severe and highly stigmatized mental illness. High internalized stigma affects FGs' quality of life and caregiving capacity.Worldwide studies aimed at internalized stigma among patients diagnosed with mental illness or their FGs have reported significant stigma and some correlates, but studies involving FGs that focus on a specific mental illness (e.g. schizophrenia) and report the impact of potential psychosocial variables (e.g. coping and hope) on internalized stigma are limited. What does the paper add to existing knowledge?: Internalized stigma was common among Chinese FGs of patients diagnosed with schizophrenia and half of them presented at a mild level. Internalized stigma was negatively associated with hope and positively associated with passive coping. FGs, who live with patients, have difficulty supervising medication, or care for a male relative has higher internalized stigma. What are the implications for practice?: Regarding informative support, interventions (e.g. enhancing mental health literacy programs and cognitive therapies) to provide knowledge about schizophrenia, the skills to manage patients' adherence to medications, the benefits of treatment and the possibilities of rehabilitation are necessary for FGs. Regarding psychosocial processes, effective interventions (e.g. group psychoeducation and group social skills training) aimed to enhance hope, social support and coping styles towards internalized stigma should be implemented among FGs. Both informative support and psychosocial interventions used to decrease FGs' internalized stigma can be delivered by healthcare providers or by peer caregivers. Introduction: Internalized stigma is prevalent among patients diagnosed with schizophrenia. Their family caregivers (FGs) also suffer from internalized stigma, but limited studies have addressed the issue. Aim: The aim of this study was to determine the severity of internalized stigma and its correlates among FGs of patients diagnosed with schizophrenia in Changsha, Hunan, China. Methods: A consecutive sample of 299 FGs was recruited at the psychiatric outpatient department of a tertiary hospital in Changsha. This study explored the relationships between internalized stigma and potential factors. Results: Nearly 50% of the FGs perceived mild internalized stigma, 24% of the FGs reported moderate level, and 6% had a severe level. Internalized stigma was associated with patients' characteristics (severity of illness) and FGs' characteristics (hope, social support, passive coping, age, education background, residence with the patient, caring for a male or a young patient and difficulty in supervising medication). Discussion and implications for practice: Informative and psychosocial interventions based on education and contact for FGs such as enhancing mental health literacy programs, cognitive therapies and group psychoeducation can provide FGs with a better understanding of schizophrenia and to promote hope, active coping and social support. [ABSTRACT FROM AUTHOR]

This paper compares the prevalence and age-specific changes of coresidence patterns, by means of a classification of 12 coresidence types, for the age range from 16 to 30 in the United States (US), Germany (GE), Taiwan (TW), and mainland China (CN). Panel data were used in separate nested logistic regression models to estimate transitions in coresidence for individuals in each society in the transition to adulthood. On the first level, decisions to move from different types of family-of-origin-households were modeled, depending on intergenerational solidarity and parental resources. On the second level, target household types were modeled, depending on others' trajectory events and their interaction with gender. The analysis used the National Longitudinal Study of Youth (NLSY97) from the United States, the German Family Panel (pairfam), the Taiwanese Youth Project (TYP), and the China Family Panel Studies (CFPS). Age-specific coresidence patterns were pooled and transitions probabilities were estimated for a two-year period. The systematic comparative approach makes it possible to correct misinterpretations based on analyses from single societies. Our results demonstrated that differences in coresidence patterns within the patrilineal, collectivistic societies (CN and TW), and within the bilineal, individualistic societies (US and GE) were as important as the differences between these two groups of societies. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

China's urban population has experienced rapid fertility decline over the past six decades. This drastic change will have a significant impact on China's demographic, social and economic future. However, the patterns and characteristics of urban China's fertility decline have not been systematically examined. This study analyses the trends and age patterns of fertility in urban China since the 1950s, and summarizes the major characteristics of reproductive behaviours into four 'lows': extremely 'low' level of fertility; 'low' proportion of two and higher parity births; 'low' mean age at birth; and 'low' level of childlessness. The paper argues that the highly homogenous reproductive behaviours found in China's now near 800 million urban population have been in part shaped by the country's unprecedented government intervention in family planning. The 'later, longer, fewer' campaign in the 1970s and the 'one-child' policy, in particular, have left clear imprints on China's reproductive norms and fertility patterns. The government-led family planning programme, however, has not been the only driving force of fertility decline. A wide range of social, economic, political and cultural changes have also affected the transition in family formation, reproductive behaviour and fertility patterns, and this has become increasingly prominent in the past two decades. [ABSTRACT FROM AUTHOR]

