Equity and prediction of health resource allocation of traditional Chinese medicine in China.

OBJECTIVE: To analyze the equity of health resource allocation of Traditional Chinese Medicine(TCM) and predict its development during the 14th Five-Year Plan period, and to provide a scientific basis for promoting the improvement of TCM service capacity. METHODS: The Chinese Mainland (excluding Hong Kong, Macao and Taiwan) was divided into the Northeast, Eastern, Central and Western regions, and the number of TCM medical institutions, the number of TCM beds, practitioners (assistants) of TCM and Chinese pharmacists from 2016 to 2020 were selected as evaluation indicators, and the equity of health resource allocation of TCM was evaluated by Concentration index(CI), Theil index(T) and Health resource agglomeration degree (HRAD), and the development of health resource of TCM during the 14th Five-Year Plan period was predicted by grey prediction model GM (1,1). RESULTS: The Concentration index of the number of TCM medical institutions and TCM beds is negative, and the allocation tends to the regions with low economic development level. The Concentration index of practitioners (assistants) of TCM and Chinese pharmacists is positive, and the allocation tends to the regions with higher economic development level. The number of TCM medical institutions, TCM beds, practitioners (assistants) of TCM and Chinese pharmacists' Theil index allocated by geography is larger than that allocated by population, which indicates that the equity of TCM health resources allocated by population is better than that allocated by geography. The number of TCM medical institutions, practitioners (assistants) of TCM and Chinese pharmacists in between regions by population contributed more than 72% to the Theil index, indicating that the inequity mainly comes from between regions. The number of TCM medical institutions, TCM beds, practitioners (assistants) of TCM and Chinese pharmacists in within regions by geography contributed more than 80% to the Theil index, indicating that the inequity mainly comes from within regions. The HRAD in the Eastern and Central regions is greater than 1, indicating that the equity is better by geography. The HRAD in the Western region is less than 1, indicating insufficient equity by geography. The HRAD/PAD of the Central region (except for the number of TCM beds in 2020) is less than 1, indicating that it cannot meet the medical needs of the agglomerated population. The HRAD/PAD of the Western region (excluding for the Chinese pharmacists) is greater than 1, indicating that the equity is better than that of the agglomeration population. CONCLUSION: The number of TCM medical institutions and TCM beds tends to regions with low economic development levels, while the number of practitioners (assistants) of TCM and Chinese pharmacists tends to regions with high economic development levels. The equity of the allocation of TCM health resources by population is better than that by geography, and the inequity of the allocation by geography mainly comes from within region. The allocation of health resources of TCM in the four regions is different, and there is a contradiction between equity and actual medical needs.

Assessing the algal population dynamics using multiple machine learning approaches: Application to Macao reservoirs.

The quality of reservoir water is important to the health and wellbeing of human and animals. Eutrophication is one of the most serious problems threatening the safety of reservoir water resource. Machine learning (ML) approaches are effective tools to understand and evaluate various environmental processes of concern, such as eutrophication. However, limited studies have compared the performances of different ML models to reveal algal dynamics using time-series data of redundant variables. In this study, the water quality data from two reservoirs in Macao were analyzed by adopting various ML approaches, including stepwise multiple linear regression (LR), principal component (PC)-LR, PC-artificial neuron network (ANN) and genetic algorithm (GA)-ANN-connective weight (CW) models. The influence of water quality parameters on algal growth and proliferation in two reservoirs was systematically investigated. The GA-ANN-CW model demonstrated the best performance in reducing the size of data and interpreting the algal population dynamics data, which displayed higher R-squared, lower mean absolute percentage error and lower root mean squared error values. Moreover, the variable contribution based on ML approaches suggest that water quality parameters, such as silica, phosphorus, nitrogen, and suspended solid have a direct impact on algal metabolisms in two reservoirs' water systems. This study can expand our capacity in adopting ML models in predicting algal population dynamics based on time-series data of redundant variables.

The Effect of Mindfulness Intervention on the Psychological Skills and Shooting Performances in Male Collegiate Basketball Athletes in Macau: A Quasi-Experimental Study.

