Rural Guangdong Research Articles

Willingness to pay for diabetic retinopathy screening in Qujiang District, rural Guangdong, southern China: a cross-sectional study

ObjectiveTo determine willingness to pay for a diabetic retinopathy screening, and its determinants, among people with diabetes mellitus in Qujiang District of Shaoguan City, rural Guangdong, southern China.DesignThis cross-sectional study...

Antibiotic Prescription Patterns for Acute Respiratory Infections in Rural Primary Healthcare Settings in Guangdong, China: Analysis of 162,742 Outpatient Prescriptions

Overuse and inappropriate use of antibiotics are important contributors to bacterial antimicrobial resistance (AMR), especially in ambulatory primary healthcare (PHC) settings in low- and middle-income countries. This study aimed to investigate antibiotic prescription patterns among patients with acute respiratory infections (ARIs) in rural PHC facilities in the Guangdong Province, China. A total of 444,979 outpatient prescriptions were extracted from the electronic medical record system of 35 township health centers (THCs) and 2 community health centers (CHCs) between November 2017 and October 2018. We used the chi-square test to analyze the antibiotic prescription patterns and binary logistic regression to explore patient-related factors associated with antibiotic prescriptions. Of the 162,742 ARI prescriptions, 85.57% (n = 139,259) included at least one antibiotic. Among the 139,259 prescriptions with antibiotics, 37.82% (n = 52,666) included two or more antibiotics, 55.29% (n = 76,993) included parenteral antibiotics, and 56.62% (n = 78,852) included Watch group antibiotics. The binary logistic regression indicated that (1) female patients were slightly less likely to be prescribed antibiotics than males (adjusted odds ratio (OR) = 0.954, 95% confidence interval [CI] [0.928-0.981]; p = 0.001); and (2) compared to patients aged ≤5 years, those who were 6-15 years old (adjusted OR = 1.907, 95% CI [1.840-1.978]; p < 0.001), 16-60 years old (adjusted OR = 1.849, 95% CI [1.785-1.916]; p < 0.001), and >60 years old (adjusted OR = 1.915, 95% CI [1.810-2.026]; p < 0.001) were more likely to be prescribed antibiotics. The overuse and irrational use of antibiotics in PHC settings remain major healthcare challenges in rural Guangdong. Thus, it is imperative to implement targeted antimicrobial stewardship (AMS) policies to address this problem.

Return migration, rural household investment decision, and poverty alleviation: Evidence from rural Guangdong, China

AbstractReturn migration has been considered advantageous to the productivity of labor and the economic development of origin regions and countries. However, how and why return migrants make their investment decisions and how such processes contribute to poverty alleviation remains unclear. This study evaluated how migration experience influences rural families' choices for productive investments and the underlying mechanism of village poverty alleviation. The result indicates that, when all are given the same monetary budgets, return migrants are more inclined to invest in single agricultural‐related subjects rather than multiple subjects. A concentrated investment implies the investor's intention of expanding the production scale, which can further lead to a more organized, professional agricultural production that can be considered beneficial for community poverty alleviation. Moreover, different approaches of human capital accumulation led to varied capacity growth, among which migration experience effectively enhances the non‐cognitive ability of return migrants. Based on these findings, we suggest that more returnee‐preferential policies, supporting production and organization services should be established to promote agricultural entrepreneurship among the returning groups in poor rural areas.

Decoupling and Decomposition Analysis of Residential Energy Consumption from Economic Growth during 2000–2017: A Comparative Study of Urban and Rural Guangdong, China

