Economic Stress, Quality of Life, and Mortality for the Oldest-Old in China

China??s oldest old population is estimated to quadruple by 2050. Yet, poverty rate for the oldest old has been the highest among all age groups in China. This paper investigates the relationship between economic stress, quality of life, and mortality among the oldest-old in China. Both objective economic hardships and perceived economic strain are examined. We base our investigation on data drawn from the Chinese Longitudinal Healthy Longevity Survey conducted between 2000 and 2005. Our sample includes 10,972 men and women between the ages of 80 and 105 in 2000. The data show that about 16% of these oldest-old lived under economic stress in 2000. The risk factors that make one vulnerable to economic stress include age, being male, being widowed or never married, being a minority member, having no education, having no living children, and not having children as main source of income, and having no pension. Economic stress is negatively associated with indicators of quality of life, such as the quality of medical care and mental well-being. The poor quality of life contributes to the higher mortality rate for the oldest old who are under economic stress. Results also show that perceived economic strain increases the risk of mortality by 42% in rural areas, even after controlling for basic demographic characteristics, life style factors, and major health events.?For the rural oldest-old, having children as a main source of income and having access to pension alleviates the negative impact of economic hardship on mortality hazard by 23 and 66% respectively. However, in urban areas, economic stress has no direct impact on the hazard of mortality.     

Bayesian adaptive dose‐escalation designs for simultaneously estimating the optimal and maximum safe dose based on safety and efficacy

The main purpose of dose‐escalation trials is to identify the dose(s) that is/are safe and efficacious for further investigations in later studies. In this paper, we introduce dose‐escalation designs that incorporate both the dose‐limiting events and dose‐limiting toxicities (DLTs) and indicative responses of efficacy into the procedure. A flexible nonparametric model is used for modelling the continuous efficacy responses while a logistic model is used for the binary DLTs. Escalation decisions are based on the combination of the probabilities of DLTs and expected efficacy through a gain function. On the basis of this setup, we then introduce 2 types of Bayesian adaptive dose‐escalation strategies. The first type of procedures, called “single objective,” aims to identify and recommend a single dose, either the maximum tolerated dose, the highest dose that is considered as safe, or the optimal dose, a safe dose that gives optimum benefit risk. The second type, called “dual objective,” aims to jointly estimate both the maximum tolerated dose and the optimal dose accurately. The recommended doses obtained under these dose‐escalation procedures provide information about the safety and efficacy profile of the novel drug to facilitate later studies. We evaluate different strategies via simulations based on an example constructed from a real trial on patients with type 2 diabetes, and the use of stopping rules is assessed. We find that the nonparametric model estimates the efficacy responses well for different underlying true shapes. The dual‐objective designs give better results in terms of identifying the 2 real target doses compared to the single‐objective designs.     

When women veterans return: The role of postsecondary education in transition in their civilian lives

Objective: The purpose of this study was to assess the current state of postsecondary educational settings’ outreach to military women who become students postservice. Participants: Data for the present cross-sectional study were obtained from the American College Health Association’s (ACHA) 2011–2014 National College Health Assessment II (NCHA). Methods: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with Fisher’s exact test, maximum likelihood multiple logistic regression, as appropriate. Results: Women service member and veteran students received health information from their university/college less often than women students with no military experience on the following topics: alcohol and other drug use, depression and anxiety, sexual assault and relationship violence prevention, and stress reduction. Conclusions: The findings of this research identified clear gaps in service provision for women student veterans on college campuses and provided some possible models for intervention development.     

Expediting youth's entry into employment whilst overlooking precariousness: Flexi‐employability and disciplinary activation in Hong Kong

With an emphasis placed on supply‐side interventions such as skills training and incentives enhancement, active labor market polices (ALMPs) are strongly promoted by international organizations and widely adopted across different welfare regimes to boost employment rates. This article first presents the under‐examined relationship between ALMPs and employment precariousness, which has posed a challenge to the neoliberal notion of employability and activation. Youth‐focused employment policies tend to speed up employment entry whilst downplaying the risk of precariousness and the importance of job quality, and thus further reinforcing the belief that engaging in precarious employment is tolerable if not inevitable. The article then examines the case of Hong Kong, which illustrates that its relatively low rate of youth unemployment may conceal the unfavorable employment conditions confronted by youth. It is argued that the service‐led employment policies and short‐term vocational training define the employability of young workers in terms of labor flexibilities. The coined phase of “flexi‐employability” is characterized by promoting youth's readiness for, and adaptability to, the volatilities and changing demands of the labor market. Arguably, the disciplinary approach to youth activation would only strengthen the work‐first principle by enforcing young people to take up jobs available and leave welfare as soon as possible, but without thoroughly addressing the risks and insecurities generated by the labor market in undermining their well‐being.     

