Wavelength-polarization-multiplexed multichannel perfect vortex array generator based on dielectric metasurface.

The multi-channel perfect vortex (PV) array based on metasurface has important applications in optical communication, particle manipulation, quantum optics, and other fields due to its ultra-thin structure and excellent wavefront control ability. However, it is very challenging to utilize a single metasurface to simultaneously achieve independent channel PV arrays at different wavelengths with low crosstalk and low structural complexity. Here, we propose and design a single rectangular structured metasurface based on TiO2, achieving a multi-channel PV beam array with dual-wavelength and dual-polarization multiplexing. Simulation and experimental results show that when two orthogonal linearly polarized beams with wavelengths of 532 nm and 633 nm are incident on the metasurface, clear PV arrays with corresponding topological charge arrangements can be obtained in different diffraction regions of the same observation plane. The metasurface proposed in this article can enhance the channel capacity of a PV beam array through wavelength-polarization-multiplexing, thus having important application potential in spatial information transmission, high-dimensional information storage, and secure information encryption.

Associations between self-leadership and self-reported execution of infection prevention and control among physicians and nurses.

BACKGROUND: There is poor self-reported (SR) execution of infection prevention and control (IPC) among physicians and nurses. Self-leadership is considered an important factor to enhance IPC SR-execution. This study aims to explore the associations between self-leadership and IPC SR-execution among physicians and nurses. METHODS: A cross-sectional study of 26,252 physicians and nurses was conducted in all secondary and tertiary hospitals in Hubei province, China. A questionnaire was designed to measure physicians' and nurses' self-leadership, which includes positive traits and negative traits, and IPC SR-execution, which includes motivation, process, and outcome. RESULTS: Positive traits and negative traits of self-leadership had significant positive associations with SR-execution motivation (ß = .582, P < .001) (ß = .026, P < .001), SR-execution process (ß = .642, P < .001) (ß = .017, P < .001), and SR-execution outcome (ß = .675, P < .001) (ß = .013, P < .001). CONCLUSIONS: This study recommends that health care institutions should focus on cultivating positive traits of self-leadership among physicians and nurses. Although negative traits of self-leadership can also promote IPC SR-execution, the association is limited and may lead to risks.

A study of the effect of number of children on depression among rural older women: empirical evidence from China.

The association between early reproductive events and health status in later life has always been of interest across disciplines. The purpose of this study was to investigate whether there was an association between the number of children born in the early years of elderly women and their depression in later life based on a sample of older women aged 65 years and above with at least one child in rural China. Data from the Chinese Longitudinal Healthy Longevity Survey in 2018, this study used the ordinary least square method to conduct empirical research. This study has found a significant correlation between an increase in the number of children and depression in older rural women. When considering the sex of the child, the number of daughters had a greater and more significant impact on depression. Number of children may exacerbate depression of older women through declining self-rated health and reduced social activity, while increased inter-generational support alleviated depression. The association between number of children born and depression also existed in urban older women, though not significant. Therefore, it is suggested to accelerate the improvement of supporting policies related to childbirth, developing a healthy and scientific fertility culture, and improving rural maternal and child health services. Women should be assisted in balancing their roles in the family and in society, and in particular in sharing the burden of caring for children. Targeted efforts to increase old-age protection for older people.

Effects of the Implementation of Transport-Driven Poverty Alleviation Policy on Health Care-Seeking Behavior and Medical Expenditure Among Older People in Rural Areas: Quasi-Experimental Study.

