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The changing population age structure has a significant influence on the economy, society, and numerous other aspects of a country. This paper has innovatively applied the method of compositional data forecasting for the prediction of population age changes of the young (aged 0–14), the middle-aged (aged 15–64), and the elderly (aged older than 65) in China, India, and Vietnam by 2030 based on data from 1960 to 2016. To select the best-suited forecasting model, an array of data transformation approaches and forecasting models have been extensively employed, and a large number of comparisons have been made between the aforementioned methods. The best-suited model for each country is identified considering the root mean squared error and mean absolute percent error values from the compositional data. As noted in this study, first and foremost, it is predicted that by the year 2030, China will witness the disappearance of population dividend and get mired in an aging problem far more severe than that of India or Vietnam. Second, Vietnam’s trend of change in population age structure resembles that of China, but the country will sustain its good health as a whole. Finally, the working population of India demonstrates a strong rising trend, indicating that the age structure of the Indian population still remains relatively “young”. Meanwhile, the continuous rise in the proportion of elderly population and the gradual leveling off growth of the young population have nevertheless become serious problems in the world. The present paper attempts to offer crucial insights into the Asian population size, labor market and urbanization, and, moreover, provides suggestions for a sustainable global demographic development. [ABSTRACT FROM AUTHOR]

In this paper, we aim to establish a mathematical model to design a maximizing social welfare intervention mechanism of healthcare service goods in China. The intervention mechanism is helpful to facilitate the adoption of the healthcare service goods. We consider a research problem that regulates the supply chain system for healthcare service goods by an intervention mechanism, and two intervention strategies composed of demand-growth strategy and subsidy strategy are used to the combination of intervention mechanism. Then this paper presents a new method based on fuzzy set and bilevel programming to design the intervention mechanism. To demonstrate the effectiveness of the proposed model, we conduct a case study for Wudang personalized health package and verify our model by the specific result analysis, the result indicates that our joint intervention mechanism is helpful to achieve the target and increase social welfare. [ABSTRACT FROM AUTHOR]

Aiming to solve the safety problems of high-speed railway operation and management, one new method is urgently needed to construct on the basis of the rough set theory and the uncertainty measurement theory. The method should carefully consider every factor of high-speed railway operation that realizes the measurement indexes of its safety operation. After analyzing the factors that influence high-speed railway safety operation in detail, a rough measurement model is finally constructed to describe the operation process. Based on the above considerations, this paper redistricts the safety influence factors of high-speed railway operation as 16 measurement indexes which include staff index, vehicle index, equipment index and environment. And the paper also provides another reasonable and effective theoretical method to solve the safety problems of multiple attribute measurement in high-speed railway operation. As while as analyzing the operation data of 10 pivotal railway lines in China, this paper respectively uses the rough set-based measurement model and value function model (one model for calculating the safety value) for calculating the operation safety value. The calculation result shows that the curve of safety value with the proposed method has smaller error and greater stability than the value function method’s, which verifies the feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

To balance the supply and demand in China's beef market, beef consumption must be scientifically and effectively forecasted. Beef consumption is affected by many factors and is characterized by gray uncertainty. Therefore, gray theory can be used to forecast the beef consumption, In this paper, the structural defects and unreasonable parameter design of the traditional gray model are analyzed. Then, a new gray model termed, EGM(1,1,r), is built, and the modeling conditions and error checking methods of EGM(1,1,r) are studied. Then, EGM(1,1,r) is used to simulate and forecast China’s beef consumption. The results show that both the simulation and prediction precisions of the new model are better than those of other gray models. Finally, the new model is used to forecast China’s beef consumption for the period from 2019–2025. The findings will serve as an important reference for the Chinese government in formulating policies to ensure the balance between the supply and demand for Chinese beef. [ABSTRACT FROM AUTHOR]

This paper reports the development and baseline data of a vignettes-based measure of gender equality. Methods: Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China. Results: Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings. Conclusion: This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist. [ABSTRACT FROM AUTHOR]

