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Reflecting on different theoretical premises within geographies of care, this paper develops their connections and responds to the normativity and universalism in care literature through conceptualising live‐in elder care (LEC). Considering the relationality of differential contributions to care, we propose a conceptualisation of multiple interrelated approaches by: (1) extending the critical frameworks of care to understand the broader frames of institution, market, and morality in mediating interpersonal connectedness of elder care; (2) thinking care relationally, we challenge the dominant conceptualisation of care and power as unidirectional flows and elder care relationships as a receiver–giver dyad; (3) emplacing care, we focus on the actual conditions of care through which ethics are assembled in their geo‐historical context; (4) treating care as grounded, we centre voices from both older people and LEC workers and how ethics of care are comprehended in the everyday rather than prescribed for commodified care. Our thematic analysis starts with a commodification process where LEC is negotiated in tensions; yet moving beyond arguments around systems of dominance and ideal ethics of care, findings show LEC also creates a space of care where LEC workers and older people constantly negotiate norms, boundaries, and care as a relational process. Conceptually, this paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the entangled and relational nature of care as grounded in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care. This paper recognises the role of power in shaping the market and intimate relationships of elder care by elaborating on the inequities of age, gender, and place (not just gender). Moving beyond critiques, this paper emphasises the relational nature of care as grounded and emplaced in a series of everyday concerns and resistance, where ethics of difference are negotiated and a cultural‐historical configuration of care still perpetuates in its locale. Finally, this paper speaks to the active yet overlooked role of age and ageing in constructing an ethics of care. [ABSTRACT FROM AUTHOR]

Background: We aimed to provide an overview of all diagnostic tools developed to diagnose appendicitis with their reported accuracy and to further characterize these including their need for diagnostic equipment. Methods: This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and a protocol was registered at Open Science Framework. We performed a systematic literature search in PubMed, Embase, China National Knowledge Infrastructure, Índice Bibliográfico Espanhol de Ciências da Saúde, and Latin American and Caribbean Health Sciences Literature. We included original articles of all languages with the purpose to derive an accessible diagnostic tool. We extracted data regarding study- and diagnostic tool characteristics, and the accuracy of each diagnostic tool. Results: The search led to 6419 records, where 74 studies were included, yielding 82 diagnostic tools reported in seven different languages. Among these tools, 35% included patient characteristics, 85% symptoms, 93% physical examinations, 37% vital signs, 78% laboratory values, and 16% imaging. Among the diagnostic tools, 35% relied on a medical doctor/surgeon with access to a laboratory, and six diagnostic tools did not require a bedside medical doctor/surgeon. The median positive predictive value, negative predictive value, sensitivity, and specificity across diagnostic tools were 91%, 94%, 89%, and 86%, respectively. Conclusions: We identified 82 diagnostic tools that most frequently were based on symptoms and physical examinations. Most diagnostic tools relied on a medical doctor/surgeon with access to laboratory values. The accuracy was high across the diagnostic tools. [ABSTRACT FROM AUTHOR]

Objective(s): To understand how community as 'enabling places' is experienced by older people and brings about enabling resources for supporting ageing in community (AIC). Methods: From a health geographical perspective, we conceptualize community as enabling places that are produced by the interaction of material, social, and symbolic resources. Focusing on a community‐based care centre (CBCC) in Beijing, China, we conducted semi‐structured interviews with 17 older persons to examine how a CBCC enabled AIC. Results: The CBCC site created three interdependent spaces and material/social/affective resources for enabling AIC: (1)living space (residential care beds) to create a sense of connection and safety; (2) a CBCC‐supported care space at home to create an atmosphere of trust and safety; and (3) a social space to create feelings of belonging and contribution. Variations in how the three resources interacted produced not only different spaces at the same site for various users but also different AIC experiences for the same user. Conclusions: Community is not simply a static research context or spatial container. Rather, community as an enabling place involves a dynamic process in which spatial/social/affective resources are encountered and interact. Older people's AIC experiences change as their encounters change in the three types of resources we described and thus their capacities for ageing well change correspondingly. Furthermore, the binary idea of community versus institution needs to be expanded to explore how home, community, and institution are related, in order to create enabling spaces for AIC. [ABSTRACT FROM AUTHOR]