BACKGROUND: This study adopted a quasi-experimental design to examine the effect of a 7-week mindfulness intervention on the psychological coping ability and shooting performance of college-level male basketball athletes in Macau. METHODS: A total of 43 male college basketball athletes in Macau were selected as the participants. Besides the regular basketball training, the intervention group (n = 23) received a 7-week mindfulness training; the weekly mindfulness intervention session lasted around one hour according to the mindfulness training manual for athletes, while the control group (n = 20) did not receive any mindfulness training. Before and immediately after the 7-week intervention, all players performed the following tests: the "Five-Facet Mindfulness Questionnaire", the "Acceptance and Action Questionnaire", the "Sport Competition Anxiety Test", the "Mindfulness Attention Awareness Scale", and three shooting tests. An independent-sample t-test and a paired-sample t-test were used to analyze the between- and within-group differences. Moreover, a repeated measures ANOVA was used to assess the group, time, and group-by-time effects on psychological skills and shooting performances. RESULTS: The intervention resulted in both significant between-group and within-group differences in mindfulness level, acceptance level, attention level, three-point, and free-throw shooting performances (all p < 0.05, Cohen's d ranging from 0.565 to 1.117). CONCLUSION: While further study is necessary, the present study suggests that the 7-week mindfulness training program can significantly improve psychological outcomes and shooting performance in Macau college basketball athletes. Future studies involving competition settings and objective metrics will aid in verifying mindfulness as the prevalent practice among basketball practitioners and athletes.

Development and Psychometric Evaluation of a Chinese Instrument of Knowledge, Attitude and Preventive Practice on Dementia Care in Macao.

BACKGROUND: Very few instruments to integrate knowledge, attitude and practice into dementia care as a holistic perspective were available to the Chinese. METHOD: This article documented the development of a 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care and reported the results of psychometric testing among 1500 Chinese in Macao Special Administrative Region (SAR), including 234 primary health professionals, 272 staff working at day-care centers and nursing homes, 586 high school students and 408 community-dwelling older people. The Chinese instrument was developed through literature review and committee review. The psychometric methods were used to evaluate the reliability and validity of the Chinese instrument as measures of knowledge, attitude and preventive practice on dementia care for the Chinese. RESULTS: The preliminary results indicated that the Content Validity Index of the Chinese instrument was .973 and Cronbach's alpha coefficient of the Chinese instrument was .842, among which Knowledge subscale, Attitude subscale and Preventive Practice subscale were .749, .633 and .845 respectively. The means and standard deviation were 65.13 ± 24.56 for Knowledge subscale, 74.76 ± 8.37 for Attitude subscale, 73.22 ± 14.05 for Preventative Practice subscale, and 70.99 ± 11.27 for the Chinese instrument. CONCLUSION: The 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care had satisfied the psychometric evaluation well enough to warrant further use, and could also have particular implications for other Chinese populations all over the world.

Omicron subvariant BA.5 is highly contagious but containable: Successful experience from Macau.

Introduction: Due to its high transmissibility and immune escape, Omicron subvariant BA.5 has become the dominant strain of the SARS-CoV-2 virus and led to escalating COVID-19 cases, how to cope with it becomes an urgent issue. A BA.5 infection surge burst out on 18 June 2022 and brought an unprecedented challenge to Macau, the most densely populated region worldwide. This study aimed to analyze the characteristics of this outbreak and summarize the useful anti-epidemic measures and experiences during this outbreak. Methods: All data were obtained from the Government Portal of Macao SAR (https://www.gov.mo), and the Special Webpage Against Epidemics, the Macao Health Bureau (www.ssm.gov.mo). An epidemiologic study was performed to analyze epidemic outcomes, including the infection rate, the proportion of symptomatic cases, the case fatality ratio (CFR), etc. Data were analyzed using SPSS Version 20. A p-value <0.05 was considered statistically significant. The anti-epidemic measures and experience were reviewed and summarized. Results: The BA.5 outbreak resulted in 1,821 new cases, which was significantly more than the cumulative cases of the previous variants of COVID-19 in Macau. The symptomatic cases accounted for 38.71% of the total cases, which was higher than that of the previous variants. After 6-week concerted efforts, Macau effectively controlled the outbreak, with an infection rate of 0.27%, which was much lower than many BA.5-attacked regions. The CFR was approximately 0.86%, which was not statistically different from that of previous variants. Six victims were chronically ill senior elders and their vaccination rate was much lower than the average level. Macau took a comprehensive anti-epidemic strategy to win a quick victory against BA.5, especially the "relatively static" strategy that was first formulated and applied by Macau for the management of the COVID-19 pandemic. Successful experience showed that although BA.5 was highly contagious, it could be contained by comprehensive anti-epidemic measures, including adequate anti-epidemic preparation, herd immunity through vaccination, repeated mass nucleic acid tests and rapid antigen tests, KN-95 mask mandate, the "relatively static" strategy, precise prevention and control, epidemiological investigation and tracing, and traditional Chinese medicine treatment, etc. Discussion: In Macau, compared with the previous subvariants, BA.5 is associated with increased transmissibility and a higher proportion of symptomatic cases, however, the risk of death remains similar, and the infection rate is much lower than that in many other BA.5-attacked regions. BA.5 is highly contagious but still containable, Macau's experience may offer hints for the regions experiencing the BA.5 waves to choose or adjust a more rational anti-epidemic strategy.

