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Why do people view economic success as zero-sum? In seven studies (including a large, nationally representative sample of more than 90,000 respondents from 60 countries), we explore how personal relative deprivation influences zero-sum thinking-the belief that one person's gains can only be obtained at other people's expense. We find that personal relative deprivation fosters a belief that economic success is zero-sum, and that this is true regardless of participants' household income, political ideology, or subjective social class. Moreover, in a large and preregistered study, we find that the effect of personal relative deprivation on zero-sum thinking is mediated by lay perceptions of society. The more people see themselves as having been unfairly disadvantaged relative to others, the more they view the world as unjust and economic success as determined by external forces beyond one's control. In turn, these cynical views of society lead people to believe that economic success is zero-sum. We discuss the implications of these findings for research on social comparisons, the distribution of resources, and the psychological consequences of feeling personally deprived. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

For individuals with knee osteoarthritis (OA), stair negotiation is a challenging task and the first task during which they report pain due to the high knee loading required. The use of lateral wedge insole (LWI) has been found to reduce loading in patients with OA but not to reduce pain, whereas the use of knee sleeve has been shown to result in good pain reduction. Understanding the effect of combining LWI and knee sleeve use on healthy individuals before testing on individuals with knee OA is an important step.The current study aimed to evaluate the effect of combining the use of LWI and knee sleeve and compare the results with the application of each treatment separately and with the control condition.This randomised cross-over study included 17 healthy participants who underwent 3D gait analysis. Participants performed ascending and descending stair activities with the following four treatment conditions: five-degree LWI, off-the-shelf knee sleeve, both LWI and knee sleeve and control condition. External knee adduction moment (EKAM) and knee frontal plane range of motion (ROM) were evaluated as primary outcomes. Repeated measure ANOVA or the Friedman test was selected based on meeting the assumption followed by multiple pairwise comparisons with Bonferroni correction.In general, the use of LWI reduced the first peak EKAM significantly (p 0.001) compared to the control condition in stir ascending (12% reduction) but not in stair descending (p 0.05). Interestingly, knee sleeve use did not result in any reduction in the first peak EKAM compared to the control or any other condition. However, knee sleeve use led to a significant reduction in the knee frontal plane ROM during stair descending. The combined treatment was not superior to the LWI use when compared to control in the EKAM reduction.Combined knee sleeve and LWI use was not superior to LWI use alone in reducing the knee loading, but it may be beneficial for individuals with knee OA since it helped in reduction of the knee frontal plane ROM during stair descending. Importantly, the effect of LWI use or any other treatment must be investigated for each different activity, and the results found in one activity must not be generalised across other activities.

Individual recognition via communication signals is a critical component of social behavior, and provides the basis of conflict resolution, territorial behavior, and mate choice. However, the function of chemical signals in mammalian individual recognition and conflict resolution has largely been unexplored despite olfaction being a dominant sensory modality in many mammalian species. Here, we describe behavioral tests designed to evaluate the potential role of forehead gland secretions during conflict related to territorial defense in male Great Himalayan leaf-nosed bats. We used gas chromatography-mass spectrometry to quantify the chemical composition. Our results showed that forehead gland secretions contain 16 categories of compounds, including 84 volatile compounds. The concentrations of compounds and their categories differed significantly among individuals. Moreover, behavioral studies indicated that males can use chemical signals for individual recognition. Contests were staged between males with or without functioning forehead glands. Paired males without functioning forehead glands displayed more physical contact and longer contest duration compared with pairs with functioning glands. Moreover, males with a functioning gland were more likely to win in contests when paired with males without a functioning gland. These findings support a growing amount of evidence that chemical signals play a vital role in conflict resolution in mammals.

A growing number of adolescents are seeking medical care to alleviate gender dysphoria (GD). This qualitative study explored the subjective experiences of GD among help-seeking transgender and gender nonconforming (TGNC) youth in order to develop a more nuanced conceptualization of the phenomenon. Fifteen life-mode interviews were conducted with newly referred youth between the ages of 13 and 19. All participants were assigned female at birth. The data were analyzed using thematic analysis. The participants targeted five major themes that characterize GD: (1) Bodily sensations were constant reminders of GD throughout the day, (2) emotional memories from the past of being different and outside triggered GD, (3) the process of coming out was a transformative experience that changed how the participants understood themselves, (4) GD both increased and decreased in relation to others, (5) everyday life required careful negotiation to feel whole without developing new forms of GD. Based on the results, we suggest a more conceptually nuanced model of GD, one which accounts for how bodily sensations and emotional memories from the past were sources that elicited GD. The sources were mediated through the process of coming out and relating to others, and this resulted in the negotiation of GD today. The conceptual model suggested in the present study could ideally shed light on preexisting knowledge on TGNC youth struggling with GD. In addition, an improved understanding of GD could ideally help clinicians when addressing individual treatment needs.

