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There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

• 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]

Highlights • This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. • Lower level of exclusion from social relationships was associated with less likely to report fair or poor SRH. • Lower level of subjective feelings of exclusion was associated with less likely to report fair or poor SRH. • Lower level of subjective feeling of exclusion was associated with less likely to report depression. • Lower level of exclusion from financial products was associated with less likely to report depression. Abstract Background It is well established that social exclusion is a key social determinant of health; however, such association between social exclusion and health outcomes among older people remain a relatively under-researched area. This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. Methods This paper includes 8038 individuals aged 60 and over from the first wave national multi-stage probability sample (2014) from the China Longitudinal Aging Social Survey (CLASS). Descriptive univariate information for individual variables and four dimensions of social exclusion are presented. Multinomial and binary logistic regression models are used to examine the associations between social exclusion and self-rated health and depression. Results Older people who were in the lower level of exclusion from social relationships or subjective feelings of exclusion were significantly less likely to report fair or poor self-rated health than people in the higher level of exclusion (lower level of exclusion from social activities was significantly associated with being less likely to report poor SRH only). Older people who were in the lower level of subjective feeling of exclusion or exclusion from financial products were significantly less likely to report depression. Conclusions Different dimensions of social exclusion have different effects on self-rated health and depression. Social policies need to reflect this and efforts of services could usefully be oriented to prevent multi-dimensions of social exclusion. Ultimately, such policies should have the potential to enhance the health of older people in China. [ABSTRACT FROM AUTHOR]

The aim of this paper is to track the whereabouts of basic old-age insurance (BOI) contribution subsidies. Little research has paid attention to the misalignment between the implementation objects of subsidy policies and the actual beneficiaries. In recent years, local governments in China have followed a contribution subsidy policy to help persons with disabilities (PWDs) with lower life expectancies. This study applied an actuarial model to calculate the leakage rate of the BOI contribution subsidy. The primary data are from the life tables of the entire population and PWDs in K province in China in 2015. It was found that, under different booking interest rates, 35.27%–61.26% of the contribution subsidy for PWDs in the individual account will be inherited by their heirs, and under different discount rates, 18.21%–68.74% in the pooling account will be enjoyed by non-disabled participants. The policy of BOI contribution subsidy for PWDs failed to account for the shorter average life expectancy and the lower average income of PWDs and would result in a welfare loss for PWDs. Therefore, it was suggested that it should be replaced by a non-contributory pension policy for PWDs. • Track the whereabouts of basic old-age insurance (BOI) contribution subsidies. • Built an actuarial model to calculate the leakage rate of contribution subsidy. • 35%–61% of the contribution subsidy for PWDs will be inherited by their heirs. • 18%–69% in the pooling account will be enjoyed by non-disabled participants. [ABSTRACT FROM AUTHOR]