This paper combines a Granger causality test and a VAR model to investigate the relationships among oil price shocks, global economic policy uncertainty (GEPU), and China’s industrial economic growth. Based on monthly data from 2000 to 2017, we reveal that GEPU and world oil prices jointly Granger cause China's industrial economic growth; world oil prices have a positive effect on China's industrial economic growth, while GEPU has a negative effect. Further analyses investigate the asymmetry effect of oil prices and find that the negative component shows a more significant impact on China's industrial economic growth. The results are robust to different oil price and EPU proxies. [ABSTRACT FROM AUTHOR]

Limited data exist related to low birth weight (LBW) incidence and risk factors in Western China. This paper aims to assess LBW and its relationship with antenatal care (ANC) in the poor counties of Western China. A community-based study in rural Western China was conducted in 2011. A kernel distribution was used to estimate the adjusted LBW incidence, and associations between LBW and socio-demographic or maternal factors were examined using multilevel logistic regression. Among 8,964 participants, 65.7% were weighed at birth. Crude LBW incidence was 6.6% and the adjusted rate was 9.3%. The study revealed that risk factors of LBW are being female, raised within a minority group, and with a family income below the national poverty line. For maternal risk factors, LBW was positively associated with not attending at least five or eight ANC visits, not receiving any ANC during the first trimester, and not having access to assess certain ANC content (weight, blood pressure, blood test, urine test, B-scan ultrasound, and folic acid supplement). There is urgent need to promote quality ANC in poor and rural areas of Western China and to prioritize vulnerable women and children who will benefit from quality ANC. [ABSTRACT FROM AUTHOR]

Following the emergence of H7N9 influenza in March 2013, local animal and public health authorities in China have been closing live bird markets as a measure to try to control the H7N9 influenza epidemic. The role of live bird market (LBM) closure on the spread of N7N9 influenza following the closure of LBMs during March to May 2013 (the first wave) and October 2013 to March 2014 (the second wave) is described in this paper. Different provinces implemented closure actions at different times, and intensive media reports on H7N9 in different provinces started at different times. Local broiler prices dropped dramatically in places with outbreaks and more live chickens were transported to other LBMs in neighboring areas without human cases from infected areas when live bird markets were being closed. There were six clusters of human infection from March to May 2013 and October 2013 to March 2014 and there may have been intensive poultry transportation among cluster areas. These findings provide evidence that the closure of LBMs in early waves of H7N9 influenza had resulted in expansion of H7N9 infection to uninfected areas. This suggests that provincial authorities in inland provinces should be alert to the risks of sudden changes in movement patterns for live birds after LBM closure or increased publicity about LBM closure. [ABSTRACT FROM AUTHOR]

Background: AIDS is a worrying public health issue in China and lacks timely and effective surveillance. With the diffusion and adoption of the Internet, the ‘big data’ aggregated from Internet search engines, which contain users’ information on the concern or reality of their health status, provide a new opportunity for AIDS surveillance. This paper uses search engine data to monitor and forecast AIDS in China. Methods: A machine learning method, artificial neural networks (ANNs), is used to forecast AIDS incidences and deaths. Search trend data related to AIDS from the largest Chinese search engine, Baidu.com, are collected and selected as the input variables of ANNs, and officially reported actual AIDS incidences and deaths are used as the output variable. Three criteria, the mean absolute percentage error, the root mean squared percentage error, and the index of agreement, are used to test the forecasting performance of the ANN method. Results: Based on the monthly time series data from January 2011 to June 2017, this article finds that, under the three criteria, the ANN method can lead to satisfactory forecasting of AIDS incidences and deaths, regardless of the change in the number of search queries. Conclusions: Despite the inability to self-detect HIV/AIDS through online searching, Internet-based data should be adopted as a timely, cost-effective complement to a traditional AIDS surveillance system. [ABSTRACT FROM AUTHOR]