Spatial patterns and influencing factors of sewage treatment plants in the Guangdong-Hong Kong-Macau Greater Bay Area, China.

Over the past few years the discharge of waste and sewage in the Guangdong-Hong Kong-Macau Greater Bay Area (GHMB) of China has increased, exerting a great amount of pressure on ecological protection. In this study, we focus on achieving a balanced spatial layout of sewage treatment plants in order to reveal the regional differences and spatial patterns of sewage treatment plants in the GHMB and identify the key factors influencing the spatial patterns. In particular, we employ POI (point of interest) geographical data to evaluate the spatial patterns and agglomeration status of sewage treatment plants in the GHMB using Exploratory Spatial Data Analysis (ESDA). We then explore the principle influencing factors of the determined spatial patterns using the geographical weighted regression model (GWR). Results demonstrate that: (1) the absolute number of sewage treatment plants is highest in the central and western regions, while the per capita of sewage treatment plants is clearly clustered in the northwest and southwest regions; (2) the absolute number of sewage treatment plants exhibits larger spatial dissimilarity than that of the per capita values, with High-High cluster types principally distributed in the conjunction areas of Jiangmen, Foshan and Zhaoqing in western GHMB and Low-Low clusters in the western Pearl River Delta (PRD) estuary; and (3) the key influencing factors are identified as GDP per capita, the output value of the primary and secondary industries and industrial water consumption. Regions with high regression coefficient fluctuations of the four influencing factors are centralized within the PRD estuary and adjacent regions. Policy recommendations including optimizing the sewage treatment plant layout, enhancing the service capacity potential of the existing sewage treatment plants and upgrading the industrial structure are proposed to promote a spatial equilibrium configuration of sewage treatment plants in the GHMB.

[Macau "Baimahang" Hospital: an early western medicine hospital in China].

The Macau Baimahang Hospital (Hospital de S. Rafael), took more than 400 years from 1569 to 1975 to develop as a comprehensive western medicine hospital , and is believed to be one of the earliest western medicine hospitals in China. Up to now, very little has been written about it as most of the records are kept in Macao, and few materials are recorded in Chinese. The author will review the archives and literature comprehensively with field work, in order to provide reference for further research.

Usage and promotion on Chinese medicine in Portuguese-speaking countries.

As the continuous opening-up and communication have been seen between China and other countries, traditional Chinese medical science and Chinese medicine now have gain popularity in China as well as the surrounding countries. As a window that China's opening-up through, Macau has been serving as a link between China and Portuguese language countries. The Forum for Economic and Trade Co-operation between China and Portuguese-speaking Countries (Macau), also known as Forum Macau, since it was established in 2003, has further enhanced the mutual exchange of commerce, culture and technologies. Promoting the industry of Chinese medical science among Portuguese-speaking countries has become one of the priorities of the Forum Macau. With multiple years of collaboration, among the Portuguese-speaking countries, Chinese medical science has gained promotion to some extent, as well as recognition from the government and people. The current study introduced the development of Chinese medical science among Portuguese-speaking countries from aspects such as legislation, cooperation and promotion, medical assistance, and clinical usage.

[Analysis of survey data of popularization of traditional Chinese medicine health culture knowledge in 2017].

