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All-solid-state metal batteries (ASSMBs) have been regarded as the ideal candidate for the next-generation high-energy storage system due to their ultrahigh specific capacity and the lowest redox potential. However, the uncontrollable chemical reactivity during cycling which directly determines the growth behaviour of metal dendrites, the low coulombic efficiency and the safety concerns severely limit their real-world applications.. Crystallographic optimization based on solid-state electrolytes (SSEs) provides an atomic-scale and fundamental solution for the inhibition of dendrite growth in metal anodes, which has attracted widespread attentions. From this perspective, we summarize the recent advance of the crystallographic optimization for various classes of solid-state electrolytes. We highlight the recent experimental findings of crystallographic optimization for a new generation of all-solid-state batteries, including lithium-ion batteries, sodium-ion batteries, magnesium-ion batteries, with the aim of providing a deeper understanding of the crystallographic reactions in ASSMBs. The challenges and prospects for the future design and engineering of crystallographic optimization of SSEs are discussed, providing ideas for further research into crystallographic optimization to improve the performance of rechargeable batteries.

This report outlines the results from the research project Food for Urban Life and Localities (FULL) funded by Formas (2020-02864). The research set out to learn how COVID-19 response strategies in six cities (Stockholm, London, Wuhan, Singapore, Sydney, and Seoul) have facilitated access to food for vulnerable groups and how new food supply solutions have emerged through social and technological innovations. This report presents the case of each city in turn and pauses on the role of community-based organisations, ad- hoc community initiatives and municipalities during the COVID-19 pandemic. The report provides a detailed discussion of local or community-level responses in cities that aim to provide access to food through social and/or technological innovations. The lessons learned are important for the Swedish context in the case of similar events that challenge local access to food. The research collected data through qualitative and quantitative methods, and also made use of the breadth of online data sources in response to COVID-19 restrictions on free movement and travelling. The overall finding is that in situations such as the COVID-19 pandemic, local access to food is extremely challenging and cannot be addressed by existing welfare or state arrangements only;civil society organisations and voluntary community organizations (VCOs) step in to fill the gap in public provision; and the stricter the lockdown, the more dependent on civil society response urban areas and communities were. 2023-03-27 First published online.2023-05-17 New version published with a minor correction in the abstract including funding information. To this date, the report has been downloaded 188 times.

This is the supplementary information for the paper -Life-course inequalities in intrinsic capacity and healthy ageing: retrospective evidence from pre-old and older populations in China

What can we learn from civil society responsesto COVID-19 food supply? The COVID-19 pandemic has resulted in food shortages, lockdowns, and restrictions onmovement, which have completely reshaped the food system and the interaction betweenpeople and their food environment. The pandemic has highlighted that while states arestruggling to handle all the impacts of the pandemic, civil society organizations have taken onan important role in filling the gaps and mitigating the shocks from the pandemic. Actionstaken by civil society and the market have shown that the existing welfare structures createdby states are unable to handle the impact of a pandemic when it comes to critical tasks suchas food supply for vulnerable groups.

Migration may lead to changing power dynamics between parents and children in families. Children may change their behavior in order to exercise agency to respond to migration of family members or themselves. This systematic review seeks to understand how children exercise agency within families in the context of migration. The authors searched ten databases to collect English-written articles published in academic journals in or after 2010. The studies were coded to generate a quality indicator. 65 Articles with moderate and strong quality were included in this review, including 41 qualitative studies, 16 quantitative studies, and 8 mixed-methods studies. Children and adolescents with demographically and culturally diverse backgrounds were analyzed in these studies. The systematic review shows that children have different levels of behavioral agency in the migration decision-making process; they also exercise agency in different aspects of family life. For example, left-behind children exercise agency in care provision and information nondisclosure, and migrant children in media and language brokering. Children’s behavioral agency is place-specific. Adults working with children need to pay more attention to children’s behavioral agency in order to support children’s healthy development and facilitate their adaptation in the context of migration. Supplementary Information The online version contains supplementary material available at 10.1007/s40894-021-00175-0.