Of the Wenchuan earthquake victims, there was a special group who lost their only child, known as the Shidu parents. The purpose of this paper is to examine social support as a moderator between resilience and quality of life (QOL) in Shidu parents. A cross-sectional sample survey was conducted to collect data from 22 earthquake-stricken counties in Sichuan province. Of the Shidu parents from the Wenchuan earthquake, being of Han ethnicity, receiving a high monthly income, having a high education, having lost a younger child (18-27), and having lost a male child were all risk factors for a lower QOL ( p < 0.05). This study highlighted that different types of social support have different roles in building resilience and improving QOL. The results emphasized the importance of developing suitable social support strategies as mediators to improve resilience and the QOL in Shidu parents. [ABSTRACT FROM AUTHOR]

Background: In the past 20 years, the trends of ischemic heart disease (IHD) mortality in China have been described in divergent claims. This research analyzes mortality trends for IHD by using the data from 102 continuous Disease Surveillance Points (DSP) from 1991 to 2009.Method: The 102 continuous DSP covered 7.3 million people during the period 1991-2000, and then were expanded to a population of 52 million in the same areas for 2004-2009. The data were adjusted by using garbage code redistribution and underreporting rate, mapped from international classification of diseases ICD-9 to ICD-10. The mortality rates for IHD were further adjusted by the crude death proportion multiplied by the total number of deaths in the mortality envelope, which was calculated by using logrt = a + bt. Age-standard death rates (ASDRs) were computed using China's 2010 census population structure. Trend in IHD was calculated from ASDRs by using a joinpoint regression model.Results: The IHD ASDRs increased in total in regions with an average annual percentage change (AAPC) 4.96%, especially for the Southwest (AAPC = 7.97%) and Northeast areas (AAPC = 7.10%), and for male and female subjects (with 5% AAPC) as well. In rural areas, the year 2000 was a cut-off point for mortality rate with annual percentage change increasing from 3.52% in 1991-2000 to 9.02% in 2000-2009, which was much higher than in urban areas (AAPC = 1.05%). And the proportion of deaths increased in older adults, and more male deaths occurred before age 60 compared to female deaths.Conclusion: By observing a wide range of areas across China from 1991 to 2009, this paper concludes that the ASDR trend for IHD increased. These trends reflect changes in the Chinese standard of living and lifestyle with diets higher in fat, higher blood lipids and increased body weight. [ABSTRACT FROM AUTHOR]

Background: Common bile duct (CBD) stone is one of the most common diseases among elderly people. In recent decades, there are numerous studies regarding the safety and efficacy of laparoscopic common bile duct exploration (LCBDE). Elderly patients are often regarded as high-risk patients because they are more likely to present with age-specific deterioration of organ function and coexisting chronic diseases, which may reduce their tolerance of laparoscopic surgery. Although laparoscopic surgery for choledocholithiasis is now widely accepted as the treatment for CBD stone, its appropriateness for the treatment of elderly patients or those with coexisting high-risk patients has not been well established. Therefore, the objective of this paper is to analyze the safety and efficacy of LCBDE in elderly patients.Methods: Between January 2012 and November 2015, 376 patients underwent LCBDE in our center. Based on their ages, they were divided into two groups, and a retrospective study was performed. By making comparisons between younger group who were younger than 70 years (n = 253) and elderly group who were 70 years old or older (n = 123), the demographics, clinical characteristics, laboratory data, operative parameters and outcomes were analyzed.Results: Before operation, elderly patients had more coexisting chronic diseases and risk factors, such as arterial hypertension, heart diseases, pulmonary diseases and previous abdominal surgery (P < 0.05). In both groups, LCBDE was equally successful with a high clearance rate (100 % in elderly patients vs. 98.8 % in younger group, P = 0.554). Besides, the operating time, intraoperative blood loss, postoperative hospital stay, total costs and overall complication showed no significant difference between two groups (P > 0.05). There was no major bile duct injury or death in either group.Conclusion: Although elderly patients are frequently confronted with coexisting disorders, LCBDE can be considered as a safe and effective technique in choledocholithiasis treatment for elderly patients. [ABSTRACT FROM AUTHOR]