Stakeholder advisory boards are recognized as an essential and useful part of patient-centered research. However, such engagement can involve exchanges of diverse individual experiences, multiple opinions, and strong feelings in the face of researchers’ limitations, deadlines, and agendas. Yet, little work examines how these potential tensions occur and are resolved in actual advisory board meetings. This perspective article describes and employs a communication framework for analyzing a patient advisory council (PAC) for a comparative effectiveness study on acupuncture and pain counseling for inpatients with cancer. The framework, Action-Implicative Discourse Analysis (AIDA), is an observational method that examines challenges through recorded and transcribed, naturally occurring interaction. Our analysis focused on two short excerpts from the first PAC meeting to demonstrate members’ navigation of advice-giving and advice-receiving—one in which advice was ultimately implemented by the study team and another in which it was deemed unfeasible. Although advice is inherent to the work of all PACs, it often emerges unannounced as negotiated moments, made up of seemingly minor conversation moves. As a recurring event, advice can and should be analyzed and discussed within PACs to improve communication and team dynamics.

The COVID-19 pandemic led to lockdown measures where congregational faith-based activities were prohibited. With time, the collateral impacts of confinement emerged as priorities, and impositions had to be balanced with the collaboration of the population. In this process, faith-based organizations played a key role in encouraging their congregations to adhere to lockdown measures while fostering their mental wellbeing and resilience. This paper describes the process of establishing a collaborative negotiation among the Montreal Regional Public Health Unit, the police, and the Muslim and Jewish communities, examining the role of mediation in this context. Despite some obstacles, such as communication difficulties and decision-making limitations, the collaborative approach seems to buffer the escalation of intercommunity tension and to promote communities’ commitment to physical distancing measures and should be considered in times of pandemic for a more inclusive public health approach.

Objective: Coherence between the hippocampus and other brain structures has been shown with the theta frequency (3–8 Hz). Cortical decreases in theta coherence are believed to reflect response accuracy efficiency. However, the role of theta coherence during conflict resolution is poorly understood in noncortical areas. In this study, coherence between the hippocampus and orbitofrontal cortex (OFC) was measured during a conflict resolution task. Although both brain areas have been previously implicated in the Stroop task, their interactions are not well understood. Methods: Nine patients were implanted with stereotactic electroencephalography contacts in the hippocampus and OFC. Local field potential data were sampled throughout discrete phases of a Stroop task. Coherence was calculated for hippocampal and OFC contact pairs, and coherence spectrograms were constructed for congruent and incongruent conditions. Coherence changes during cue processing were identified using a nonparametric cluster-permutation t test. Group analysis was conducted to compare overall theta coherence changes among conditions. Results: In 6 of 9 patients, decreased theta coherence was observed only during the incongruent condition (P < 0.05). Congruent theta coherence did not change from baseline. Group analysis showed lower theta coherence for the incongruent condition compared with the congruent condition (P < 0.05). Conclusions: Theta coherence between the hippocampus and OFC decreased during conflict. This finding supports existing theories that theta coherence desynchronization contributes to improved response accuracy and processing efficiency during conflict resolution. The underlying theta coherence observed between the hippocampus and OFC during conflict may be distinct from its previously observed role in memory.

Promoting evidence-based treatments and the human rights of people living with mental illness are the two pillars of Global Mental Health (GMH). Critics counter that human rights narratives must also include social justice frameworks. We draw on the cases of autism and ADHD in Brazil to discuss the role of human rights in mental health in the context of GMH. A human rights perspective involves citizenship rights for individuals living with mental distress and provides a framework to problematise the logic of GMH centred on individual rights and rights to treatment. We begin with an overview on human rights discussions in GMH and examine the introduction of human rights discourses in the Brazilian psychiatric reform. We then explore how autism and ADHD became priorities of GMH interventions as well as the constitution of two styles of activism and mobilisation of human rights around these conditions. One follows the universal public health logic and promotes health as a social right. The other follows the logic of parents' associations that redefined those conditions as forms of disability to advocate for specialised services and interventions. Finally, we discuss these forms of human rights mobilisation and their implications for Brazilian mental health and GMH.

