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Previous research has identified that unmet needs are associated with adverse mental health outcomes in older adults. However, the unmet needs of older adults' spousal caregivers are unknown. The present study examined the association between unmet needs and depression among spousal caregivers, and whether marital satisfaction mediated this association. We included 1,856 participants who provided care to their spouses with difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL) from the 2018 China Health and Retirement Longitudinal Survey. Unmet needs of spousal caregivers were assessed as the total number of ADL/IADL tasks with which respondents had unmet needs. Path models were conducted to evaluate the associations between unmet needs, marital satisfaction, and depression. Subgroup analyses by sex were conducted to examine the sex differences regarding the associations. Spousal caregivers with more unmet ADL/IADL needs reported higher levels of depression (p < 0.001). Additionally, for wife caregivers, unmet ADL/IADL needs were associated with lower marital satisfaction, and lower marital satisfaction was associated with higher degrees of depression, indicating that marital satisfaction partially mediated the association between unmet needs and depression (p < 0.01). However, marital satisfaction did not mediate the association between unmet needs and depression among husband caregivers. The mediating effect of marital satisfaction on the association between unmet needs and depression only existed in wife caregivers. Social services should be provided to meet the needs of caregivers with ADL/IADL difficulties, and interventions should be implemented to promote the marital satisfaction of wife caregivers. [ABSTRACT FROM AUTHOR]

With sociodemographic changes, men are increasingly taking responsibility for spousal caregiving. Previous studies have described gender differences in the psychological outcomes of caregiving; however, few have focused exclusively on husband caregivers. This study investigates the influence of starting spousal caregiving on the psychological well-being of older husbands in rural areas and examines whether living arrangements can moderate this relationship. A total of 1,167 baseline non-caregiver husbands aged 60 and above in rural areas were taken from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS). The generalized estimating equation (GEE) was employed to examine the effects of spousal caregiving transitions and living arrangement changes on depressive symptoms over four years. Compared with rural husbands who remained non-caregivers, those transitioning into activities of daily living (ADL) caregiving reported higher depressive symptoms at follow-up (B = 1.67, p < 0.05). Moreover, the increase in depressive symptoms when transitioning into ADL caregiving was significantly lower among participants who changed from living with spouse alone to living with spouse and other family members together (B = − 5.37, p < 0.05). There was an association between transitioning into ADL caregiving and an elevated level of depression over four years among older husbands, which could be alleviated by living with family members. Co-residence with family members could serve as a natural support resource, buffering adverse mental health outcomes when older husbands start a demanding caregiving role. [ABSTRACT FROM AUTHOR]

In recent years, the prevalence of allergic diseases has increased significantly, causing great concern, and wheat, as one of the top 8 food allergens, is a common allergy trigger. Nevertheless, reliable estimates of the positivity rate of wheat allergens in the allergic population in China are still lacking. The systematic review and meta-analysis aims to evaluate the positive detection rate of wheat allergens in the Chinese allergic population and further provide a reference for the prevention of allergy. CNKI, CQVIP, WAN-FANG DATA, Sino Med, PubMed, Web of Science, Cochrane Library, and Embase databases were retrieved. Related research and case reports about the positive rate of wheat allergen in the Chinese allergic population published from inception to June 30, 2022, were searched, and meta-analysis was performed using Stata software. The pooled positive rate of wheat allergens and 95% confidence interval were calculated by random effect models, and the publication bias was evaluated using Egger's test. A total of 13 articles were included for the final meta-analysis, in which wheat allergen detection methods involved only serum sIgE testing and SPT assessment. The results showed that the wheat allergen positivity detection rate in Chinese allergic patients was 7.30% (95% CI 5.68–8.92%). Subgroup analysis showed that the positivity rate of wheat allergens was influenced by region, but hardly by age and assessment method. The positive rates of wheat allergy in the population with allergic diseases were 2.74% (95% CI 0.90–4.58%) and 11.47% (95% CI 7.08–15.87%) in southern and northern China, respectively. In particular, the positive rates of wheat allergens were greater than 10% in Shaanxi, Henan and Nei Mongol, all of which belong to the northern region. These results suggest that wheat allergens are an important cause of sensitization in allergic populations from northern China, and therefore attention should be paid to early prevention in high-risk populations. [ABSTRACT FROM AUTHOR]

