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Prior research indicates that just 4.5 percent of mainland China's higher educational institution leaders are female. This article extends theory and research by drawing attention to identity and Discourse as an important, yet under-researched, aspect of the problem of women's underrepresentation in higher education leadership. Drawing on in-depth qualitative interviews with nine female academics in Chinese universities and informed by discursive approaches to identity and constructionist views, we analyze how women construct multiple identities, the interplay of identities, and the influence of broader societal Discourses of gender and leadership. The findings highlight the interplay between competing multiple identities, and illustrate how the women's identities are shaped and constrained by dominant historical and cultural Discourses in Chinese society, which results in identity regulation (Alvesson and Billing 2009), notably identity positioning that is congruent with social norms and conventions. A key finding is that the female academics reject the leader identity. This is true for those in middle management positions, as well as women in early career stages, who might otherwise aspire to leadership. Implications for the leadership pipeline in China's universities is discussed and recommendations are made for future research directions.

Older adults needing assistance with activities of daily living can receive support in various settings. Senior housing communities, such as independent living, assisted living, and continuing care retirement communities, are an increasingly popular option for adults not requiring nursing home–level care. However, limited research exists due to a dearth of data on these types of communities. We use a proprietary data set to describe the market of private pay senior housing and community-level characteristics in 140 metropolitan statistical areas, from 2015 to 2019. Although the number of senior housing communities increased substantially, the supply of senior housing options supporting the continuum of care has not necessarily kept up with population growth. Describing the supply of senior housing communities across the spectrum of levels of care provides a more complete description of the formal noninstitutional long-term care supply among the 140 most populated metropolitan statistical areas.

Jian Fan,1,* Yan Shang,1,* Fei Shen,2,* Qiaowen Huang,3 Ziyu Wang,1 Yiping Han,4 Jiayi Zhao1 1Department of General Practice, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, People's Republic of China; 2Yinhang Community Healthcare Center, Shanghai, 200433, People's Republic of China; 3Zhaoxiang Community Healthcare Center, Shanghai, 200433, People's Republic of China; 4Department of Respiratory and Critical Care Medicine, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, People's Republic of China*These authors contributed equally to this workCorrespondence: Jiayi Zhao, Department of General Practice, Changhai Hongkou Hospital, Shanghai, 200081, People's Republic of China, Email rayzhaojiayi@163.com Yiping Han, Department of Respiratory and Critical Care Medicine, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, People's Republic of China, Email yphan2006@163.comBackground: Venous thrombosis (VTE) is a high-incidence disease that affects different systems of the body, but no comparative studies have been conducted to explore its incidence in different systems in patients with the coexistence of multiple diseases. Primary care is a medical institution that has the first contact with patients' conditions. The majority of outpatients suffer from multiple diseases, and they are more prone to VTE, which is of significance and requires investigation. At the same time, we observed that the primary care patients' cognition level of VTE is insufficiency at present, and the prevention and management of VTE in China is still in its infancy. Most studies focus on whether doctors and nurses are clear about the diagnosis and manifestations of VTE, however, few studies on patients' cognitive level and influencing factors of symptoms and prevention of VTE. Therefore, it is necessary to study the causes of cognitive deficiency of VTE from the perspective of patients, conduct targeted cognitive and behavioral interventions, and finally achieve the purpose of improving the effect of VTE prevention and management.Aim: This study aimed to explore the risk factors, cognitive level and cognitive potential influence factors of VTE in outpatients of primary care in Shanghai, as well as which diseases, are more likely to promote occurrence of VTE among patients with multiple diseases.Methods: A total of 710 patients were included in the analysis. Shanghai in China is divided into urban and suburban areas by their geographical location, and a random sample of 10 primary care areas was investigated, including 5 urban areas and 5 suburban areas. The Padua scale and the VTE cognitive level-related knowledge test scale were used for the investigation. Statistical software was used to conduct univariate Pearson correlation analysis and multivariate logistic regression analysis for VTE high-risk factors among outpatients of primary care. Furthermore, the high-risk factors for VTE and the types of chronic disease in patients with multiple diseases were subjected to subgroup analyses. t-test was used to statistically analyze cognitive level of VTE and the potential influence factors related to the patients' VTE cognitive level.Results: Univariate analysis of risk factors for VTE in 710 outpatients showed that age (χ2=83.895, Pcerebral infarction>malignant tumor>respiratory system disease>coronary heart disease> diabetes. In addition, patients' age (t=6.869, P< 0.001), region (t=3.420, P< 0.001), education level (t=− 7.341, P< 0.001), chronic disease (t=5.875, P< 0.001), BMI (t=6.404, P=0.012), smoking (t=4.152, P=0.042) were related to the VTE cognitive level.Conclusion: General practitioners should pay close attention to independent risk factors for VTE among patients in routine outpatient care, especially patients with co-existing diseases with independent risk for VTE, placing them high risk of VTE. At the same time, health education and other measures should be strengthened to improve the patients' awareness and cognitive level of VTE to prevent the occurrence of VTE and its related complications.Keywords: venous thrombosis, risk assessment, cognitive level