This article aims to examine how rural everyday life has changed in the Chinese context in response to the process of urbanisation. Drawing on a mobilities perspective, changes in everyday life are represented by spatial mobilities and the impacts of social mobilities on them are assessed at a household level. Employing rural survey data for 2007 and 2017 conducted in Jianghan Plain, China, results reveal that everyday life in central rural China has undergone an uneven development and is significantly impacted by social mobilities. As one of the main agricultural production regions in China, the livelihood strategies in the study area have been shifting from full-time farming to part-time farming and non-farm. The effects of the process of social mobilities on working, consuming and leisure mobilities are also unevenly distributed. Our findings suggest that the perspective of everyday life deserves further investigation for its important role in exploring the human–land relationship in a rural context. And the mobilities paradigm can provide an alternative insight into rural restructuring and its social effects. [ABSTRACT FROM AUTHOR]

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In sum, the topic under consideration here is certainly important, but this book's explanation of China's rise as a maritime power is neither profound nor insightful, though it does provide an extensive review of the literature on China's maritime security strategy. Chan's account shifts between historical review and normative prescription, often resulting in ambiguous comments: for example, "China's involvement in maritime security has been extensive. The author's conclusion is underwhelming: "In conclusion, despite all the limitations and obstacles, China's sea power development has been a long historical process. [Extracted from the article]

Increasing the income of poor rural households is essential for the realization of China's goal of sustainable development, which entails inclusive and equitable development and reducing the developmental gap between urban and rural areas. We conducted a case study of Wangqing County, a frontier minority area in Northeast China to examine spatial patterns and income differentials among poor rural households in this area. We quantified existing associations between household-level and environmental-level characteristics and income by applying hierarchical linear models. We subsequently applied Geographically Weighted Regression to analyze the spatial heterogeneity of the environmental-level variables and develop an understanding of the interaction mechanism of influencing factors. The results revealed that the distribution of villages, where income levels were similar, showed significant spatial agglomeration characteristics. Our findings also provide empirical evidence that household- and village-level characteristics together determine the income of poor households, but that household-level characteristics determine destitution to a greater extent than environmental characteristics. More specifically, the sex, health condition, and labor capacity of the household head, household size, the dependency ratio, social welfare, and off-farm work are significantly associated with household income. At the environmental level, arable land, the distance to the county center, and the average altitude had spatially heterogeneous impacts that varied in direction and intensity. This systematic study provides a more comprehensive and integrated understanding of the factors influencing the income of poor households in a frontier minority area in Northeast China. [ABSTRACT FROM AUTHOR]

Background: The importance of social and economic capital as predictors of health is widely documented, yet the complexity of interactions between them and effects on older people's health is still unclear. Combining the material and psychosocial explanations of health, this study explores the potential interactions between social and economic capital in influencing older adults' health in urban and rural China. Methods: Using data from the China Family Panel Survey, physical and mental health in 2018 were regressed on social and economic capital indicators in 2016, controlling for sociodemographic characteristics of 3535 respondents aged 65 and older. Rothman's synergy index was calculated to investigate potential interaction effects. Results: Economic hardships were significantly related to both self-reported health and mental health. Neighborhood cohesion and social participation were significantly associated with mental health for all, bonding trust was significantly associated with mental health for urban older people. We found no significant associations between social capital components and self-reported health. There was an interaction effect between low neighborhood cohesion and economic hardships, and between low social participation and economic hardships, creating an increased burden of poor mental health. The interaction effect between low bonding trust and economic hardships on mental health was apparent only among urban older people. Conclusions: Geographical settings are important factors in the complexity between social and economic capital in affecting older health. Intervention efforts directed towards reducing simultaneously multiple dimensions of deprivation, such as poverty, social exclusion, social isolation, could be helpful in improving older people's health. In materially deprived places, policies to promote health equity by improving social capital but without eliminating poverty may be less effective. [ABSTRACT FROM AUTHOR]