Ex post moral hazard, the additional healthcare utilization induced by health insurance, can be decomposed into an efficient portion generated by the income effect and an inefficient portion caused by the substitution effect, which has been discussed theoretically, but few studies have provided evidence of the efficient moral hazard. In 2016, the Chinese government launched the consolidation of urban and rural resident health insurance at the national level. After the consolidation, insurance benefits for nearly 800 million rural residents got improved. This paper uses a nationally-representative sample of 30,972 individuals from the China Health and Retirement Longitudinal Study (2011–2018) and adopts a 2-step empirical approach with the difference-in-differences method and the fuzzy regression discontinuity design to estimate the efficient moral hazard in the consolidation among rural residents. We find that the price shock contained in the consolidation increases inpatient care utilization, and the corresponding price elasticity is between −0.68 and −0.62. Further analysis shows that the efficient moral hazard resulting in welfare gains accounts for 43.33%–66.36% of the additional healthcare utilization. These findings highlight the necessity of evaluating the efficient moral hazard when analyzing the cost-benefit of health insurance reform. • We provide rare evidence of the efficient moral hazard effect in health insurance. • We focus on low-income groups from developing countries. • We use a 2-step empirical approach to estimate the efficient moral hazard effect. • The efficient moral hazard generated by income effect accounts for 43.33%–66.36%. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Though inflammatory response is beneficial to body damage repair, if it is out of control, it can produce adverse effects on the body. Although purely western anti-inflammatory drugs, orthodox medicines, can control inflammation occurrence and development, it is not enough. The clinical efficacy of anti-inflammation therapies is unsatisfactory, thus the search for new anti-inflammation continues. Chinese Material Medica (CMM) remains a promising source of new therapeutic agents. CMM and herbal formulae from Traditional Chinese Medicine (TCM), unorthodox medicines, play an improtant anti-inflammatory role in multi-targets, multi-levels, and multi-ways in treating inflammation diseases in a long history in China, based on their multi-active ingredient characteristics. Due to these reasons, recently, CMM has been commercialized as an anti-inflammation agent which has become increasingly popular in the world health drug markets. Major research contributions in ethnopharmacology have generated vast amount of data associated with CMM in anti-inflammtion aspect. Therefore, a systematic introduction of CMM anti-inflammatory research progress is of great importance and necessity. Aim of the study: This paper strives to describe the progress of CMM in the treatment of inflammatory diseases from different aspects, and provide the essential theoretical support and scientific evidence for the further development and utilization of CMM resources as a potential anti-inflammation drug through a variety of databases. Material and methods: Literature survey was performed via electronic search (SciFinder®, Pubmed®, Google Scholar and Web of Science) on papers and patents and by systematic research in ethnopharmacological literature at various university libraries. Results: This review mainly introduced the current research on the anti-inflammatory active ingredient, anti-inflammatory effects of CMM, their mechanism, anti-inflammatory drug development of CMM, and toxicological information. Conclusion: CMM is used clinically to treat inflammation symptoms in TCM, and its effect is mediated by multiple targets through multiple active ingredients. Although scholars around the world have made studies on the anti-inflammatory studies of CMM from different pathways and aspects and have made substantial progress, further studies are warranted to delineate the inflammation actions in more cogency models, establish the toxicological profiles and quality standards, assess the potentials of CMM in clinical applications, and make more convenient preparations easy to administrate for patients. Development of the clinically anti-inflammatory drugs are also warranted. [Copyright &y& Elsevier]

Ethnopharmacological relevance Seven species from the genus Dictamnus are distributed throughout Europe and North Asia and only two species grow in China. One is Dictamnus dasycarpus Turcz., which could be found in many areas of China and has been recorded in Chinese Pharmacopoeia . The other is Dictamnus angustifolius G. Don ex Sweet, which is only present in Xinjiang province and has been used as an alternative for Dictamnus dasycarpus in the local for the treatment of rheumatism, bleeding, itching, jaundice, chronic hepatitis and skin diseases. The present paper reviewed the traditional uses, phytochemistry, pharmacology and toxicology of the genus Dictamnus . Materials and methods Information on the Dictamnus species was collected from classic books about Chinese herbal medicine and globally accepted scientific databases including PubMed, Elsevier, ASC, Scopus, Google Scholar, Web of Science, CNKI and others. Results About 170 chemical compounds, which include quinoline alkaloids, limonoids, sesquiterpenes, coumarins, flavonoids and steroids, have been isolated from the genus Dictamnus . The characteristic and active constituents of Dictamnus species are considered to be quinoline alkaloids and limonoids, which exhibited a broad spectrum of biological activities such as anti-cancer, anti-inflammation, anti-microbe, anti-platelet-aggregation, vascular-relaxation, anti-insect, anti-HIV, anti-allergy and neuroprotection. Moreover, quinoline alkaloids and limonoids could be used as quality control markers to distinguish different species from the genus Dictamnus . However, there were also some reports on the toxic hepatitis and phototoxic effect of Dictamnus species, and the related research needs to be further studied. Conclusion In this review, we summarized the chemical constituents, pharmacology, quality control and toxicology of the species from genus Dictamnus . Phytochemical investigations indicated that quinoline alkaloids and limonoids were the major bioactive components with potential cytotoxic, neuroprotective, anti-inflammatory, antimicrobial, anti-platelet-aggregation and vascular relaxing activities. These two kinds of compounds have attracted great interests in the past few years and may have great potential to be new drug lead compounds. [ABSTRACT FROM AUTHOR]

