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Background Welfare for the disabled is becoming an important issue in China and care for people with intellectual disability is challenging because of the inadequacies in formal support and the social service system. Material and Method Based on ethnographic research in two villages in North China, this paper analyses the dilemmas of family care for people with intellectual disability. The essential data is the ethnographic record of three cases. Results Rural families strive to provide care through a set of arrangements and bear tremendous stress in the process. Conclusion Family care for people with intellectual disability in rural China has been increasingly challenged by the forces of labour migration, demographic changes and the ever-growing processes of commoditization. The role of the state has to be strengthened in welfare provision to balance the weakened family care ethos in transforming societies. [ABSTRACT FROM AUTHOR]

Although the relationship between socio‐economic status (SES) and prosocial practices has been extensively studied, little is known about the role that social capital plays in this relationship. This study examines the mediating effect of different forms of social capital, including informal neighbourhood capital, membership in voluntary associations, and professional connection, on the relationship between SES and prosocial practices. A total of 3,300 urban samples and 2,170 rural samples from the Chinese General Social Survey (CGSS) 2012 were selected to conduct two‐group structural equation modelling. Our results suggested that (a) all three forms of social capital mediated the effect of SES on donating, but only informal neighbourhood capital and membership mediated the effect of SES on volunteering, and (b) SES had a different relationship with social capital in urban China than in rural China. SES had a weak positive correlation with informal neighbourhood capital in rural areas but a negative one in urban areas. SES also had a stronger relationship with membership in voluntary associations in rural areas. Our analyses support the notion that higher SES promotes prosocial practices through social capital. [ABSTRACT FROM AUTHOR]

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government‐funded nutrition programme, Ying Yang Bao (YYB; soybean powder‐based iron‐rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6–23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check‐up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check‐ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron‐rich or iron‐fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource‐limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education. Key messages: Current evidence suggests there is a decrease in the prevalence of undernutrition among children under 5 years of age in China during recent decades. However, imbalanced development exists between rural and urban areas.Government‐funded Ying Yang Bao (YYB) programme has been implemented in poor rural areas across China covering over 800 counties, to decrease the risk of developing anaemia among children aged 6–23 months.After a child health counselling intervention jointly implemented with YYB programme, the prevalence of stunting, underweight, wasting, and anaemia among children decreased significantly.Child health counselling intervention could be well integrated into the ongoing YYB programme to reach resource‐limited areas on a large scale. [ABSTRACT FROM AUTHOR]

