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• Reducing modifiable risk factors could prevent the onset of cognitive decline. • Physical multimorbidity–cognitive function association was mediated by depression. • Routine screening for depression in multimorbidity patient may delay dementia onset. This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. The mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms ('overall proportion due to mediation'). The association was not found in Indonesia. Cognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives: This paper describes and preliminarily evaluates the usefulness of the daily syndrome-specific absenteeism surveillance system (DSSASS) as an early warning system of school outbreaks in rural China. Study design: We conducted an experimental study in rural areas of Hubei Province from September 19, 2011 to December 31, 2011. Methods: Nine public elementary schools from two counties were selected as pilot sentinel schools. Daily monitoring data of the absent date and reason, sex, age and class of each absent student was collected and entered into a web database. Reported data were checked daily and field investigation was carried out when there was abnormal absentee aggregation. Descriptive analysis and preliminary evaluation were then conducted after the pilot study. Results: The findings showed that the total average of daily absenteeism rate was 3%, and the absenteeism rate differed by county, school level and grade level. The daily absenteeism rate in illness absentees was highest (2.74%), followed by business absentees (0.13%) and injury absentees (0.09%). The total timeliness report rate was 64.84% and the total incident report rate was 29.22%. One varicella outbreak and one influenza B outbreak were identified, but neither of them was detected by China Information System for Diseases Control and Prevention (CISDCP). The study shows syndrome-specific absenteeism data would be useful for early detection of unusual public health events or outbreaks in school. However, more efforts are needed to enhance the quality of surveillance data, and longer follow-up and more analysis are required to evaluate the system comprehensively. Our study might provide useful experience and evidence for other developing regions or counties establishing similar systems. [ABSTRACT FROM AUTHOR]

• Parental belief is associated with Child social-emotional development. • Parental investments mediate parental belief and child development. • The mediation effects vary across investments and developmental outcomes. • The varieties of play materials and activities are the strongest mediators. Parental investments are associated with early child outcomes, and some evidences outside China suggest that parental belief might affect parental investments. However, the interrelationships of parental belief, parental investments, and early child development has not been well documented in China. This paper aims to study the interrelationships between the caregiver's parental belief, the caregiver's parental investments, and the child's early developmental outcomes in rural China. A total of 1787 sample households in an undeveloped rural area of western China are enrolled in the cross-sectional study. A parental belief questionnaire, the Family Care Indicators (FCI), the Bayley Scales of Infant Development version III (BSID-III), and a socioeconomic questionnaire were used to measure the caregiver's parental belief on parenting practices, the caregiver's parental investments, the child's early developmental outcomes, and the socioeconomic characteristics of sample households, respectively. The mediation model was then applied to estimate the interrelationships. The results find that the caregiver's parental investments significantly mediate in the relationships between the caregiver's parental belief and the child's early developmental outcomes. Through parental investments, one standard deviation (SD) increase in the caregiver's parental belief is corresponding to 3% of one SD increase in the child's four developmental outcomes (cognition, language, motor, and social–emotion) respectively. For future studies aimed at designing targeted interventions on early child development in rural China, the key findings of this paper might be informative. Early interventions aimed at strengthening the caregiver's subjective belief on parenting practices and increasing the parental investments in the household might be effective to improve the development of rural children. [ABSTRACT FROM AUTHOR]

Abstract: Ethnobotanical relevance: Due to the global rise in the use of traditional Chinese medicine (TCM), Chinese materia medica (medicinal materials, or CMM) are giving cause for concern over their evidence base, safety/possible toxicity, questionable quality and use of endangered species of both animals and plants. However, little if anything is actually known about the range of species used to produce CMM used in Europe and even in China. This study represents the first attempt to identify and compare the most important CMM used in both regions, to begin the process of assessing the risks to public health and possible future benefits. Materials and methods: Data were collected from a convenience sample of TCM practitioners in the EU and mainland China, using a paper/online survey. Among other questions, respondents were asked (1) which conditions they most commonly treated using CMM and the likelihood of them using herbal manufactured products and decoctions in addition to raw herbs; (2) the perceived frequency with which they observed adverse events to CMM; (3) the frequency and reasons for use of 1 herbal formula and 6 specific individual herbs; (4) an open question about other CMM they used, including materials of non-plant origin. Data were entered into PASW statistics package and analysed using frequency tables, cross-tabulations and chi-squared tests to compare EU and Chinese results. Results: From a total of 747 useable questionnaires (420 from China, 327 from the EU) of those responding from the EU, TCM was generally more commonly used for obstetric/gynaecological and dermatological conditions, compared to neurological and gastrointestinal diseases in China. Disorders treated by Chinese practitioners were more varied, and often more serious, than those treated by their European counterparts, and the range of materials used in China was wider. The potential for toxicity was not high in either region, but although greater in China due to the use of more potent CMM, the incidence of side effects was perceived to be higher by EU practitioners. Conclusions: Very few of the species used to prepare CMM in the EU in this study give rise to safety concerns from what is known from the scientific and other literature, and in China only a few toxic CMM appear to be commonly used, some of them only after processing and mainly for serious disorders. The main cause for concern is likely to be interaction with prescribed medication, especially in central nervous system and cardiovascular conditions where drug interactions have previously been reported most frequently and which would currently be more applicable in China than Europe. [Copyright &y& Elsevier]