This study analyzed the relationship between parents' son preference in a person's childhood and their health when they become older, and tested whether childhood educational opportunities, health level, and care resources play mediating roles in this relationship. China has entered a stage of aging population. The health of the elderly determines whether the government can successfully cope with the challenges brought about by the aging of the population. Chinese people are deeply influenced by Confucianism. The concept of "son preference" is related to residents' parenting strategies. Then, if one's parents exhibit a son preference in their childhood, will it affect one's health in old age? Based on the data of China Health and Retirement Longitudinal Study collected in 2014, this paper uses the least square method to analyze the impact of parents' preference in childhood for boys on the health of the elderly, and uses Karlson-Holm-Breen (KHB) to analyze the mediating effects of childhood educational opportunities, health level and care resources. This study found that parents' preference for boys had a positive impact on the health of male children when they became elderly but had a negative impact on the health of female children when they became elderly. Childhood educational opportunities, health level, and care resources mediated this relationship. It is necessary to analyze the impact of parents' preference for sons in one's childhood on the health of elderly, and intervene the adverse factors affecting the health, to improve the health level and quality of life of the elderly. • Parents' preference for boys had a significant impact on older people's health. • The effect relies on the mediating role of childhood education, health, and care resources. • The idea of prioritizing boys over girls be changed, to improve the health level of the elderly. [ABSTRACT FROM AUTHOR]

• Risk perception of COVID-19 negatively correlated to willingness to help. • Interpersonal alienation partially mediated the link between risk perception of COVID-19 and willingness to help. • Expressive suppression moderated the associations between interpersonal alienation and willingness to help. Previous studies have revealed that situational risk factors have a significant influence on the willingness to help. Amidst the COVID-19 pandemic, maybe risk perception of COVID-19 is also correlated to the willingness to help. This study examined the mediating effect of interpersonal alienation and the moderating effect of cognitive reappraisal and expressive suppression in the relationship between risk perception of COVID-19 and willingness to help. Data from a large sample of Chinese college students (N = 2, 163) completed the measures of risk perception of COVID-19, willingness to help, interpersonal alienation, emotion regulation strategies including cognitive reappraisal and expressive suppression. The results indicated that the risk perception of COVID-19 negatively correlated to willingness to help. Interpersonal alienation partially mediated the link between risk perception of COVID-19 and willingness to help. College students' expressive suppression moderated the associations between interpersonal alienation and willingness to help. And who adopted more expressive suppression, the connection between interpersonal alienation and willingness to help was weaker compared to students who reported less expressive suppression. But cognitive reappraisal did not moderate the relationship between risk perception of COVID-19 and interpersonal alienation. Implications of the present paper for theory and practice are discussed. [ABSTRACT FROM AUTHOR]