BACKGROUND: Improving the rural residents' accessibility to and affordability of health care is recognized as a common target globally. The Health in All Policies approach, from the Declaration of Helsinki to the United Nations' Decade Of Healthy Ageing, strengthened the far-reaching effect of large-scale public policies on health care-seeking behavior; however, the effects of national transport policy on health care-seeking behavior is unclear. OBJECTIVE: This quasi-experimental study aimed to examine the effects of the implementation of transport-driven poverty alleviation (TPA) policy on health care-seeking behavior and medical expenditure among older adults in rural areas and the mechanism underlying these effects. METHODS: We designed a quasi-experiment to estimate the effects of TPA policy implementation on health care-seeking behavior and medical expenditure among older adults in rural areas through a difference-in-differences (DID) analysis based on data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, and 2018. The underlying mechanism was analyzed and effect modification patterns were further investigated by poor households, health status, and age. RESULTS: Our findings validated a positive contribution of TPA policy on health care-seeking behavior among older adults in rural areas. After the implementation of TPA policy, the number of inpatient visits increased by annually 0.35 times per person, outpatient medical expenditure increased by 192% per month, and inpatient medical expenditure increased by 57% annually compared with those of older adults in rural areas without the implementation of TPA policy. Further, there was a significant modification effect, with a positive effect among poor households, healthier older adults, and those aged 60-80 years. Additionally, the policy improved the patients' capabilities to seek long-distance care (ß=23.16, 95% CI -0.99 to 45.31) and high-level hospitals (ß=.08, 95% CI -0.02 to 0.13), and increased individual income to acquire more medical services (ß=4.57, 95% CI -4.46 to 4.68). CONCLUSIONS: These findings validate the positive contribution of TPA policy on health care-seeking behavior among older adults in rural areas; however, the medical expenditure incurred was also high. Concerted efforts are needed to address health care-seeking dilemmas in rural areas, and attention must be paid to curbing medical expenditure growth for older adults in rural areas during TPA policy implementation.

The impacts of knowledge and attitude on behavior of antibiotic use for the common cold among the public and identifying the critical behavioral stage: based on an expanding KAP model.

BACKGROUND: This study aims to explore the impacts of knowledge and attitude on the behavior of antibiotic use during the treatment of the common cold based on the expanding KAP model, and then identify the critical behavioral stage. METHODS: A cross-sectional study was conducted on 815 public from 21 community health centers (CHCs) in Chongqing, China. Based on the expanding KAP model, a self-administered questionnaire was designed to measure knowledge, attitude, multi-stage behavior, and perceived threat, in which multi-stage behavior was divided into pre-use antibiotic behavior, during-use antibiotic behavior, and post-use antibiotic behavior. A structural equation model was used to examine the model fit and the direct, indirect, mediating effects, and moderating effect of the variables. RESULTS: The expanding KAP showed good model fit indices with χ²/df = 0.537, RMSEA = 0.033, CFI = 0.973, GFI = 0.971, NFI = 0.934, TLI = 0.979. Knowledge had a positive effect on attitude (ß = 0.503, p < 0.05), pre-use antibiotic behavior (ß = 0.348, p < 0.05), during-use antibiotic behavior (ß = 0.461, p < 0.001), and post-use antibiotic behavior (ß = 0.547, p < 0.001). Attitude had a positive effect on during-use antibiotic behavior (ß = 0.296, p < 0.001), and post-use antibiotic behavior (ß = 0.747, p < 0.001). The mediating effect of attitude was positive among knowledge, during-use antibiotic behavior (ß = 0.149, p < 0.05), and post-use antibiotic behavior (ß = 0.376, p < 0.001). Perceived threat also had a positive moderating effect between knowledge and post-use antibiotic behavior (ß = 0.021, p < 0.001). CONCLUSIONS: Knowledge, attitude and perceived threat had different effects on different stages of antibiotic behavior. The critical behavioral stage prioritized the post-use antibiotic behavior and during-use antibiotic behavior over pre-use antibiotic behavior.

Depression as a Mediator and Social Participation as a Moderator in the Bidirectional Relationship Between Sleep Disorders and Pain: Dynamic Cohort Study.