The first case of human transmission of SARS-CoV-2 was reported in China in December 2019. A few months later, this viral infection had spread worldwide and became a pandemic. The disease caused by SARS-CoV-2, termed COVID-19, is multifactorial and associated with both specific antiviral as well as inflammatory responses, the extent of which may determine why some individuals are asymptomatic while others develop serious complications. Here we review possible life-threating immune events that can occur during disease progression to uncover key factors behind COVID-19 severity and provide suggestions for interventions with repurposed drugs in well-controlled and randomized clinical trials. These drugs include therapeutics with potential to inhibit SARS-CoV-2 entry into host cells such as serine protease inhibitors of the cellular protease TMPS2 and drugs targeting the renin-angiotensin system; antivirals with potential to block SARS-CoV-2 replication or factors that could boost the antiviral response; monoclonal antibodies targeting pro-inflammatory cytokines that drive the hyperinflammatory response during COVID-19 progression toward the severe stage and therapeutics that could ameliorate the function of the lungs. Furthermore, in order to help make more informed decisions on the timing of the intervention with the drugs listed in this review, we have grouped these therapeutics according to the stage of COVID-19 progression that we considered most appropriate for their mechanism of action. [ABSTRACT FROM AUTHOR]

This article uses the theory of uneven and combined development (U&CD) to produce a novel explanation of 'Brexit and Trump' – the two shock political events of 2016. The argument proceeds in three steps. First, we identify the global conjuncture of historical unevenness in which the votes occurred: how the neoliberal transformation of the advanced capitalist countries was synchronized with the radically different process of primitive accumulation in China. Second, we apply the theory of U&CD to this peculiar 'simultaneity of the non‐simultaneous': the 'big country' effects of China's industrialization, we find, were thrice multiplied by its combination with the advanced sectors of the world economy, which accelerated China's take‐off, brought forward its export phase, and widened its export profile at a moment of maximum openness in international trade. Finally, this produced the pattern of development that led to the events of 2016: the resultant trade shocks intensified the internal inequalities of British and American societies in ways that match the geography of the Leave and Trump votes. The analysis has a wider intellectual implication too, for the phenomena of historical unevenness and combination are intrinsic to the history of the global political economy; and the theory of U&CD therefore has a unique contribution to make to the field of International Political Economy. [ABSTRACT FROM AUTHOR]

Climate is closely related to human longevity. In China, there are many climate types. According to national population censuses from 1982 to 2000, most provinces with a high ratio of centenarians are located in western and northwestern China far from the sea; these areas are characterized by a dry, cold climate, very high altitude, very high daily temperature range, strong winds, and partial hypoxia. Meanwhile, provinces with a high ratio of nonagenarians from 1982 to 2000 are located in southern China near the sea. Previous studies have attributed the high ratio of centenarians in western and northwestern China to the extreme local climate. However, centenarians in these areas decreased greatly in 2010, whereas residents in southern China frequently reached 90 to 100 years old in 2010. This study aims to explain this strange phenomenon and find whether extreme climate in Tibetan plateau and northwestern China or moderate climate in southern China is more conducive to longevity. The study found that mortality rate in Tibetan plateau is much higher than southern China, then a population evolution experiment was proposed to compare longevity indicators between low mortality rate and high mortality rate and shows that longevity indicators will decrease in the near future and increase above their original levels after several decades when the mortality rate is decreased. Results of this study show individuals in northwestern China do not live as long as those in eastern and southern China. A moderate climate is more conducive to longevity than extreme climate in China. The longevity of a region should be judged by long-term longevity indicators. [ABSTRACT FROM AUTHOR]

China's rapid socioeconomic growth in recent years and the simultaneous increase in many forms of pollution are generating contradictory pictures of residents' well-being. This paper applies multilevel analysis to the 2013 China General Social Survey data on social development and health to understand this twofold phenomenon. Multilevel models are developed to investigate the impact of socioeconomic development and environmental degradation on self-reported health (SRH) and selfreported happiness (SRHP), differentiating among lower, middle, and higher income groups. The results of the logit multilevel analysis demonstrate that income, jobs, and education increased the likelihood of rating SRH and SRHP positively for the lower and middle groups but had little or no effect on the higher income group. Having basic health insurance had an insignificant effect on health but increased the likelihood of happiness among the lower income group. Provincial-level pollutants were associated with a higher likelihood of good health for all income groups, and community-level industrial pollutants increased the likelihood of good health for the lower and middle income groups. Measures of community-level pollution were robust predictors of the likelihood of unhappiness among the lower and middle income groups. Environmental hazards had a mediating effect on the relationship between socioeconomic development and health, and socioeconomic development strengthened the association between environmental hazards and happiness. These outcomes indicate that the complex interconnections among socioeconomic development and environmental degradation have differential effects on well-being among different income groups in China. [ABSTRACT FROM AUTHOR]

