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PURPOSE: This study aimed to examine the associations between perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment (EM). METHODS: Data were from the Population Study of Chinese Elderly in Chicago. Perceived social support and informal/formal help-seeking intentions and behaviors were measured. Descriptive statistics, multiple linear regressions, and multinominal logistic regression analyses were performed. RESULTS: A total of 450 participants reported EM. Mean age of the sample was 72.73 ± 8.03 years old. Perceived social support was associated with an increase in intentions of seeking help from informal sources. Compared with not seeking help, older Chinese-American adults with any EM who perceived social support were more likely to seek help from informal and formal sources. CONCLUSION/IMPLICATION: The potential role of social support in increasing help-seeking was highlighted. Culturally tailored interventions that provide social support might promote help-seeking among U.S. Chinese elder immigrants who experienced EM.

We examined the associations of activities of daily living (ADL) and instrumental activities of daily living (IADL) with changes in sleep-related measurements among Chinese older adults from 2005 to 2014.Four waves of longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS; 2005-2014; n = 42,417) were used. Two sleep-related measurements were included: sleep quality and meeting the recommended daily sleep duration (7-8 h). We used Cox two-state regression models to examine the different states of sleep quality and duration.Approximately 43.6% of observations were between 81 and 95 years old, and 35.9% were between 65 and 80 years old. Around 54.8% of observations were female. Older adults with more ADL and IADL limitations had a higher risk of experiencing declines in sleep quality and the transition from meeting to not meeting the recommended sleep duration over time (all p 0.01).ADL and IADL limitations are significant risk factors for the development of sleep-related issues over time among Chinese older adults. Functional limitations need to be included in intervention strategies focused on sleep hygiene and studies examining changes in sleep patterns over time.

To evaluate the performance of velocity-selective (VS) ASL among patients with untreated gliomas by comparing with both pseudo-continuous (PC) ASL and dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).Forty-four consecutive patients with newly diagnosed glioma who underwent preoperative perfusion MRI including VSASL, PCASL, and DSC-PWI between 2017 and 2019 were retrospectively evaluated. Visual inspection was performed to evaluate the tumor signal intensity relative to gray matter based on 1-5 score criteria and weighted kappa was used to evaluate the pair-wise concordance between VSASL or PCASL and DSC-PWI. The relative tumor blood flow (rTBF) was measured from sampling intra-tumoral areas of hot-spot on the blood flow map and normalized against the contralateral normal gray matter blood flow. Linear regression and Bland-Altman analyses were performed to evaluate the correlation and agreement of rTBF measurements between ASL methods and DSC-PWI. The ROC analysis was constructed to determine the diagnostic performance of three perfusion methods for grading gliomas.TBF maps derived from VSASL were more comparable with DSC-PWI than PCASL on visual inspection (weighted kappa of 0.90 vs 0.68). In quantitative analysis, VSASL-rTBF yielded higher correlation with the values from DSC-PWI than PCASL-rTBF (RVSASL showed great promise for accurate quantification of TBF and could potentially improve the diagnostic performance of ASL in preoperative grading of gliomas.• VSASL demonstrated a greater agreement with DSC-PWI than with PCASL on visual inspection and perfusion quantification. • VSASL showed a higher diagnostic sensitivity, negative predictive value, and accuracy than PCASL for glioma grading. • With the advantages of insensitivity to transit delay and no need of prescribing a labeling plane, VSASL could potentially improve the diagnostic performance of ASL for a more accurate, noninvasive quantification of TBF in patients with glioma.

This study compared the associations of child–parent relationships with older adults’ multidimensional health in the United States and China. Two waves of data from the US Health and Retirement Study and its sister study in China (2012–2015) were used (2174 non-Hispanic [NH] White Americans and 4467 Chinese). Linear regression models were conducted for cross-sectional and longitudinal comparisons. Results showed most child–parent relationships had nonsignificant associations with NH White Americans’ health. In contrast, closer child–parent relationships were linked to fewer depressive symptoms and better cognitive function among Chinese. Co-residence was associated with poorer health among older Chinese. Over a 2-year period, living nearby was linked to poorer cognitive function among NH White Americans and fewer depressive symptoms among Chinese. Having weekly contact was predictive of better cognition among Chinese. This study revealed cross-cultural differences in the associations between child–parent relationships and older adults’ health. Family relationships in accordance with Chinese culture could improve health.

Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged ≥50) from the Health and Retirement Study in 2014-2015 were included ( N = 6286). Their reasons for discrimination (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) were examined. Latent class analysis examined the subgroup profiles. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived high discrimination. Intersectional discrimination was associated with poorer self-rated health and higher depressive symptoms compared to the no/minimal discrimination group. Multiple marginalized identities co-occur and contribute to discrimination. An intersectional approach is recommended to understand discrimination in later life.