Residential energy consumption (REC) is now the second largest energy sector in China. However, decoupling analysis of REC has not received enough attention. Here, we explore the decoupling relationship between REC and economic growth in urban and rural Guangdong from 2000 to 2017. First, we use the Tapio decoupling model to study the decoupling state. Then, key drivers affecting the decoupling were explored by combining the Tapio decoupling model with the Log-mean Divisa Index (LMDI) method. Finally, the decoupling efforts were evaluated by using the decoupling efforts model. The main results are as follows: (1) The decoupling state in urban regions was better than that in rural regions. Urban regions experienced weak decoupling (WD) in most years during 2000–2017, while expansive negative decoupling (END) mostly was seen in rural regions. (2) The per capita income effect was the most important driver inhibiting decoupling in Guangdong urban and rural regions. The energy intensity effect was the biggest driver promoting decoupling in urban Guangdong, followed by the family size effect. In contrast, the family size effect exerted the dominant influence on accelerating the decoupling in rural Guangdong. Overall, the household effect inhibited decoupling in urban regions, but promoted decoupling in rural regions. (3) The decoupling efforts results suggest that the energy efficiency improvement played a major role in the decoupling efforts of urban Guangdong, while the decrease of family size in rural Guangdong was the leading contributor to the decoupling efforts.

Filial Considerations in Mate Selection: Urban and Rural Guangdong in the Post-Mao Era

This article examines the transformation of filial piety by probing disagreements between parents and children over marriage decisions. Based on field observations and in-depth interviews in Guangdong, this research shows that children’s responses to disagreements vary by gender, generation, and rural or urban background. Collective family economies and intergenerational moral imperatives create a strong patriarchal basis for filial obedience for older respondents and rural non-migrants. Rural migrants’ responses are the most diverse given the option to live separately from their parents, although they feel obligated to please their parents, who are morally and culturally constrained by their rural community. The resurgence of parental power is conflated with strong reciprocal emotional bonding in young urbanites, contributing to painful and prolonged negotiations with parents. Sons are more constrained by parental authority than daughters, given the continued importance of patrilineality. This study therefore illustrates the resilience and the multifaceted transformation of filial piety in China.

From Traditional to Transnational: The Chung Family History as a Case Example

A harmonious family of three generations living under one roof is often an assumed image of a Chinese traditional family. In reality, few Chinese families resemble this image. My article uses the Chung family history to illustrate how a family in rural Guangdong, South China, experienced a fast social ascent or descent in one generation. Its history reveals many aspects of Chinese family tradition, such as filial piety, equal inheritance system among sons, or education as an important family agenda. The rise and fall of this family also helps us understand the competitive social environment of Guangdong that sent hundreds of thousand immigrants overseas in the mid-nineteenth and early twentieth century. When some members of the Chung family migrated overseas, other members followed. The Chung lineage, similar to numerous Cantonese immigrant families in America, became transnational in culture.

The relationship between psychosocial risk factors, burnout and quality of life among primary healthcare workers in rural Guangdong province: a cross-sectional study

BackgroundHealthcare workers are often exposed to stressful working conditions at work which affect their quality of life. The study investigated the relationship between psychosocial risk factors, stress, burnout, and quality of life among primary healthcare workers in general medical practice in Qingyuan and Chaozhou cities in Guangdong province.MethodThe cross-sectional study was conducted in 108 primary health facilities including 36 community health centers (CHCs) across two developing cities in Guangdong province. A total of 873 healthcare workers completed the questionnaires. Quality of life was evaluated using The World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and psychological risk factors were evaluated by the Copenhagen Psychosocial Questionnaire (COPSOQ). General quality of life and the quality of life domains were transformed into a score range from minimum 0 to 100 maximum. Higher scores indicated better quality of life and vice versa. Significant associations were verified using multiple regression analysis.ResultsPoor quality of life was observed in 74.6% of healthcare workers surveyed. General poor quality of life was significantly higher among workers who reported higher burnout (Beta = − 0.331, p < 0.001). In addition, workers with high levels of burnout, unmarried workers and female workers had a higher possibility of physical health. A greater risk of poor psychological health was observed among workers with high burnout, poor sense of community and those with lower educational levels. Workers who lacked social support, those with fewer possibilities for development had increased probability of poor quality of life in the social domain. Poor quality of life in the environmental domain was observed among workers who were dissatisfied with their jobs and workers with low salaries.ConclusionsPrimary healthcare workers in developing cities in China have a highly demanding and strained working environment and poor quality of life. Reducing job stress and improving work conditions may ultimately improve the well-being of primary healthcare workers.