Informal payment for medical services is a common phenomenon in China. Patients make informal payments, in cash or in kind, to physicians in addition to official charges billed for medical services. This paper assesses the associations between patients' perceptions of the physician as an agent for the patient's interests (physician agency problem) and informal payment behavior. Using data of 24,000 and 6700 rural households respectively from the Health Development of Rural China Program database (collected in 2008) and Ningxia data source (collected in 2015), we find that patients' concern about physician agency problems is significantly associated with informal payments. The data shows that patients are more likely to make informal payments when they show low trust towards their physicians. For example, in the surgical cases, among patients who strongly distrusted the physicians, 17.9% (95% confidence interval [CI]:]: 13.5, 22.3) initiated informal payments, compared to 8.0% (95% CI: 5.1, 10.9) who expressed "strong trust" in their physicians. Poor communication was also significantly associated with an increase in the informal payment rate. For example, in the non-surgical setting, among the patients who rated the physicians' explaining skills as "poor," 5.9% (95% CI: 5.0, 6.9) of them made informal payments, significantly higher than the patients who rated "excellent" (of whom 1.8% made informal payments 95% CI, 0.9, 2.7). In this study, we provide an explanation for this finding: patients may initiate informal payments to physicians in order to mitigate the physician agency problem. It suggests that to mitigate informal payments, improving alignment between doctors' incentives and patients' interests would be essential. • Informal payments were directly related to patients' concerns about physicians' behavior. • Patients were more likely to make informal payments when they showed low trust towards their physicians. • Poor communication between patients and physicians was related to informal payment rate. • Informal payment might be viewed as an effort by the patients to align the physicians. [ABSTRACT FROM AUTHOR]

A cross-sectional study of a large, middle-school student sample ( N = 966) was presented in this paper aiming to examine how parental behavior and self-control influence Internet addiction (IA) among Chinese adolescents. Fifty-one adolescents (the top 5% of IA score distribution) were categorized as at high risk. Males were more likely addicted to Internet than females. MANOVA demonstrated that, compared with non-IA group, adolescents with IA revealed lower mean score for parental positive support behavior and higher for parental negative control behavior and had lower capacity of self-control. SEM analyses revealed that low capacity of self-control had a negative correlation with parents’ positive support and a positive correlation with negative control. More importantly, Internet addiction was explained negatively by parents’ positive support and positively by parents’ negative control and individual low capacity of self-control. Further mediating analyses indicated that self-control accounted for an indirect role between parental behavior and adolescents’ Internet addiction. The findings of the present study are of significance in investigating adolescents’ problem behaviors and very helpful to provide educational advice for intervening in these behaviors. Moreover, the present finding’s potential relevance to Confucian styles of filial parenting was discussed. [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]

Ecological degradation has become an important constraint to global socio-economic development. Therefore, ecological protection and restoration has received increasing attention. The important goal and the most direct effect of ecological protection and restoration are the vegetation restoration, which emphasizes the maximum or minimum range of NDVI of different vegetation types under specific terrain conditions. Based on the data of NDVI and topographic factors in a stable ecosystem, this paper comprehensively used descriptive statistics, multiple regression with interaction terms and threshold regression to analyze the spatial distribution of vegetation and its relationship with elevation, slope and aspect in the Wanhuigou catchment on the Loess Plateau. It showed that the NDVI values were high in the northwest and low in the southeast, and were generally consistent with the distribution of elevation. The change of NDVI with the slope was large, but the change with the aspect was not obvious. Meanwhile, the effect of elevation on NDVI would be limited by slope, but would not be affected by aspect; the positive effect of slope on NDVI would also be limited by the elevation and aspect. In addition, the influence of topographic factors on NDVI was non-linear, i.e. there was a threshold effect and different types of vegetation require different topographic factor conditions. Therefore, by rationally arranging the growth areas of different types of vegetation in accordance with the laws of topographic factor conditions, ecological protection and restoration could be more targeted to help build a stable ecosystem in areas with severe soil erosion such as the Wanhuigou catchment. Unlabelled Image • There are interactive effects on NDVI between different topographic factors. • The influence of terrain factors on NDVI is non-linear and has threshold effects. • Suitable topographic factor conditions for vegetation growth were found out. • This paper provides a reference for ecological protection and restoration. [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: Ethnopharmacological relevance: Carthamus tinctorius L. (Compositae), a widely used traditional Chinese medicine, was known as Hong hua (Chinese: ▪), safflower. Safflower with a wide spectrum of pharmacological effects has been used to treat dysmenorrhea, amenorrhea, postpartum abdominal pain and mass, trauma and pain of joints, etc. The present paper reviews the advancements in investigation of botany and ethnopharmacology, phytochemistry, pharmacology and toxicology of safflower. Finally, the possible tendency and perspective for future investigation of this plant are discussed, too. Materials and methods: The information on safflower was collected via piles of resources including classic books about Chinese herbal medicine, and scientific databases including Pubmed, Google Scholar, ACS, Web of science, CNKI and others. Results: Over 104 compounds from this plant have been isolated and identified, and quinochalcones and flavonoids are considered as the characteristic and active constituents of safflower. Safflower with its active compounds possesses wide-reaching biological activities, including dilating coronary artery, improving myocardial ischemia, modulating immune system, anticoagulation and antithrombosis, antioxidation, antiaging, antihypoxia, antifatigue, antiinflammation, anti-hepatic fibrosis, antitumor, analgesia, etc. Conclusions: As an important traditional Chinese medicine, it is important to investigate the pharmacological effects and molecular mechanisms of this plant based on modern realization of diseases' pathophysiology. More bioactive components should be identified using bioactivity-guided isolation strategies, and the possible mechanism of action as well as potential synergistic or antagonistic effects of multi-component mixtures derived from safflower need to be evaluated integrating pharmacological, pharmacokinetic, bioavailability-centered and physiological approaches. Further studies on safflower can lead to the development of new drugs and therapeutics for various diseases, and how to utilize it better should be paid more attention to. [ABSTRACT FROM AUTHOR]