Background: Inequalities in demographic, socio-economic and health status for China labor force place them at greater health risks, and marginalized them in the utilization of healthcare services. This paper identifies the inequalities which limit the utilization of health services among China labor force, and provides a reference point for health policy. Methods: Data were collected from 23,505 participants aged 15 to 65, from the 2014 China Labor Force Dynamic Survey (a nationwide cross-sectional survey covering 29 provinces with a multi-stage cluster, and stratified, probability sampling strategy) conducted by Sun Yat-sen University. Logistic regression models were used to study the effects of demographic (age, gender, marital status, type of hukou and migration status), socio-economic (education, social class and insurance) and health status (self-perceived general health and several chronic illnesses) variables on the utilization of health services (two-week visiting and hospitalization during the past 12 months). Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating curve (AUC). Results: Migrants with more than 1 (OR 2.80, 95% CI 1.01 ~ 7.82) or none chronic illnesses (OR 1.26, 95% CI 1.01 ~ 7.82) are more likely to be two week visiting to the clinic than non-migrants; migrants with none chronic illnesses (OR 0.61, 95% CI 0.45 ~ 0.82) are less likely to be in hospitalization during the past 12 months than non-migrants. Female, elder, hukou of non-agriculture, higher education level, higher social class, purchasing more insurance and poorer selfperceived health were predictors for more utilization of health service. More insurance benefited more two-week visiting (OR 1.12, 95% CI 1.06 ~ 1.17) and hospitalization during the past 12 months (OR 1.12, 95% CI 1.07 ~ 1.18) for individuals with none chronic illness but not ≥1 chronic illnesses. All models achieved good calibration (Hosmer-Lemeshow test's P range of 0.258-0.987) and discrimination (AUC range of 0.626-0.725). Conclusions: This study has shown that there are inequalities of demographic, socio-economic and health status in the utilization of health services for China labor force. Prudent health policy with equitable utilization of health services eliminating mentioned inequalities should be a priority in shaping China's healthcare system reform. [ABSTRACT FROM AUTHOR]

This paper discusses how class and gender may be read against the narration of contemporary films in urban China, specifically in Beijing. The paper acknowledges that the effects of marketisation on social life in China are extremely complex, but argues that, nonetheless, a feminist reading is appropriate and necessary at this time. The premise of the paper is therefore that China is experiencing both macro-symptoms of new class structures and divisions, and micro-examples of moral ambivalence, formations of taste, and ascriptions of gender value to certain behaviours and age groups. In government-sponsored surveys in 2005, 61 million citizens self-identified as richer than before [bi qian fu], or as middle market-class [zhongchan jieji], or as middle-class (as a rough translation of that market analysis) people. A great many more fall outside the income bracket of affluence or even of aspiration to affluence, but are nonetheless caught up in the manifestations of social value and individual worth that such trends engender. Unsurprisingly, given the connections to consumption and urban growth, contemporary media in China are fascinated with the idea of the middle class and there are endless popular debates on the definitions, behaviours and meanings of such a force in contemporary society. In film, there is also a growing awareness that narratives of everyday experience will and must reflect on the consequences of a market economy for human relationships. [ABSTRACT FROM AUTHOR]

Today China has the world’s largest older population, defined as aged 65 and over. The size of the older population in the United States is also large, ranking third in the world in 2000. The combined older populations of China and the United States represented 29 percent of the world’s population 65 and older in 2000. The large older populations in these two countries are projected to more than double in size over the next three decades. Although currently China is younger than the United States and many other countries, its aging process will accelerate in the next few decades, with a speed surpassing the experience of many Western European countries and the United States. This paper examines the current and future situation of the older population in China and compares China’s aging with that of the United States, using 2000 and earlier censuses from both countries as well as the population projections data from the U.S. Census Bureau. Growth of the older population, changes in the age distribution in China with comparisons to the United States, and the projections of the older population’s future growth are analyzed and presented. The paper also discusses sources of financial support and living arrangements in China and the United States. Finally, the paper assesses trends in the older population support ratio and the implications for the economic well-being of an aging population. [ABSTRACT FROM AUTHOR]