THE IMPACT OF VOLUNTEER TOURISM: CASE STUDY OF MEIXIAN TEAM

Volunteer tourism has been growing as an important segment of youth tourism. This paper takes Meixian Team ( Meixian Dui) as the case study. College students in Guangzhou, Southeast China, ride bicycles to rural China to help with primary teaching in rural Guangdong Province. By means of in-depth interviews, the research attempts to analyse their reflection and personal experience in relation to their volunteer tours. Young volunteers developed their personalities during their journey of helping rural children with limited resource. There were diverse modes of personal and interpersonal interactions among the research respondents. These volunteer tourists manifested how their experience resulted in shifts in personal attitude and world views of Chinese colleague students.

Early Chinese-American Society as Portrayed in Chinese Letters of the Ah Louis Family of San Luis Obispo, California, usa早期美国华侨社会：美国加州,圣路易斯-奥比 斯波市-黄安家族的中文信件

This research report presents the English-language translations of several hand-written, Chinese-language letters from the overseas-Chinese Ah Louis family of San Luis Obispo, California. During the late 1800s and early 1900s, when these letters were written, this medium-sized town on the Pacific coast between San Francisco and Los Angeles was home to hundreds of Cantonese immigrants. As unofficial “mayor” of San Luis Obispo’s Chinatown, the Guangdong-born Ah Louis interacted with a wide variety of merchants, employees, friends, family members, and officials. These documents discuss commerce in Chinatown, a legal case about local Chumash Indians, migration between China and the United States, family life in rural Guangdong Province, and labor relations in California, providing a near-unique window into ordinary Chinese-American life around the turn of the twentieth century. Extensive footnotes also place the letters in their historical and cultural context.

The role of awareness in Internet non-use

Despite the transformational impacts of the Internet on society and commerce, surveys have shown a sizable portion of non-Internet users reporting that they have no need for the Internet. Literature often explains Internet non-use as a result of lack of skills and/or informed decision to reject the Internet. This paper raises an alternative explanation: nonusers may report no need for the Internet because they are not fully aware of the Internet’s information and transaction benefits. Our survey data from rural Guangdong, China suggest that nonusers are comparatively under-informed about the Internet’s utilitarian benefits (such as aiding work and learning). Alternative explanations for the reported lack of need for the Internet are examined and policy implications are also discussed.

Using biomass fuel at home and the development of hypertension in adult women living in rural areas of Guangdong: a multilevel model analysis

To understand the situation of biomass fuel use in rural Guangdong, and how it affecting the prevalence of hypertension in adult women. Inhabitants aged 18 and above were chosen, using multi-stage stratified cluster sampling method from 13 rural countries in Guangdong province in 2010. Questionnaire survey and blood pressure measurement were conducted. Multilevel logistic regression model was used to study the relationship between biomass fuel use and the prevalence of hypertension at both country and individual levels. Of the 5794 rural families, 2 569 (44.3%) cooked with biomass fuel in the kitchen. 1233 (46.2%) and 1 436 (53.8%) out of the 2669 adult women used biomass fuel and clean energy, respectively. Results from χ² study showed that biomass users presented higher prevalence of hypertension (RR = 1.26, 95% CI: 1.04-1.52), but in multilevel model analysis, the difference was not significant. In addition, using an extractor fan when cooking seemed to have protected factor in decreasing the risk of hypertension among biomass users (RR = 0.61, 95% CI: 0.39-0.98). Proportion of the use of biomass fuel was still high among rural families in Guangdong province. Although there was not enough evidence to verify the relationship between the use of biomass fuel and hypertension in adult women. However, concerns about the use of biomass fuel which causing the indoor air pollution, should be raised.

