Do Age-Friendly Community Policy Efforts Matter in China? An Analysis Based on Five-Year Developmental Plan for Population Aging.

(1) Background: The study will examine whether local governments' policy efforts on age-friendly communities (AFC) promote older adults' social participation in China. The extensive scope of AFC makes measuring policy efforts very challenging. The study attempts to introduce the developmental planning and goal-setting theory in public policy literature to answer this question. (2) Methods: We look at the Eleventh Five-Year Developmental Plan for Population Aging in subnational governments and CHARLS (the China Health and Retirement Longitudinal Study) baseline dataset from 2011, with data on policy strength and social participation of older adults. By using multilevel linear models, we regress social participation at the individual level on the policy strength of age-friendly communities at the provincial level. (3) Results: The results show that policy strength on AFC does vary substantially among provinces within China. And the interaction between policy strength of physical environment of local governments and community infrastructures is positively associated with social participation of rural older adults in China. (4) Conclusions: We conclude that policy efforts of local governments on the physical environment of age-friendly communities have effectively promoted the social participation of rural older adults in China. Policy makers could integrate physical infrastructures into their rural revitalization strategy to improve the wellbeing of Chinese older adults.

Altered voxel-mirrored homotopic connectivity in right temporal lobe epilepsy as measured using resting-state fMRI and support vector machine analyses.

Background: Prior reports revealed abnormalities in voxel-mirrored homotopic connectivity (VMHC) when analyzing neuroimaging data from patients with various psychiatric conditions, including temporal lobe epilepsy (TLE). Whether these VHMC changes can be leveraged to aid in the diagnosis of right TLE (rTLE), however, remains to be established. This study was thus developed to examine abnormal VMHC findings associated with rTLE to determine whether these changes can be used to guide rTLE diagnosis. Methods: The resultant imaging data of resting-state functional MRI (rs-fMRI) analyses of 59 patients with rTLE and 60 normal control individuals were analyzed using VMHC and support vector machine (SVM) approaches. Results: Relative to normal controls, patients with rTLE were found to exhibit decreased VMHC values in the bilateral superior and the middle temporal pole (STP and MTP), the bilateral middle and inferior temporal gyri (MTG and ITG), and the bilateral orbital portion of the inferior frontal gyrus (OrbIFG). These patients further exhibited increases in VMHC values in the bilateral precentral gyrus (PreCG), the postcentral gyrus (PoCG), and the supplemental motor area (SMA). The ROC curve of MTG VMHC values showed a great diagnostic efficacy in the diagnosis of rTLE with AUCs, sensitivity, specificity, and optimum cutoff values of 0.819, 0.831, 0.717, and 0.465. These findings highlight the value of the right middle temporal gyrus (rMTG) when differentiating between rTLE and control individuals, with a corresponding SVM analysis yielding respective accuracy, sensitivity, and specificity values of 70.59% (84/119), 78.33% (47/60), and 69.49% (41/59). Conclusion: In summary, patients with rTLE exhibit various forms of abnormal functional connectivity, and SVM analyses support the potential value of abnormal VMHC values as a neuroimaging biomarker that can aid in the diagnosis of this condition.

Adoption of Major Housing Adaptation Policy Innovation for Older Adults by Provincial Governments in China: The Case of Existing Multifamily Dwelling Elevator Retrofit Projects.

(1) Background: The housing environment is crucial to the health of older Chinese people and is becoming an urgent policy initiative. This study explores factors that facilitate or impede the adoption of policy innovation on major housing adaptation (HA) by Chinese provincial governments using the framework of policy innovation and diffusion theory. (2) Methods: This study constructs an event history dataset on HA policy related to elevator retrofitting in existing multifamily dwellings in China; the lack of elevators constitutes an insurmountable barrier in older adults' daily lives in China. The hypotheses were tested by using a traditional event history analysis (EHA) model and a piecewise constant exponential (PCE) model, which is a modified EHA model. The dataset was summarized as "province-year" event history data on 30 Chinese provinces from 2008 to 2019. (3) Results: In addition to internal determinants (e.g., population aging level and financial dependency), diffusion mechanisms can significantly facilitate or impede the adoption of major HA policy innovation by provincial governments. Policy adoption by neighboring governments helps facilitate policy adoption by nonadopters, but policy adoption by subordinate city governments impedes provincial governments' adoption of major HA policy innovation. (4) Conclusions: This study concludes that provincial governments' adoption of major HA policy innovation should be given a higher policy priority. The central government can promote provincial governments' adoption of major HA that primarily benefits older adults by using fiscal transfer payments and enhancing the legitimacy of such policy.

City Government's Adoption of Housing Adaptation Policy Innovation for Older Adults: Evidence From China.

OBJECTIVES: Utilizing policy innovation and diffusion theory, this study aims to explain why city governments adopt housing adaptation policies that primarily benefit older people based on the case of China. METHODS: The data are drawn from an event history data set of a housing adaptation policy for older people collected from 283 Chinese cities from 2010 to 2018. Piecewise constant exponential models are utilized. RESULTS: The results indicate that cities facing greater internal pressure and a higher political status are more likely to adopt a housing adaptation policy for older people. Policy adoption by neighboring cities could further facilitate this process. DISCUSSION: Policy innovation and diffusion theory provide a useful framework for this study. That is, the Chinese city government's adoption of housing adaptation policy for older adults is initially driven by local needs and then accelerated by interactions among neighboring governments.

Debt and depression among the Dibao population in northwestern China.

BACKGROUND: With the rapid development of economy, depression disorder is not only a public health issue but also a socioeconomic problem and attracting more and more attention in China. AIMS: The target of this study is to examine the prevalence of depression and the related risk factors in the Dibao population in northwestern China. METHOD: A cross-sectional analysis in a random sample survey conducted in three northwestern Chinese cities in 2007. The data from 4459 respondents with completed Center for Epidemiological Studies-Depression (CES-D) scales were evaluated to explore the key risk factors for depression. Using depression as a binary variable according to the cutoff of the CES-D score and then as a continuous variable, multiple logistic and line regression analysis were performed to compare the odds ratio and the weight of different risk factors for depression. RESULTS: The prevalence of depression in non-Dibao population was 34.7% but that in the Dibao population was 50.0% (p < .001). After adjusting for important confounders, Dibao population had an odds ratio (OR) of 1.38 (95% confidence interval (CI): 1.16-1.63) to have possible depression compared to those non-Dibao people. Furthermore, depression was associated with a higher OR of indebtedness (OR: 1.59, 95% CI: 1.31-1.93), and a small amount of debt would increase the possibility of depression for Dibao people (OR: 1.69, 95% CI: 1.28-2.23). In addition, gender, body mass index (BMI), tobacco use and social network were also important risk factors for depression in the Dibao population. Using depression as a continuous variable, being a member of the Dibao population and being indebted will add 2.06 and 1.83 to the CES-D score, respectively, compared with the non-Dibao population and not being indebted. A comparison of the odds ratios of depression between the Dibao and the non-Dibao population showed that factors such as gender, BMI, tobacco use, social network and indebtedness were statistically significant in the Dibao population but were not statistically significant in the non-Dibao population. Additionally, having a savings account was statistically significant in the non-Dibao population but not in the Dibao population. CONCLUSIONS: It was not surprising, as proved by other studies, that gender, obesity and social network were risk factors associated with depression in the Dibao population. Our findings indicated that a small amount of indebtedness was also closely related to depression in the Dibao population.