Abstract: This study aims to explore the prevalence and influence factors of depressive symptoms in Chinese older adults from 1987 to 2012. The study investigated 81 published papers on depressive symptoms in Chinese older adults using the 30-item Geriatric Depression Scale (GDS-30) or the Center for Epidemiologic Studies Depression Scale (CES-D) as a measuring tool through meta-analysis. A total of 88,417 Chinese older adults were included in this review. The pooled prevalence of depressive symptoms in Chinese older adults was 23.6% (95% CI: 20.3–27.2%). The pooled prevalence of depressive symptoms was greater in women. In addition, the prevalence of depressive symptoms in married older adults was lower than in single adults (i.e., divorced, unmarried or widowed). Depressive morbidity with GDS-30 was significantly higher than with CES-D. The prevalence of depressive symptoms in Chinese older adults presented a downward tendency with increasing educational level. Moreover, the prevalence of depressive symptoms gradually increased with the year of data collection. Significant differences were found in the measurement tools, gender, degree of education and marital status, but none in age. [Copyright &y& Elsevier]

Abstract: This paper explores whether educational attainment has a cognitive reserve capacity in elder life. Using pilot data from the China Health and Retirement Longitudinal Study (CHARLS), we examined the impact of education on cognitive abilities at old ages. OLS results showed that respondents who completed primary school obtained 18.2 percent higher scores on cognitive tests than those who did not. We then constructed an instrumental variable (IV) by leveraging China's Great Famine of 1959–1961 as a natural experiment to estimate the causal effect of education on cognition. Two-stage least squares (2SLS) results provided sound evidence that completing primary school significantly increases cognition scores, especially in episode memory, by almost 20 percent on average. Moreover, Regression Discontinuity (RD) analysis provides further evidence for the causal interpretation, and shows that the effects are different for the different measures of cognition we explored. Our results also show that the Great Famine can result in long-term health consequences through the pathway of losing educational opportunities other than through the pathway of nutrition deprivation. [Copyright &y& Elsevier]

