Objectives: To study the relationship between social capital and depression among older adults from urban China and the mediating effect of social support on the influence of social capital on depression. Methods: Data were collected from face-to-face interviews targeting older adults (N = 928, response rate = 68.1%) aged over 60 years residing in Hangzhou, China, in 2013. Indicators of social capital included both cognitive (trust and reciprocity) and structural (social network and social participation) aspects. The dependent variable depression was measured by the Geriatric Depression Scale, social support was measured by the Multidimensional Scale of Perceived Social Support, and sociodemographic variables (age, education, and household income) and physical function were controlled for analysis. The data were analyzed by factor analysis and a hierarchical regression model. Results: Trust, reciprocity, and social network were significantly associated with geriatric depression after controlling. Social participation was not correlated with geriatric depression. Social support partially mediated the relationships between social capital and geriatric depression. Conclusion: This study provides new evidence that social capital effectively mediates geriatric depression directly and indirectly. The intervention of social capital on depression should therefore consider the two pathways. Future longitudinal studies should help further understand the mechanisms linking social capital and depression.

In more recent times, health-related quality of life (HRQOL) measurements have formed an important part of assessing the quality of routine care in general practice. For a measure to have clinical usefulness it must not only be valid, appropriate, reliable, responsive, and capable of being interpreted, but it must also be simple, fast to complete, easy to score, and provide useful clinical data. The Two-step method of choosing appropriate measures is introduced. Then through comparison of generic instruments with disease-specific instruments, we can conclude that sometimes a combination of generic and disease-specific HRQOL measures may be more appropriate for monitoring changes in a patient's health status due to an intervention.

Purpose An estimated 9 million elderly people accompanied their adult children to urban areas in China, raising concerns about their social capital and mental health following re-location. The aim of this study was to examine the effect of migration on social capital and depression among this population. Methods Multistage stratified cluster sampling was applied to recruit the migrant and urban elderly in Hangzhou from May to August, 2013. Data were collected from face-to-face interviews by trained college students using a standardized questionnaire. Social capital measurements included cognitive (generalized trust and reciprocity) and structure (support from individual and social contact) aspects. Depression was measured by Geriatric Depression Scale-30 (GDS-30). Chi-square tests and binary logistic regression models were used for analysis. Results A total of 1248 migrant elderly and 1322 urban elderly were eligible for analysis. After adjusting for a range of confounder factors, binary logistic regression models revealed that migrant elderly reported significantly lower levels of generalized trust [OR = 1.34, 95% CI (1.10–1.64)], reciprocity [OR = 1.55, 95% CI (1.29–1.87)], support from individual [OR = 1.96, 95% CI (1.61–2.38)] and social contact [OR = 3.27, 95% CI (2.70–3.97)]. In the full adjusted model, migrant elderly were more likely to be mentally unhealthy [OR = 1.85, 95% CI (1.44–2.36)] compared with urban elderly. Conclusions Migrant elderly suffered from a lower mental health status and social capital than their urban counterparts in the emigrating city. Attention should focus on improving the social capital and mental health of this growing population.

Objectives: To determine the prevalence of physical violence and threats against health workers and the aftermath in tertiary, secondary and primary care facilities in China.Design: A cross-sectional questionnaire study.Setting: 5 tertiary hospitals, 8 secondary hospitals and 32 primary care facilities located in both urban and rural areas of Zhejiang Province, China, were chosen as the study sites.Participants: A total of 4862 health workers who have contact with patients completed a survey from July 2016 to July 2017.Outcome measures: The prevalence of physical violence, threats and Yi Nao, specific forms of physical violence and their aftermath were measured by a self-designed and verified questionnaire. Multivariable logistic regression models were used to examine the association between perceived organisational encouragement of reporting workplace violence (WPV) and physical violence, threats and Yi Nao after controlling for age, sex, level of facility, professional ranking and type of health worker.Results: Among all respondents, 224 (4.6%) were physically attacked and 848 (17.4%) experienced threats in the past year. Respondents in secondary hospitals were more likely to experience physical violence (AOR=3.29, 95% CI 2.21 to 4.89), threats (AOR=1.61, 95% CI 1.32 to 1.98) and Yi Nao (AOR=2.47, 95% CI 2.10 to 2.91), compared with primary care providers. Lack of organisational policies to report WPV was associated with higher likelihood of physical violence (AOR=3.64, 95% CI 2.57 to 5.18) and threats (AOR=2.21, 95% CI 1.76 to 2.78). Among physical violence cases, only 29.1% reported the attack to police mainly because most felt it useless to do so (58.8%). Only 25.7% were investigated and 72.4% of attackers received no punishment. Of all those attacked or threatened, 59.4% wanted to quit current post and 76.0% were fearful of dealing with urgent or severe cases.Conclusions: Proper management of the aftermath of violence against health workers is inadequate. Formal guidelines for reporting and managing WPV are urgently needed.

Background: Inappropriate use of antibiotics has caused antimicrobial resistance, presenting a major health challenge to the world population. Self-medication with antibiotics (SMA) is currently at an alarming level in China. Objectives: To determine the sources of antibiotics leftover at home, the risk factors of keeping antibiotics at home, and the associations between keeping antibiotics at home and SMA among Chinese university students. Methods: Six provinces were purposely selected from six regions of China, and one multi-disciplinary university was selected from each chosen province. A total of 11,192 university students were selected using cluster random sampling from the selected universities. Logistic regression was conducted to examine the relationship between keeping antibiotics at home and SMA. Results: Out of the 11,192 students surveyed, 7057 (63.1%) reported keeping antibiotics at home at the time they were surveyed. Of those who kept antibiotics in their home, 1965 (27.8%) reported that these antibiotics were left over from a previous prescription by a doctor and 4893 (69.3%), purchased antibiotics over the counter. Additionally, 29.6% (507/1711) of students self-medicated with antibiotics when ill during the month before the survey. Students keeping antibiotics at home were five times (95% CI 3.53, 7.05) more likely to engage in SMA when ill and 2.6 times (95% CI 2.34, 2.89) more likely to self-medicating with antibiotics for prophylaxis than the other students. Female students, those with a family background of higher education, and those who had a parent working in the medical field had a significantly higher chance of keeping antibiotics at home. Conclusions: The high prevalence of keeping antibiotics at home and SMA among young adults is a serious concern. Professional regulations and population-tailored health education are needed.