While China's economy has grown rapidly in recent decades, urban-rural inequalities in mental health have persisted, and depression is more prevalent among rural women. Using a nationally-representative survey data in China, this paper investigates the impact of women's off-farm employment on their depressive symptoms. Results from instrumental variable and individual fixed effects estimation show that women's participation in off-farm employment leads to a significant reduction in depressive symptoms. We further take into account the confounding effects of working conditions, and the main results are robust. Moreover, off-farm employment enhances women's mental health mainly through pathways including increased absolute income, higher self-perceived relative income, more frequent healthy behaviors, increased likelihood of health investment, and obtaining more formal social support. Further evidence suggests that the depression-reducing effect of off-farm employment is more effective for those with more severe depressive symptoms, middle-aged and elderly persons, and women with lower body mass index. The findings have important implications for preventing depressive disorders and improving mental health in China and other developing countries. • We investigate the impact of women's off-farm employment on their depressive symptoms in rural China. • Women's participation in off-farm employment leads to a significant reduction in depressive symptoms. • Formal social supports derived from workplace are important mechanisms by which employment affects depressive symptoms. • The depression-reducing effect is more effective for women with more severe symptoms and middle-aged and elderly persons. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

Background: Cancer has become a global health problem. China still suffers continuous increasing cancer mortality. To study the trend of cancer mortality in rural China, this paper established an Age-Period-Cohort model to discuss the age effect, period effect and cohort effect on cancer mortality in rural China. Methods: The data were collected from the “China Health Statistical Yearbook” from 1990 to 2010. Collected data were analyzed by Age-Period-Cohort model and Intrinsic Estimation method. Results: The age effect on the total cancer mortality represented a V trend. Compared with Group 0–4, Group 5–9 showed 71.87% lower cancer mortality risk. Compared with Group 5–9, Group 75–79 showed 38 times higher cancer mortality risk. The period effect on the total cancer mortality risk weakened firstly but then increased. It increased by 35.70% from 1990 to 2010, showing an annual average growth of 1.79%. The cohort effect on the total cancer mortality risk weakened by totally 84.94% from 1906–1910 to 2005–2010. Three “deterioration periods” and three “improvement periods” were witnessed during this period. The malignant cancer mortality varied similarly with the total cancer mortality, while benign cancer mortality and other cancer mortality represented different variation laws. Conclusions: Although the total cancer mortality risk is increasing at an accelerated rate, cancer mortality risk in recent born year is decreasing, indicating very important impact of social change on the cancer mortality in rural China. [ABSTRACT FROM AUTHOR]

Using adjusted 2000 population census data, this paper conducts projections of China's population up to 2050. Three fertility and four mortality scenarios yield 12 sets of results. Even though fertility is below replacement, China's population will continue growing for many years. One of the notable trends is the rapid ageing of the population. By the end of 2050, one-fifth to one-third of China's population will be aged 65 and over. The demographic dividend is expected to continue in next 10 to 20 years depending on future fertility which, in turn, is determined by changes in China's one-child policy. The Chinese government should be aware of all possible situations of population change, and particularly population ageing in the first half of the century, and be well prepared for all possible challenges that may arise. [ABSTRACT FROM AUTHOR]

The research reported in this paper investigated the effects of semantic relatedness of words (closely related vs. distantly related) and morpheme type (free morpheme vs. bound morpheme) on young Chinese children's homophone awareness, an aspect of morphological awareness, in two experiments. The first experiment was a cross-sectional study including 39 children in a beginning kindergarten class, 39 children in an intermediate kindergarten class, and 36 children in a senior kindergarten class. The second experiment was a 7-month longitudinal study involving 43 first graders and 50 second graders at the beginning of the study. In both experiments, the children judged whether orally presented words shared the same morpheme or contained homophonous morphemes. The results suggest that homophone awareness emerges in Chinese children in the kindergarten years. Children's morpheme identification is facilitated by the semantic proximity of words that share a morpheme, and awareness of free morphemes is developed before that of bound morphemes. Furthermore, although semantic relatedness is the most prominent factor in kindergarten, its effect varies as a function of morpheme type in the early primary grades. Our research sheds light on the developmental course of morphological awareness and the factors that influence it. [ABSTRACT FROM PUBLISHER]