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: Ethnopharmacological relevance:: Abelmoschus manihot (L.) Medik. var. manihot is one of the most commonly used Chinese medicines and has played an important role in treating chronic glomerulonephritis and diabetic nephropathy. Aim of the study:: Metabolites identification of traditional Chinese medicine (TCM) is a complex and time-consuming process due to the complicity of TCM and subsequent large number of detected ions. In this paper, UPLC–MS combined with pattern recognition analysis approach were used to simplify and quicken the identification of the metabolites of Abelmoschus Manihot. Materials and methods:: Rat urine samples were collected before (as control sample) and after Abelmoschus Manihot administration. Pattern recognition analysis method was used to differentiate components between Abelmoschus Manihot-treated group and its controlled comparison. These components could be considered as Abelmoschus Manihot-related metabolites in vivo. Results:: LC–MS based metabolomics could be an advanced tool to help us find metabolites with regards to its capacity of processing large datasets, differentiating and classifying of sample groups, as well as its indiscriminative nature of biomarker and metabolite identification. Using this method, seven metabolites were identified, which are flavonoid aglycone glucuronidation, sulfatation, and methylation metabolites. Conclusion:: Our results showed that UPLC–MS based- pattern recognition analysis approach can be used to quickly identify Abelmoschus Manihot related metabolites in biological fluids. Furthermore, this work demonstrates the potential application of combining the UPLC–MS approach with the metabolomics approach in identifying the metabolites of TCM. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: The lateral root of Aconitum has been popularly used in traditional Chinese medicine (TMC) known as Fuzi which is beneficial for the treatment of various diseases, such as rheumatism, painful joints, syncope and bronchial asthma. However, it has a potential carditoxicity with a relatively narrow margin of safety. Aim of the study: This paper was designed to explore the mechanisms of Fuzi's toxicity and find out potential tissue-specific biomarkers of toxic effects. Material and methods: A myocardial lipidomics based on ultraperformance lipid chromatography coupled with quadrupole-time-of-flight mass spectrometry (UHPLC/Q-TOF MS) was developed to compare three cardiac lipid extraction methods and investigate the changes of lipids in mice heart of three different dosage groups. In addition, we concurrently inspected the biochemical parameters in plasma, observed the histology of the heart and recorded the electrocardiogram (ECG). Results: The cardiotoxicity of Fuzi was dose-dependent, and the high-dose group obviously manifested the heart damage in histology and a certain degree of arrhythmia. Significant changes of 14 lipid metabolites which primarily involved in phospholipid metabolism, sphingolipid metabolism, saturated fatty acid oxidation and unsaturated fatty acid peroxidation were identified and considered as the potential biomarkers of Fuzi toxicity. Conclusion: The lipidomics approach is helpful to search potential tissue-specific biomarkers and understand the underlying mechanisms of Fuzi toxicity on the heart. [Copyright &y& Elsevier]

Abstract: Arctiin, an important lignan compound in Fructus Arctii, has been reported to possess various kinds of bioactivities. Previous studies on the pharmacokinetic of arctiin after oral administration showed that it had a rapid absorption phase followed by a sharp but lasting disappearance. To gain deep insight into the action mechanism of arctiin, the excretion and metabolism of arctiin in vivo should be further studied. In this paper, three metabolites were isolated and identified in rat feces as (−)-enterolactone (M-1), (−)-arctigenin (M-2) and [(2R,3R)-2-(3′-hydroxybenzyl)-3-(3″,4″-dimethoxybenzyl)-butyrolactone] (M-3). Based on the structures of three metabolites, possible metabolic pathways of arctiin in rats are proposed. At the same time, the cumulative excretion rate of arctiin and its metabolites in rat urine and feces were determined, indicating that arctiin was excreted 19.84% in urine and 1.80% in feces, respectively, enterolactone, the most main metabolite, was excreted 35.80% in feces. These results provide very important information for understanding the metabolism and excretion of arctiin in vivo and speculating its action mechanism, they can provide useful information and reference for further metabolic investigations on arctiin in humans. [Copyright &y& Elsevier]