Food insecurity and mental disorders are pressing public health issues during COVID-19. Empirical evidence on the extent to which food insecurity affects mental health outcomes of American adults as the pandemic unfolds remains limited. Longitudinal data from the Understanding Coronavirus in America survey collected biweekly between April and December 2020 were used (N=4,068). Respondents were asked about their food insecurity experiences and stress, anxiety, and depressive symptoms. Linear mixed-effect models were estimated. Food insecurity was associated with higher levels of stress, anxiety, and depressive symptoms. Stress, anxiety, and depressive symptoms declined among food-secure U.S adults. However, mental health trajectories of respondents with various food insecurity categories remained stable or worsened over time. The mental health gap between food-secure and food-insecure groups widened over time. Food insecurity has substantial mental health implications amidst the pandemic. Screening for and addressing food insecurity may alleviate the mental health burden borne by food-insecure people.

Objectives This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse’s memory. Methods Longitudinal data from the Health and Retirement Study (2004–2016) were used ( N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory. Results Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives’ depressive symptom trajectories was significantly associated with husbands’ memory ( p > .05), husbands’ decreasing trajectory was linked to wives’ better memory (β = 0.498, 95% CI = 0.106, 0.890). Discussion Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses’ memory.

Objective Dyadic perspective is scarce in existing advance directive (AD) literature. Particularly, the significance of one’s own and/or one’s partner’s cognitive function on AD remains unknown. This study investigates the relationship of cognitive function and other factors with AD completion within the spousal context. Method Data from the Health and Retirement Study (2014–2015) were used. Older heterosexual couples (age ≥65) married for 10+ years were asked if they had a living will and/or appointed a durable power of attorney for health care (DPAHC). Structural equation models examined the actor and partner effects of sociodemographic, health, and couple-level characteristics on wife’s and husband’s AD, respectively. Results Moderate spousal interdependence was observed in living will (kappa coefficient, κ = .60) and DPAHC (κ = .53). Older age and higher education were related to both spouses having AD. Less household wealth and being racial/ethnic minority were associated with a lower probability of having AD. Notable gender contrasts in actor and partner effects were found. Wife’s higher level of cognitive function was associated with husband’s AD completion. Contrarily, husband’s lower level of cognitive function was associated with wife’s AD completion. Retirement status had primarily actor effects for both husbands and wives. More chronic conditions were linked to husband’s AD completion. Discussion The spousal interdependence of AD warrants practitioner efforts to facilitate family-oriented end-of-life planning. Wives and husbands may have different thoughts regarding their spouse’s cognitive capacity to surrogate. Facilitating couple-based discussions may be a feasible approach to promote engagement with AD among older adults.

Objectives: This study investigated the predictors of risk perception and its effect on older adults’ preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Methods: Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 ( n = 4395). Structural equation models were used. Results: Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Discussion: Disseminating correct information to older adults could help them evaluate infection risk accurately. Educational programs on the precautions implemented at clinical settings to ensure patient safety may encourage older adults to seek timely medical care.

Using a nationally representative sample of U.S. older adults (50+), this study investigates gender-based depression trajectories following heart disease onset and associated risk of disability and mortality over an 8-year period.Six waves of longitudinal data from the Health and Retirement Study (2006-2016) were used (Three distinct depression trajectories were identified, including persistent minimal depression (men: 68.65%; women: 60.17%), moderate depression (women: 29.70%; men: 17.97%), and chronic depression (women: 10.12%) or emerging depression (men: 13.38%). Younger age and depression status at baseline were associated with women's chronic depression and men's emerging depression. Chronic/emerging and moderate depression were associated with higher disability risks than was minimal depression among both women and men (hazard ratios [HR] ranged from 2.12 to 3.92,Longitudinal course of depression following onset of heart disease is heterogeneous in later life. Unfavorable depression trajectories (i.e. moderate, chronic, and emerging) were associated with higher disability risk compared to the minimal depression trajectory. Study findings characterize risk stratification regarding depression after heart disease onset, which can inform the development of interventions to improve health outcomes among older adults with heart conditions.

Background and aims: The increasing prevalence of mental illness and low treatment rate presents a pressing public health issue in China. Pervasive stigma is a significant barrier to mental health recovery and community inclusion. In particular, stigmatizing or supportive attitudes held by healthcare providers could either perpetuate or mitigate self-stigma of people with mental illness. Moreover, mental health resources are unevenly distributed in China, with most of them concentrated in urban centers and provincial capitals. This study explores healthcare providers’ attitudes toward mental illness and the challenges they faced at work in a rural Chinese county. Method: Four focus groups were conducted with 36 healthcare providers from a three-tier mental healthcare system in a rural county in southwestern China. Focus group discussions were recorded and transcribed verbatim. The team employed a conventional content analysis approach for data analysis. All transcripts were double-coded by three bilingual team members who are native Chinese speakers. Coding discrepancies were resolved by consensus. Results: Healthcare providers recruited from the county, township, and village levels varied in educational background, professional qualification, and experience of working with people with mental illness. Five thematic categories identified across four groups include (1) barriers to mental healthcare delivery, (2) keys to mental health recovery, (3) providers’ attitudes toward providing care, (4) providers’ perception toward patients and family members, and (5) providers’ perception of training needs. Conclusions: This is a unique study that included healthcare providers from a three-tier healthcare system. Findings signal the importance of understanding healthcare practitioners’ experiences and views to inform the design of training initiatives in rural or low-resource communities.