The aim of this paper was to: (i) describe the Beijing 2008 Olympic Games swimmer's ages and; (ii) compare ages according to swimmer's gender. It was analyzed 1101 inscriptions (588 men and 513 women) for all swimming events held at the Beijing 2008 Olympic Games: 50 meters freestyle (L50), 100 meters freestyle (L100), 200 meters freestyle (L200), 400 meters freestyle (L400), 800 meters freestyle (L800, only women) 1500 meters freestyle (L1500, only men), 100 meters backstroke (C100), 200 meters backstroke (C200), 100 meters breaststroke (B100), 200 meters breaststroke (B200), 100 meters butterfly (M100), 200 meters butterfly (M200). The final result lists was consulted at the Beijing 2008 Olympic Games official internet site, collecting the swimmer's name and chronological age for each event. Afterwards, chronological age was converted into decimal age at the day of the event heats. From the quartile analysis became clear that there was a tendency for the age median and variance to decrease from the shorter to the longest events for both genders. There were significant variations in the age, according to gender at the L400 ( p = .01), L1500/L800 ( p = .02), C100 ( p < .01), C200 ( p < .01), B100 ( p = .02), B200 ( p = .04), M100 ( p = .05) and M200 ( p < .01). For all these events, decimal age was higher for men than for women. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study investigating nurse burnout and its association with occupational stressors in Shanghai, China. Background. Burnout is described as feelings of emotional exhaustion, depersonalization and reduced personal accomplishment. Measuring burnout among nurses and its association with occupational stressors are important in providing appropriate intervention to reduce stress and burnout. Method. In total, 527 nurses from 41 hospitals in Shanghai returned self-reported questionnaires in June 2008. Their burden of burnout was measured by the Chinese version of 'Maslach Burnout Inventory', and their stress by the Chinese version of 'job content questionnaire' and 'effort-reward imbalance questionnaire'. Results. Most nurses (74.76%) had a Demand/Control ratio higher than 1 and 27.13% had an Effort/Reward ratio higher than 1. The nurses showed a high level of emotional exhaustion, moderate level of depersonalization, and low level of reduced personal accomplishment. Linear regression analyses showed higher burden of stress and burnout among nurses at younger age, or on shift duty or from higher grade hospitals. Both the job content questionnaire and effort-reward imbalance questionnaire models had good predictive powers of the nurses' burnout, especially the effort-reward imbalance questionnaire model is more powerful than the other in predicting two Maslach Burnout Inventory subscales of emotional exhaustion and depersonalization. Conclusion. Nurses in Shanghai were suffering from high levels of burnout, which was strongly associated with work-related stress. Interventions in reducing occupational stress are needed to reduce the burden of burnout in Chinese nurses. [ABSTRACT FROM AUTHOR]

SummaryIntroduction1Definitions of ethnic groups and demographics of minority ethnic groups in the UK○ 1.1 Definitions of 'ethnic groups' and 'ethnicity'○ 1.2 Demographics and characteristics of minority ethnic groups in the UK– Countries of origin– Age/sex distribution and life expectancy– Geographical distribution and size of household– Religious beliefs– Education and employment patternsKey points2Overview of the health profile and dietary habits of minority ethnic groups in the UK○ 2.1 Available surveys○ 2.2 Overview of the health profiles among adults from minority ethnic groups– Overall health– Cardiovascular disease (CVD)– Coronary heart disease (CHD)– Stroke– Type 2 diabetes– Obesity○ 2.3 Possible causes of increased disease risk among minority ethnic groups○ 2.4 Smoking, drinking and physical activity habits○ 2.5 Dietary habits and nutritional status○ 2.6 Overview of the health profiles and dietary and health behaviour patterns of children from minority ethnic groups– Overall health– Diet and health behaviour patterns○ 2.7 Gaps in data availabilityKey points3Factors affecting food choice– Income and socio‐economic status– Food availability and access– Awareness of healthy eating– Religious beliefs– Food beliefs– Time and cooking skills– Generation and genderKey points4Traditional diets of minority ethnic groups○ 4.1 Overview of traditional diets of minority ethic groups– South Asians– African‐Caribbeans– Chinese○ 4.2 Dietary acculturation○ 4.3 Nutritional composition of ethnic‐style cuisineKey points5Nutritional interventions and health promotion among minority ethnic groups○ 5.1 Effective nutritional interventions○ 5.2 Health promotion interventions to prevent problems associated with fasting○ 5.3 Priorities for nutritional interventions and health promotion○ 5.4 Using behaviour change models○ 5.5 Current community initiatives○ 5.6 Catering for institutionalised individuals○ 5.7 Recommendations for future research, policy and practiceKey points6Conclusion• Acknowledgements• References Summary: According to the latest census, non‐white minority ethnic groups made up 7.9% of the UK's population in 2001. The largest of these groups were South Asians, Black African‐Caribbeans and Chinese. Studies have shown that some minority ethnic groups are more likely to experience poorer health outcomes compared with the mainstream population. These include higher rates of cardiovascular disease (CVD), type 2 diabetes and obesity. The differences in health outcomes may reflect interactions between diet and other health behaviours, genetic predisposition and developmental programming, all of which vary across different groups. As is the case for the rest of the population, the dietary habits of minority ethnic groups are affected by a wide variety of factors, but acquiring a better understanding of these can help health professionals and educationalists to recognise the needs of these groups and help them to make healthier food choices. Unfortunately, to date, there have been few tailored, well‐designed and evaluated nutritional interventions in the UK targeting minority ethnic population groups. Further needs assessment and better evaluation of nutritional interventions have been recommended to enhance the understanding of the effectiveness of different approaches amongst minority ethnic groups. This briefing paper will provide an overview of the health profile, dietary habits and other health behaviours of the three largest non‐white minority ethnic groups in the UK, explore the factors affecting their food choices, provide a summary of their traditional diets and review the evidence base to identify the factors that support successful nutrition interventions in these groups. [ABSTRACT FROM AUTHOR]

