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Suicides, excessive overtime, hostility and violence on the factory floor in China. Drawing on vivid testimonies from rural migrant workers, student interns, managers and trade union staff, Dying for an iPhone is a devastating expose of two of the world's most powerful companies: Foxconn and Apple.As the leading manufacturer of iPhones, iPads and Kindles, and employing one million workers in China alone, Taiwanese-invested Foxconn's drive to dominate global electronics manufacturing has aligned perfectly with China's goal of becoming the world leader in technology. This book reveals the human cost of that ambition and what our demands for the newest and best technology mean for workers.Foxconn workers have repeatedly demonstrated their power to strike at key nodes of transnational production, challenge management and the Chinese state, and confront global tech behemoths. Dying for an iPhone allows us to assess the impact of global capitalism's deepening crisis on workers.

Growing Old in a New China: Transitions in Elder Care is an accessible exploration of changing care arrangements in China.Combining anthropological theory, ethnographic vignettes, and cultural and social history, it sheds light on the growing movement from home-based to institutional elder care in urban China.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Aim: To investigate the current state of work‐related quality of life among Chinese nurses and to explore the mediating effect of clinical leadership between psychological empowerment and quality of work life. Background: The quality of work‐life significantly affects nursing team stability and the provision of high‐quality care. Psychological empowerment and clinical leadership are considered influential factors in nurses’ work‐life quality. However, there is a lack of large‐scale studies investigating the relationships between these variables. Methods: This nationwide cross‐sectional study utilized a multistage stratified proportional sampling approach to select 2633 registered nurses with more than one year of work experience from 17 tertiary general hospitals in China. The data were analyzed using descriptive analysis, Pearson correlation analysis, and structural equation modeling. Results: The quality of work‐life score for nurses was 3.38 ± 0.67. Positive correlations were observed between clinical leadership and quality of work life ( r = 0.470, p < 0.01). Psychological empowerment was also positively associated with quality of work life ( r = 0.570, p < 0.01). The structural equation model revealed that psychological empowerment had a positive direct effect on the quality of work life ( β = 0.587, p < 0.001), with clinical leadership playing an intermediary role, accounting for 8.42% of the total effect. Conclusion: Nurses’ psychological empowerment was positively associated with the quality of work life and was partially mediated by clinical leadership. These results suggest that psychological empowerment and clinical leadership are key facilitators improving nurses’ work‐life quality. Implications for Nursing Management: Hospital managers should further raise awareness of empowerment among nurse managers, implement scientifically sound empowerment and clinical leadership programs for nurses, enhance nurses’ clinical leadership skills, and promote the quality of nurses’ work‐life.

Aim To evaluate the association of erectile dysfunction (ED) with work productivity loss, activity impairment and health‐related quality of life (HRQoL) across Brazil, China, France, Germany, Italy, Spain, the UK and the US. Methods This cross‐sectional observational study used data from adult men (40‐70 years old; N = 52 697) from the 2015 and 2016 National Health and Wellness Surveys. ED assessment was based on self‐reported difficulty in achieving or maintaining an erection in the past 6 months. Impairment to work and non‐work activities and HRQoL were assessed for each country and compared against the US. Multivariable models tested interactions between ED status and country for each outcome. Results Overall ED prevalence was reported as 49.7%, with Italy reporting the highest rate (54.7%). Men with ED reported significantly higher absenteeism (7.1% vs 3.2%), presenteeism (22.5% vs 10.1%), overall work productivity impairment (24.8% vs 11.2%), activity impairment (28.6% vs 14.5%) and significantly lower Mental Component Summary scores (MCS; 46.7 vs 51.2), Physical Component Summary scores (PCS; 48.3 vs 53.0), and health state utilities (SF‐6D: 0.693 vs 0.778; all, P < 0.001) than men with no ED. After adjusting for covariates, compared with the US, the association of ED status with overall work productivity impairment was greatest in the UK (26% higher; P < 0.05), and with MCS, PCS and SF‐6D scores was greatest in China (−2.67, −1.58, and −0.043 points, respectively; all, P < 0.001). Greater ED severity was significantly associated with higher impairment to work and non‐work activities and lower HRQoL, with China reporting the highest burden, compared with the US (most P < 0.05). Conclusion ED poses a significant burden with respect to work productivity and HRQoL, with greater severity associated with worse outcomes. Better management and earlier detection may help reduce this burden, especially in countries reporting a strong association between ED and poor economic and health outcomes.