Made available in DSpace on 2022-05-01T05:29:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-19 It is challenging for people with Parkinson's disease (PwPD) to adjust their gait to perturbations, including fatigue. Obstacle negotiation increases the risk of tripping and falling in PD. Being physically active can improve gait control and the ability to negotiate obstacles while walking under fatigue state. We thus determined the effects of Parkinson's disease, fatigue, and level of physical activity on gait during the approach to and crossing an obstacle during gait. Forty participants were stratified to people with Parkinson's disease active and inactive, and control individuals active and inactive. Participants walked on an 8 m walkway and stepped over an obstacle placed at the middle (4 m). They performed three trials before and after repeated sit-to-stand (rSTS)-induced fatigue state. Maximum voluntary force was assessed before and after rSTS. We measured the length, width, duration, and velocity of the approach (stride before obstacle) and crossing (step over the obstacle) phases and the leading and trailing placements and clearance during crossing phase. Fatigue trait was determined by multidimensional fatigue inventory. Before rSTS, people with Parkinson's disease inactive vs. other subgroups approached the obstacle using 18–28% shorter, wider and slower steps and crossed the obstacle slower (all p < 0.04). After rSTS, people with Parkinson's disease inactive increased (23–34%) stride length and velocity and decreased (-21%) the step width (p < 0.01). People with Parkinson's disease approached the obstacle similarly to control individuals. Physical activity minimizes Parkinson's disease-typical gait impairments during obstacle negotiation and affords a protective effect against fatigue-effects on obstacle negotiation. São Paulo State University (UNESP) Graduate Program in Movement Sciences Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences Department of Physical Education Human Movement Research Laboratory (MOVI-LAB) University of Groningen University Medical Center Groningen Center for Human Movement Sciences Institute of Sport Sciences and Physical Education Faculty of Sciences University of Pécs Somogy County Kaposi Mór Teaching Hospital São Paulo State University (UNESP) Graduate Program in Movement Sciences Institute of Biosciences Posture and Gait Studies Laboratory (LEPLO) São Paulo State University (UNESP) Graduate Program in Movement Sciences Department of Physical Education Human Movement Research Laboratory (MOVI-LAB)

Background The diagnostic odyssey for people with a rare disease is well known, but difficulties do not stop at diagnosis. Here we investigate the experience of people, or parents of children with a diagnosed mitochondrial respiratory chain disorder (MRCD) in the management of their disease. The work complements ongoing projects around implementation of consensus recommendations for management of people with MRCD. People with or caring for a child with a formally diagnosed MRCD were invited to take part in an hour-long focus group held via videoconference. Questions elicited experiences of receiving management advice or information specific to their MRCD in four areas drawn from the consensus recommendations: diet and supplements, exercise, access to social services, and mental health. Sessions were audio-recorded, transcribed and analysed using a combination of inductive and deductive coding. Results Focus groups were conducted with 20 participants from five Australian states in June–September 2020. Fourteen adults with a MRCD (three of whom also had a child with a MRCD), and six who cared for a child with a MRCD took part. The overarching finding was that of the need for ongoing negotiation to access the advice and service required to manage their condition. The nature of these negotiations varied across contexts but mostly related to joint decision-making, and more commonly, the need to advocate for their care with non-specialist services (e.g., dieticians, schools). The effort required for this self-advocacy was a prominent theme. While most participants reported receiving adequate advice around supplements, and to a lesser extent diet and exercise, the majority reported no formal advice around mental health or practical assistance accessing social services. Conclusion These focus groups have revealed several gaps in the system for people with a MRCD, interacting with care providers after diagnosis. Focus group participants had to negotiate with a range of different stakeholders in order to secure appropriate advice or services. Notable was the gap in appropriate generalist services (e.g., dieticians) with sufficient knowledge of MRCD to support people with their day-to-day challenges.