The period from birth to 2years of age is highly sensitive with respect to the relationship between nutrition and neurodevelopment, but data regarding the association between dietary diversity and early childhood neurodevelopment are limited. We sought to examine the association of two feeding indicators—minimum dietary diversity (MDD) and minimum meal frequency (MMF)—with the neurodevelopment of children aged 6–23 months, using data from a cross‐sectional survey conducted in six rural counties in China. Data on 1,534 children were analysed using logistic regression to explore the associations between dietary diversity and early neurodevelopment, with adjustments for the age, sex and prematurity of the child; the age, sex and educational level of the caregiver; and family size, income and simulative care practices and resources. We found that 32.4% of children had suspected developmental delays based on the Chinese version of the Ages and Stages Questionnaires Version 3, whereas 77.0% and 39.2% failed to meet the MDD and MMF, respectively. Meeting the MDD was associated with a 39% lower risk of developmental delays (AOR = 0.61, 95% CI [0.43, 0.86]). There was a significant association between MDD and reduced likelihood of developmental delays in gross motor, fine motor, problem‐solving and personal social subscales, whereas MMF was only associated with a lower risk of developmental delays in the gross motor subscale (AOR = 0.63, 95% CI [0.42, 0.94]). We observed an inverse dose–response relationship between the number of food groups consumed and the risk of developmental delays (P <.001). [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the levels of illness perception and identify interrelations among the variables of illness perception, demographic, and health‐related characteristics in a sample of rural Chinese adults with hypertension (HTN). Design: This is a cross‐sectional descriptive study using descriptive and correlation analysis. Sample: It included 163 people diagnosed with HTN for at least 3 years who lived in two rural villages in Zhejiang Province of mainland China during 2014–2015. Measurements: Illness perception was measured by the Chinese Illness Perception Questionnaire‐Revised. Demographic and illness characteristics were collected by the researcher. Weight, height, and blood pressure (BP) were, respectively, measured by calibrated scale and digital sphygmomanometers. Results: The findings showed that the BP control rate was 28.80% in the village. The highest average item score found in timeline (3.98 ± 0.76) and control (3.29 ± 0.67) subscales indicated that rural Chinese adults believe in the chronicity and controllability of HTN. Negative illness representation presented the lowest mean item score (2.64) suggesting that the participants neither perceive symptom variation of the illness nor their illness as serious. Interrelations existed among the illness perception variables with variation from that in other previous study. The cause of HTN was attributed to balance factors, psychological factors, risk factors, and cultural factors in sequence. Age, education, body mass index, and household annual income were correlated with illness perception. Conclusion: These findings suggested that misconceptions about HTN perception existed among rural adults in the villages. Comprehensive health education program is needed to increase rural adults' knowledge and management of HTN. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Perspectives on Caring for Older Patients scale into Chinese, both the full and the shortened versions, and test its psychometric properties among Chinese nursing students. In this methodological research, the scale were translated and administered to 307 nursing students recruited from two universities in mainland China. The psychometric testing mainly included internal consistency reliability using Cronbachʼs alphas, 2‐week test–retest reliability using the intraclass correlation coefficient, convergent validity with Koganʼs Attitude toward Older People scale, and factorial validity using exploratory factor analysis. Cronbachʼs alphas for the full and the shortened version scales were 0.77 and 0.75, respectively. The intraclass correlation coefficient values of both versions exceeded 0.70 and their scores were moderately correlated with the Koganʼs Attitude toward Older People scaleʼs scores. While exploratory factor analyses revealed a six‐factor structure for the full version with factor loadings of five items below 0.3, the shortened version identified two factors with all factor loadings above 0.3. This study concluded that the psychometric properties of the full version scale were adequate and similar to those of the shortened version except for factorial validity. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to examine the trends in the mortality rate and years of life lost (YLL) rate of lung cancer in Tianjin, China, during the period from 1999 to 2016. Methods: Lung cancer death data were obtained from Tianjin residents' all‐cause death monitoring system, which covers the whole population of Tianjin. Crude mortality rate, age‐standardized mortality rate, truncated rate (35–64 years), YLL and age‐standardized YLL rate data were calculated and trends examined. Results: From 1999 to 2016, a total of 93 358 lung cancer deaths were reported in Tianjin, which accounted for 38.0% of all cancer deaths (93 358/245744). The crude mortality rate of lung cancer had increased 58.5% from 1999 (40.15/100000) to 2016 (63.64/100000), average annual percent change (AACP) = 2.9%, P < 0.01. However, the age‐standard YLL rate had decreased to 13.3% in 2016 than in 1999, AACP = –0.8%, P < 0.01, with a stable trend in males (AACP = –0.2%), and noticeable decreasing trend in females (AACP = –1.4%). The lung cancer mortality rate (ASRW) in urban areas was higher than that in rural areas in 1999, with a ratio of 1.99:1. However, it was lower in 2016, with the ratio of 0.98:1. For the truncated rate (35–64 years), it had decreased in urban areas compared with rural areas since the year 2013. Conclusion: Lung cancer remains the most fatal cancer in Tianjin. However, the age‐standard YLL rate of lung cancer has decreased considerably accompanied by a decline in smoking rate years ago, especially in women and people living in urban areas. Considerable attention is therefore needed in the rural areas where cases of lung cancer are still rapidly increasing. [ABSTRACT FROM AUTHOR]

Economic growth has brought improvements in many areas of child health, but its effects on anaemia among school‐aged children remain unknown. However, this is important because iron deficiency anaemia is common and is the main cause of disability‐adjusted life years for school‐aged children. In this study, we included 429,222 Chinese children aged 7–17 years from five consecutive national cross‐sectional surveys during 1995–2014. Using altitude‐adjusted haemoglobin concentration measured from capillary blood samples, we defined anaemia status according to World Health Organization's recommendation. We used logistic regressions weighted by provincial population to examine the association between provincial gross domestic product (GDP) per capita and anaemia, adjusting for sex, age, urban–rural location, regional socio‐economic status (SES), fixed effect of province, and clustering of schools. We used generalised additive mixed models to evaluate a potentially non‐linear relationship. For each 100% growth in GDP per capita, there was a 40% (odds ratio [OR] = 0.60; 95% confidence interval [CI; 0.56, 0.65]) reduction in anaemia. However, the association was weaker for girls and in cities with a lower SES. The association was weaker across 2005–2014 (OR = 0.75, 95% CI [0.62, 0.90]) compared with 1995–2005 (OR = 0.52; 95% CI [0.44, 0.61]), reflecting a weaker association when GDP per capita reaches around $2,000. The results were similar for moderate‐to‐severe anaemia. We concluded that economic growth has been associated with reductions in anaemia among school‐aged children in China but with fewer benefits for girls and those in poorer settings. Further economic development in China is unlikely to bring similar reductions in anaemia, suggesting that additional population level and targeted interventions will be needed. [ABSTRACT FROM AUTHOR]