ImportanceFalls have become a major public health issue in China with population aging. Although falls prevention for older community-dwelling people has been included in the National Essential Public Health Service Package since 2009, there is limited understanding of the implementation of this program.ObjectiveTo identify the associated factors and provide recommendations to inform the better implementation of falls prevention in the Chinese primary health care system.Design, Setting, and ParticipantsThis qualitative study was conducted in 3 purposively selected cities in China from March 1 to June 7, 2021. Health administrators from the local health commission or bureau, staff members from local Centers for Disease Control and Prevention and primary health care facilities and community-dwelling older people were recruited, using a combination of purposive sampling and snowball sampling.Main Outcomes and MeasuresIn-depth interviews were conducted with health administrators and focus groups with other participants. Data analysis followed the guidance of the Consolidated Framework for Implementation Research. Study outcomes included facilitators and barriers of implementing falls prevention for older people in the Chinese primary health care settings. A framework with recommendations was developed to inform the future intervention implementation.ResultsAmong a total of 130 participants interviewed, 77 (59.2%) were female and the mean (SD) age was 47.4 (16.7) years. Clear recognition of the challenges and benefits of falls prevention, adaptive regionally tailored guidance plans, and continuous governmental policy and financial support were the major facilitators, whereas the major barriers consisted of insufficient confidence in delivering interventions and poor understanding of the falls burden, low recognition of the importance of falls prevention, limited multisectoral collaboration, and weak financial incentives. A 7-strategy embedded framework—including data-driven surveillance, audit and feedback, implementation strategy, workforce strengthening, community empowerment, internal services integration, and external enabling environment—was developed to foster successful implementation.Conclusions and RelevanceThis qualitative study identified major facilitators and barriers to the implementation of falls prevention for older people at the primary care level, which have the potential to contribute to better implementation of falls prevention for older people in the Chinese primary health care system.

Background Maintaining and optimising intrinsic capacity (IC) across a person’s life course is a core component of the World Health Organization’s model of healthy ageing. However, the contribution of cumulative health inequalities over time to subtle changes in IC in late life is not well understood. Methods We included 21,783 participants aged 45 + from the China Health and Retirement Longitudinal Study and calculated a validated prognostic value of IC. We included eleven early-life factors to investigate their direct influence on IC over thirty years later and cumulative influence through four current socioeconomic factors. We used multivariable linear regression and concentration index decomposition to investigate the contributions of each determinant to IC inequalities. Mediation analysis identified the direct and cumulative contribution of early-life factors. Results Participants with an advantaged environment in childhood and a higher current socioeconomic position had a significantly higher IC score. This inequality was greatest for cognitive capacity and sensory capacity. Overall, early-life factors directly explained 13.92% (95% CI: 12.07–15.77%) of IC inequalities, while 28.57% (95% CI: 28.19–28.95%) of IC inequalities were explained through the cumulative effects of socioeconomic inequalities over a person’s life course. Conclusion In China, unfavourable early-life factors appear to directly decrease late-life health status, particularly cognitive and sensory capacities rather than locomotor functioning, psychological capacity or homeostasis, and these effects are exacerbated by the cumulative socioeconomic inequalities over a person’s life course. Interventions in early life and subsequently across the life course may be effective in reducing these disparities.

