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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]

The ageing of the rural population and the citizenization of the rural-urban migrated population have brought unprecedented pressure and challenges to Chinese farmers' old-age care. Socialized old-age care services are a necessity to fulfil the service needs of farmers' old-age care. This study examines the farmers' willingness to pay for socialized old-age care and its influencing factors. Based on field survey data, this paper employs the descriptive statistics method and a binary logistic model to determine and analyze the influencing factors of rural residents' willingness to pay for rural socialized old-age care. We observed the following: rural residents generally have a willingness to pay for rural socialized old-age care services but are subject to their own economic conditions, traditional concepts, and external supply conditions. The influencing factors of rural socialized old-age care include the marital status, self-care ability, enrollment in the New Old-Age Insurance System for Rural Residents, proportion of migrating children, health status, and the population living in the same household. The marital status, the enrollment of New Old-Age Insurance System for Rural Residents, and proportion of migrating children have a positive facilitating effect on willingness to pay. The self-care ability, health status, and the number of residents in the same household have a reverse effect. Considering the willingness to pay, the already-old are more affected by the traditional old-age care concept and more dependent on their children. For the not-yet-old, factors that contribute to transferring old-age care responsibilities to themselves and society have become more significant, which contributes to the existing literature. • Rural residents generally have a WTP for rural socialized old-age care. • The marital status, enrollment of the insurance, and proportion of children migrating have a positive effect on the WTP. • Self-care ability, health status, and number of residents in the same household have the reverse effect on the WTP. • The 'age' and 'generations' are not significant influencing factors of the WTP for rural socialized old-age care. • The not-yet-old are relatively less affected by the traditional concept of old-age care and more dependent on their children. [ABSTRACT FROM AUTHOR]

This paper aims to assess the current knowledge, attitudes, and behaviors of nursing staff regarding sarcopenia and explore associating factors that influence them. Sarcopenia has an insidious onset and is easily overlooked. However, it is has become very common in older people, seriously jeopardizing the quality of life in patients. The present situation of nurses in China is inadequate, even though they are the primary professionals tasked with screening for sarcopenia, the ability to recognize and effectively manage the disease, and the critical role they play in preventing and controlling sarcopenia in patients. We conducted a cross-sectional design of nurses. Facilitated sampling was used in seven hospitals in Jiangsu Province, China. A total of 409 hospital nursing staff participated in the survey from December 2022 to March 2023. The main survey instruments were the nursing staff about the knowledge of sarcopenia, beliefs, a behavior questionnaire, and a self-designed general information questionnaire. Descriptive of general data, t-test, and ANOVA for influencing factors of three dimensions, whereas multiple linear regression analyses were performed using SPSS23.0 software. Questionnaires were distributed to 460 nurses, and of the 426 (92.6%) questionnaires returned, 409 (96.0%) were valid. The total mean score of nurses' knowledge, beliefs, and behavior about sarcopenia was 125.42 (SD 18.97), the mean score of knowledge latitude was 29.09 (SD 7.80), the mean score of attitude dimension was 57.53 (SD 7.63), and the mean score of behavior latitude was 38.80 (SD 10.71). Multiple linear regression analysis revealed that the nurse's position, Knowledge of sarcopenia, whether or not they were specialist nurses and years of experience in the workplace were the most significant factors correlated with the level of knowledge, belief, and practice (P < 0.05). In China, nurses have little knowledge about sarcopenia, but their attitude towards sarcopenia care is positive. However, there is potential for improvement in nursing behavior toward sarcopenia management. Managers are advised to develop targeted training programs for nurses. Further, it improves their screening and diagnosing abilities, allowing them to prevent and control sarcopenia more effectively. [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]

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]

Ecosystem services economic valuation (ESV) is widely advocated as a useful tool to support ecosystem management decision-making. However, whether ESV is used and the application areas of ESV by decision-makers in coastal and marine management in China remain largely unexplored. This paper aims to determine whether ESV is used, the application areas of ESV and the possible limits of ESV in coastal and marine management in China. To characterize the classification, applications and limits of ESV, a questionnaire was designed, and a nationwide survey was conducted. Descriptive statistics addressing the application level and application areas of ESV were produced, and then, four regression models were run to examine the factors that limit the application of ESV in the decision-making process. The results show the following. (i) Use value information is being applied by decision-makers in coastal and marine management in China. More specifically, direct use value information is more frequently applied than indirect use value information. (ii) Nonuse values, i.e., existence value and bequest value, are still rarely applied in coastal and marine management in China. (iii) Theoretical and technical barriers are found to have more limitations on the application of nonuse value information than social and economic barriers. [ABSTRACT FROM AUTHOR]

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]