OBJECTIVES Self-insured employers cover more people than Medicare, Medicaid, or direct purchasers of private insurance.This study examined the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States. STUDY DESIGN Repeated cross-section analysis of commercial claims. METHODS We used the US Census Bureau County Business Patterns data to estimate employer market power at the metropolitan statistical area (MSA)-year level and used the Truven Health MarketScan commercial claims to estimate mean hospital prices and price ratios at the MSA-year level (2010-2016). We calculated descriptive statistics for employer market power, mean hospitalization prices, and a case mix-adjusted price ratio measure during the study period and analyzed the 10 most concentrated labor markets. We estimated MSA-year-level ordinary least squares regressions of hospitalization price and the price ratio measure on employer market power. RESULTS Large self-insured employers had concentrated market power in very few MSAs in 2016. The mean value of our employer market power measure was 62 for 2016, compared with the mean value of 5410 for hospital market power in the United States. Regression analyses find a slight relationship: A 1-point increase in employer market power was associated with a $6.61 decrease in the hospitalization price (mean = $20,813), but this result becomes statistically insignificant once the models control for hospital wages. CONCLUSIONS Employer market power is low in most MSAs. Self-insured employers may consider building purchase alliances with state and local government employee groups to enhance their market power and lower negotiated prices for hospital services.

Health practices are shaped by gender relations and constructs. Utilising qualitative data, this study explores a shift in medication practices among gay men living with HIV (GMLH) in light of changing HIV/AIDS responses in Taiwan. In the 1980s and 1990s, the mobilisation of moralising discourses forged a gender hierarchy that subordinated HIV-positive gay males. In the 2000s, new state programmes on HIV/AIDS were implemented to enhance patients' adherence to treatment, but GMLH often expressed ambivalence towards medication, which could lead to HIV disclosure and, consequently, social exclusions under the gender hierarchy. Starting in the 2010s, the knowledge of HIV 'treatment as prevention' and a policy on early treatment have offered a new path for GMLH to navigate gender power dynamics and to strive towards an inclusive social life by taking medicine and optimising health, which facilitates a biomedicalisation of subordinated masculinity. This study contributes to the scholarship on HIV/AIDS by underscoring the significance of biomedicine for configuring masculine identities and practices among a subordinated group of men, as well as by highlighting the gender power relations and everyday 'nonbiomedical' negotiating practices that legitimise biomedicalisation.

Objective We conducted an intersectional analysis to explore how demographic characteristics and mobility device use were associated with psychological distress (depression and anxiety) and confidence negotiating physical and social environments. Design Cross-sectional data were collected using the Hospital Anxiety and Depression Scale, modified Wheelchair Use Confidence Scale and self-reported functional independence scale. Participants The sample included 105 participants. Primary mobility devices used included mobility scooters (27%), power wheelchairs (26%), manual wheelchairs (25%), walkers (11%), and cane or crutch (12%). The mean age of participants was 58 years, 53% were female, 52% lived alone and were functionally independent with the use of assistive technology. Results We were able to explain between 39% and 65% of the variance (adjusted R2) in the dependent variables with parsimonious regression models. Age was an independent predictor of all outcomes. Women were less confident negotiating the physical environment, and walker use was associated with depression and lower confidence negotiating physical environments, but increased confidence negotiating social environments. Conclusions Age is associated with psychosocial outcomes for assistive device users and those who use walkers may experience increased challenges with depression and negotiating the physical environment. Pending confirmatory research, the findings may have important implications for targeted interventions related to device provision.

BACKGROUND: Implementing workplace accommodations is an effective means of retaining employees with mental health conditions. However, the process is poorly understood and poorly documented. OBJECTIVE: The purpose of this research is to explore the interactive process of negotiating workplace accommodations from the perspective of employees with mental health conditions and workplace stakeholders. METHODS: We interviewed employees across Canada who self-identified as having a mental health condition requiring accommodations, and six stakeholders at various workplaces across Canada who are involved in providing accommodations. Data were analyzed using a qualitative descriptive approach to identify key themes. RESULTS: The findings highlight that the process of negotiating accommodations is non-linear, interactive, and political. The process is shaped by organizational and political factors and collaboration between stakeholders. CONCLUSIONS: The negotiation process is a combination of social, relational and political factors. Clear and accessible accommodation policies, workplace awareness and specific workplace training on how to implement accommodations are needed to optimize the accommodation process for all involved.