Hearing loss is the most common sensory impairment, but limited studies focused on the association of socioeconomic status (SES) with hearing loss among adults of working age. This paper aimed to fill this gap among Chinese adults. We obtained data from Ear and Hearing Disorder Survey conducted in four provinces of China in 2014–2015. The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 25,860 adults aged 25 to 59 years were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. SES was measured by occupation, education and income. Results show after adjusting for SES measures and covariates, in urban areas, compared with white-collar workers, blue-collar workers and the unemployed were more likely to have hearing loss, with an odds ratio of 1.2 (95%CI: 1.0, 1.3) and 1.2 (95%CI: 1.0, 1.4), respectively. Compared with people with education of senior high school or above, those with junior high school, primary school and illiteracy had 1.6 (95%CI: 1.4, 1.8), 2.1(95%CI: 1.7, 2.5) and 2.6 (95%CI: 1.9, 3.7) times as likely to have hearing loss, respectively. In rural areas, the unemployed had 1.5 (95%CI: 1.0, 2.3) times the risk of hearing loss compared with white-collar workers, and illiterates had 1.6 (95%CI: 1.6, 2.1) times the risk of hearing loss compared with people with education of senior high school or above, after SES variables and covariates were taken into considerations. Income was not significantly associated with hearing loss in urban and rural areas. In conclusion, SES, in the form of occupation and education, was associated with hearing loss among working-aged population, and further studies are needed to explore the mechanism of such association. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the role of parental education in child disability in China. We used nationally representative data from China’s National Sample Survey on Disability, iterated twice, in 1987 and 2006, with data of 764,718 children aged 0–14 years. Logit models were used for statistical analysis. Results showed that the prevalence of child disability was significantly associated with each parent’s education. Maternal education was more important than paternal education in child disability in both surveys. The analysis of marginal effect indicated a one-year increase in maternal and paternal schooling led to an average decrease of 0.121% and 0.091% in the probability of child disability in 1987, and 19 years later, these figures had dwindled to 0.091% and 0.072%, respectively. [ABSTRACT FROM AUTHOR]

The Hospital Authority (HA) is a statutory body managing all the public hospitals and institutes in Hong Kong (HK). In recent decades, Hong Kong Hospital Authority (HKHA) has been making efforts to improve the healthcare services, but there still exist some problems like unfair resource allocation and poor management, as reported by the Hong Kong medical legislative committee. One critical consequence of these problems is low healthcare efficiency of hospitals, leading to low satisfaction among patients. Moreover, HKHA also suffers from the conflict between limited resource and growing demand. An effective evaluation of HA is important for resource planning and healthcare decision making. In this paper, we propose a two-phase method to evaluate HA efficiency for reducing healthcare expenditure and improving healthcare service. Specifically, in Phase I, we measure the HKHA efficiency changes from 2000 to 2013 by applying a novel DEA-Malmquist index with undesirable factors. In Phase II, we further explore the impact of some exogenous factors (e.g., population density) on HKHA efficiency by Tobit regression model. Empirical results show that there are significant differences between the efficiencies of different hospitals and clusters. In particular, it is found that the public hospital serving in a richer district has a relatively lower efficiency. To a certain extent, this reflects the socioeconomic reality in HK that people with better economic condition prefers receiving higher quality service from the private hospitals. [ABSTRACT FROM AUTHOR]