To continuously track and analyze the popularization and change trend of traditional Chinese medicine(TCM) health culture knowledge, so as to provide scientific basis for formulating relevant policies, strategies and measures for popularizing Chinese medicine health culture knowledge. In this study, PPS combined with random sampling method was used to survey residents aged between 15 and 69 in 328 survey sites in 30 provinces, autonomous regions and municipalities(excluding Tibet Autonomous Region, Hong Kong, Macao and Taiwan). In the study, a standardized questionnaire was used to survey the contact, cognition, trust and use of Chinese medicine health culture knowledge. A total of 89 107 people were respondent in this study, including 87 287 valid questionnaires, with an effective rate of 97.96%. Among them, the urban residents accounted for 51.35%, rural residents accounted for 48.65%; males took up 48.25%, and females took up 51.75%. In 2017, the national Chinese medicine health culture knowledge popularization rate was 91.72%, the reading rate was 89.61%, the trust rate was 89.60%, and the action rate was 55.53%. The study found that TCM health culture knowledge was more popular among young people, high-education residents and non-sickness groups. It is recommended to strengthen the popularization of traditional Chinese medicine in key areas and key populations, provide differentiated Chinese medicine health education to population in different areas, and cooperation with mass media to provide diversified contents and forms.

The prevalence, perceptions and behaviors associated with traditional/complementary medicine use by breastfeeding women living in Macau: a cross-sectional survey study.

BACKGROUND: There is a long history of traditional/complementary medicine (T/CM) use by women during lactation. While it is important to evaluate such use within a scientific paradigm to ensure efficacy and safety, knowledge about the prevalence and characteristics of T/CM use during lactation is limited. This study aimed to generate preliminary data on the prevalence, perceptions and behaviors related to T/CM use by women living in Macau during lactation. METHODS: Between April to June 2018, women aged 18 years or above who had breastfed within the previous 12 months were invited to complete a questionnaire which asked about their perceptions and behaviors related to the use of T/CM while breastfeeding. Chi-square analysis and logistic regressions were used to conduct data analysis. RESULTS: A total of 500 women completed the survey with 62.6% (95% CI 58.37-66.83) reporting use of at least 1 T/CM while breastfeeding. Of these 48.9% (95% CI 44.67 to 53.13) believed T/CM were safe to take during lactation and 55.6% (95% CI 51.37 to 59.83) suggested there were inadequate resources to assist making an informed decision. Working status, monthly family income and the presence of a breastfeeding-related health problems were associated with T/CM use (all p < 0.05). The most commonly used T/CM were Tetrapanax papyriferus, lecithin, Vaccaria segetalis, docosahexaenoic acid and Trigonella foenum-graecum commonly referred to as Fenugreek. The most common reasons for using T/CM were "to unblock milk ducts", "to increase milk supply" and "to improve baby development". Women were recommended to use T/CM from multiple sources; 15.0% from health personnel (HP) only, 40.0% received recommendations from non-HP only; and 42.2% from both. CONCLUSIONS: The use of T/CM by women during lactation is common in Macau. The current support and resources available to women during the breastfeeding period to make informed decisions about T/CM use is not standardized nor integrated. The gaps identified in this study provide an opportunity to develop resources and a more defined role for HPs to ensure the appropriate and safe use of T/CM in this population.

[Uses of fresh herbs with antioxidant effect and prospect for population ecology reconstruction in Macau].

The average life expectancy in Macau is ranking the second in the world, the consumption of fresh medicinal plants is a profound culture in Macau. The paper focus on the distribution of the antioxidant herbs, a comprehensive investigation and analysis the amount of the plant resources was carried out. The antioxidant activity of alcohol extracts was determined by using the DPPH method, and six kinds fresh herbs with high antioxidant free radical activity were screened out. Reference to adult daily dose of vitamin C, it is calculated that the daily dose amount of fresh herbs is less than 200 g. For the expected shortage of resources and the ecological status of Macau, we give some suggestions of herbal introduction in population ecology reconstruction.

Uses of fresh herbs with antioxidant effect and prospect for population ecology reconstruction in Macau / 中国中药杂志

The average life expectancy in Macau is ranking the second in the world, the consumption of fresh medicinal plants is a profound culture in Macau. The paper focus on the distribution of the antioxidant herbs, a comprehensive investigation and analysis the amount of the plant resources was carried out. The antioxidant activity of alcohol extracts was determined by using the DPPH method, and six kinds fresh herbs with high antioxidant free radical activity were screened out. Reference to adult daily dose of vitamin C, it is calculated that the daily dose amount of fresh herbs is less than 200 g. For the expected shortage of resources and the ecological status of Macau, we give some suggestions of herbal introduction in population ecology reconstruction.