Objective Healthcare expenditures have increased very fast in many countries. Overuse of health care is a potential factor explaining the rapid increase. However, overuse, defined as ‘the provision of health care service when its likely risk of harm exceeds its potential benefit’ is difficult to measure 1. This study employs a novel method using unannounced standardised patients (SPs) to identify overuse, document its patterns, and quantify its financial impact on patients in primary care in China. Methods We conducted an SP study in a capital city of western China in 2017 and 2018. We trained 18 SPs to present consistent cases of two common chronic diseases, unstable angina and asthma. The SPs recorded 492 physician-patient interactions in 63 public and private primary hospitals. Overuse, defined as the provision of unnecessary medical tests and drugs, was identified by a judging panel based on national clinical guidelines. We estimated linear regression models to quantify the financial impact of overuse after controlling for hospital, physician and patient characteristics and a series of fixed effects. Findings We found overuse in 72.15% (95% CI: 68.18–76.13%) of the SP visits, including overuse of medical tests (54.67%, 95% CI: 50.26–59.09%) and overuse of drugs (28.05%, 95% CI: 24.07–32.03%). The high prevalence of overuse was similar among public and private hospitals, low-competence and high-competence physicians, male and female physicians, junior and senior physicians, and male and female patients but varied across patients presenting different diseases. Compared to the non-overuse group, the overuse had significantly increased the total cost by 118.8% (95% CI: 75.5–162.2%), the test cost by 60.0% (95% CI: 22.2–97.9%) and the drug cost by 100.2% (95% CI: 56.8–143.7%). The financial impact of overuse did not vary substantially across high-competence and low-competence physicians, male and female physicians, junior and senior physicians, and patients presenting different diseases. However, the financial impact of overuse was driven by physician-patient interactions in public hospitals rather than private hospitals, and it was driven by female patients rather than male patients. Interpretation Overuse of health care is pervasive in the primary care of China and leads to a significant increase in healthcare expenditure. The overuse in this study seems unlikely to be attributable to physician incompetence. We use a consultation-treatment transaction model to understand physician behaviour and show that overuse of medical tests and overuse of drugs are partial substitutes. These findings shed light on the cost escalation of primary care in China, which is a form of medical inefficiency and low quality of care that should be urgently addressed.

Despite being disproportionately affected by poor mental health, culturally and linguistically diverse (CaLD) individuals seek help from mental health services at lower rates than others in the Australian population. The preferred sources of help for mental illness amongst CaLD individuals remain poorly understood. The aim of this study was to explore sources of help in Arabic-, Mandarin-, and Swahili-speaking communities in Sydney, Australia. Eight focus-group discussions (n = 51) and twenty-six key informant interviews were undertaken online using Zoom. Two major themes were identified: informal sources of help and formal sources of help. Under the informal sources of help theme, three sub-themes were identified: social, religious, and self-help sources. All three communities strongly recognised the role of social sources of help, with more nuanced roles held by religion and self-help activities. Formal sources of help were described by all communities, although to a lesser extent than informal sources. Our findings suggest that interventions to support help-seeking for all three communities should involve building the capacity of informal sources of help, utilising culturally appropriate environments, and the collaboration between informal and formal sources of help. We also discuss differences between the three communities and offer service providers insights into unique issues that require attention when working with these groups.

To compare axial elongation, relative corneal refractive power (RCRP) distribution within the pupillary diameter, and corneal higher-order aberrations (HOAs) in myopic children wearing orthokeratology (ortho-k) lenses with different back optic zone diameters (BOZD).Children aged 8-11 years were fitted with 5.0 or 6.2 mm-BOZD ortho-k lenses (groups A and B, respectively). Axial length (AL) and corneal topography were measured at baseline and during the annual visit. RCRP and corneal HOAs were compared between the two groups after one-year treatment. Multivariate linear regression analysis was performed to determine the association between AL elongation and RCRP parameters, corneal HOAs, and other variables between the groups.After one-year treatment, axial elongation was slower in group A than in group B, with a difference of 0.15 mm. Children in group A showed smaller treatment zone size, smaller 3/4X value (describing the distance from the apex RCRP profile rising to its three-quarter-peak level), greater RCRP sum value within the pupillary area, and higher increases in corneal total HOAs and horizontal coma (ZOrtho-k lenses designed with smaller BOZD increased myopia control efficacy, induced a steeper distribution of the RCRP profile within the pupillary diameter, and induced greater increases in corneal total HOAs and horizontal coma (Z