Background Unrecorded traditional distilled spirits ( bai jiu, 白酒) are made and used throughout rural China for everyday use and special occasions. Nearly every town or village has a distiller to supply the demand. In rural China, distilling bai jiu is legal and regulated lightly or not at all. The World Health Organization estimates that as much as 25% of all alcohol consumed in China is unrecorded alcohol, of which an unknown portion is unrecorded bai jiu. Little is known about the composition of unrecorded Chinese spirits from rural parts of the country. This study focused on white spirits because the high ethanol (EtOH) concentration makes them more likely to contribute to health risks compared to other types of lower alcohol by volume ( ABV) Chinese unrecorded alcohol. Methods Researchers purchased samples of Chinese white spirits from small-factory distillers in central China. An independent laboratory conducted the analysis. Alcohol strength ( ABV) was determined by hydrometer. Gas chromatography was used to determine the concentration of volatile organic compounds: EtOH, methanol, acetaldehyde, ethyl acetate, and higher alcohols. Samples were tested for 3 heavy metals-arsenic, cadmium, and lead. We used the guidelines developed by the Alcohol Measures for Public Health Research Alliance ( AMPHORA) of the European Commission to assess risk. Results ABV ranged from 35.7 to 61.4%, and 58 of the 61 samples exceeded 40% ABV. The concentration of methanol, ethyl acetate, lead, arsenic, and cadmium was below AMPHORA guideline. The sum of higher alcohols exceeded the AMPHORA maximum in just 1 sample. Forty of the 61 samples had acetaldehyde levels beyond the AMPHORA guideline. Conclusions The unrecorded Chinese alcohols we analyzed had a high EtOH concentration-a public health concern that is also presented by recorded alcohols. The high percentage of samples (65.5%) that had elevated acetaldehyde suggests the need to investigate the causes for this result and the need for steps to reduce acetaldehyde levels. The cumulative long-term risks of using high EtOH and high acetaldehyde Chinese spirits are heightened by the percentage of people in China who have a genetic trait for impaired acetaldehyde metabolism. [ABSTRACT FROM AUTHOR]

Computer assisted learning (CAL) programs have been shown to be effective in improving educational outcomes. However, the existing studies on CAL have almost all been conducted over a short period of time. There is very little evidence on how the impact evolves over time. In response, we conducted a clustered randomized experiment involving 2741 boarding students in 72 rural schools in China to evaluate impacts of CAL programs over the long term. Our results indicate that a CAL program that was implemented for one year and a half increased math scores by 0.25 standard deviations for third graders and 0.26 standard deviations for fifth graders. In addition, we have shown that students gained in math learning in both CAL Phase I (which ran for one semester in spring 2011) and CAL Phase II (which ran for both semesters of the 2011-2012 academic year) programs. By testing for heterogeneous effects, we find that the CAL intervention worked well for both the poorer performing and better performing students in the third and fifth grades. We also find that the third grade girls seem to have improved more than the boys in math in the short term (CAL Phase I). [ABSTRACT FROM AUTHOR]

The aim of our study was to systematically review studies which had compared self-concept in left-behind children with the general population of children in China. Relevant studies about self-concept of left-behind children in China published from 2004 to 2014 were sought by searching online databases including Chinese Biological Medicine Database ( CBM), Chinese National Knowledge Infrastructure ( CNKI), Wanfang Database, Vip Database, Pub Med Database, Google Scholar and Web of Science. The methodological quality of the articles was assessed by using Newcastle- Ottawa Scale ( NOS). Poled effect size and associated 95% confidence interval ( CI) were calculated using the random effects model. Cochrane's Q was used to test for heterogeneity and I2 index was used to determine the degree of heterogeneity. Nineteen studies involving 7758 left-behind children met the inclusion criteria and 15 studies were included in a meta-analysis. The results indicated that left-behind group had a lower score of self-concept and more psychological problems than the control group. The factors associated with self-concept in left-behind children were gender, age, grade and the relationships with parents, guardians and teachers. Left-behind children had lower self-concept and more mental health problems compared with the general population of children. The development of self-concept may be an important channel for promoting mental health of left-behind children. [ABSTRACT FROM AUTHOR]

Background Little is known about the prevalence and relevant factors of polypharmacy in nonagenarian and centenarians. Aim The aim of this study is to examine the prevalence and associated factors of polypharmacy in a sample of nonagenarians and centenarians living in a rural area of China. Methods The data were from the 'Project of Longevity and Aging in Dujiangyan' study. Medication use and relevant covariates were obtained by face-to-face interviews. Minor polypharmacy was defined as the concomitant use of two to four medications, whereas major polypharmacy referred to the concomitant use of five or more medications. Results We included 859 participants with mean age of 93.7 ± 3.3 years. The number of chronic diseases was 1.4 ± 1.2 per subject, whereas the number of drugs was 0.8 ± 1.4 per subject. The prevalence of minor polypharmacy and major polypharmacy was 16.5% and 3.7% respectively. Illiteracy (odds ratio ( OR) 2.93, 95% confidence interval ( CI) 1.52 to 5.66), cognitive impairment ( OR 3.15, 95% CI 1.44 to 6.88), hypertension ( OR 2.88, 95% CI 1.46 to 5.67), respiratory disease ( OR 2.22, 95% CI 1.08 to 4.58), osteoarthritis ( OR 1.24, 95% CI 1.01 to 1.51), and cancer ( OR 10.70, 95% CI 1.90 to 126.80) were positively associated with minor polypharmacy. Illiteracy ( OR 4.24, 95% CI 1.53 to 11.81), hypertension ( OR 3.40, 95% CI 1.22 to 9.49) and cancer ( OR 3.40, 95% CI 1.14 to 10.12) were also positively associated with major polypharmacy. Conclusions Although most subjects suffer from some chronic diseases, minor polypharmacy and major polypharmacy are not common among nonagenarians/centenarians in rural China. [ABSTRACT FROM AUTHOR]