Background In the transitional stage of socioeconomic development, the traditional practice of home-based care in China is being tested. The evolution and factors of home-based care utilization are the prerequisites for the formulation of a support policy. However, no extant research has studied home-based elder care on a national scale. Aim This paper aims to examine changing caregiving relationships nationwide for home-based elderly individuals and investigate the changing factors of care utilization in a ten-year period, with special attention to the effects of “location” on care patterns. Methods The data come from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Andersen and Newman's behavioral model is employed as the theoretical framework for this research. The trends in care use from 2002 to 2011 are explored and multilevel multinomial analyses are performed to investigate the changing factors of care patterns between 2002 and 2011. Results From 2002 to 2011, China saw a sharp decrease in children as caregivers, a significant increase in spousal caregivers, and a gradual decrease in other caregivers. Compared to 2002, the effects of the predisposing and enabling factors are more important than the need factors in 2011. Location and the interactions of the north-south divide and the urban-rural divide had a significant effect on care patterns. Conclusions From 2002 to 2011, there was a decline in the traditional values-advocated care system and the elderly had to rely more on their own resources to find caregivers. In the design of a support program, there is an urgent need for policy makers to take social inequality among elderly individuals and the effects of location into consideration. [ABSTRACT FROM AUTHOR]

Food security has been identified as an important issue for elderly people's quality of life and ageing in place. A food security index composed of three indicators (food intake, food quality and food affordability) was developed to measure the food security status of community-living elderly people. Food security was then examined among community-living elderly in the central urban districts of Beijing, China. Data were collected by a questionnaire survey in the summer of 2013 and the response rate was 78.5%. Descriptive statistics and binary logistic regression were applied to analyse food security and the associations between food security and demographic and socioeconomic factors. The results showed that 54.2% of the surveyed elderly experienced food security. Participants with better education ( OR = 1.68) and better health ( OR = 1.47) were more likely to experience food security. The young-old were less likely to experience food security than the older old ( OR = 0.94). Elderly people who lived with their children were less likely to experience food security than those who lived alone ( OR = 0.43). The results of impact factors on food security highlight both similarities with studies from more developed countries and the unique challenges faced in a rapidly changing China with its unique social, cultural and political systems. The food security index we developed in this study is a simple and effective measure of food security status, which can be used in surveys for evaluating the food security status of elderly people in the future. [ABSTRACT FROM AUTHOR]

The Village Redevelopment Program is an ambitious policy which attempts to reshape the physical living environment in the countryside. In implementing the policy, local officials nationwide largely subsidize wealthy villages. Based on fieldwork conducted in two counties in different provinces, this article points to a politics of command as the main reason. It concludes that superiors, through the normal Chinese mechanisms for promoting new programs, have left local officials with little choice but to subsidize wealthy villages. This finding has implications for China's governance in a wider sense. [ABSTRACT FROM AUTHOR]

The transition from traditional rural residences to urban-like multi-storey buildings and from traditional villages to rural residential communities (shequ) is one of rural China's most profound developments of the early twenty-first century. Official discourse highlights the potential benefits for villagers, portraying the new residential communities as gateways to modernity and significant steps toward reducing inequality and disparity between the rural and the urban. Based on extensive research in two counties in Shandong and Anhui provinces, this article concludes that while imposing urban-like models of residence may coincide with prosperous communities' circumstances, it may easily become a statist venture of predation and a source of tension and rural discontent in less prosperous communities [ABSTRACT FROM AUTHOR]

The article focuses on the developments in international commercial transactions, distribution law and franchising around the world in 2012. It informs that the Chinese Ministry of Commerce has issued a Notice on the Strengthening of Commercial Franchise Records Management and the Annual Report and Indonesia has transformed its franchise regulatory framework. It also mentions two court cases, Rafferty v. Madgwicks and Bertico v. Dunkin' Brands Canada, Ltd.