BACKGROUND: Chronic pain, sleep disorders, and depression are major global health concerns. Recent studies have revealed a strong link between sleep disorders and pain, and each of them is bidirectionally correlated with depressive symptoms, suggesting a complex relationship between these conditions. Social participation has been identified as a potential moderator in this complex relationship, with implications for treatment. However, the complex interplay among sleep disorders, pain, depressive symptoms, and social participation in middle- and old-aged Asians remains unclear. OBJECTIVE: This study aimed to examine the bidirectional relationship between sleep disorders and pain in middle- and old-aged Chinese and measure the role of depression as a mediator and social participation as a moderator in this bidirectional relationship through a dynamic cohort study. METHODS: We used data from the China Health and Retirement Longitudinal Study across 5 years and included a total of 7998 middle- and old-aged people (≥45 years old) with complete data in 2011 (T1), 2015 (T2), and 2018 (T3). The cross-lag model was used to assess the interplay among sleep disorders, pain, depressive symptoms, and social participation. Depressive symptoms were assessed by the 10-item Centre for Epidemiological Studies Depression scale. Sleep disorders were assessed by a single-item sleep quality scale and nighttime sleep duration. The pain score was the sum of all pain locations reported. Social participation was measured using self-reported activity. RESULTS: Our results showed significant cross-lagged effects of previous sleep disorders on subsequent pain at T2 (ß=.141; P<.001) and T3 (ß=.117; P<.001) and previous pain on subsequent poor sleep at T2 (ß=.080; P<.001) and T3 (ß=.093; P<.001). The indirect effects of previous sleep disorders on pain through depressive symptoms (ß=.020; SE 0.004; P<.001; effect size 21.98%), as well as previous pain on sleep disorders through depressive symptoms (ß=.012; SE 0.002; P<.001; effect size 20.69%), were significant across the 3 time intervals. Among participants with high levels of social participation, there were no statistically significant effects of previous sleep disorders on subsequent pain at T2 (ß=.048; P=.15) and T3 (ß=.085; P=.02), nor were there statistically significant effects of previous pain on subsequent sleep disorders at T2 (ß=.037; P=.15) and T3 (ß=.039; P=.24). Additionally, the mediating effects of depressive symptoms on the sleep disorders-to-pain pathway (P=.14) and the pain-to-sleep disorders pathway (P=.02) were no longer statistically significant. CONCLUSIONS: There is a bidirectional relationship between sleep disorders and pain in middle- and old-aged Asians; depression plays a longitudinal mediating role in the bidirectional relationship between them; and social participation moderates the bidirectional relationship between them directly and indirectly by affecting depression. Future interventions may consider the complex relationship between these conditions and adopt a comprehensive treatment regime.

The effect of widowhood on depression of caregivers.

BACKGROUND: It is known that caregivers are more likely to be depressed compared to those without caregiving burden. The disappearance of caregiving burden after widowhood may alleviate depression, but at the same time the diminishment of marital resources caused by widowhood may exacerbate depression. So, what effect does widowhood have on depression among caregivers?, which was valuable for promoting the mental health of caregivers in the context of China's aging. METHODS: China Health and Retirement Longitudinal Study (CHARLS), a longitudinal data, was selected and the effect of widowhood on depression among middle-aged and elderly caregivers was explored by using Ordinary Least Squares and Propensity Score Matching methods based on 2018 CHARLS data. The channels and subgroup difference were also analyzed. RESULTS: Widowhood significantly increased CES-D scores of caregivers, and there were higher CES-D scores among women, the middle-aged, rural residents, and those with higher levels of education. Widowhood increased depression of caregivers through reducing personal economic resources, and increasing possibilities to live with children and participate in social activities. CONCLUSIONS: Caregivers who experienced widowhood tend to be depressed and concerted efforts are needed. On the one hand, more social security measures and economic subsidy policy should focus on the middle-aged adults and elderly who experienced widowhood. On the other one hand, it is helpful to relieve depression by providing more social support from society and families to the middle-aged adults and elderly who experienced widowhood.

Effect of widowhood on the risk of disability among the elderly in China.

Background: The deteriorating health status of widowed elderly individuals becomes an important restriction factor affecting healthy aging in China. This paper aimed to find effective ways to reduce the risk of disability among the widowed elderly. Methods: An empirical analysis was conducted by using four surveys from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018. A fixed-effects model was performed to estimate the effect of widowhood on the disability risk of the elderly in China and its disparities in different groups, and influencing channels and moderating effects were further investigated. Results: Widowhood significantly increased the risk of disability, and the results were robust. The risk of disability was higher among those who were male, living in urban areas, educated, and 60-to-70-years-old. Possible channels in the association were psychological stress and unhealthy behavior. Meanwhile, more financial support, contact from children, and social activities decreased the risk of disability. Conclusion: The health risks of older adults after widowhood can be reduced by concerted efforts from society and government, including promoting the traditional Chinese virtue of filial piety and providing health interventions and social support services.