Background Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses’ sleep quality in public hospitals in Shandong, China and explored its influencing factors. Methods A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis. Results The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4–6 vs. never, ≥7 vs. never) and high occupational stress. Conclusions The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses’ sleep quality.

Aim. To examine the state of sleep quality among maternal and child health (MCH) nurses and explore the associations between chronotype, night shift work schedule, quality of work life, and sleep quality among MCH nurses. Background. MCH nurses, who play an important role in protecting the health of women and children, often experience poor sleep quality. However, research on the sleep quality of MCH nurses has been scarce following implementation of the three-child policy in China. Methods. A multicentre cross-sectional study was conducted with 1426 MCH nurses. Data were collected using a demographic questionnaire, participants’ self-reported chronotype, the Pittsburgh Sleep Quality Index, and the Work-Related Quality of Life-2 scale. A chi-squared test, independent samples t-test, Pearson correlation test, and binary logistic regression analysis were used to analyse the data. Results. Of the 1426 respondents, 57.9% reported poor sleep quality. Binary logistic regression analysis indicated that chronotype, including intermediate-morning, intermediate-evening, and evening (reference: morning), and quality of work life, including stress at work, control at work, and general well-being, had effects on sleep quality among MCH nurses. Older age, frequent caffeine intake, and irregular meals were also associated with poor sleep quality. However, night shift work schedule did not affect sleep quality in the adjusted model. Conclusions. Poor sleep quality was common among MCH nurses. The findings of this study also illustrate that chronotype and quality of work life are closely related to sleep quality. Implications for Nursing Management. Nursing managers should be aware of MCH nurses’ chronotype and quality of work life and tailor interventions to address both modifiable and nonmodifiable factors associated with sleep to improve MCH nurses’ sleep quality.

Background Despite growing interest in population aging and extended working lives, little is known in developing countries about people’s quality of working life and their capacity to work for longer years when approaching retirement age. This study therefore aimed to estimate the healthy working life expectancy for the middle-aged and older population in China. Methods We used the data of 7294 adults aged 60 years and older from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2018. Healthy working life expectancy was estimated for the Chinese population aged 60 years and older overall and analyzed by four dimensions: sex, educational attainment, occupational type, and geographic location, using the population-based multistate life table method. Results Adults in China can expect 21.60 years (95% CI 21.38–21.82) of remaining lifetime at age 60, of which 7.64 years (95% CI 7.52–7.76) were in healthy working status and 10.04 years (95% CI 9.86–10.21) were in healthy but not working status. Females had a shorter healthy working life expectancy (6.40 years [95% CI 6.26–6.53]) than males (8.90 years [95% CI 8.72–9.05]) at age 60, despite their longer total life expectancy at that age. Geographically, the highest healthy working life expectancy was observed in the Southwest Zone (7.95 years [95% CI 7.72–8.18]) and the lowest in the Northeast Zone (5.15 years [95% CI 4.87–5.42]). Conclusion The healthy working life expectancy at 60 years old in China exceeds the targeted retirement age of 65. Salient socioeconomic and geographic variations of healthy working life expectancy exist in China.

Background: The global shortage of nurses is a pressing social issue, and the high mobility of the nursing profession further exacerbates this challenge. Novice nurses’ experiences of workplace bullying significantly increase their risk of leaving the profession. Therefore, exploring the mechanisms by which workplace bullying affects novice nurses’ turnover intention is important for alleviating the nursing shortage and maintaining the stability of the nursing workforce. Method: This cross‐sectional study of 832 novice nurses in northeastern China self‐reports assessed workplace bullying, professional quality of life, and turnover intention‐related status. The structural equation model was developed to analyze how workplace bullying (including person‐related negative, work‐related negative, and organizational injustice) affects turnover intention through the mediating role of the professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress). Result: The results indicated that workplace bullying was significantly associated with novice nurses’ turnover intention. Person‐related negativity, work‐related negative, and organizational injustice can influence turnover intentions by decreasing company satisfaction and increasing burnout; furthermore, work‐related negativity can increase turnover intention by exacerbating secondary traumatic stress. Conclusion: This study provides new perspectives for understanding novice nurses’ psychological reactions and career decisions in a workplace bullying environment and provides empirical support for nursing management practices. The findings highlight the importance of effective intervention strategies to improve the stability of the nursing team, optimize the quality of patient care, and reduce nurse turnover.