The demand for residential care by older people is increasing in Beijing as a result of dramatic demographic and socio-economic transformations. Little is known about the way older people access residential care in the context of Beijing. In this research, qualitative data collected from 46 in-depth semi-structured interviews with residential care facility (RCF) managers, older residents, and their family members in six RCFs in Beijing were transcribed and analysed using the constant comparative method. The findings included the following themes: access to residential care as geographical access, information access, economic access, socio-cultural access, and the socio-managerial environment. Geographical access is influenced by location, distance, and the micro-physical environment and amenities of RCFs. Information access refers to the capability to acquire related information on available resources. Economic access is the financial affordability for the resources. Socio-cultural access is affected by individual attitudes and aggregative cultural values on ageing and care of older people. Additionally, the social-managerial environment such as reputations of RCFs, quality of services, and management mechanisms are also important to the decision-making process. All these factors influence older people and their family members’ decision-making process of which RCF to choose. The research provides a multi-perspective analysis of access to residential care and suggestions on improving the accessibility of residential care for older people in Beijing. [ABSTRACT FROM PUBLISHER]

Abstract: In recent years, residential care has become an alternative option for elder care in Beijing, China. Little is known, however, about the well-being of elderly residents and the relationship between their health and living in residential care facilities (RCFs). Hence this research aims to understand the well-being of elderly residents in RCFs and how the environment of RCFs affects elderly people’s everyday activities and health. The concepts of therapeutic landscapes, active aging, and well-being contribute to understanding the relationships among aging, health, and environment within RCF settings. Qualitative data from 46 in-depth semi-structured interviews with RCF managers, elderly residents, and family members in Beijing were transcribed and analysed using the constant comparative method. The results show that most of the elderly residents are satisfied with their lives in RCFs, but a few of them feel isolated and depressed after their relocation. Each RCF, as a place with its unique physical and social environment, has a significant influence on the elderly residents’ physical and psychological well-being. Individual factors such as characteristics of elderly residents, their attitudes on aging and residential care, and family support also play important roles in their adaptation and well-being after relocation from home to RCFs. Although this study focuses on residential care at the local level, it sheds light on future research on geographical and socio-cultural meanings of elder care at local, regional, and national levels in China. [Copyright &y& Elsevier]

Biliary tract cancer encompasses tumors of the gallbladder, bile duct and ampulla of Vater. Gallbladder cancer is more common in women, whereas bile duct cancer is more common in men, suggesting that sex hormones may play a role in the etiology of these cancers. The intracellular action of estrogens is regulated by the estrogen receptor (ESR); thus, we examined the role of common genetic variants in ESR genes on the risk of biliary tract cancers and stones in a population-based case–control study in Shanghai, China (411 cancer cases, 895 stone cases and 786 controls). We genotyped six single-nucleotide polymorphisms (SNPs), four in ESR1 (rs2234693, rs3841686, rs2228480 and rs1801132) and two in ESR2 (rs1256049 and rs4986938). In all participants, the ESR1 rs1801132 (P325P) G allele was associated with excess risks of bile duct [odds ratio (OR) = 1.7, 95% confidence interval (CI) 1.1–2.8] and ampulla of Vater cancers (OR = 2.1, 95% CI 0.9–4.9) compared with the CC genotype. The association with bile duct cancer was apparent among men (OR = 2.8, 95% CI 1.4–5.7) but not among women (P-heterogeneity = 0.01). Also, the ESR2 rs4986938 (38 bp 3′ of STP) GG genotype was associated with a higher risk of bile duct cancer (OR = 3.3, 95% CI 1.3–8.7) compared with the AA genotype, although this estimate was based on a small number of subjects. None of the other SNPs examined was associated with biliary tract cancers or stones. False discovery rate-adjusted P-values were not significant (P > 0.1). No association was found for ESR1 haplotype based on four SNPs. These preliminary results suggest that variants in ESR genes could play a role in the etiology of biliary tract cancers, especially bile duct cancer in men. [ABSTRACT FROM PUBLISHER]