Effect of retirement on medical reimbursement expenses-evidence from China.

BACKGROUND: Medical reimbursement in China is not for all diseases, and medical reimbursement expenses are not completely consistent with medical service demand, though the scope and proportion of medical reimbursement are gradually expanding. This study aimed to examine the effect of retirement on medical reimbursement expenses in urban China. METHODS: The effect of retirement on medical reimbursement expenses were estimated by using fuzzy regression discontinuity based on data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018. Its group heterogeneity by educational backgrounds and marital status, and underlying mechanisms were also explored. RESULTS: Retirement increased medical reimbursement expenses of outpatient significantly (P < 0.05).Low time cost and deteriorating health status after retirement were possible mechanisms in this association. Retirement increased the reimbursement expenses significantly among the older adults with more educational obtainment or being widowed/divorced. CONCLUSION: The above findings indicated that there was a positive association between retirement and medical reimbursement expenses. The scope and proportion of medical reimbursement should be incorporated into retirement policy for improving medical service accessibility and rational healthcare utilization of retired population.

Reproductive behaviour and longevity: Evidence from Chinese centenarians.

With the implementation of the three-child policy in China, the debate between fertility and health and longevity has again become a hot topic in the era of increasing ageing. This study aimed to explore the association between reproductive behaviour and longevity of older women and men in China. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018, a total of 1428 deceased older people were enrolled in the study, including 421 centenarians and 1007 non-centenarians. The analysis of the association between fertility and longevity was conducted in the multivariate logistic regression. Compared to women aged 99 years and below, centenarian women had significantly fewer children (p < 0.01), fewer sons (p < 0.01) and fewer daughters. Centenarian men had more children, more daughters and fewer sons. For both men and women, centenarians were significantly characterized by later age at first birth (p < 0.01) and later age at last birth (p < 0.01). Centenarians were significantly characterized by having children and having a daughter, however, non-centenarians were significantly characterized by having a son (p < 0.01). The association between fertility and health of both men and women should be taken into account in the development of fertility policies and supporting policies. Fertility levels should be increased without compromising the health benefits of individuals in their later years.

The impacts of self-expectation leadership and organizational commitment on hand hygiene behavior of medical staff based on the theory of implicit leadership.

Hand hygiene behavior (HHB) in healthcare settings remains suboptimal globally. Self-expectation leadership and organizational commitment are emphasized as important factors influencing HHB. However, there are no studies to support any relationship between self-expectation leadership and organizational commitment to HHB. This study will fill the gap by applying implicit leadership theory (ILT) to support the further promote HHB among medical staff. A cross-sectional study of 23,426 medical staff was conducted in all second-level and third-level hospitals in Hubei province, China. Based on ILT, an online self-administered and anonymous questionnaire was designed for measuring the medical staff's self-expectation leadership, organizational commitment, and HHB based on Offermann's 8 dimensions scale, Chang's 3 dimensions scale, and the specification of hand hygiene for healthcare workers, respectively, in which self-expectation leadership was divided into positive traits and negative traits parts. The structural equation model was used to examine the direct, indirect, and mediating effects of the variables. Positive traits of self-expectation leadership had a positive effect on organizational commitment (ß = 0.617, p < 0.001) and HHB (ß = 0.180, p < 0.001). Negative traits of self-expectation leadership had a negative effect on organizational commitment (ß = -0.032, p < 0.001), while a positive effect on HHB (ß = 0.048, p < 0.001). The organizational commitment had a positive effect on HHB (ß = 0.419, p < 0.001). The mediating effect of the organizational commitment showed positively between positive traits of self-expectation leadership and HHB (ß = 0.259, p < 0.001), while negatively between negative traits of self-expectation leadership and HHB (ß = -0.013, p < 0.001). Positive traits of self-expectation leadership are important predictors of promoting organizational commitment and HHB, while negative traits of self-expectation leadership have a limited impact on organizational commitment and HHB in the field of healthcare-associated infection prevention and control. These findings suggest the need to focus on positive traits of self-expectation leadership; although negative traits of self-expectation leadership can also promote HHB to a lesser degree among medical staff, it will reduce their organizational commitment.