Objectives This study aimed to (1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and (2) evaluate whether there exists a rural–urban difference in such relationships. Methods Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

This study applied the theory of planned behavior to examine predictors of U.S. older adults’ (65+ years) intention and behavior of moving to a nursing home. Two waves of Health and Retirement Study data were used ( N = 9,969). Moving intention was measured by respondents’ self-reported probability to move in the next 5 years in Wave 1. Moving behavior was measured by whether they actually moved in Wave 2. Structural equation modeling was used to examine the relationships of demographic and health predictors with moving intention and behavior. For both genders, advanced age, poorer health, having fewer children, and long-term care insurance were associated with higher levels of moving intention and behavior. Men’s intention was a significant predictor of subsequent moving behavior. However, women’s intention was not associated with moving behavior, probably due to inadequate resources to support their preference. The findings provide meaningful personhood-centered insights into nursing home entry decisions.

Face-saving represents a unique culturally salient construct among Chinese. However, our understanding regarding its relationship with psychological distress in this population remains limited. The objective of this cross-sectional study is to examine (1) the relationship between face-saving and depressive symptoms among U.S. Chinese older adults; and (2) whether face-saving mediates the relationship between acculturation and depressive symptoms. Data were from the Population Study of Chinese Elderly in Chicago (N = 3132), the largest epidemiologic study of Chinese older adults in Western countries. The relationship between face-saving and self-reported depressive symptoms was investigated by step-wise multivariable linear regression models. The Sobel test was used to test the mediating effect of face-saving. U.S. Chinese older adults with higher face-saving values experienced greater levels of depressive symptoms (B = 0.05, p < 0.001) than those with lower face-saving values, even after sociodemographic factors, health characteristics, and social support were accounted for. The mediation effect of face-saving was not statistically significant. The study findings underscore the significance of a unique cultural factor, specifically face-saving, in understanding U.S. Chinese older adults’ experience of depressive symptoms. Depression screening and treatment programs should pay attention to face-saving issues among U.S. Chinese older adults. Future studies need to incorporate cultural factors in mental health research in diverse populations.

Objectives: Studies on the interdependence of couples’ health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011–2018) were used ( N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013–2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples’ sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

Background Studies have suggested older spouse caregivers experience burden-related adverse health outcomes compared to non-caregivers. However, potential causal inferences remain unclear. This study examined the effect of caregiving on insomnia symptoms of spouse caregivers over time, compared to non-caregiver samples matched by propensity score (PS). Methods Longitudinal data from the Health and Retirement Study from 2006 to 2018 were used. Caregivers (Nf403) were respondents (aged 50+) who assisted their heterosexual spouses in performing (instrumental) activities of daily living at baseline. PS-matching was used to match non-caregivers based on sociodemographic, household, and health-related characteristics. Symptoms of insomnia were evaluated every four years for both groups. The link between caregiver status and number/severity of insomnia symptoms over time was assessed using a Poisson mixed-effects model. Results The propensity-matched sample achieved a satisfactory covariate balance. There was no statistically significant difference between caregivers and non-caregivers in the number of insomnia symptoms at baseline (β_caregiver=0.092, 95% CI = -0.017, 0.201). However, caregivers reported a slower increase in insomnia symptoms compared to non-caregivers (β_caregiver×time = -0.012, 95% CI = -0.021, -0.003). Results were cross-validated in modelling the severity of insomnia symptoms. Conclusion There is weak evidence that a spouse’s role as a caregiver may be beneficial for his/her sleep health over time. The negative effects of caring on older individuals’ sleep may vary depending on the caregiving context. The potential health benefits of informal spousal caring and their underlying mechanisms warrant further investigations.

Background This study investigates types of parent-child relationships and associated health outcomes among older adults of U.S. and China. Method: Cross-sectional data from Health and Retirement Study in the U.S. and Health and Retirement Longitudinal Study in China were used (N_(U.S.)=3918, N_China=4058). Relationship indicators included co-residence, living nearby, having weekly contacts, receiving assistance with daily activities, providing grandchild care, and having financial transfer from/to children. Latent class and regression analyses were conducted. Results Four classes were identified for older Americans, including (1) distant and uninvolved (6.58%); (2) geographically proximate with frequent contacts and downward support (47.04%); (3) co-resident with frequent contacts and upward support (13.1%); and (4) geographically proximate with frequent contacts (33.28%). By contrast, three classes were identified among older Chinese, including (1) co-resident with frequent contacts and upward support (37.46%); (2) coresident/interdependent (25.65%); (3) geographically proximate with frequent contacts and upward financial support (36.89%). For both countries, providing downward support was associated with fewer functional limitations and better cognitive function. Receiving instrumental support from children was associated with more depressive symptoms and functional limitations, and poorer cognitive function among Chinese older adults only. Conclusions Cultural contrasts were evident in parent-adult child relationship types and their associations with health outcomes. Overall, child-parent relationships in China tend to be more tight-knit than that of the U.S. Receiving financial support from children and co-residence are unique features of child-parent relationships in China. Cultural differences in child-parent relationships call for culturally-relevant strategies to address needs of older adults from various cultures.