Left Behind by Parents in China: Internal Migration and Adolescents’ Well-Being

This study investigates how growing up as a left-behind child due to parents’ labor migration in China is associated with adolescents’ cognitive and socioemotional development, based on data from the China Family Panel Studies. We find that adolescents do worst when both parents are absent in all developmental indicators we examined: short-term and long-term word recall tests, numeracy test, self-concept, and self-expectation of educational attainment. However, the differences between left-behind children and those in rural two-parent families are not statistically significant. Left-behind adolescents do have significantly lower well-being than those in urban two-parent families. These differences can largely be accounted for by father's education, family spending on the adolescent's education, quality of parenting, and the social support available to an adolescent. The gap in Chinese adolescents' development is, thus, not so much related directly to how many parents one grows up with as it is to whether one grows up in a rural or urban environment.     

It is risky business: can social capital reduce risk-taking behaviours among disadvantaged youth?

This study addresses the gap in the research for sound multidimensional assessment of social capital and its relationship with risk-taking behaviour among youths living in disadvantaged communities. Social capital and adolescent risk-taking outcomes were studied cross-sectionally in 1371 secondary students living in two disadvantaged communities within Australia. First, a multidimensional measure of social capital was developed and tested using confirmatory factor analysis. Then, the associations between social capital and a range of youth risk-taking behaviours were examined using structural equation modelling across five-year groups (Grades 7–12). With a few exceptions, higher levels of social capital and belongingness within the school and community were generally associated with decreases in smoking, alcohol and drug consumption, and physical violence. Some outcomes were more strongly associated with family and peer social capital, while others associated more with neighbour and community social capital, indicating that attempts to build social capital need to be targeted across the whole community. This study supports the notion that social capital can be measured empirically and is beneficial in alleviating many of the detrimental health outcomes commonly associated with risk-taking behaviours during adolescence.     

Assessing the Tongzhi Label: Self-Identification and Public Opinion

Tongzhi is one of several Chinese terms that refer to individuals who are attracted to the same sex. Using data from two different surveys in Hong Kong, this research note examines how the term tongzhi coexists with other terms. We investigate the prevalence of self-identification as tongzhi, and we explore the extent to which using the term tongzhi influences public attitudes toward gay people and gay rights. Activists began popularizing the term tongzhi in the late 1980s, but less than one third of the participants in our 2008 survey of sexual orientation minorities (n = 728) described themselves as tongzhi. Using a split-ballot experiment in a 2013 public opinion poll (n = 831), we found that attitudes toward gay people and gay rights were not significantly impacted by whether questions were phrased in terms of tongzhi or the main alternative term tongxinglianzhe. We discuss how our findings can enrich understandings of earlier research and illuminate avenues for future study.     

Religious Involvement and Participation in Volunteering: Types,Domains and Aggregate

Prior research on investigating the religion–volunteering relationship has tended to commonly treat religious involvement as single-item measures, e.g., frequency of church attendance, and has defined volunteering as a simple dummy variable (1 = volunteers, 0 = otherwise). The present study attempted to look at the above relationship by measuring religious involvement as a multifaceted and multi-item measure and volunteering as engaging in different types of voluntary activity, and specific domains and overall aggregate of volunteering. The results based on a statewide representative sample from the Survey of Texas Adults 2004 showed that religious involvement was generally and significantly related to higher volunteering across voluntary types, domains, and aggregate count of volunteering, but varied in magnitude contingent on the types and domains being examined. In addition, the religious effects were held even adjusting for a variety of pertinent socio-demographic and denominational characteristics, in which these background characteristics are more dynamic in relation to volunteering than we knew. Implications of the findings related to social services and policy making are discussed.     

Childhood family structure and young adult behaviors

This paper examines a wide variety of forms, and full histories, of family structure to test existing theories of family influences and identify needs for new theories. The focus is on links between childhood family structure and both completed schooling and risk of a nonmarital birth. Using a 27-year span of panel (PSID) data for U.S. children, we find that: (a) change is stressful, (b) timing during childhood is relevant, (c) adults other than parents are important, and (d) two more recently studied family structures (mother-with-grandparent(s) and mother-with-stepfather) do not fit the molds of existing theories. The findings suggest that new theories should consider allocation of resources and reasons people group into family structures. Received: 11 September 1998/Accepted: 27 March 2000