Based on the precipitation records of 2474 meteorological stations, this study investigated precipitation characteristics and trends in China from 1961 to 2010, including spatiotemporal distribution and changes in average annual precipitation amount, number of days when daily precipitation > = 1, 5, 10, 25, 50 mm, and extreme precipitation indices. The results showed that: (1) in terms of annual average precipitation amount, both dry to wet, wet to wetter, and shifting between wet and dry showed decadal and climatical fluctuations in annual precipitation totals in space and time, with a clear shift in space from the 0 to 200 mm and above 400 mm precipitation levels to the 200 to 400 mm precipitation level. (2) In terms of graded precipitation days, three kinds of trend changes were observed: (a) enhancement, manifested as an increase in precipitation events, mainly in the northwest and northeast of China; (b) reduction, manifested as a decrease in precipitation events, mainly in the central parts of China; and (c) polarization, which is manifested as a decrease in gentle and light precipitation events but an increase in dry days, heavy, and rainstorm precipitation events, primarily along coastal area in southeast China. (3) In terms of extreme precipitation events, precipitation persistence showed a decreasing trend, but an increasing trend in precipitation intensity and magnitude in most regions of China. This paper also presents the relationship between certain atmospheric circulation indices and the seasonal precipitation of summer and winter. The distribution characteristics and changes in minor precipitation events were highlighted, including gentle and light rain events. Relevant findings can provide scientific guidance for water resource management and conservation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the joint effects of self and spousal frailty status on functional and mental health in Chinese older adults and determine whether such effects vary by urban versus rural residency. Background: Frailty is a clinical syndrome among old adults and would lead to adverse outcomes. However, studies on the interactive patterns of frailty status between spouses and the joint effects of such patterns on health outcomes are scarce. Design: Data were from the China Health and Retirement Longitudinal Study (CHARLS). A total of 2,581 married seniors who participated both 2011 and 2015 waves of the CHARLS were categorised into four groups: robust self–robust spouse (RR), robust self–frail spouse (RF), frail self–robust spouse (FR) and frail self–frail spouse (FF). Methods: Frailty was measured using the physical frailty phenotype scale. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CESD). Functional health was measured by difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). The generalised estimating equation was used to estimate the effects of concordant frailty on mental and functional outcomes, stratified by rural/urban residency. This study followed the STROBE checklist. Results: The FF group reported higher levels of ADL/IADL difficulties and depressive symptoms at follow‐up than the RR group; urban individuals in the RF group reported higher follow‐up depression than the RR group; and rural individuals from the FR or RF groups reported more follow‐up ADL/IADL difficulties than the RR group. Conclusion: Frailty and subsequent health decline are interdependent in older couples, and the rural/urban context is important for understanding this interdependence in the older Chinese population. Relevance to clinical practice: Couples‐based intervention strategies are needed to tackle situations in which one or both spouses are concurrently facing frailty. [ABSTRACT FROM AUTHOR]

Background: It is unknown whether and how poverty influences the long-term outcome of persons with severe mental illness (SMI). Aims: To explore the change of poverty status in persons with SMI from 1994 to 2015 and examine the impact of poverty status on patients' outcome in rural China. Method: Two mental health surveys using identical methods and International Classification of Disease (ICD-10) were conducted in 1994 and 2015 in the same six townships of Xinjin County, Chengdu, China. Results: The annual net income per person was 19.8% and 100.2% higher for the general population than for persons with SMI in 1994 and 2015 respectively. Compared with 1994 (48.2%), persons with SMI in 2015 had significantly higher rates of poor family economic status (

• Five multimorbidity clusters were identified among middle-aged and older adults in China: minimal disease, arthritis, cardiovascular disease, lung/asthma, and multisystem morbidity. • The multisystem morbidity group had the highest use in outpatient, inpatient and self-treament healthcare, and the highest cost in self-treatment. • The five groups did not show significant differences in outpatient costs. While the lung/asthma and arthritis groups reported lower inpatient costs than other groups. This study investigated multimorbidity patterns among middle-aged and older Chinese people and whether healthcare costs varied among different multimorbidity patterns. Data were from the 2011–2018 waves of the China Health and Retirement Longitudinal Study (CHARLS). We included 20,855 unique observations with information coming from their last wave of interviews and aged at least 45 years or older. Latent class analysis (LCA) was performed to classify individuals with common multimorbidity clusters based on 14 self-reported chronic diseases. Healthcare costs were from participants' self-reports and categorized into outpatient, inpatient, and self-treatment. Two-part regression was performed to analyze the association of multimorbidity patterns with healthcare costs. Five multimorbidity clusters were identified: minimal disease, arthritis, cardiovascular disease (CVD), lung/asthma, and multisystem morbidity. The multisystem morbidity group had the highest use in all three types of healthcare and the highest self-treatment cost. Compared with the minimal disease group, the other four groups did not show significant differences in outpatient costs. Relative to the minimal disease group, the lung/asthma group reported lower inpatient costs. Healthcare use and costs varied across multimorbidity patterns among middle-aged and older Chinese people. Implementing an integrated care plan for multimorbidity is suggested to improve the cost-effectiveness of healthcare provision and reduce the financial burden of the healthcare system. Reimbursement policy design should also take multimorbidity patterns into account. [ABSTRACT FROM AUTHOR]