Grassroots authority in rural Guangdong during late Qing and early Republican times

Gongju, or public offices, controlled by the local gentry class, were the grassroots authorities in rural Guangdong during the late Qing. These offices maintained their own armed forces and usually had powers of administration, tax collection, and self-defense, as well as judicial powers. They were considered the extension of prefecture and county governments. With the authorization of the prefecture and county governments, these offices had the power to deal with important legal cases. Although they came under attack during the 1911 Revolution, these offices were able to recover quickly in different forms. In the late Qing era, local gentry with official titles earned in middle-level or lower-level civil service examinations took the leadership roles in such grassroots offices, but they were replaced by people who had direct control over the armed forces during Republican times.

Syphilis Screening among 27,150 Pregnant Women in South Chinese Rural Areas Using Point-of-Care Tests

ObjectivesTo determine the prevalence and correlates of syphilis among pregnant women in rural areas of South China.MethodsPoint-of-care syphilis testing was provided at 71 health facilities in less developed, rural areas of Guangdong Province. Positive samples were confirmed at a local referral center by toluidine red unheated serum tests (TRUST) and Treponema pallidum particle agglutination (TPPA) tests.ResultsAltogether 27,150 pregnant women in rural Guangdong were screened for syphilis. 106 (0.39%) syphilis cases were diagnosed, of which 78 (73.6%) received treatment for syphilis. Multivariate analysis revealed that older pregnant women (31–35 years old, aOR 2.7, 95% CI 0.99–7.32; older than 35 years old, aOR 5.9, 95% CI 2.13–16.34) and those with a history of adverse pregnant outcomes (aOR 3.64, 95% CI 2.30–5.76) were more likely to be infected with syphilis.ConclusionsA high prevalence of syphilis exists among pregnant women living in rural areas of South China. Enhanced integration of syphilis screening with other routine women's health services (OB GYN, family planning) may be useful for controlling China's syphilis epidemic.

Epidemiologic Characterization of Human Papillomavirus Infection in Rural Chaozhou, Eastern Guangdong Province of China

BackgroundHuman papilloma virus (HPV) infection was the main cause of cervical cancer. There were only a few reports and detailed data about epidemiological research of HPV infection in rural population of China.Materials and MethodsThe cervical cells of rural Chaozhou women were collected, and multiplex real time PCR was firstly performed to detect high-risk HPV (HR-HPV) infection, which could detect 13 types of HR-HPV (types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68). Then, HPV-positive samples were typed by HPV GenoArray test.ResultsHR-HPV DNA was detected by multiplex real time-PCR in 3830 of 48559 cases (7.89%). There was a peak incidence in age of 55–60 years group, and a lower incidence in who lived in plain group compared with suburban, mountain and seashore group. 3380 cases of HPV positive sample were genotyped, 11.01% (372/3380) cases could not be classified, among the typed 3008 cases, 101 cases were identified without HR-HPV type infection, 2907 cases were infected with one HR-HPV type at least, the 6 most common HR-HPV types in descending order of infection, were type 52 (33.4%, 16 (20.95%), 58 (15.93%), 33 (9.94%), 68 (9.22%) and 18 (8.36%). The combined prevalence of HPV types 16 and 18 accounted for 28.52% of total infection. However, type 52 plus 58 presented 48.23% of total infection. 2209/2907 cases were infected with a single HPV type and 698/2907 cases were infected with multiple types, and multiple infection constituent ratio increased with age, with a peak incidence in age 55–60 years group.ConclusionsOur findings showed low prevalence of HPV vaccine types (16 and 18) and relatively high prevalence of HPV-52 and -58, support the hypothesis that the second-generation HPV vaccines including HPV-52 and -58 may offer higher protection for women in rural Guangdong Province.