Zeng et al.'s Ethics Review highlights some of the challenges associated with clinical research in China. They found that only a minority of published clinical trials of anti-dementia drugs reported that they fulfilled the basic ethical principles as outlined in the Declaration of Helsinki. With recent reports of scientific misconduct from China, there is an urgent need to find approaches to compel researchers to adhere to ethical research practices. This problem does not call for a simple solution, but if forces are joined with governmental regulations, education in ethics issues for medical researchers, and strong reinforcement by Chinese journal editors not to publish studies with these flaws, then research ethics and publication standards will probably improve. Other solutions to foster ethical practice of drug trials are discussed including Chinese initiatives directed at managing conflict of interest from the pharmaceutical industry and educating clinical researchers. [ABSTRACT FROM AUTHOR]

We examined the associations between 21 single nucleotide polymorphisms (SNPs) of eight lipid metabolism genes and lipid levels in a Chinese population. This study was conducted as part of a population-based study in China with 799 randomly selected healthy residents who provided fasting blood and an in-person interview. Associations between variants and mean lipid levels were examined using a test of trend and least squares mean test in a general linear model. Four SNPs were associated with lipid levels: LDLR rs1003723 was associated with total cholesterol ( P-trend = 0.002) and LDL ( P-trend = 0.01), LDLR rs6413503 was associated with total cholesterol ( P-trend = 0.05), APOB rs1367117 was associated with apoB ( P-trend = 0.02), and ABCB11 rs49550 was associated with total cholesterol ( P-trend = 0.01), triglycerides ( P-trend = 0.01), and apoA ( P-trend = 0.01). We found statistically significant effects on lipid levels for LDLR rs6413503 among those with high dairy intake, LPL rs263 among those with high allium vegetable intake, and APOE rs440446 among those with high red meat intake. We identified new associations between SNPs and lipid levels in Chinese previously found in Caucasians. These findings provide insight into the role of lipid metabolism genes, as well as the mechanisms by which these genes may be linked with disease. [ABSTRACT FROM AUTHOR]

Biliary tract cancers, encompassing gallbladder, extrahepatic bile duct and ampulla of Vater cancers, are uncommon but often fatal malignancies. Hormone-related factors, including parity, oral contraceptive use, obesity, and gallstones, have been implicated in the etiology of these cancers. To further clarify the role of hormones in biliary tract cancers and biliary stones, we genotyped 18 single-nucleotide polymorphisms (SNPs) in nine genes involved in steroid hormone biosynthesis, metabolism and transport in a population-based case-control study in Shanghai, China. This study included subjects who completed an interview and provided blood, which totaled 411 biliary tract cancer and 893 biliary stone patients and 786 healthy Shanghai residents. The CYP1A1 IVS1 + 606 (rs2606345) T allele was associated with gallbladder [odds ratio (OR) = 2.0, 95% confidence interval (CI), 1.3–3.0] and bile duct cancers (OR = 1.8, 95% CI = 1.1–3.1), whereas the CYP1A1 Ex7 + 131 (rs1048943) G allele was associated with ampulla of Vater cancer (OR = 2.9, 95% CI = 1.5–5.4). After taking into account multiple comparisons for SNPs within each gene, CYP1A1 was significantly associated with gallbladder (P = 0.004) and ampulla of Vater cancers (P = 0.01), but borderline with bile duct cancer (P = 0.06). The effect of CYP1A1 IVS1 + 606 on gallbladder cancer was more pronounced among non-obese (body mass index P interaction = 0.001). Among women taking oral contraceptives, the effect of SHBG Ex8 + 6 (rs6259) on gallbladder cancer (OR = 6.7, 95% CI = 2.2–20.5; P interaction = 0.001) and stones (OR = 2.3, 95% CI = 1.1–4.9; P-interaction = 0.05) was statistically significant. Our findings suggest that common variants in hormone-related genes contribute to the risk of biliary tract cancers and stones, possibly by modulating hormone metabolism. [ABSTRACT FROM AUTHOR]