Despite the well-documented health interdependence in the spousal context, empirical evidence on how psychological wellbeing of one’s partner might affect one’s cognitive function remains limited. Using dyadic data, the objective of this study is to examine trajectories of depressive symptoms and associated cognitive function outcomes among U.S. older married couples. Longitudinal Health and Retirement Study data (2004-2016) were used (N=6,289 heterosexual couples). Latent class growth analysis characterized depressive symptom trajectories for wives and husbands, separately. Structural equation models examined the actor and partner effects of depressive symptom trajectories on cognitive function in 2016 after adjusting for covariates. Four distinct depressive symptom trajectories were identified, including persistently low (wives: 73.61%; husbands: 79.59%), increasing (wives: 8.60%; husbands: 8.27%), decreasing (wives: 12.80%; husbands: 8.32%), and persistently high (wives: 4.99%; husbands: 3.81%). Compared to the low trajectory, increasing and high depressive symptom trajectories were associated with poorer cognitive function for wives and husbands (β_(wife,increasing,actor)=-0.92,95%CI=-1.30,-0.54; β_(wife,high,actor)=-0.71,95%CI=-1.19,-0.23; β_(husband,increasing,actor)=-0.81,95%CI=-1.16,-0.45; β_(husband,high,actor)=-1.20,95%CI=-1.78,-0.63). Notable gender discrepancies in partner effects were observed. Specifically, wife’s depressive symptom trajectories were not associated with husband’s cognitive function (P>0.05). However, husband’s decreasing depressive symptom trajectory was linked to wife’s better cognitive function. One’s own depressive symptom trajectories predicts his/her own cognitive function. Specifically, older adults with increasing and persistently high depressive symptoms over time may experience poorer cognitive function, and thereby warrant additional policy and clinical attention. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses’ cognitive function. Future studies need to validate such gender differences.

This study examined the gap between need and provision of community services in China and its association with older adults' life satisfaction over time. Longitudinal data from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014 were used (3 waves, N = 16,199). Respondents reported if they needed nine types of community service and if their community provided such service. Growth curve models analyzed whether individual- and/or province-level characteristics predicted the initial level and/or changes of life satisfaction over time. Results indicated the presence of major unmet service needs in China. Available community services were mismatched with older adults' perceived needs. Unmet service needs were associated with decreased life satisfaction at baseline. However, unmet service needs were not associated with changes in life satisfaction over time. Study findings highlighted the urgent need to optimize service design in accordance with older adults' needs, which ultimately could promote older adults' well-being.

The development of information technology has brought the driving force for the development of modern education, and has provided rich information resources and tools for modern education. The application of information technology has become one of the characteristics of modern education technology. Refrigeration Principles and Equipment is a practical professional course for energy and power engineering. The main content includes refrigeration methods, basic theories of refrigeration systems, system composition, thermal processes and cycles, thermal analysis and calculations, and properties of refrigerants. Refrigeration equipment, etc. In order to use modern education informatization to achieve the goal of cultivating applied-skilled talents, the author uses an online learning platform, implements a hybrid online and offline teaching mode, redesigns the teaching content, and at the same time integrates ideological and political education into all teaching links. Teachers make full use of network resources online, push diversified learning resources, conduct online discussions, tests, interactive Q&A, assessments, etc., to meet the needs of students’ personalized learning. Offline learning is mainly used for in-depth learning through activities such as teacher’s face-to-face instruction and Q&A. Through curriculum ideological and political education, students can establish the core values of socialism, cultivate their innovative thinking ability and practical ability, guide students to behave correctly and do things correctly, and make students become talents with both ability and political integrity and comprehensive development.

The retinoid-interferon-induced mortality-19 (GRIM-19) gene has been identified as a negative regulator associated with tumor development. The current study created a model of an orthotopically implanted hepatocarcinoma tumor to verify the inhibitory effect of GRIM-19 in vivo. After treatment with GRIM-19 carried by attenuated Salmonella, transplanted tumors were measured with an Imaging System. The expression of GRIM-19, Stat3/p-Stat3, cyclinD1, CDK4, PCNA, Bax/Bcl-2, cleaved caspase-9/3, VEGF, and MMP-2/9 was determined using immunohistochemistry and Western blot analysis. The cell cycle was assessed using flow cytometry (FCM). Apoptosis was determined using FCM and a TUNEL assay. Results indicated that GRIM-19 overexpression resulted in inhibition of peritoneal metastasis, induction of cell cycle arrest, and apoptosis in vivo. In addition, the expression of Stat3/p-Stat3 was down-regulated by GRIM-19. These results suggest that GRIM-19 overexpression could suppress the growth of orthotopically implanted hepatocarcinoma tumors by reversing the regulation of the Stat3 signaling pathway. This approach could potentially be a powerful treatment for hepatocarcinoma.