Abstract: During the past three decades, an estimated 200 million rural residents have moved to urban centers in China. They are “sojourners” in the cities and maintain close ties with their home communities, which we term trans-local ties. This paper examines the relationship between migrants'' social ties and their mental health, and contrasts the trans-local ties with migrants'' ties in the receiving communities, which are termed local ties. We expect that for the migrants, trans-local ties foster better mental health not only through providing emotional support but also through generating favorable social comparisons; whereas local ties may furnish important social support, but may also produce negative social comparisons. We use data collected in Shanghai to test our expectations. We compare the migrants to a sample of Shanghai natives to assess patterns of relationship between social ties and mental health that are unique to the migrants. We find that for the migrants, more numerous trans-local ties are associated with better mental health, whereas the number of local ties is not a significant predictor. This pattern is not observed among the Shanghai natives. Moreover, for migrants, trans-local ties foster a favorable evaluation of their status in Shanghai and buffer their perception of discrimination; in contrast, more numerous local ties tend to be associated with a more negative perception of social status. The findings highlight an often-overlooked pathway between social ties and health outcomes, namely, through influencing social comparison and perceived social status. This study also suggests that in addition to reducing institutional and personal discrimination, facilitating close bonds between the migrants and their home communities may be a productive way to foster their well-being, in the context of contemporary urban China. [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]

Abstract: Aims: This paper is aimed to develop and validate the hypertension scale of the system of Quality of Life Instruments for Chronic Diseases, QLICD-HY. Methods: The QLICD-HY instrument was developed based on programmed decision procedures with multiple nominal and focus group discussions and pilot testing. A total of 157 inpatients with hypertension were used to provide the data measuring QOL three times before and after treatment. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness employing correlation and factor analyses, and t-tests. Results: Correlation and factor analyses confirmed good construct validity and criterion-related validity when using Short Form (36) Health Survey (SF-36) as a criterion. Test–retest reliability coefficients (Pearson r and intra-class correlation (ICC)) for the overall instrument score and all domains except for the hypertension-specific domain (SPD) (0.75) were higher than 0.80 with a range of 0.75–0.91; the internal consistency α for all domains except for the hypertension-specific domain (0.66) was higher than 0.70. The overall score and scores for most facets within each domain except for the social domain (SOD) had statistically significant changes (t-tests) after treatment with moderate effect sizes. Conclusion: QLICD-HY has good validity, reliability, responsiveness and can be used as the quality-of-life instrument for patients with hypertension. [Copyright &y& Elsevier]

Abstract: This paper examines the associations between Chinese and Korean immigrant parents’ early life material and food deprivation and their concern about their child’s diet or weight, preferences for heavier children, and weight-promoting diet and child weight, alongside the moderating role of parents’ acculturation toward American culture. In 2010, Chinese and Korean immigrant parents of children ages 3–8 years in the United States (N = 130) completed interviews which asked about their perceived early life material deprivation and food insecurity, acculturation, child feeding practices, and evaluations of whether their child weighed more or less than the ideal, and child consumption of soda and candy. Independent measures of child and parent BMI were also obtained. Regression analyses revealed that parents’ early life food insecurity was associated with the evaluation that their child should weigh more than they do and greater consumption of soda and sweets by their child, among the least acculturated parents. Parental material deprivation was associated with more laissez-faire child feeding practices: less monitoring, less concern about the child’s weight or diet, and less perceived responsibility for the child’s diet, but only among less acculturated parents. Overall, the results suggest that immigrant parents’ child feeding practices and body size evaluations are shaped by material hardship in childhood, but these influences may fade as acculturation occurs. [Copyright &y& Elsevier]