This study aims to review China's national policies related to non-communicable disease (NCD) prevention and control at the primary health care (PHC) level since China's 2009 health system reform. Policy documents from official websites of China's State Council and 20 affiliated ministries were screened, where 151 out of 1,799 were included. Thematic content analysis was performed, and fourteen ‘major policy initiatives’ were identified, including the basic health insurance schemes and essential public health services. Several areas showed to have strong policy support, including service delivery, health financing, and leadership/governance. Compared with WHO recommendations, several gaps remain, including lack of emphasis on multi-sectoral collaboration, underuse of non-health-professionals, and lack of quality-oriented PHC services evaluations. Over the past decade, China continues to demonstrate its policy commitment to strengthen the PHC system for NCD prevention and control. We recommend future policies to facilitate multi-sectoral collaboration, enhance community engagement, and improve performance evaluation mechanisms.

This study aimed to explore the effect of repeated low-level red light (RLRL) on axial length (AL), choroid blood flow, and anterior segment components in myopic adults. Ninety-eight myopic adults were randomly divided into the RLRL group (n = 52) and the control group (n = 46). Subjects in the RLRL group completed a 4-week treatment composed of a 3-min RLRL treatment session twice daily, with an interval of at least 4 h. Visits were scheduled before and on 7, 14, 21, and 28 days after the treatment. AL, subfoveal choroidal thickness (SChT), choroidal vascularity index (CVI), and anterior segment parameters were measured at each visit. A linear mixed-effects model showed that the AL of the subjects in RLRL decreased from 24.63 ± 1.04 mm to 24.57 ± 1.04 mm, and the SChT thickened by 18.34 μm. CVI had a slight but significant increase in the 0–6 zone. However, all the anterior segment parameters did not change after RLRL treatment. Our study showed that the choroid’s thickening is insufficient to explain the axial length shortening. The unchanged anterior segment and improved choroid blood flow suggest that the AL shortening in this study is mainly related to changes in the posterior segment.

The second King’s College London Symposium on Ageing and Long-term Care in China was convened from 4 to 5th July 2019 at King’s College London in London. The aim of the Symposium was to have a better understanding of health and social challenges for aging and long-term care in China. This symposium draws research insights from a wide range of disciplines, including economics, public policy, demography, gerontology, public health and sociology. A total of 20 participants from eight countries, seek to identify the key issues and research priorities in the area of aging and long-term care in China. The results published here are a synthesis of the top four research areas that represent the perspectives from some of the leading researchers in the field. © The Author(s) 2020.

This special issue brings together original research papers from a diverse range of disciplines in disability studies, media and communication studies, social policy, business and management, commu...

It is increasingly a concern that technological innovations may create as many problems as they solve. Together with the articles in this special issue, we outline the challenges and opportunities ...

Local Chinese governments have been experimenting with a form of top-down “co-production” under different names and for various purposes. This paper examines practices in four Chinese cities to understand the process by which this co-production is introduced, its implementation and its outcomes. We found that in these cities, co-production is imposed on urban communities by the higher authorities, with the state playing very active roles in initiating, financing and facilitating the process. Despite the much-improved community environment, communities are not participating to the extent that the state would like. Nonetheless, we argue that this top-down approach has its merits. It may be an efficient way to ignite the co-production process and to some extent sustain it. When these practices are embedded in an authoritarian hierarchy, however, local officials involved are unavoidably evaluated by two separate performance assessment systems, the hierarchical and the horizontal, which so far have not been compatible.

This article studies the causes for unequal access to rural community and social development infrastructures in China. We use a dataset in the China Health and Retirement Longitudinal Study (2011–2012), the National Baseline Survey of Communities, to examine the availability of four types of infrastructures: public transportation, sanitation, health care and aged care. Three hundred and seven villages are included in this study. The findings suggest that the primary funder of infrastructures and the status of village governance have impacts on the unequal availability of rural infrastructures. The effects vary by the type of infrastructures under discussion. This is the first attempt to combine planning, finance and governance factors in explaining rural infrastructure availability. It has strong policy implications and shed important light on state–society relations and the urbanisation trends in China.