The Sample Error Pre-Antimicrobial Susceptibility Testing and Its Influencing Factors from the Perspective of Hospital Management: A Cross-Sectional Study.

The overuse of antibiotics remains serious and has led to a dramatic increase in antimicrobial resistance, which poses a significant threat to global public health, although much action has been taken by World Health Organization and countries. As the direct evidence to guide the prescribing of antibiotics, the Antimicrobial Susceptibility Testing (AST) results were biased by sample errors, which was urgent and poorly explored in quality management. This study aimed to analyze sample errors pre-AST and its influencing factors from the perspective of hospital management, to provide evidence for promoting rational antibiotic use and antimicrobial stewardship. A cross-sectional survey of 5963 clinical nurses involved in pathogenic sample collection was conducted in 118 public hospitals in Hubei province, China. Dependent variables were sample errors attributed to resources and technology-oriented, capability-oriented, and attitude-oriented errors, which were measured by times per week. Independent variables were sample management information such as guidelines, record after collection, performance appraisal, training, and publicity activities, in which guidelines, record time, and record method were dummy variables, with 1 indicating having and 0 not. Others were continuous variables ranging from 0 to 4 times per month. Ordinary Least Square regression models were performed to analyze influencing factors on sample error times. The averages of sample errors on resource and technology-oriented, capability-oriented, and attitude-oriented were 1.48, 1.35, and 1.36 times per week, and their proportion were 25.3%, 38.9%, and 35.8%, respectively. The results showed that recording timeliness (r = −0.354, p < 0.01), record using both paper and digital methods(r = −0.060, p < 0.01), performance appraisal(r = −0.188, p < 0.01), and publicity activities (r = −0.186, p < 0.01) significantly reduced times of resource and technology-oriented errors. Performance appraisals(r = −0.171, p < 0.01) and training activities (r = −0.208, p < 0.01) had a positive impact on the reduction of capability-oriented error times. The times of attitude-oriented error decreased significantly when recording timeliness (r = −0.299, p < 0.01), implementing performance appraisal (r = −0.164, p < 0.01), and training activities (r = −0.188, p < 0.01). This study found that there was a high frequency of sample errors in quality management, especially capability-oriented and attitude-oriented errors. Sample information management, performance appraisal, training, and publicity activities were associated with the quality of samples valuable for the rational use of antibiotics.

Fertility experiences and later-life cognitive function among older adults in China.

OBJECTIVES: The relationship between fertility history and human health has long fascinated scholars; however, whether there is a link between number of children and cognitive function in older adults remains unclear. We investigated the associations between parity and the timing of first and last births with the cognitive function of older adults over 65. METHODS: The mini-mental state examination (MMSE) was selected as a tool to measure cognitive function. We analyzed data on 5847 older adults in rural and urban communities in China from the 2018 Chinese Longitudinal Healthy Longevity Survey using ordinary least squares. To further explore the transmission mechanism, we also conducted a mediating effect analysis. RESULTS: We found a negative association between number of children and cognitive function in older adults. Compared with older adults with four children, the MMSE scores of older adults with more than five children decreased significantly, and the score of older adults with zero to three children increased. Further, a late age at first birth (≥35) and a late age at last birth (≥35) were negatively associated with cognitive function. We also found that the associations between parity and cognition might be partly explained by variations in health. CONCLUSION: Our analyses provided evidence from China to support the link between fertility history and cognitive function that has been observed in previous international studies: We suggest that high parity (≥5) is negatively associated with cognitive function.

A study on the impact of Internet use on depression among Chinese older people under the perspective of social participation.

PURPOSE: This study aimed to evaluate the role of social participation in the relationship between internet use and depressive symptoms among Chinese older adults and investigate how the internet use interact with social participation to reduce the risk of depressive symptoms. METHODS: Based on the survey from the China Health and Retirement Longitudinal Study (CHARLS) in 2018, we identified 4645 subjects and used the Ordinary Least Square method (OLS) and Propensity Score Matching method (PSM) to identify the association between Internet use and depression of older people, and further test how social participation played a role in the relationship. RESULTS: The level of depression of older people was significantly reduced in those who using internet in China, and the effect was still robust under different identification methods. The mental health was improved when using internet because of the increase of social participation and social capital. Further, The positive effect was stronger especially in those who were female, living in rural areas, has low education attainments and were 70-79 years old. CONCLUSIONS: The popularity of internet use has a positive effect on the depressive symptoms of Chinese older adults. Effective measures were encouraged to improve the friendliness of internet for older people and promote the popularization of the Internet and older group, achieving the spiritual well-being of them in the Internet society.