This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Objective: The world population is aging rapidly and the well-being of older people is of great interest. Therefore, this study investigates the determinants of life satisfaction among the oldest-old (i.e. individuals aged 80 or over) in China. Materials and methods: We use the 2011/2012 Chinese Longitudinal Healthy Longevity Survey data (n = 6530) for this paper. Logistic regression is used to analyse the effects of socio-demographic, economic, health, instrumental activities of daily living, family and community factors on life satisfaction and depression among the oldest-old in China. Results: Our analysis confirms the significance of many factors affecting life satisfaction among the oldest-old in China. Factors that are correlated with life satisfaction include respondent’s sex, education, place of residence, self-rated health status, cognitive ability (using mini mental state examination), regular physical examination, perceived relative economic status, access to social security provisions, commercialized insurances, living arrangements, and number of social services available in the community (p<0.05 for all these variables). Although life satisfaction is negatively associated with instrumental activities of daily living (β = -0.068, 95%CI = -.093—.043), and depression (β = -0.463, 95%CI = -.644—.282), the overall effect of self-rated health status is positive (p<0.001). This confirms the primacy of health as the determinant of well-being among the oldest-old. Conclusions: Majority of the oldest-old in China rated their life satisfaction as good or very good. Our findings show that health and economic status are by far the most significant predictors of life satisfaction. Our finding on the primacy of health and relative income as determinants of well-being among the oldest-old, and the greater influence of self-rated health status over objective health measures is consistent with the findings of many past studies. Our results suggest that efforts should be directed at enhancing family support as well as health and social service provisions in the community to improve life satisfaction of older people. [ABSTRACT FROM AUTHOR]

Background: Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China. Methods: Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined. Results: 76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were acceptable. Conclusions: The instrument was shown to be both valid and reliable for measuring clinical physicians’ competency in China. The results of the competency-based instrument can be used by ministry of health and administrators of hospitals to assess physicians’ competencies, encourage and guide them to modify their behaviors according to the evaluation criteria, and also cultivate physicians with strong clinical practice, innovation and independent scientific research ability. Through these measurements and understandings, the overall level of clinical physicians will be increased in China. [ABSTRACT FROM AUTHOR]

Severe outbreaks of hand, foot and mouth disease (HFMD) have occurred in China for decades. Our understanding of the HFMD transmission process and its determinants is still limited. In this paper, factors that affect the local variation of HFMD transmission process were studied. Three classes of factors, including meteorological, demographic and public health intervention factors, were carefully selected and their effects on HFMD transmission were investigated with Pearson’s correlation coefficient and multiple linear regression models. The determining factors for the variation of HFMD transmission were different for the southeastern and the northwestern regions of China. In the northwest, fadeouts occurred yearly, and the average age at infection and the fadeout were negatively correlated with the population density. In the southeast, HFMD transmission was governed by the combined effects of the birth rate, the relative humidity and the interaction of the Health System Performance and the log of the population density. When the Health System Performance was low, HFMD transmission increased with the population density, but when the Health System Performance was high, the better health performance counteracted the transmission increase due to the higher population density. [ABSTRACT FROM AUTHOR]

Pigs have played a major role in the economic, social and symbolic systems of China since the Early Neolithic more than 8,000 years ago. However, the interaction between the history of pig domestication and transformations in Chinese society since then, have not been fully explored. In this paper, we investigated the co-evolution from the earliest farming communities through to the new political and economic models of state-like societies, up to the Chinese Empire, using 5,000 years of archaeological records from the Xiawanggang (XWG) and Xinzhai (XZ) sites (Henan Province). To trace the changes of pig populations against husbandry practices, we combined the geometric morphometric analysis of dental traits with a study of the stable carbon and nitrogen isotope ratios from bone collagen. The domestication process intensified during the Neolithic Yangshao, prompted by greater selective pressure and/or better herd control against wild introgression. After that, pig farming, in XWG, relied on local livestock and a gradual change of husbandry practices overtime. This was characterized by a gentle increase in millet foddering and animal protein intake, until a complete change over to household management during the Han dynasty. The only rupture in this steady trend of husbandry occurred during the Longshan period, with the appearance of small sized and idiosyncratic pigs with specific feeding practices (relying on millet and household scraps). From three exploratory hypothesis, we explored the possibility of anti-elite pig production in XWG during the Longshan period, as a means to resist incorporation into a new economic model promoting intensified domestic production. This exploratory hypothesis is the most suitable to our dataset; however, numerous areas need to be explored further in order to adequately document the role of pigs in the rise of China’s complex societies. [ABSTRACT FROM AUTHOR]