Summary: The study cohort comprised 196 females and 163 males. Lumbar spine bone mineral density (BMD) and magnetic resonance imaging (MRI) were acquired. Females had more severe disc degeneration than males. Lumbar spine lower BMD was associated with less severe disc degeneration. Lumbar disc spaces were more likely to be narrower when vertebral BMD was higher. Introduction: The purpose of this paper is to study the relationship between gender, BMD, and disc degeneration in the lumbar spine. Methods: The study cohort comprised 196 females and 163 males (age range 67-89 years) with no age difference between the two groups. Lumbar spine BMD was measured with dual X-ray densitometry, and MRI was acquired at 1.5 T. A subgroup of 48 males had additional lumbar vertebral quantitative computerized tomography densitometry. Lumbar disc degeneration was assessed using a MRI-based eight-level grading system. Results: Female subjects had more severe disc degeneration than male subjects. After removing age effect, a positive trend was observed between T-score and severity of lumbar disc degeneration. This was significant in female subjects while not significant in male subjects. Lumbar disc spaces were more likely to be narrowed when vertebral BMD was higher. These observations were more significant in the midlumbar region (L3/4 and L4/5) and less so at the thoracolumbar junction. Conclusion: Female subjects tended to have slightly more severe lumbar disc degeneration than male subjects. Lower lumbar spine BMD was associated with less severe disc degeneration. [ABSTRACT FROM AUTHOR]

Background: Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor. Methods: Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including “burnout”, “doctors” and “China” in 3 electronic databases has been undergone. Traditional understanding of “work attitude” and “doctors’ humanity” from ancient Chinese literature has also been retrieved. Results: Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors’ level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life. Conclusions and implications: The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China. [ABSTRACT FROM AUTHOR]

• The middle Permian sedimentary rocks were sourced from the Yinshan–Yanshan Orogen. • The Yinshan–Yanshan Orogen was the main source for most areas of North China. • The closure of the Paleo-Asian Ocean occurred between 267 and 261 Ma. • The tectonic evolution of North China results from closure of the Paleo-Asian Ocean. • Jurassic unconformity was recorded in response to the Late Triassic compression. The North China Craton (NCC) and its adjacent areas experienced a series of complex tectonic events during the late Paleozoic–early Mesozoic, the closure of the Paleo-Asian Ocean (PAO), the collision between the Central Asian Orogenic Belt (CAOB) and the NCC, and the subduction of the Yangtze Plate. This paper provides an overview of the provenances and tectonic implications of late Paleozoic and early Mesozoic sediments in the northern NCC based on a comprehensive analysis of the available geological and geochronological data together with our new clast compositions, paleocurrents, detrital zircon ages and Hf isotope data. Detrital zircons from the middle Permian Shihezi Formation in the Yungang basin have age distributions of 442–264 Ma, 2179–1606 Ma and 2665–2249 Ma and are characterized by negative ε Hf (t) values that match the age population and Hf isotope peculiarities of the Yinshan–Yanshan Orogenic Belt (YYOB). These observations suggest that these zircons were derived from the YYOB, which is consistent with most regions of the NCC. The CAOB became a minor source of sediments in the northern NCC no earlier than the late Permian, and the ultimate closure time of the PAO can be constrained to 267–261 Ma by the youngest detrital zircon ages. The tectonic evolution of the northern NCC in the late Paleozoic was closely related to the southward subduction of the PAO and the amalgamation of the CAOB and the NCC. The angular unconformity underlying the Early Jurassic strata and the absence of Triassic strata in the Yungang basin might be ascribed to the continuous collision of the CAOB and the NCC during the Late Triassic. [ABSTRACT FROM AUTHOR]