Abstract: Background: As cardiovascular diseases have become the leading cause of death in many countries including China, nurses are increasingly required to be abreast of technological advances and the skills necessary to manage this increasing health care problem. Chinese nurses are under pressure to provide skilled electrocardiography monitoring, and be sufficiently skilled to detect myocardial ischemia and infarction, in this large patient population. This presents a challenge for the nursing profession in China, particularly for nurses working in coronary care in a country where advancement has been so rapid, yet little research has been conducted or reported in the literature. Objectives: The two main objectives were: to explore the demographic and educational factors that affect the use of ST-segment monitoring and correct electrode placement by CCU/ICU nurses in China; and to explore the factors both individual and institutional that affect monitoring and lead placement. Methods: A self-administered questionnaire was distributed to nurses in 126 randomly selected tertiary hospitals, which were stratified into three homogeneous regions across China. The instrument examined demographics, information about hospitals, electrocardiogram devices, current practice patterns and perceptions toward monitoring and lead placement. Data from 734 nurses and 59 nurse managers from 59 hospitals were analyzed using t-tests, ANOVA, Chi-square test and logistic regression. Results: Electrocardiogram monitoring was used to detect myocardial ischemia by 43.7% of respondents, and 35.1% selected leads according to electrocardiogram or angiography findings. Most (70%) agreed that monitoring for acute coronary syndrome was important, while 39.2% did so, and 15.7% were able to identify correct placement. Logistic regression revealed a significant relationship between the uses of ST-segment monitoring and number of hospital beds, continuing education and a belief in its use and ease of use. Correct electrode placement was significantly correlated with respondents from university hospitals, hospitals with more acute coronary syndrome admissions and more independent thinking nurses. Conclusions: Despite best practice evidence, less than half of the sample used electrocardiogram monitoring to detect myocardial ischemia and the majority could not identify correct electrode placement, while ST-segment monitoring was not used routinely. This paper highlights the need for improvements in education both in universities and hospitals and discussion addresses conventions in units, which inhibit development of nurses’ skills. [Copyright &y& Elsevier]

There is an increasing interest in using ordinal data collection methods, such as the best-worst scaling (BWS), to develop preference-based tariffs (value sets) for health-related quality of life instruments, yet the evidence on their performance is limited. This paper proposed to use an anchored BWS technique (in which the state of "death" served as an anchoring state) to directly develop a utility weight that lies on a scale anchored at 0 = death and 1 = full health for the Simplified Chinese version of the Short Form 6 Dimension version 2 (SF-6Dv2). An online panel from the general population of Mainland China completed an online survey between 20th July and 19th August, 2019 and 463 respondents were included in the main analysis. The Conditional Logit (CL) model, which assumes a homogeneous preference, as well as a Hierarchical Bayes (HB) model, which accounts for preference heterogeneity, were used to analyze the BWS data. The model performances were evaluated based on monotonicity and model-fit statistics. The majority of respondents indicated that the BWS questions were easy to understand and complete. Initial analyses suggested that the best and worst choices should not be pooled together. Based on model fit statistics of separated estimations and previous literature on health state valuation studies using BWS, the best choices were used for developing the final algorithm. The HB estimates were found to have better model performance than the CL estimates. This study provides an essential insight into using an anchored BWS approach in health state valuation. Furthermore, it demonstrates the advantage of using HB compared to the traditional CL model in producing preference values. • An anchored best-worst scaling technique has been used to develop preference weights directly. • Accounting for individual heterogeneity leads to a better model fit. • Incorporating respondents' views of attribute importance can improve model performance. • A Chinese online-panel-based scoring algorithm for SF-6Dv2 is developed. [ABSTRACT FROM AUTHOR]