In the current study, we evaluated behavioral and electrophysiological evidence to determine whether bilinguals differ from monolinguals in the efficiency of response inhibition. Bilinguals and matched monolingual controls performed the flanker task while behavioral and electrophysiological measures were collected. Participants were slower and less accurate in responding to incongruent trials, but the magnitude of the behavioral effect of congruence was not modulated by participant group. The electrophysiological data revealed a biphasic N200/P300 signature. Incongruent trials elicited a larger N200 response, followed by a larger P300 response than congruent trials. The mean amplitude of the N200 component, a marker of conflict detection, was not modulated by group, suggesting that monolinguals and bilinguals did not differ on the ability to detect conflict. However, the mean amplitude of the P300 component, an index of response inhibition, was smaller in bilinguals than monolinguals. This indicates that bilinguals may be more efficient in resolving response conflict relative to monolinguals. Even though the two groups do not differ in behavioral task performance, the event-related potential (ERP) data suggest that monolinguals may be working harder to reach similar patterns of performance as bilinguals. The P300 magnitude correlated positively with picture naming latencies and negatively with Operation Span scores, suggesting that the ERP response to nonlinguistic conflict resolution may capture individual differences in language proficiency and cognitive resources.

Our study aims to assess improvement with symptomatic treatment of pain-related functional gastrointestinal disorders (FGIDs) in a biopsychosocial construct and evaluate validity of Rome III criteria. Children with chronic abdominal pain diagnosed with an FGID or organic disease were followed for 1 year: 256/334 were diagnosed with an FGID and 78/334 were diagnosed with a possible organic disease due to alarm signs or not meeting Rome III criteria. After 1 year, 251 had true FGID and 46 had organic diseases. Ninety percent of FGID patients improved with symptomatic treatment over an average of 5.4 months. With a 95% confidence interval, Rome criteria predicted FGIDs with sensitivity 0.89, specificity 0.90, positive predictive value 0.98, and negative predictive value 0.59. We conclude that symptomatic treatment of pain-related FGIDs results in clinical improvement and could reduce invasive/expensive testing. Rome III criteria’s high specificity and positive predictive value suggest they can rule in a diagnosis of FGID.

Background Major depressive disorder (MDD) is a multifaceted mental disorder where participants, in addition to various symptoms, often suffer from increased focus on past time perspective and higher incidence of childhood trauma. Whether the abnormal time perspective is a result of the depressive symptoms or, alternatively, mediates between childhood trauma and depression remains unclear. Aims To examine the triangular relationship between early life trauma, time perspective, and depressive symptoms. Method We investigated a large-scale MDD sample (n = 93) and healthy subject sample (n = 69) with Beck depression inventory-II (BDI-II), Beck hopelessness scale (BHS), childhood traumatic questionnaire-Short Form (CTQ-SF), and the Zimbardo time perspective inventory (ZTPI). Results The MDD patients reported more childhood trauma experiences, and were featured by abnormal time perspectives on past and future when compared to healthy control. By applying two alternative mediation models, we observed that the time perspective acted as a mediator between childhood trauma and depressive symptom severity, rather than as a consequence of depressive symptom. Furthermore, this abnormal time perspective was a risk factor to MDD, as the childhood trauma only mediated the time perspective in MDD. Finally, we showed that time perspective was a long-term personal trait and unchanged after the remission of depression symptoms under five-day transcranial magnetic stimulation. Conclusions Abnormal time perspective mediates the impact of early childhood trauma on depressive symptomatology. Besides better understanding of the temporal basis of depressive symptoms, we highlight the importance of preventive time perspective therapy in subjects with childhood trauma.

Background The hierarchical culture in high-stake areas such as operating rooms (ORs) may create volatile communication challenges. This unfunded exploratory study sought to establish whether a conflict resolution course was effective in preparing anesthesiology residents to handle and deescalate disagreements that may arise in the clinical environment, especially when challenging a surgeon. Methods Thirty-seven anesthesiology residents were assessed for ability to deescalate conflict. Nineteen had completed a conflict resolution course, and 18 had not. The 2-hour course used 10 videotaped vignettes that showed attending anesthesiologists, patients, and surgeons challenging residents in a potentially confrontational situation. Guided review of the videos and discussions was focused on how the resident could optimally engage in conflict resolution. To determine efficacy of the conflict resolution course, we used simulation-based testing. The setting was a simulated OR with loud music playing (75-80 dB) under the control of the surgeon. The music was used as a tool to create a potential, realistic confrontation with the surgeon to test conflict resolution skills. The initial evaluation of the resident was whether they ignored the music, asked for the surgeon to turn it off, or attempted to turn it off themselves. The second evaluation was whether the resident attempted to deescalate (eg, calmly negotiate for the music to be turned off or down) when the surgeon was scripted to adamantly refuse. Two trained observers evaluated residents' responses to the surgeon's refusal. Results Of the residents who experienced the confrontational situation and had not yet taken the conflict resolution course, 1 of 5 (20.0%; 95% CI, 0.5-71.6) were judged to have deescalated the situation. In comparison, of those who had taken the course, 14 of 15 (93.3%; 95% CI, 68.1-99.8) were judged to have deescalated the situation (P = .002). Only 2 of 19 (10.5%; 95% CI, 1.3-33.1) of those who completed the course ignored the music on entering the OR versus 10 of 18 (55.6%; 95% CI, 30.8-78.5) who did not complete the course (P = .004). Conclusions This study suggests that a conflict resolution course may improve the ability of anesthesiology residents to defuse clinical conflicts. It also demonstrated the effectiveness of a novel, simulation-based assessment of communication skills used to defuse OR confrontation.