There is great inequality of educational resources between different provinces in China due to unbalanced economic development. Despite continued redistribution of financial resources by the central government in favor of poorer provinces, educational inequality remains. In this paper, we argue that focusing on educational resources is far from sufficient. Poorer provinces do not only suffer from a lower level of educational resources, but they also have more children to educate, i.e. a greater need for education. Combining and analyzing the data in the Sixth National Population Census of China and the official statistics on education spending and resources, we found that provincial-level variations in the child population and the child dependency ratio have made access to educational resources even more unequal given the unequal financial capacity at the provincial level. Poorer provinces face a higher child dependency ratio and have lower economic development, and these two factors jointly lead to limited educational resources. Apart from a much higher level of redistribution in favor of less developed provinces, encouraging more balanced distribution of teachers and more broadly promoting economic equality are essential to reduce inequality in educational resources in China.

Development induced displacement and resettlement (DIDR) projects should share their benefits with those affected by them. This paper shows that in the case of the Yangtze-Huai River Diversion Project in China perceptions of compensation received differs amongst different groups of resettled people even if levels of compensation are similar. Based on a survey with displaced people, a fuzzy comprehensive evaluation concludes that those with generic skills’ sets are the most satisfied, mainly because they are able to find new work and re-establish livelihoods after resettlement more quickly. On the other hand, those with only agricultural skills find it difficult to re-establish their livelihood and are often dissatisfied. Finally, those who did not have any work before resettlement were found to be satisfied overall as their life quality is said to have improved. The skills of those affected are therefore a key explanatory factor for satisfaction with compensation following resettlement

Summary There remains limited literature to facilitate understanding of healthy ageing-related policies in China over the last five-year policy planning cycle. This study aims to characterise all relevant policies and identifies the policy gaps from a health system perspective. A scoping review framework was used. A thorough search for healthy ageing-related policies was performed on the websites of all government ministries affiliated with the Chinese State Council. Essential information was extracted and mapped to an integrated framework of the World Health Organization's Health System Building Blocks and the Chinese 13th Five-Year Plan for Healthy Ageing. A total of 12471 policy documents were identified, while 99 policy documents were included. There were 14 ministries involved in the generation of policies, but multisectoral collaboration between the ministries remained limited. National Health Commission and Ministry of Civil Affairs were the leading ministries. Promoting the integration of medical services and older people care was most frequently addressed within these policies. Applying the health system perspective, governance and financing were often addressed, but there were limited policies on other components of the health system. The findings of this study support four policy recommendations: (1) to enhance multisectoral collaboration in policy development; (2) to strengthen health system building blocks, including healthcare workforce, service delivery, health information, and medical products and technologies; (3) to establish a consolidated policy system centered on the national healthy ageing plan; (4) to formulate a national implementation work plan to promote an integrated health care model for older people.

Pulmonary fibrosis is a rapidly progressive and fatal fibrotic lung disease with high mortality and morbidity. However, pulmonary fibrosis therapy in the clinic has been limited by poor selectivity and inefficiency of drug delivery to fibroblasts. Herein, a clodronate (CLD)-loaded liposome and fibroblast-derived exosome (EL-CLD) hybrid drug delivery system with non-specific phagocytosis inhibition and fibroblast homing properties, was designed for the treatment of pulmonary fibrosis. EL-CLD effectively depleted Kupffer cells via apoptosis by passive targeting after intravenous injection, and thus significantly reduced accumulation in the liver. Notably, the EL-CLD hybrid system preferentially accumulated in the fibrotic lung, and significantly increased penetration inside pulmonary fibrotic tissue by targeted delivery due to the specific affinity for fibroblasts of the homologous exosome. Nintedanib (NIN), an anti-fibrotic agent used to treat pulmonary fibrosis, was loaded in the EL-CLD system, and achieved a remarkable improvement in curative effects. The enhanced therapeutic efficacy of NIN was a result of enhanced pulmonary fibrotic tissue accumulation and delivery, combined with a diminished macrophage-induced inflammatory response. Hence, the EL-CLD hybrid system acts as an efficient carrier for pulmonary anti-fibrotic drug delivery and should be developed as an efficient fibroblast specific therapy.