A positive doctor-patient relationship is believed to play a key role in the healing process in clinics. While challenges to the doctor-patient relationship are a global concern, complex social contexts which introduce familial collectivism and totalitarian bureaucracy to maintain a doctor's authority have complicated doctor-patient relationships in China. This study delineates a multi-dimensional therapeutic landscape of hospitals in China, focusing on the doctor-patient relationship performances used to improve patients' healing experiences. Based on fieldwork in two primary hospitals in Eastern China, we find that primary hospitals in China are not only professional spaces, but hybrids of professional and non-professional spaces. In these spaces, both professional and other discourses in various forms of social-environmental engagement affect therapeutic experiences. Varying time and space in hospitals allow doctors to construct multi-dimensional therapeutic landscapes vis-a-vis patients to secure patients' compliance with their recommendations, and thus improve health outcomes. We argue that these dimensions may also cause negative therapeutic experience such as unnecessary health care. This study contributes to the literature on therapeutic landscapes of health care by providing a critical view on the construction of multi-dimensional therapeutic hospital landscapes. Furthermore, it links the critical health geographies literature with China's broader social context to explicate the cultural and social transformation of health care spaces in contemporary China. Findings from this study inform both theoretical and empirical debates regarding therapeutic landscapes of health care by embedding the professional spaces of health care into broader geographical discourses. This calls for health professionals to reflect on ethical concerns in multi-dimensional health care landscapes. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of anxiety and depressive symptoms among patients with somatic diseases in urban China. Method: A hospital-based cross-sectional study was carried out in four major cities of China from June to August in 2004. There were 2111 eligible subjects with Stroke, Parkinson's Disease, Epilepsy, Irritable Bowel Syndrome, Functional Dyspepsia, and Menopausal Syndrome, and 317 Post-natal women were recruited from general hospitals. Self-completed hospital anxiety and depression scale (HAD) questionnaire was used for screening anxiety and/or depressive symptoms. Subjects with a HAD score of >=9 were further assessed with Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) by certified psychologists or psychiatrists. Results: The prevalence of "screened" depressive and anxiety symptoms using HAD were 11~19% and 11~22% respectively in patients with above somatic diseases and post-natal women. Assessed by HAMA/HAMD scale, the prevalence of "definite" depressive symptoms was 30%~59% in subjects with "screened" depressive symptoms, and 44%~84% in subjects with "screened" anxiety symptoms. About half of the subjects had co-morbidity depressive and anxiety symptoms. Less than one-fourth of these subjects had ever been diagnosed as depressive/anxiety disorders and been treated prior to the investigation. Conclusion: There is a high prevalence and low diagnosis and treatment rate of depressive and anxiety symptoms in patients with these somatic diseases in China. [ABSTRACT FROM AUTHOR]

The unusual discovery of associated cranial and postcranial elements from a single Middle Pleistocene fossil human allows us to calculate body proportions and relative cranial capacity (encephalization quotient) for that individual rather than rely on estimates based on sample means from unassociated specimens. The individual analyzed here (Jinniushan) from northeastern China at 260,000 years ago is the largest female specimen yet known in the human fossil record and has body proportions (body height relative to body breadth and relative limb length) typical of cold-adapted populations elsewhere in the world. Her encephalization quotient of 4.15 is similar to estimates for late Middle Pleistocene humans that are based on mean body size and mean brain size from unassociated specimens. [ABSTRACT FROM AUTHOR]

The present study aimed to describe the disease progression of chronic hepatitis B patients without or with compensated cirrhosis at baseline, to estimate the risk of progression to decompensated cirrhosis, hepatocellular carcinoma and death, and to determine prognostic factors of disease progression in patients in Shanghai, China. Stored medical records from 322 biopsy-confirmed chronic hepatitis B cases diagnosed between 1981 and 1993 were selected, and the status of patients was tracked in 1999–2000. Among consenting patients, ultrasound examination and laboratory tests were conducted. Person-year incidence rates, Kaplan–Meier analysis, log-rank tests, and Cox regression analysis were conducted. Among chronic hepatitis B patients without compensated cirrhosis, the incidence rates of decompensated cirrhosis, hepatocellular carcinoma, and death were 6.3, 2.8, and 7.6 per 1000 person-years, respectively, while for patients with compensated cirrhosis, the rates were 35.6, 8.2, and 35.2 per 1000 person-years, respectively. The 15-year survival rate was 88% for patients without compensated cirrhosis, compared with 56% for patients with compensated cirrhosis ( P < 0.001). Cox regression analysis demonstrated that increased α-fetoprotein (AFP) ( P < 0.01), γ-globulin ( P < 0.05), and high-level severity of hepatic fibrosis ( P < 0.01) at baseline were risk factors of decompensated cirrhosis. Factors associated with a high risk of death included elevated AFP at baseline ( P < 0.01), severity of hepatic fibrosis ( P < 0.003), and sustained positivity for hepatitis B surface antigen ( P < 0.004). Increased AFP and severity of hepatic fibrosis at baseline were associated with higher risk of decompensated cirrhosis and death. These data provide rare empirical estimates of the negative long-term outcomes for patients with chronic hepatitis B in Shanghai, China. [ABSTRACT FROM AUTHOR]