• Parental investment and skill mediate caregiver mental health and child development. • Caregiver depression are more harmful to parenting practices and child development. • The variety of play material has significant mediation effect on child development. • Coercive parenting mediate caregiver mental health and child development. Parenting practices are associated with early childhood development (ECD), and some evidences suggest that mental health might affect parenting practices. However, the interrelationships of mental health, parenting practices, and ECD outcomes have not yet been well documented in developing contexts like rural China. This paper aims to investigate the interrelationships between the caregiver's mental health, parenting practices, and the child's ECD outcomes in rural China. A total of 1787 sample households in an undeveloped rural area of western China are enrolled in the study. A socioeconomic questionnaire, the Depression, Anxiety and Stress Scale, the Family Care Indicators, the Parent and Family Adjustment Scales, and the Bayley Scales of Infant Development version III were used to measure the socioeconomic characteristics of sample households, the caregiver's mental health, parental investments and parenting skills, and the child's development outcomes, respectively. Mediation model was then applied to estimate the interrelationships. The results showed that parental practices significantly mediated between the caregiver's mental health and the child's cognition, language, motor, and social–emotion development. Through parental investments, one standard deviation increases in the caregiver's mental health test score was associated with the decline in the child's four development scores by 0.6% standard deviation, respectively. Through parenting skills, one standard deviation increases in the caregiver's mental health test score was associated with the decline in the child's language and social-emotional score by 2% and 5% standard deviation, respectively. Different dimensions of caregiver mental health, parental investments and skills played heterogeneous roles in the interrelationships. Early interventions aimed at improving the caregiver's mental health, parental investments and skills are important and might be effective to improve early childhood development in rural China. [ABSTRACT FROM AUTHOR]

• The gender disparities in DCM vary among different maltreatment subtypes. • DCM's negative effect was more severe for girls than for boys. • Gender heterogeneity is less evident than gender homogeneity in the risk factors. Currently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue. Data were derived from a survey of 4,308 children (M age = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted. This study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children's problematic behaviours, family structure, parents' experiences of childhood violence and family relationships are common predictors of maltreatment for all children. This paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue. [ABSTRACT FROM AUTHOR]

• Explore the effect of work-family conflict on parenting stress for ADHD families. • Identify work-family conflict as a potent contributor to parenting stress. • Non-working parents have higher parenting stress than employed parents do. • Chinese mothers experience higher parenting stress than fathers do. • More research is needed given the absence of work and parenting stress research. This paper reports the results of a one-time survey among Chinese families of children with attention-deficit/hyperactivity disorder (ADHD) (n = 314) and families with typically developing (TD) children (n = 308) in mainland China, which aimed to examine the effects of the parenting role, work-family conflict, child ADHD symptoms, parental depression, anxiety, and somatization, parenting alliance, and social support on parenting stress. The results of the study have shown that (i) parents of children with ADHD experienced significantly higher levels of parenting stress than did parents of TD children; Chinese mothers experienced significantly higher parenting stress than fathers did; (ii) mothers of children with ADHD had more work-family conflict than mothers of TD children did; (iii) non-working parents had higher levels of parenting stress than the employed parents did; (iv) work-family conflict, depression, anxiety, and somatization, child ADHD symptoms, parenting role, and social support accounted for 40.9% of the variance in parenting stress; parenting alliances did not approach significance in the regression. Implications for social work practice and service development are discussed. [ABSTRACT FROM AUTHOR]

• Adopted Chinese youth scored more favorably on BASC-3 than non-adopted Chinese youth. • Adopted Chinese youth scored more favorably on BASC-3 than non-adopted US youth. • High adoptive family SES benefited adopted youth adjustment. • Testing measurement invariance is important for cross-cultural comparison. In this paper, we examined if high SES families had an effect on youth's adjustment by comparing 226 internationally adopted female Chinese youth who experienced pre-adoption institutionalization with 1059 non-adopted Chinese peers living in China, as well as 209 non-adopted American peers. On average, the adopted youth's families had a higher SES status than the two comparison groups. Survey data on behavioral problems and prosocial adjustment were collected with the third edition of the Behavioral Assessment for Children (BASC-3). We found the adopted Chinese youth outperformed their Chinese counterparts in all comparisons and their US counterparts in most comparisons. These results offer some evidence that a high family SES may compensate for the adoption-related risks such as earlier institutionalization. Possible mechanisms underlying the benefit of high SES were discussed. [ABSTRACT FROM AUTHOR]