This paper explains the reasons behind the growing social tension and increased number of conflicts in China after a good performance in meeting the Millennium Development Goals. In this paper, we map out the issues with old urbanization (1978–2014) and the problems unsolved by past policy, and analyse whether the new policy changes introduced by the New Urbanization Plan (2014–2020) may help to deal with those problems. We argue that the tensions that evolve into conflicts are often a result of unaddressed social anxiety. Using money to purchase social stability can only be part of the solution. There need to be more serious attempts to improve governance, which involve: improving multi-level governance and inter-regional coordination, enhancing policy transparency and rule by law, adjusting the level of redistribution, and integrating rural and urban community governance structures.

Background: China has the largest number of aging people in need of long-term care, among whom 70% have chronic diseases. For policy planners, it is necessary to understand the different levels of needs of long-term care and provide long-term care insurance to ensure the long-term care needs of all people can be met. Methods: This study combines the 2013 wave of CHARLS survey and the Life Course Survey of 2014. The combination allows us to factor in both childhood and adulthood data to provide life-course analysis. We identified 7,734 older adults with chronic diseases for analysis. The need for long-term care is defined by the presence of functional limitations based on the performance of basic activities of daily living (ADLs) and of instrumental activities of daily living (IADLs). Two dummy variables, ADLs disability and IADLs disability, and two count variables, ADLs score and IADLs score, were defined to measure incidence and severity of long-term care need, respectively. The concentration index was used to capture the inequality in long-term care need, and a decomposition method based on Probit Regression and Negative Binomial Regression was exploited to identify the contribution of each determination. Results: At least a little difficulty was reported in ADLs and IADLs in 20.44% and 19.25% of respondents, respectively. The concentration index of ADLs disability, ADLs score, IADLs disability, IADLs score were −0.085, −0.109, −0.095 and −0.120, respectively, all of which were statistically significant, indicating the pro-poor inequality in the incidence and severity of long-term care need. Decomposition analyses revealed that family income, education attainment, aging, and childhood experience played a significant role in explaining the inequalities. Conclusions: The long-term care need among older adults with chronic disease is high in China and low socioeconomic groups had a higher probability of needing long-term care or need more long-term care. It is urgent to implement long-term care insurance, especially for the individuals from lower socioeconomic groups.

This study investigates the characteristics of Chinese older people receiving home and community care and the factors associated with the sources of payment for care services. The data come from the Social Survey of Older People in Urban China, which collected information from a random sample of 3,247 older people aged 60 and over in 10 large cities in different regions of China in 2017. Anderson's behavioural model of care utilisation is used to guide the analyses. The study identifies four striking features of the Chinese social care system. First, although disabilities are a significant predictor of receiving home and community care, a large proportion of care recipients do not have disabilities. Second, perceived proximity of care is the most important predictor, which implies high elasticity of demand for care services with regard to perceived distance and the great geographical inequality of care resources in the cities. Third, the government policies support the use of the internet to facilitate care access, but the enabling effect of the internet among older people is limited. Finally, sources of payment for care differ significantly according to people's age, living arrangements, disability and level of education. We argue that the government should consider shifting the focus of financial support from service providers to care recipients in the future.