Understanding Barriers to Cataract Surgery Among Older Persons in Rural China Through Focus Groups

Purpose: To utilize focus groups (FGs) to identify barriers to cataract surgery specific to older persons in rural Guangdong, China.Methods: Three focus groups in separate locations were carried out for persons aged 60 years and above with best-corrected vision <= 6/18 due to cataract, either accepting or refusing surgery. Participants also ranked responses to questions about acceptance of surgery among the elderly. FG transcripts were coded independently by two investigators using qualitative data management software.Results: Twenty participants had a mean age of 72.7 ± 6.1 years, 14 (70.0%) were women and 17 (85.0%) were blind (best-corrected vision <= 6/60) in at least one eye. Cost was ranked by two of three groups as the main barrier to surgery, and all groups listed reducing cost as the best strategy to increase surgical uptake. Many respondents planned to use China’s New Cooperative Medical Scheme (NCMS) health insurance to pay for surgery. Participants showed poor understanding of cataract, but ranked educational interventions low as methods of increasing uptake. Though opinions of local service quality were poor, respondents did not see quality as an important barrier to accepting service. Participants frequently depended on family members to pay for surgery.Conclusions: Contrary to some previous reports, cost may be an important barrier to cataract surgery in rural China, which NCMS may help to alleviate. Educational interventions to increase knowledge about cataract are needed, but may face skepticism among patients. Strategies to promote cataract surgery should target the entire family.

Myopia, Spectacle Wear, and Risk of Bicycle Accidents Among Rural Chinese Secondary School Students

To study the effect of myopia and spectacle wear on bicycle-related injuries in rural Chinese students. Myopia is common among Chinese students but few studies have examined its effect on daily activities. Data on visual acuity, refractive error, current spectacle wear, and history of bicycle use and accidents during the past 3 years were sought from 1891 students undergoing eye examinations in rural Guangdong province. Refractive and accident data were available for 1539 participants (81.3%), among whom the mean age was 14.6 years, 52.5% were girls, 26.8% wore glasses, and 12.9% had myopia of less than -4 diopters in both eyes. More than 90% relied on bicycles to get to school daily. A total of 2931 accidents were reported by 423 participants, with 68 requiring medical attention. Male sex (odds ratio, 1.55; P < .001) and spectacle wear (odds ratio, 1.38; P = .04) were associated with a higher risk of accident, but habitual visual acuity and myopia were unassociated with the crash risk, after adjusting for age, sex, time spent riding, and risky riding behaviors. These results may be consistent with data on motor vehicle accidents implicating peripheral vision (potentially compromised by spectacle wear) more strongly than central visual acuity in mediating crash risk.

Distribution and visual impact of postoperative refractive error after cataract surgery in rural China: Study of Cataract Outcomes and Up-Take of Services report 4

To model the possible impact of using average-power intraocular lenses (IOLs) and evaluate the postoperative refractive error in patients having cataract surgery in rural China. Rural Guangdong, China. Patients having cataract surgery by local surgeons were examined and visual function was assessed 10 to 14 months after surgery. Subjective refraction at near and distance was performed bilaterally by an ophthalmologist. Patients had a target refraction of -0.50 diopter (D) based on ocular biometry. Of the 313 eligible patients, 242 (77%) could be contacted and 176 (74% of contacted patients, 56% overall) were examined. Examined patients had a mean age of 69.4 +/- 10.5 years. Of the 211 operated eyes, 73.2% were within +/-1.0 D of the target refraction after surgery. The best presenting distance vision was in patients within +/-1.0 D of plano and the best presenting near vision, in those with mild myopia (<-1.0 D to > or =2.0 D) (P= .005). However, patients with hyperopia (>+1.0 D) reported significantly better adjusted visual function than those with emmetropia or myopia (<-1.0 D). When the predicted use of an average-power IOL (median +21.5 D) was modeled, predicted visual acuity was significantly reduced (P= .001); however, predicted visual function was not significantly altered (P>.3). Accurate selection of postoperative refractive error was achieved by local surgeons in this rural area. Based on visual function results, aiming for mild postoperative myopia may not be suitable in this setting. Implanting average-power IOLs significantly reduced postoperative presenting vision, but not visual function.