Few studies have linked social factors to air pollution exposure in China. Unlike the race or minority concepts in western countries, the Hukou system (residential registration system) is a fundamental reason for the existence of social deprivation in China. To assess the differences in ozone (O 3 ) exposure among social groups, especially groups divided by Hukou status, we assigned estimates of O 3 exposure to the latest census data of the Beijing urban area using a kriging interpolation model. We developed simultaneous autoregressive (SAR) models that account for spatial autocorrelation to identify the associations between O 3 exposure and social factors. Principal component regression was used to control the multicollinearity bias as well as explore the spatial structure of the social data. The census tracts (CTs) with higher proportions of persons living alone and migrants with non-local Hukou were characterized by greater exposure to ambient O 3 . The areas with greater proportions of seniors had lower O 3 exposure. The spatial distribution patterns were similar among variables including migrants, agricultural population and household separation (population status with separation between Hukou and actual residences), which fit the demographic characteristics of the majority of migrants. Migrants bore a double burden of social deprivation and O 3 pollution exposure due to city development planning and the Hukou system. [ABSTRACT FROM AUTHOR]

• LB children were more vulnerable to psychological problems and more attention should be paid to how psychological trait resilience interplays with protective support for LB children and affects their psychological status. • LB children with higher level of trait resilience would perceive themselves as more confident and valuable, therefore, their self-esteem would be higher. • LB children with higher level of protective support would feel warmth and goodwill from the surroundings, and pay more attention to positive aspects of life and had lower depression. The left-behind children phenomenon appeared in the process of development of industrialization and urbanization in China has become a social problem that needs close attention. Meanwhile, the importance of resilience on the psychological health of left-behind children has been highlighted in academic field. This study examined the mediating effect of psychological trait resilience on the relationship between protective factors from social network and self-esteem/depression of the left-behind children in China. A total of 345 left-behind children at middle schools completed the questionnaire of Healthy Kids Resilience Assessment (HKRA), Self-Esteem Scale (SES) and Children's Depression Inventory (CDI). Path analysis showed that psychological trait resilience played a fully mediating role on the relationship between protective factors and self-esteem, as well on the association between the relationship between protective factors and depression. Building protective social network may be helpful to improve trait resilience of left-behind children, which further increase self-esteem and mitigate depression of them. The implications of these findings on social work practice were discussed. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effects of baseline and changes in frailty states on subsequent depressive symptoms, and whether sleep duration would modify these effects. Design Prospective, cohort study. Setting: The 2011 baseline and 2013 follow‐up waves of the China Health and Retirement Longitudinal Study (CHARLS). Participants: Community‐dwelling old adults who were aged 60 or above at baseline and participated in the 2011 and 2013 waves of the CHARLS (N = 5,026). Measurements: Frailty was measured using the physical frailty phenotype (PFP) scale. Levels of depressive symptoms were measured by the 10‐item Center for Epidemiologic Studies Depression Scale (CES‐D). Using the generalized estimating equations (GEE), the effects of baseline and transitions in frailty states were examined on subsequent depressive symptoms, adjusting for a range of confounding variables. Results: Baseline prefrail (b = 0.97, P <.05) and frail states (b = 0.35, P <.05) were associated with higher subsequent level of depressive symptoms 2 years later. Within individuals who were robust at baseline, transitioning into prefrail/frail (b = 3.04, P <.001) was associated with a higher subsequent level of depressive symptoms, and this association was accelerated by short sleep duration. Within individuals who were prefrail at baseline, transitioning into frail (b = 1.76, P <.001) was associated with higher subsequent levels of depressive symptoms, and this association was stronger among those who reported short sleep duration. Conclusion: Baseline and transitions in frailty states were significantly related with higher subsequent levels of subsequent depressive symptoms. Short sleep duration significantly moderated the effects of baseline or transitions of frailty on subsequent depressive symptoms. Targeted interventions could be implemented to improve sleep quality for prefrail and frail older adults. [ABSTRACT FROM AUTHOR]

The article presents a study which analyzed the precipitation in the three Gorges from 1958 to 2007 in China. The study performed the examination of the monthly and annual precipitation trend concerning the precipitation, drought, and the number of rainy days (NRDs) in the three gorges to determine the precipitation data. The result of the study shows that the frequent drought and precipitation in the three gorges occurred during 1980s which is said to be influenced by the multiple systems.