Fertility Histories and Heart Disease in Later Life in China.

Purpose: Based on life course theories, health among older people is driven by a continuous and cumulative process that develops over the life course. To better understand the aging process, it is important to assess associations between parity and heart disease in older people of China. Method: The associations between heart disease prevalence and number of births, number of boys or girls ever born were evaluated among 5,990 samples (mean age 64.1 years) using the Probit regression model based on the data from China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013 and 2018. The model was adjusted only for rural or urban residents, and multivariate regression models were run separately by gender. Results: Our results showed that more than three children or more than two boys ever born were associated with a higher risk of heart disease. However, the number of girls ever born had no significant effect on heart disease in the elderly. We further analyzed the group difference between urban and rural residents using the regression model. More than three children or more than two boys ever born were associated with a high risk of heart disease in rural areas. Compared to urban residents, rural residents were more likely to be suffering from heart disease due to high parity. When considering the digender difference the paper found that more than three children ever born were associated with a high risk of heart disease in the female group. Late age at the time of giving birth for the first time was associated with a poorer risk level of heart disease in the rural residents, because the phenomenon of early childbearing was serious in the rural residents. But after considering the impact on the physical health of using chronic diseases, the first birth and the last birth both increased the risk of heart disease. Conclusions: Some policy implications were being put forward. Firstly, parents who were ready to give birth should be aware of the possible health loss of high parity. Postpartum nutrition supplements and chronic disease prevention were suggested to prevent heart disease in later life. Secondly, the elderly in rural areas should pay more attention to heart diseases. Participating in more daily exercise and physical examinations was a good choice to reduce the risk of heart disease. Thirdly, women who give birth prematurely have a higher risk of CVD. Based on our results, age at entry to parenthood was closely related to the risk of heart disease in later life.

Number of Births and Risk of Diabetes in China's Older Women.

As an important life event in individuals' life, childbirth will affect the health of women to different degrees. More and more attention has been paid to whether the number of births will affect the incident diabetes in elderly women, but there are few related studies. Based on the data of the Chinese Longitudinal Healthy Longevity Survey in 2018, 6,159 older women are selected as the study population. Logistic regression analyses are used to estimate the relationship between the number of births and diabetes risk. For each additional birth, the odds ratio of maternal diabetes will decrease by 6.9% and the result is significant at the 1% level, especially among mothers having four children or less. The conclusion is equally applicable in the sample of fathers and urban mothers, but the increase in the number of births will increase the risk of diabetes in rural mothers, although this result is not statistically significant. Later age at first birth, later age at last birth, the longer childbearing period, and birth interval will significantly reduce the risk of diabetes.

Effects of Serving as a State Functionary on Self-Rated Health: Empirical Evidence From China.

Purpose: There is a strong link between occupation and self-rated health. Existing research has revealed the effects of occupation on self-rated health outcomes and the corresponding mechanisms. However, there is a lack of research on the effects of state services on self-rated health in China. Therefore, this study focuses on exploring the effects of serving as a state functionary in China on self-rated health to enrich research in related fields. Method: Based on the data of 14,138 individuals collected from the 2016 China Labour-Force Dynamics Survey, the logit model was used to investigate the effects of serving as a state functionary on self-rated health and the difference in the effects across different populations. Results: The results show that (1) serving as a state functionary has a significant positive effect on self-rated health; (2) self-rated health of elderly state functionaries is higher than that of younger state functionaries; (3) self-rated health of state functionaries in non-eastern regions is higher than that of state functionaries in eastern regions; and (4) state functionaries with lower education have higher self-rated health than highly-educated state functionaries; (5) Higher self-rated health of state functionaries is achieved primarily through better work time, better work environment and lower relative deprivation. Conclusion: Serving as a state functionary in China has a significant positive correlation with self-rated health, with differences across populations of state functionaries. This study expands the current literature on the effects of occupation on self-rated health in the context of China.