Gambling in China: socio-historical evolution and current challenges.

AIMS: This paper provides an overview of gambling issues in China, including historical development, governmental responses and social consequences. METHODS: Based on materials written in Chinese or English available at academic databases and other online resources, historical, cultural and policy analyses were conducted. The focus is on mainland China, but reference is made to Hong Kong and Macao to illustrate differences. RESULTS: Throughout Chinese history, gambling was strictly prohibited by law. In contrast, small-stakes betting for entertainment instead of monetary gain, defined as 'gaming' in this paper, has been culturally acceptable and tolerated by governments. After banning gambling for three decades, the Chinese government attempts to meet public demand for 'gaming' and to confine gambling to 'gaming' by issuing national lotteries. In response to increased economic wealth, gambling opportunities were allowed to develop, but were restricted to Macao. Social problems such as illegal and youth gambling are, however, emerging. The 'gaming' perception may predispose Chinese individuals to wagering activities and increase the risk of gambling disorder, which has been widely seen as misconduct rather than a mental disorder. Currently, the country has a dearth of gambling research and limited prevention and rehabilitation services, almost none at national level. CONCLUSIONS: A distinction between small-stakes 'gaming' and large-stakes 'gambling', which has cultural roots, plays an important role in relevant governmental policies and social responses in mainland China. Gambling disorder prevention and treatment is not yet on the national agenda. The country's knowledge and services gaps on gambling problems need to be filled out.

Baduanjin exercise improved premenstrual syndrome symptoms in Macau women.

OBJECTIVE: To investigate the effect of Baduanjin, a traditional Chinese medical exercise, on improving premenstrual syndrome (PMS) symptoms in women. METHODS: Forty reproductive age women with PMS in Macau practiced standardized Baduanjin exercise for three menstrual cycles. A questionnaire, the daily record of severity of problems (DRSP), was used to measure symptom severity. DRSP was filled out every day starting from the last cycle before exercise (i.e., the first menstrual cycle) to the third cycle after exercise initiation (i.e., the fourth menstrual cycle). The total scores and the scores of each item during the 5 premenstrual days and follicular phase (5-9 postmenstrual days) were calculated. RESULTS: After exercise, the total DRSP scores during the 5 premenstrual days and differences in the total DRSP scores between the 5 premenstrual days and the follicular phase were both significantly reduced. Of note, the physical symptom total scores in the 5 premenstrual days and the differences between its total score in the 5 premenstrual days and in the follicular phase were both significantly reduced. The differences between the total scores of depressed mood, anxious mood, loss of interest, and reduction in social activity during the 5 premenstrual days and the follicular phase were also reduced. CONCLUSION: Baduanjin exercise was able to improve the mental and especially the physical symptoms of PMS.

The etiology of mental disorders: public endorsement of traditional Chinese beliefs in Macau.

BACKGROUND: Public beliefs concerning the causes of mental disorders are important in their effective treatment. The relative importance of public beliefs related to the etiology of mental disorders among Chinese populations and their relationship to other attitudes to mental disorders are poorly understood. AIMS: To investigate the endorsement of beliefs related to the etiology of mental disorders in Macau, in particular, traditional Chinese beliefs, and to explore their relationship to general attitudes towards mental disorders. METHODS: A survey of 361 members of the public measured attitudes towards 32 possible causes of mental disorders as well as contact with and social distance from individuals with a mental disorder. RESULTS: The results indicated that traditional Chinese beliefs were ranked with relatively low importance compared with psychosocial causes. Traditional beliefs related to two underlying factors and were significantly higher in participants with lower education levels. There was a significant negative correlation between endorsement of traditional beliefs and contact with individuals with a mental disorder and a significant positive correlation between endorsement of traditional beliefs and desired social distance from individuals with a mental disorder. CONCLUSION: Factors underlying traditional Chinese beliefs concerning the causes of mental disorders are associated with more negative attitudes towards individuals with a mental disorder, with such beliefs more strongly endorsed by those with relatively lower education levels.

Study of heavy metal poisoning in frequent users of Chinese medicines in Hong Kong and Macau.