Rapid growth in pharmaceutical expenditures and high prices have greatly hampered access to medicines, especially targeted anticancer medicines. Confronted with such difficulties, the Chinese government has put more effort into supporting local research and development of cancer medicines, resulting in locally developed me-too drugs. Since 2016, the government has implemented a central reimbursement-linked drug price negotiation policy aimed at reducing the prices of expensive medicines. Locally developed me-too drugs marketed at lower prices may inject price competition and help negotiate reduced prices of similar internationally-developed products. As an example, we selected 3 tyrosine kinase inhibitors (TKIs) developed for the therapy of advanced non-small cell lung cancer harboring mutations in the epidermal growth factor receptor (EGFR). Descriptive analysis was applied to data from the Chinese Medical Economic Information database to describe the impact on the price and utilization of three TKIs after the introduction of icotinib, a locally developed me-too TKI and two national negotiations regarding the price of EGFR-TKIs in China. After two national negotiations, the daily costs of all three EGFR-TKIs were reduced to around $30. From the first quarter of 2013 to the second quarter of 2016, the market share of the purchasing volume of icotinib, China's locally developed TKI, increased from 13% to 40%, while the market shares of two internationally developed TKIs decreased from 35% to 15% and from 52% to 45%, for erlotinib and gefitinib, respectively. The prices of EGFR-TKIs decreased and China's locally developed TKI accounted for a considerable proportion of market share. Locally developed me-too drugs aid price negotiation by injecting price competition and helping negotiate reduced prices of similar internationally-developed products. Through efforts to develop me-too drugs, combined with national drug price negotiation and reimbursement policies, developing countries might improve access to more affordable targeted cancer therapies.

Among the various approaches to address rising prescription drug costs, one option is to allow the federal government to negotiate prices directly with drug manufacturers. Debates over the appropriate negotiating approach have occurred on several dimensions,1 including the number of drugs eligible for negotiation, the levers that would be implemented to obtain lower prices, the incentives necessary to ensure that all parties negotiate in good faith, and what specific populations should have access to the negotiated price. In 2019, the US House of Representatives passed the most recent proposal to allow the federal government to negotiate prices-H.R.3, The Elijah E. Cummings Lower Drug Costs Now Act-reflecting policy decisions on many of these issues.2 (Am J Public Health. Published online ahead of print January 28, 2021: e1-e6. https://doi.org/10.2105/AJPH.2020.306109).

Dementia, which used to be a private issue due to the stigma and cultural expectations of family-based support in China, has been transformed into a social concern due to its increasing number in recent years. As a response, advocates have introduced the dementia-friendly initiative to deal with related challenges. Yet, as a project mainly proposed by developed countries, we know little about its localisation in developing countries. Based on 20-month ethnographic research in Shanghai, this article explores the localisation process of this global project. While many stakeholders who advocate on behalf of people with dementia and their family caregivers have made remarkable progress in terms of embracing the global concepts and practices, one project – community-based dementia care units – generates a lot of resistance from nearby residents due to the feng shui damage, a specific scheme in traditional Chinese culture. These findings reveal an important source of obstacle – the cultural context that shapes the public understanding of dementia and the ways of arranging dementia care – that may prevent the dementia-friendly initiative from further localisation in China. Through this ethnographic analysis, I call attention to the significance of cultural contexts in the design and implementation of dementia-friendly projects globally.