OBJECTIVES: This study aims to investigate the relationship between quantity, quality, and composition of social networks and depressive symptoms among U.S. Chinese older adults. METHODS: Data were derived from the Population Study of Chinese Elderly (PINE) (N = 3,157), a study of Chinese older adults aged 60 and above in Chicago. We assessed quantitative (network size and volume of contact), qualitative (emotional closeness), and composition (proportion kin, proportion female and proportion coresident) aspects of social networks. Depressive symptoms were measured by the Patient Health Questionnaire-9. Negative binomial and logistic regressions were conducted. RESULTS: Older adults who had three to five network members with strong ties, a medium level of contact, and a high level of emotional closeness were less likely to experience depression than their counterparts. Quantitative and qualitative dimensions of social networks have stronger protective effects than the composition dimension. CONCLUSIONS: U.S. Chinese older immigrants with different levels of social network characteristics have different risks of depression, suggesting targeted subpopulation assessments to facilitate the delivery of more appropriate and effective treatment to those most in need. CLINICAL IMPLICATIONS: Health-care professionals and social service agencies are suggested to develop intervention programs to promote mental health through increasing strong ties and improving the quality of social networks for U.S. Chinese older immigrants.

Family involvement is critical to end-of-life (EOL) care among older adults. This study aims to examine the association and pathways between family relationships and older Chinese Americans’ attitude toward family involvement in EOL care discussions. Data were collected from 260 Chinese Americans aged 55 years and above. Structural equation modeling was used to examine the total and indirect effects of family relationships on attitude toward family involvement in discussing EOL care plans. Family relationships had a significant positive total effect on attitude toward family involvement in EOL care. Indirect effects of family relationships on attitude toward family involvement in EOL care through self-efficacy, perceived benefits, and perceived barriers of discussing EOL care with family members were all significant. Findings provide empirical evidence of how family relationships affect older Chinese Americans’ attitude toward family involvement in EOL care and underline the need for family-centered EOL interventions for this population.

Objectives: This study aimed to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

The main active compound of Garcinia hanburyi (referred to as gamboge) is gambogic acid (GA), which has long been a Chinese herbal medicine for treating several types of cancer. However, the potential therapeutic role and mechanisms of GA in T‑cell acute lymphoblastic leukemia (T‑ALL) remain unclear. In the present study, the effects of GA on proliferation, cell cycle, apoptosis, and autophagy in T‑ALL cell lines were investigated. The possible mechanisms underlying GA activity were also examined. The results showed that GA inhibited proliferation, induced apoptosis, and activated autophagy in T‑ALL cell lines (Jurkat and Molt‑4 cells). Findings confirmed that GA has an antileukemia effect against peripheral blood lymphocyte cells in patients with ALL. GA inhibited phospho‑GSK3β S9 (p‑GSK3β S9) protein levels to inactivate Wnt signaling and suppress β‑catenin protein levels. In addition, the inhibitory effect of GA on T‑ALL was reversed by overexpression of β‑catenin. Thus, GA can inhibit the growth and survival of T‑ALL cells. GA also had antileukemic activity, at least in part, through the downregulation of the Wnt/β‑catenin signaling pathway.

Elder abuse is a pervasive public health issue. The relationship between personality traits and elder abuse remains unclear. This study aims to examine the associations between neuroticism, conscientiousness, and elder abuse. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged study of 3,157 US Chinese older adults in the greater Chicago area from 2011-2013. Elder abuse included psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. The assessments of neuroticism and conscientiousness were derived from the NEO Five-Factor Inventory. Logistic regression was used. Higher neuroticism (score range: 6-30, OR = 1.14, CI = 1.11-1.18) and lower conscientiousness (score range: 16-60, OR = 0.97, CI = 0.96-0.99) were associated with a higher risk of elder abuse. With respect to different forms of elder abuse, higher neuroticism was associated with an increased risk of psychological abuse (OR = 1.14, CI = 1.10-1.17), financial exploitation (OR = 1.03, CI = 1.00-1.07), and caregiver neglect (OR = 1.06, CI = 1.03-1.09). Higher conscientiousness was associated with a higher risk of financial exploitation (OR = 1.02, CI = 1.00-1.05). Intervention programs could reduce neuroticism and raise conscientiousness of elder abuse victims.

Objectives To examine the factors of advance directive (AD) completion among older Chinese Americans. Design Cross-sectional survey. Setting and Participants Data came from 435 Chinese Americans aged 55 years and older living in 2 metropolitan areas through self-administered questionnaires and research assistant–administered interviews in 2018. Participants' average age was 75 years (standard deviation = 9.4). Methods Logistic regression was used to examine factors associated with AD completion. Results Approximately 14% of participants completed an AD. Older age [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02-1.12], higher level of acculturation (OR 2.15, 95% CI 1.39-3.33), higher expectation for intergenerational support (OR 1.52, 95% CI 1.02-2.27), and having US citizenship (OR 3.02, 95% CI 1.26-7.23) were positively associated with AD completion. Physical and mental health needs were not significantly associated with AD completion. Conclusions and Implications This study is among the first focusing on AD completion among Chinese Americans, one of the fastest-growing older minority populations in the United States. Findings highlight the influence of socioeconomic and cultural factors on AD completion and illustrate the importance of developing culturally sensitive interventions to promote end-of-life care decision making among older Chinese Americans.