Impact of fertility on the longevity of older rural Chinese women: an analysis of a longitudinal survey.

BACKGROUND: This study evaluates the impact of fertility during the childbearing period on the longevity of older rural Chinese women and verifies whether any trade-off exists between women's longevity and their number of children to provide empirical evidence for improving health intervention policies and formulating active fertility policies in low-fertility countries. METHODS: Based on the data of the deaths of 1623 older adults aged 65 and above during 2014-2018 in the Chinese Longitudinal Healthy Longevity Survey, this study explores the relationship between the number of children born and older rural women's longevity using the ordinary least squares method. Furthermore, the impact of fertility on the longevity of men and women in rural and urban areas, along with other reproductive behaviours on older rural women's longevity, were analysed. RESULTS: There was a significant negative correlation between the number of children born and women's longevity (ß = - 0.555, p < 0.05). Additionally, their longevity exhibited a decreasing trend with having birthed more sons and an increasing trend with more daughters. Age at first and last births had a significant positive relationship with rural women's longevity; however, the effect of fertility on the longevity of older rural and urban men and older urban women was not significant. CONCLUSIONS: It is confirmed that there is a trade-off between fertility and longevity for rural women in China. Future research should focus on compensating for the decline in female longevity caused by the number of children born and promote the concept of a healthy pregnancy, scientific nurture, and gender equality in fertility.

The effect of serving as a danwei leader before retirement on self-rated post-retirement health: empirical evidence from China.

BACKGROUND: Worker health is often influenced by their occupation type, and the accumulative effect of occupation has a significant impact on their health after retirement. Studies show that the type and level of occupation before retirement directly impact workers' self-rated post-retirement health. However, there is little research on the self-rated post-retirement health of danwei leaders in China. This study seeks to examine the self-rated health level of Chinese danwei leaders after retirement. Furthermore, the differences between their self-rated health level and that of retirees from other occupations are explored by examining the accumulative effect of occupation and the mechanism underlying these differences. METHODS: Based on 5,910 samples' data from the 2018 China Longitudinal Aging Social Survey, ordinary least squares, logit, and propensity score matching models are used to investigate the self-rated health level of Chinese danwei leaders after retirement, their differences with other occupations, and the corresponding mechanism. RESULTS: The results show that retired danwei leaders have higher self-rated health levels than retirees in other occupations. This was mainly found among female, non-eastern, married, not living with children, and highly educated respondents. The difference in self-rated health between retired danwei leaders and other retired groups was influenced by their post-retirement income and social status. CONCLUSIONS: In China, retired danwei leaders rated their health higher than retirees from other occupations. Danwei leaders have high socioeconomic status due to their occupation. Compared with other groups, their advantages are significant and enjoyed for a long time. Additionally, most danwei leaders have high social influence even after retirement and their higher income and social status have a positive impact on their self-rated health compared with other employees. This study provides empirical evidence from China and extends current literature on the effects of occupational type and level on self-rated health after retirement.

Volunteer Service and Well-Being of Older People in China.

Purpose: The social support theory suggested that involving older people in social activities could increase their level of social participation and interaction, which in turn improved their well-being. However, there has been a heated controversy about whether participating in volunteer services could enhance the well-being of older people, especially for the Chinese sample. Method: Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, this paper used an ordered probit model to examine the impact of older people's participation in volunteer services on their well-being, as well as the differences in the impact across groups and the specific transmission mechanism. Result: The empirical study found that Chinese older people's participation in volunteerism significantly enhanced their well-being, which remained robust after eliminating the possible effects of self-selection. Further heterogeneity analysis revealed that for female, non-party members and older adults with good economic status, participation in volunteerism has a higher increase in well-being. The mediating effect test indicated that older people's participation in volunteerism affected well-being mainly through enhancing positive emotions. Conclusion: It is necessary to promote the participation of older people in volunteer services and to clarify the role of government support and advocacy. Proper guidance is given to change the role of older people as care recipients to that of service providers and caregivers, and to continuously enrich the programmes and content of volunteer service to safeguard the well-being of older people.