Ocular Comorbidities among Cataract-Operated Patients in Rural China: The Caring Is Hip Study of Cataract Outcomes and Uptake of Services (SCOUTS), Report No. 3

To determine the prevalence and impact on vision and visual function of ocular comorbidities in a rural Chinese cataract surgical program, and to devise strategies to reduce their associated burden. Cross-sectional cohort study. Persons undergoing cataract surgery by one of two recently trained local surgeons at a government-run village-level hospital in rural Guangdong between August 8 and December 31, 2005. Eligible subjects were invited to return for a comprehensive ocular examination and visual function interview 10 to 14 months after surgery. Prevalent ocular comorbid conditions were identified. Presenting and best-corrected vision, visual function, and treatability of the comorbidity. Of 313 persons operated within the study window, 242 (77%) could be contacted by telephone; study examinations and interviews were performed on 176 (74%). Examined subjects had a mean age of 69.4+/-10.5 years, 116 (66%) were female, and 149 (85%) had been blind (presenting vision < or = 6/60) in the operative eye before surgery. Among unoperated eyes, 89 of 109 (81.7%) had > or =1 ocular comorbidities, whereas for operated eyes the corresponding proportion was 72 of 211 (34.1%). The leading comorbidity among operated eyes was refractive error (43/72 [59.7%]), followed by glaucoma/glaucoma suspect (14/72 [19.4%]), whereas for unoperated eyes, it was cataract (80/92 [87.0%]), followed by refractive error (12/92 [13.0%]). Among operated eyes with comorbidities, 90.3% (65/72) had > or =1 comorbidities that were treatable. In separate models adjusting for age and gender, persons with > or =1 comorbidities in the operated eye had significantly worse presenting vision (P<0.001) than those without such findings, but visual function (P = 0.197) and satisfaction with surgery (P = 0.796) were unassociated with comorbidities. Ocular comorbidities are highly prevalent among persons undergoing cataract surgery in this rural Asian setting, and their presence is significantly associated with poorer visual outcomes. The fact that the great majority of comorbidities encountered in this program are treatable suggests that strategies to reduce their impact can be successful.

The communists in rural Guangdong, 1928–1936

AbstractResearch on the subject of Chinese communism has long been marred by the “spotlight approach”, which, as Kathleen Hartford rightly criticises, “illuminates key actors and events, but leaves in the shadow the action transpiring in the corners of the historical stage”. Assuming that only a few great names and signal events bear relevance to its development, such an approach often produces simplified pictures of the Chinese communist revolution. During the last decade or so, however, an increasing number of historians have begun to take seriously the great complexities and diversities involved in this revolutionary movement. Using newly available communist Party sources, they have ventured to excavate forgotten or even deliberately ignored episodes in the history of the Chinese Communist Party (CCP). In so doing, they have not only expanded the scope of enquiry in Chinese communism but also provided new evidence for testing old interpretive structures. This article joins that trend by presenting the little-known story of the Communist struggle in rural areas of the Guangdong province from 1928 to 1936.

Computers, Scientism, and Cyborg Subjectivity in Postsocialist China

The rapid development of Chinese computer and internet industries, the immense growth in the consumption of information technologies, and the increased symbolic and practical uses of computers for both work and leisure show that Chinese subjectivity is changing to incorporate computer technology as part of how people define themselves. Based on fieldwork conducted in a rural Guangdong village from 19931999 and in urban Shanghai from 19982001, this paper will examine how scientism, an idealization of science that reifies and universalizes scientific precepts into cultural dogma, has increased traditional sources of stratification such as urban versus rural and littoral versus hinterland. With its ambivalent attitude towards new information technologies, the Chinese state has been central in shaping how computers and the internet have penetrated national borders, thus demonstrating how science and technology are subjective forms of knowledge that naturalize the particular cultural and political perspectives of the elite in postsocialist China. This paper concludes that a Chinese cyborg subjectivity is emerging, revealing how the internet and computer technology lies at the heart of the symbolic rhetoric of what it means to be a modern person in mainland China.