OBJECTIVES: To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits. METHODS: Data from a population-based study of 3,157 community-dwelling older (≥60 years) Chinese adults in the U.S. were used. Cognitive deficit was measured by the Mini-Mental State Examination (i.e., education-adjusted score: 16 [illiterate], 19 [primary school], and 23 [≥middle school]). Physical frailty was identified using the Short Performance Physical Battery (0–6 out of 15). The numbers of hospitalizations and ED visits in the previous two years were self-reported. RESULTS: In this sample, 12.63% had cognitive deficit alone, 5.95% had physical frailty alone, and 4.26% had both. Compared with participants having neither cognitive deficit nor physical frailty, those having physical frailty alone were 1.5 times as likely to have hospitalizations (Rate Ratio [RR]=1.52 [1.07, 2.16], p=0.02) and ED visits (RR=1.52 [1.07, 2.15], p=0.02). Having cognitive deficit alone was not significantly related to either outcome. However, having cognitive deficit with existing physical frailty increased the likelihood of both hospitalization (RR=2.00 [1.36, 2.96], p

Background Previous studies have found that suicide rates are likely to increase after the occurrence of earthquakes. Most existing studies that examined the relationship between PTSD and suicidality focus on risk factors. It remains unclear whether protective factors, such as post-traumatic growth (PTG) and social support, play a role in this relationship. Objectives The aim of this study was to investigate the role of PTG and social support in the association between PTSD and suicidality, using data from a cross-sectional study conducted in China. Methods 1,369 participants were recruited from two study sites that were severely affected by the Wenchuan earthquake. Univariate and multivariate regression analyses were conducted to examine the relationship between PTSD, PTG, social support, and suicidality. Results The results indicate that the prevalence of suicidal ideation, suicide plans, and suicide attempts among adult survivors were 9.06%, 2.97% and 3.31%, respectively, even after 8 years following the Wenchuan earthquake. Furthermore, the findings show that PTSD was significantly associated with suicidality (OR = 1.96; 95% CI = 1.53, 2.52). Additionally, individuals reporting lower levels of social support and the acquisition of PTSD (OR = 5.99; 95% CI = 1.66, 21.56) were significantly related to suicidality. Moreover, compared to individuals who reported no presence of PTSD and high PTG, those who lived with PTSD and lower levels of PTG (OR = 2.33; 95%CI = 1.00, 5.42) were more likely to report suicidality. Limitations The cross-sectional design of this study limits our ability to determine causal relationships. Effects of other related factors, such as cultural and life events, were not examined in this study. Conclusions Suicidality is a long-term health issue among survivors of the Wenchuan earthquake. PTG and social support play important roles on the association between PTSD and suicidality and are important contributing factors to understanding this relationship. These results contribute new knowledge of suicidal risk for a number of years after an earthquake and have implications for further mental health promotion following earthquakes.

BACKGROUND AND OBJECTIVES: Depressive symptomatology is a significant predictor of increased health services utilization and health care cost in the general older adult population. However, there is scant information on the relationship between depressive symptoms and health service utilization among U.S. Chinese older adults. The objective of this study was to examine the relationship between depressive symptoms and physician visits, emergency department (ED) visits, and hospitalization. RESEARCH DESIGN AND METHODS: Cross-sectional data were derived from the Population Study of Chinese Elderly in Chicago (PINE) collected between July 2011 and June 2013 (N = 3,159). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to examine the relationship between depressive symptoms and physician visits, ED visits, and hospitalization. RESULTS: U.S. Chinese older adults with depressive symptoms were more likely to have at least one ED visit (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.44–2.28) and hospitalization (OR = 1.9, 95% CI = 1.47–2.33) in the past 2 years than those without depressive symptoms, while adjusting for sociodemographic and health-related covariates. Other significant factors associated with health services utilization in this population included number of people in household, health insurance coverage, and acculturation. DISCUSSION AND IMPLICATIONS: Depressive symptoms are positively associated with hospitalization and ED visits among U.S. Chinese older adults. Routine screenings of depressive symptoms should be part of the clinical encounter in these care settings so that appropriate treatment or timely mental health service referrals could be provided to this population to ultimately optimize their utilization of health services.