Techno-stressors stemming from the use of information technology (IT) have become a major source of stress in the modern workplace. While research shows that techno-stressors negatively affect employees' work attitudes and performance, little is known about their effects on employees' non-work lives. This research investigates the impact of techno-stressors on work-life balance and examines job self-efficacy as a buffer of this negative impact via the attenuating effect of emotional exhaustion. We conducted two survey studies. Study 1 collected data through a paper-and-pencil survey from 316 IT workers in a northern China IT company. Study 2 replicated and strengthened Study 1 by collecting longitudinal data through an online survey platform from 646 southern China female workers across diverse occupations. The results showed that techno-stressors negatively affected work-life balance, but job self-efficacy buffered employees from this negative effect by reducing their emotional exhaustion. Our findings extend understanding of techno-stressors' effects on individuals' non-work domains and shed light on how to cope with techno-stressors. • Techno-stressors are becoming major sources of stress in the modern workplace. • Techno-stressors negatively affect work-life balance. • Employees with high job self-efficacy suffer less from techno-stressors. • The buffering role of job self-efficacy works through lowering emotional exhaustion. [ABSTRACT FROM AUTHOR]

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]

• Anxiety mediates the association between self-esteem and addictive smartphone use. • Self-esteem is negatively associated with anxiety. • Anxiety is positively associated with addictive smartphone use. • Self-control moderates the association between self-esteem and anxiety. Existing research supports an association between self-esteem and addictive smartphone use, yet the underlying mechanism is not clear. Building on the compensatory internet use model, the current study explored the possible mediator role of anxiety and moderator role of self-control in the link between self-esteem and addictive smartphone use. Two middle schools and two elementary schools in a metropolitan city in China were selected through convenient sampling. Eleven hundred and twelve adolescents from those schools completed a paper-and-pencil survey, which included measurements of self-esteem, addictive smartphone use, anxiety, and self-control. The relationships among variables were analyzed using a moderated mediation model in an SPSS macro named PROCESS. The moderated mediation model achieved satisfactory effect size, R2 = 28.65%; Specifically, (1) anxiety fully mediated the association between self-esteem and addictive smartphone use, CI = [−0.1, −0.05]: Self-esteem was negatively related to anxiety, which in turn was positively related to addictive smartphone use; (2) moderated mediation analysis results showed that high self-control enhanced the protective effect of self-esteem against anxiety. High self-esteem in adolescents is related to relatively low anxiety, which is related to less addictive smartphone use. Moreover, the protective effect of self-esteem against anxiety was enhanced by high self-control, suggesting that increasing self-esteem alone would not prevent addictive smartphone use in all adolescents. [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]

• Children with HFA have impairment in emotional prosody recognition. • Intensity increase did not improve children with HFA's overall emotion recognition. • Children with HFA have difficulty discriminating between emotions differing in valence. • Children with HFA have difficulty discriminating between emotions differing in arousal. This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness , anger , sadness and fear , in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard. [ABSTRACT FROM AUTHOR]

• Patella measurements were analyzed for sex estimation in contemporary Chinese. • An automatic measurement method was introduced. • Patella measurements can be utilized in sex estimation when the skull and pelvis are unavailable. Sex estimation is an important part of creating a biological profile, and ultimately assisting in creating a presumptive identification of unidentified skeletal remains. However, manual methods of anthropometric are time-consuming and prone to observer variability. The present study is an attempt to estimation of sex from automatic measurement of patella by multidetector computed tomography (MDCT) in a contemporary Chinese population. Four measurements for every patella, including maximum height (MAXH), maximum breadth (MAXB), maximum thickness (MAXT) and patellar volume (PV), were automatically provided by the software from CT image of 300 Chinese. The sample is composed of 156 males and 144 females with an average age of 41.44 and 45.68 years, respectively. The statistical analyses showed that all variables were sexually dimorphic. Receiver operating characteristic (ROC) analysis was performed to estimate sex from patella. The univariate analysis of each patellar parameter yielded a sex classification accuracy rate of 73.1% to 85.7%. The classification accuracy rates of sex estimation using the combination of the patellar parameters are 81.9% to 91.6%. This paper provides indications that the patella is important bone for sex estimation and it may be used as an alternative in forensic cases when the skull and pelvis are unavailable. [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]