Following the 2008/9 financial crisis, China instituted a 4 trillion RMB stimulus package that was spent mostly on infrastructure, with a particular impact at local level. The goal was to sustain economic growth and preserve social stability. We use the Asian Barometer surveys from shortly before and after the stimulus to examine its impact on public trust in government, and find a reversal of a previous downward trend and a substantial increase in trust in local government post stimulus. We consider a number of alternative explanations for this increase in trust, and conclude that the stimulus package is the most convincing explanation. Both perceptions of corruption and experience of corruption increased over the stimulus period. Given the strong negative correlation between corruption and trust, this implies that trust would have increased even further if the level of corruption had remained the same.

There is a shortage of empirical studies on the relationship between Chinese hydropower dams and social sustainability. Comparative research on Chinese-funded and Chinese-built hydropower projects is rare. This article aims to fill parts of this gap by discussing these issues in relation to Chinese overseas hydropower dams in Ghana (Bui Dam) and Cambodia (Kamchay Dam). Both projects are built by Sinohydro and financed by ExIm Bank. This article draws on in-depths interviews and focus group discussions with local communities affected by the dams, institutional actors in Ghana and Cambodia, Chinese actors, and dam builders. The article uses an environmental justice perspective as an analytical framework. The article concludes that the dam projects could improve their social sustainability framework in practice and theory; social benchmarking should be introduced and social policies need to be improved to be in line with international social standards on hydropower projects.

Welfare state is often perceived as a response to help people coping with shocks caused by economic down turn. However, as argued by Hamnett, welfare state can directly assist economic restructuring. Thus, social policies can be responses to unsatisfied social needs or be proactive measures to push for economic changes. Macau is in a somewhat special position in that policy-makers are aware that the economy has been excessively dependent on the gaming industry. The government prevent it from being hit by recess through economic restructuring. In this paper, we examine the current social spending pattern and the nature of the social security system in Macau and establish that social policy in Macau is largely reactive. To achieve economic restructuring, there needs to be more proactive measures to facilitate human development and more stress on social investment.

Intersectoral collaboration is important for policy implementation. However, effective collaboration may be difficult to achieve because of poor internal drive to collaborate, disagreements on framing the problem, institutional constraints and poor leadership. This article examines how competitive campaigns stimulate intersectoral collaboration in the context of healthy urban planning. We examine the case of the Creating Hygienic City Campaign in Jingchang, China from 2006 to 2011, illustrating how the city resorted to intersectoral collaboration to achieve the multiple targets and thus improved public and environmental hygiene. The paper argues that a competitive campaign, when well-organized, can overcome some of the barriers to intersectoral collaboration by building a campaign organization team, legitimizing the leadership, and enhancing public awareness and involvement. The article also suggests that the campaign approach in its current form failed to involve local authorities in setting the targets and was unable to sustain certain efforts.

There is a growing, although still far from comprehensive, literature within China on the impacts of climate change in urban areas; also an evolving policy framework at national level to address these concerns and an increased interest in climate change adaptation from many local governments. This paper summarizes the urban risks and vulnerabilities highlighted by the literature, and reviews central and local government responses. It then assesses policy response, including how this considers vulnerability and future risks, formulates an adaptation strategy, engages stakeholders and assesses adaptive capacity. This shows how the Chinese system limits the influence on climate change adaptation of residents and small businesses, and of social scientists. The reasons for this include the tendency to use climate change as an economic growth engine (and GDP growth remains the most important factor for assessing local government officials’ performance), little provision for participation in policy-making, and weak post-implementation evaluation once a policy has been scaled up at national level. These have affected the quality of evidence-based policy-making and make it difficult to draw lessons from unsuccessful practice.

Awards and competitions are often used to motivate public servants, and this paper examines how the central government of China uses these to try and motivate cities to improve public hygiene. The authors argue that apart from improving performance,(1) awards and competitions are good at motivating user participation and spreading good practice. However, the design of the schemes used in China tends to prioritize disproportionately the winning mentality, and sometimes causes high costs and social tension.