End-of-life (EOL) care awareness and practice remain particularly low among older Chinese Americans. More empirical evidence regarding EOL is needed to develop culturally-relevant interventions to promote EOL engagement in this minority population. Using population-specific data, this study investigates preferences and associated sociodemographic and health determinants related to EOL among older Chinese Americans. Data were from the Population-based Study of Chinese Elderly in Chicago (collected 2017-2019, N=3,124). Linear and logistic regressions were conducted. Of the sample, 46.1% considered EOL care planning as important or somewhat import. Nearly 22% had EOL discussions with families. The most preferred EOL locations were home (43.7%), hospital (35.5%), nursing home (10.1%), and hospice (4.3%). Overall, 47.1% perceived EOL care as family decisions, 39.6% regarded EOL care as personal decisions, 7.5% preferred children to make EOL decisions, and 3.3% preferred a spouse to make EOL decisions. Chinese older adults who were female (B=0.10, p

Discrimination has been more prevalent since the pandemic. Black Lives Matter (BLM) movement flourished in the summer of 2020 as protests against police brutality and racial injustice. However, the extent to which individuals’ discrimination experiences and associated mental health outcomes change amid a global pandemic and a dramatic societal movement in American society remains unknown. This study examines the dynamic relationship of racism and/or Covid-19-related discrimination with changes in mental health in the context of BLM and Covid-19. Data were from U.S. adults (age ≥18) who completed the online Understanding Coronavirus in America survey in June and September of 2020 (n=3,502). Respondents were asked to attribute their discrimination experience to 8 main reasons: (1) Covid-19; (2) national origin/race/skin color; (3) gender/sexual orientation; (4) age; (5) physical feature; (6) education/income; (7) health condition; and (8) religion/other. Quasi-Poisson regression models examined the associations between discrimination and anxiety/depression/stress. Results indicated about 33% of respondents reported discrimination in June compared to 21% in September. Racism was significantly associated with more anxiety/depression/stress in June, but not in September or in the longitudinal trend. Covid-19-related discrimination was associated with elevated levels of anxiety/depression/stress in September and in the longitudinal trend, but not in June 2020. We concluded that individuals’ discrimination experiences are shaped by societal contexts. Specifically, racism was the dominant discrimination attribution in June 2020 when BLM was at its peak. However, Covid-19 discrimination overtook racism as the primary attribution and showed a significant relationship with poorer mental health over time.

Chinese culture places a high value on saving face and not bringing shame to the family. This study aimed to examine the associations between face-saving and help-seeking among U.S. Chinese older adults who experienced elder mistreatment (EM). Data were retrieved from the PINE study. Regression analyses were performed. Most EM victims sought help from informal sources only (48.21%), followed by no help (26.79%), informal plus formal help (19.64%), and formal help only (5.36%). For EM screening, face-saving was associated with informal help-seeking intentions (p < .05). For EM subtypes, face-saving was associated with overall help-seeking intentions for financial exploitation (p < .05), but not on physical mistreatment, psychological mistreatment, and caregiver neglect. Face-saving was not associated with help-seeking behaviors. Study findings underscore the significance of a unique cultural value in understanding EM help-seeking intentions among Chinese older adults. Cultural constructs should be considered in future EM research in diverse populations.

This paper aims to describe study design of the unique dyadic older Chinese American-adult children dataset, and present sample characteristics of the dyads. A total of 807 older parents were matched with their adult children (characteristics of matched versus not matched participants will be compared). On average, adult children were 48 years old, had 12 years of education, lived with 3 persons in household, had 2 children, and lived in U.S. for 17 years. Approximately 65% of the adult children sample were female, 82% married, 93% preferred to speak Chinese dialects, and over 97% foreign-born immigrants. On the other hand, older parents were 74 years old, had 7 years of education, lived with 3 persons in household, had 3 children, and lived in U.S. for 17 years on average. About 60% of the older parent sample were female, 73% married, over 99% foreign-born immigrants who preferred to speak Chinese dialects.

Using data from 544 older parents-adult children Chinese American dyads, this study aims to understand the association between older parents’ physical function and their adult children’s perceived caregiving burden. Parents’ physical function was assessed by the Katz Index of Activities of Daily Living (ADL) and the Lawton Instrumental ADL (IADL), with higher scores indicating more functional limitations. Adult children’s caregiving burden was assessed in five dimensions, including time dependence, developmental, physical, social, and emotion burden. Logistic regression was used to examine the association. More ADL limitations were associated with a higher likelihood of developmental burden (OR:1.14 (1.06-1.23)) and physical burden (OR:1.14 (1.06-1.23)) burden. More IADL limitations was associated with a higher likelihood of time dependence burden (OR:1.08 (1.03-1.12)), developmental burden (OR:1.06 (1.03-1.09)), and physical burden (OR:1.08 (1.04-1.12)). Parents’ physical function was not related to children’s social and emotional burdens. Practice and research implications will be discussed.

In order to improve the performance of the refrigeration system, researchers have introduced nano-refrigerant and nano-lubricating oil into the latest development of airconditioning system. However, explaining the role of nano-particles based on the physical phenomena affecting the vapor compression refrigeration system (VCRS) has been limited in experiments. Therefore, this paper reviews the mechanism of using nano-refrigerant and nano-lubricating oil to improve the performance of VCRS, discusses the compression work of the refrigeration system using nano-refrigerant and nano-lubricating oil and VCRS performance parameters such as COP and COF, and relates them to the overall performance of the system. The results show that the main factors affecting the performance of VCRS are heat transfer enhancement, refinement of the characteristics of cold oil mixture and improvement of tribological properties. The influence of nano-refrigerant and nano-lubricating oil on heat transfer, cold oil mixture and tribological properties of VCRS improves the overall performance of VCRS. Therefore, nano-refrigerant and nano-lubricant are expected to be the best choice to improve the efficiency of VCRS.