This article examines the potential invasiveness of family policy illustrated by the one-child policy of China. Few governmental policies are as intimate and invasive as those that affect within-family decisions regarding copulation, procreation, family size, and the basic sense of family identity. The determination of long-term consequences of legislating family policy is even more difficult to anticipate if the object is the center of a constellation of factors, each related to other facets of life and bound together by that same social structure. Moreover, with almost one-quarter of the earth's population, China cannot help but intrude on the economic, social, and political well-being of other nations in its requirement for resources, land, food, and energy. Clearly, a revolution in family life and parental practices is taking place in China. The after effects echo throughout the political and social structure of the earth's most populous nation, with enormous impact on the Chinese people's economic well-being and quality of life.

Examines usability of economic development model of Hong Kong, China to the developing countries. Impact of export-led growth on economy; Result of economic policy providing maximum scope for entrepreneurs to perform their function; Accomplishment of growth of manufacturing industry without protection from world competition.

Housing and health studies rarely concentrate on aggregate health indicators. There is a need for more research to disentangle the complexity within housing types and between housing and socioeconomic development as they influence health. To enhance the evidence base for the understanding of the association between housing and health, from a geographic perspective, we applied spatial multilevel analyses to census and statistical yearbook data of China to investigate what and how housing conditions were associated with life expectancy at birth (LEB). The results found significant spatial auto-correlation of LEB across nearby counties and significant spatial clustering of LEB across provinces. Spatial multilevel models fit the data better than regular regression models. Housing conditions, including housing tenure and internal housing quality, were significantly associated with LEB independent of socioeconomic factors. Compared to access to clean energy and tap water, where the associations with LEB were conditional on housing tenure, having a washroom inside the house, crowding and housing tenure were robustly related to LEB. The associations between internal housing quality and LEB were confounded by housing tenure. The coefficients of housing facilities decreased or became insignificant and the coefficients of crowding increased after housing tenure was considered. Housing tenure might be one of the mediators of the economy to indirectly impact LEB, and an independent social indicator which might affect LEB directly. The associations between housing conditions and LEB were stronger in counties situated in less-developed provinces. These findings indicate that, to narrow regional gaps in life expectancy, improving the housing facilities in the least developed regions should be a priority. With rapid urbanization and the vast migration, ensuring urban dwellers have access to houses and reducing housing congestion should be the primary policy concerns all over China, but especially in the less-developed regions. • Spatial autocorrelation and clustering issue of life expectancy are considered. • Housing tenure and housing quality are independently associated with life expectancy. • Housing tenure is one of the mediators of the economy to influence life expectancy. • The impact of housing quality is confounded by housing tenure. • The impacts of housing condition are stronger in counties in less-developed provinces. [ABSTRACT FROM AUTHOR]

Investigates contraceptive method choice, switching and discontinuation before marriage, between marriage and first birth and after first birth in Shanghai, China. Probability of and reasons for discontinuing contraceptive use; Delay in adoption of methods until two or more years following first birth.

Discusses a study published in a 2002 issue of the 'Sexually Transmitted Diseases' journal, which examined the relationship between level of education, social stigma, spousal notification and treatment-seeking behavior among male patients with sexually transmitted disease in China. Factors associated with feelings of stigmatization, delay of treatment and sexual behavior.

Replies to a comment on economic development lessons from Hong Kong, China. Consideration on manufacturing export industries as basis of development; Problem on creation of industries suitable for exports to developed countries; Impact of export diversion on countryside development.