Objective: The paper examines whether out-of-pocket health care expenditure also has regional discrepancies, comparing to the equity between urban and rural areas, and across households. Method: Sampled data were derived from Urban Household Survey and Rural Household Survey data for 2011/2012 for Anhui Province, and 11049 households were included in this study. The study compared differences in out-of-pocket expenditure on health care between regions (urban vs. rural areas) and years (2011 vs. 2012) using two-sample t-test, and also investigated the degree of inequality using Lorenz and concentration curves. Result: Approximately 5% and 8% of total household consumption expenditure was spent on health care for urban and rural populations, respectively. In 2012, the wealthiest 20% of urban and rural population contributed 49.7% and 55.8% of urban and rural total health expenditure respectively, while the poorest 20% took only 4.7% and 4.4%. The concentration curve for out-of-pocket expenditure in 2012 fell below the corresponding concentration curve for 2011 for both urban and rural areas, and the difference between curves for rural areas was greater than that for urban areas. Conclusion: A substantial and increasing gap in health care expenditures existed between urban and rural areas in Anhui. The health care financing inequality merits ample attention, with need for policymaking to focus on improving the accessibility to essential health care services, particularly for rural and poor residents. This study may provide useful information on low income areas of China. [ABSTRACT FROM AUTHOR]

Background: About 1 million people worldwide commit suicide each year, and college students with suicidal ideation are at high risk of suicide. The prevalence of suicidal ideation in college students has been estimated extensively, but quantitative syntheses of overall prevalence are scarce, especially in China. Accurate estimates of prevalence are important for making public policy. In this paper, we aimed to determine the prevalence of suicidal ideation in Chinese college students. Objective and Methods: Databases including PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang (Chinese database) and Weipu (Chinese database) were systematically reviewed to identify articles published between 2004 to July 2013, in either English or Chinese, reporting prevalence estimates of suicidal ideation among Chinese college students. The strategy also included a secondary search of reference lists of records retrieved from databases. Then the prevalence estimates were summarized using a random effects model. The effects of moderator variables on the prevalence estimates were assessed using a meta-regression model. Results: A total of 41 studies involving 160339 college students were identified, and the prevalence ranged from 1.24% to 26.00%. The overall pooled prevalence of suicidal ideation among Chinese college students was 10.72% (95%CI: 8.41% to 13.28%). We noted substantial heterogeneity in prevalence estimates. Subgroup analyses showed that prevalence of suicidal ideation in females is higher than in males. Conclusions: The prevalence of suicidal ideation in Chinese college students is relatively high, although the suicide rate is lower compared with the entire society, suggesting the need for local surveys to inform the development of health services for college students. [ABSTRACT FROM AUTHOR]

The green mirid bug Apolygus lucorum is a regional pest of multiple crops in northern China, and the survival and development of diapausing eggs during winter plays an important role in the population dynamics of this species. The effect of water on the survival and development of A. lucorum eggs was investigated using laboratory-induced diapause. Diapausing eggs were exposed to various humidity regimes under three conditions: (1) termination of diapause with exposure to warm long-day (WLD) conditions (i.e., 26 ± 1°C and 75 ± 5% relative humidity (RH) under a photoperiod of 16 hours light and 8 hours dark), (2) termination of diapause by chilling at 4°C, or (3) during the post-diapause stage, i.e., from transfer to WLD conditions after chilling, until the hatching of nymphs. The results indicate that water availability is crucial for the post-diapause resumption of development of A. lucorum. However, exposure to excessive moisture was detrimental, as indicated by a decrease in diapause termination rate and a prolonged pre-hatching period of diapausing eggs, compared to limited moisture conditions. This implies that both too dry and too humid environmental conditions would suppress survival and postpone hatching of overwintered A. lucorum eggs, and might explain why this pest has not caused severe damage in either southern or western China where the respective climates are very humid or dry. [ABSTRACT FROM AUTHOR]