This study is a direct assessment of blood heavy metal concentrations of frequent users of Chinese medicines (CM), who had been taking prescribed CM at least 6 days per week for not less than 3 months, to determine whether their intake of CM could cause an increased load of toxic heavy metals in the body. From November 2009 to June 2010, 85 subjects were recruited with informed consent, and their blood samples were collected for measurement of arsenic, cadmium, lead and mercury concentrations. Results showed that blood concentrations of four heavy metals of nearly all 85 subjects were within reference ranges. Only one subject who had consumed plentiful seafood was found to have transiently increased blood arsenic concentration (29% higher than the upper limit of the reference range). However, after refraining from eating seafood for 1 month, his blood arsenic concentration returned to normal. Eighty commonly prescribed CM in both raw medicine and powder concentrate supplied by local distributors were also tested for the four heavy metals. Twelve out of the 80 raw medicines were found to contain one or more of the heavy metals that exceeded the respective maximum permitted content. Cadmium was most frequently found in the contaminated samples. None of the powder concentrates had heavy metal content exceeding their respective maximum permitted level.

Effectiveness of a positive youth development program for secondary 1 students in Macau: a pilot study.

With the rapid change to society after the opening of the gaming licensure by the government and the potential attraction to youth caused by the casinos, a well-tested and comprehensive adolescent development program previously established in Hong Kong was adopted and modified to be used in Macau. It is expected to help our adolescents achieve positive growth and be better prepared for future challenges. The aim of this study is to examine the effectiveness of the modified positive youth development program for Secondary 1 Students in Macau. Specifically, two research questions will be asked: (1) How does the positive youth development program affect positive growth for youth in Macau?; and (2) Is youth growth related to different factors such as gender, age, family financial condition, and parents' marital status? A mixed research method with a quantitative approach using a pre- and post-test pre-experimental design, and a qualitative approach using a focus group for the participants is carried out. The study sample included 232 Secondary 1 Students in two schools. The objective outcome evaluation showed that, overall, 123 (53%) of the participants had significant improvement on the total scores of the Chinese Positive Youth Development Scale (CPYDS) and the two composite scores. However, there were some increases in the behavioral intention of alcohol drinking and participation in gambling activities. The "happiness of the family life" was found to have significant differences in the score of the CPYDS, which was shown to be the factor related to youth growth. The focus group interviews revealed that both positive and negative feedback was obtained from the discussion; however, the majority of the participants perceived benefits to themselves from the program. With reference to the principle of triangulation, the present study suggests that, based on both quantitative and qualitative evaluation findings, it should be concluded that there is positive evidence supporting the effectiveness of the Tier 1 Program of the Hong Kong Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes), which was adopted and modified for Macau. In addition, special attention should be paid to the behavioral intention of alcohol drinking and participation in gambling activities in the local context.

Investigating factors associated with depression of older women in Macau.

BACKGROUND: Mental health burdens pose a grave threat to quality of life and economic productivity worldwide. Women must balance the economic, emotional and health needs of the household with their own emotional and health needs. AIMS: The purpose of this study is to explore the depression level of a group of older women in the community in Macau, and to identify factors associated with depression. DESIGN: A descriptive survey. RESEARCH METHOD: The survey was conducted during the period July and August 2004 in six parishes in Macau; 1042 older people aged 60-98 completed a structured questionnaire. OUTCOME MEASURES: Four main outcome variables were employed in the study: predisposing characteristics, physical, psychosocial and health needs/behaviours outcomes. RESULTS: Among the women, 11.9% (n = 124) had been identified as depressed. Multiple logistic regression analyses were used to identify a model to predict older women who will have depression. The results showed that variables like having hypertension (p = 0.010), a poor social network (p < 0.001), low self-perceived scores on health status (p < 0.001) and ability to meet living costs (p < 0.001), and a low level of ability to do housework (p < 0.001) were significant risk factors for depression. CONCLUSION: Providing a suitable living environment and improving health conditions for older people may improve depressive symptoms, and maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms. Apart from the findings, these conclusions resonate with recent Macau guidance on managing depression in older women. This stresses the importance of prevention, early detection and stepped care, with more intensive treatment for greater severity of illness and a multifaceted approach to management. RELEVANCE TO CLINICAL PRACTICE: It is important to regularly screen for depressive symptoms among older women in the community. Focusing on older women with increasing physical disability and social isolation should help in both the prevention and recognition of onset of depression. Light therapy and antidepressants were suggested and providing a suitable living environment and improving health conditions for older people may improve depressive symptoms; maintaining their cognitive function and improving their functional abilities may be crucial for preventing suffering from depressive symptoms.