Advance Directive (AD) allows older adults to communicate preferred care at the end of life. Numerous studies reported that ethnic minorities were less likely to complete AD then non-Hispanic Whites. However, determinants of AD completion among older Chinese Americans remain unknown. The present study aims to address this knowledge gap. Data came from a survey of 439 Chinese Americans aged from 51 to 103 living in two metropolitan areas in 2018. Participants’ average year was 75 (SD=9.37). About 63% were women and 93% were born outside the US. Approximately 14% of participants completed an AD. Guided by the Andersen’s Service Use Model, we used logistic regression to examine determinants of AD completion. Results show that older age (OR = 1.06, p < 0.01), being employed (OR = 2.63, p < 0.05), acculturation (OR = 2.09, p < 0.001), having US citizenship (OR = 3.57, p < 0.01), and expectation of intergenerational support (OR = 1.84, p < 0.05), were positively associated with AD completion. Physical and mental health needs were not significantly associated with AD completion. This is among the first studies focusing on AD completion among Chinese Americans, one of the fastest growing older minority populations in the US. Findings highlight the influence of socioeconomic and cultural factors on AD completion and illustrates the importance of developing culturally sensitive interventions to promote end-of-life care decision-making among older Chinese Americans.

Preventive healthcare utilization is an important aspect of medical practice that facilitates the identification of chronic diseases at an early stage and increases options for treatment. Cognitive function plays an important role in individuals’ utilization of preventive care services. However, our understanding of the relationship between cognitive function and preventive care utilization is limited, particularly in older minority aging populations. The study aims to assess the association between cognitive function and preventive healthcare utilization among U.S. Chinese older adults. Data were obtained from the Population Study of Chinese Elderly in Chicago (PINE). Five instruments were used to measure global cognition, including the Mini-Mental State Examination, East Boston Memory Test Immediate Recall and Delayed Recall, Digit Span Backwards, and Symbol Digit Modalities Test. Preventive care services included immunization (i.e. flu, pneumonia, and hepatitis B vaccines) and cancer screenings (i.e. colorectal, breast, cervical, and prostate). Multivariable regression analyses were used. The findings showed that higher level of global cognition was associated with higher utilization of pneumonia vaccination (OR=1.32, 95% CI= 1.14-1.52), hepatitis B vaccination (OR=1.24, 95% CI= 1.05-1.47), colon exam (OR=1.23, 95% CI= 1.07-1.41), mammogram (OR=1.46, 95% CI= 1.22-1.73), breast exam (OR=1.23, 95% CI= 1.04-1.46), and cervical exam (OR=1.38, 95% CI= 1.15-1.65). Future longitudinal studies are needed to elucidate potential mechanisms underlying the relationship between cognitive function and preventive care utilization among U.S. Chinese older adults. Study findings underscore the need to understand preventive care utilization patterns among U.S. Chinese older adults with low cognitive function.

Depressive symptoms are prevalent in the aging population and can negatively impact the health and well-being of older adults. Personality traits may interact with depressive symptoms, but there is currently limited knowledge regarding this relationship in minority aging research. This study aims to explore the associations between two personality traits, neuroticism and conscientiousness, and depressive symptoms in 3,157 U.S. Chinese older adults. Data were obtained from the Population Study of Chinese Elderly in Chicago (PINE) collected between 2011 and 2013. Neuroticism and conscientiousness were measured by the NEO Five-factor Inventory. Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). 45.3% of the participants reported at least one depressive symptom. Controlling for potential confounders, logistic regression analyses showed that both traits were significantly associated with depressive symptoms. One unit increase in neuroticism was associated with 19% increased odds of having any depressive symptoms (odds ratio [OR]=1.19, 95% confidence interval [CI]=1.17-1.22). One unit increase in conscientiousness was associated with 5% decreased odds of having any depressive symptoms (OR=0.95, 95% [CI]=0.94-0.96). Results validate the significant association between both traits and depressive symptoms among U.S. Chinese older adults, adding to the psychological and cultural profiles of those who have experienced mental distress. More in-depth examination using culturally-tailored measurements for personality traits is encouraged in minority aging studies. The NEO inventory was developed from Western populations and hence might not adequately represent personality traits valued by non-Western cultures.

Today’s world is in a wave of energy transition. Relying on the advantages of low carbon and rapid cost reduction, renewable energy has gradually become the core of many countries to promote energy transition and an important way to deal with energy crisis and environmental pollution. Renewable energy power generation has also become the main source of new power generation. Combining energy development, this article analyzes the problems of China’s renewable energy power, puts forward suggestions on related issues, promotes energy transition, and contributes to the establishment of a green and low-carbon circular economic system.