Background: The relationship between thyroid nodules (TNs) and adiposity is controversial. This paper describes a cross-sectional investigation performed to determine the existence of any such relationship. To assess adiposity, body mass index (BMI) and visceral fat area (VFA) were utilized. Methods: Between January 1, 2017 and March 3, 2019. Three thousand five hundred thirty four healthy people were examined using thyroid ultrasonography, visceral fat and anthropometric measurements, laboratory tests and questionnaire interview. Binary logistic regression analyses were used. Results: Of the 3534 healthy subjects, 58.69% (2074/3534) of the subjects had TNs. A total of 55.91% (1976/3534) had BMI ≥ 25 kg/m2 and 39.67% (1402/3534) had VFA ≥ 100 cm2. After adjustment to address confounders, BMI-based overweight and obesity levels only correlated with higher risk TNs when used as a continuous variable (OR = 1.031, 95% CI: 1.008–1.055, P = 0.008), while VFA was both a continuous variable (OR = 1.003, 95% CI: 1.000–1.005, P = 0.034) and a categorical variable (OR = 1.198, 95% CI: 1.014–1.417, P = 0.034) associated with significantly elevated risk of TNs. Analyzing the subgroups, BMI ≥ 25 kg/m2 (OR = 1.500, 95% CI: 1.110–2.026, P = 0.008) was significantly correlated with TN risk in individuals with TG ≥ 1.7 mmol/L. VFA ≥ 100 cm2 correlated with the TN risk irrespective of age (< 50 years: OR = 1.374, 95% CI: 1.109–1.703, P = 0.004; ≥ 50 years: OR = 1.367, 95% CI: 1.063–1.759, P = 0.015) and in the following subgroups: women (OR = 4.575, 95% CI: 2.558–8.181, P = 0.000), FBG ≥ 6.1 mmol/L (OR = 1.522, 95% CI: 1.048–2.209, P = 0.027), and TG ≥ 1.7 mmol/L (OR = 1.414, 95% CI: 1.088–1.838, P = 0.010). Conclusions: Adiposity correlates with TNs. To assess TN risk in Chinese individuals, VFA is better than BMI. [ABSTRACT FROM AUTHOR]

China has 55 ethnic minorities with 114 million population. As a piece of the worldwide picture of child abuse in ethnicity, the study on child abuse in Chinese ethnic regions is significant but insufficient currently. Therefore, this study examined the prevalence, negative effects, and risk factors of child abuse involving girls in Chinese ethnic regions. A multi-stage cluster sampling procedure and paper-and-pencil questionnaire survey were used to conduct the study in 126 classes in three counties of Southwest China, which includes a total sample of 2899 girls. The rates of physical abuse, emotional abuse, and neglect to girls in ethnic minority areas were significantly higher than those in the Han areas. Moreover, all types of child abuse negatively affected girls' mental health at different levels. However, the effects of abuse were more severe for girls in Han than for ethnic minorities with similar abuse severity. In addition, academic performance and parent-child relationship were correlated with child abuse for girls in the ethnic regions, and the risk was especially higher for girls in rural towns and those of younger age. Findings from this study indicated that the prevalence of child abuse of girls in ethnic regions was high. Although with lower prevalence of child abuse, girls in Han should be intervened for their more severe mental health problems with abuse than the peers in ethnic minority areas. Great attention should be paid to girls in ethnic regions with poor academic performance, bad parent-child relationship, especially in rural towns and in young age, to prevent the risk of child abuse. [ABSTRACT FROM AUTHOR]