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Reminiscing contributes to the formulation of identity in later adulthood through integrating individuals’ recomposed past, perceived present and envisioned future. Aiming to understand rural Chinese elders’ identity construction through reminiscing, we conducted semi-structured interviews with 20 elders living in ShiGo, a village located in the south-west of China. Data analysis suggests the rural elders in this study constructed a hero–victim identity through telling stories about the hardships they went through and the sacrifices they made. The participants narrated suffering from lack of basic living needs in the past, in particular before the 1980s while they were involved in turmoil brought on by wars and national movements, from destructive relationships, from making sacrifices for the country and their families, and from adapting to challenges brought on by the hardships. The rural elders shared life experiences with other villagers in daily life through bitter-sweet telling and wanted their suffering and sacrifices to be witnessed. Witnessing connects suffering, sacrifice, hero and victim into a self-enforcing system that helps the elders maintain interdependence and defence against existential concerns like death anxiety. A hero–victim dialectic model was presented to capture the self-enforcing attribute of the hero–victim identity. Findings of this study could be used to make sense of rural ageing in China and benefit clinical professionals working with rural Chinese elders.
After emancipation, most African Americans remained tethered to agricultural economies, while others migrated to cities seeking better opportunities. Although bioarchaeologists have made significant interventions in researching people of African descent, there are relatively few published comparative studies that address their morbidity and mortality after slavery. This study compares the bioarchaeological evidence for rural and urban southern United States populations to address disparities in health and longevity. It considers the biological effects of racism, including the health impacts of poverty, disease, and malnourishment. Although historians and demographers argue that urban life was especially detrimental to health, the results of this research suggest greater complexity in African American well-being. Whereas urban adults had higher midlife mortality and reduced longevity compared to their rural counterparts, both rural and urban children experienced poor health. Rural child mortality and morbidity varied significantly, suggesting differences in diet and disease exposure across rural communities. With regard to gender, rural and urban women died at younger ages than men. This disparity in mortality is partly attributed to black women's working and reproductive lives within the context of racism and gender inequality.
KOKAN region is characterized by undernutrition across all stages of lifecycle. Developmental Origins of Health & Disease hypothesis suggests that environmental influences in the early period of growth and development can contribute to the risks of noncommunicable diseases (NCD) in adulthood. Newborns and placentas of 815 pregnant mothers delivered in a rural hospital were studied. We tested the hypothesis that low placental weight will be associated with low birth weight (LBW). Mothers had a mean age of 26 years and were smaller in size at delivery [mean height of 152.1 cm (±6.1 cm), weight 52 kg (±10.2 kg), body mass index (BMI) 22.5 kg/m2 (±4.1 kg/m2)]. Mean placental weight was 488 g (±120 g). Mean birth weight, length, and head circumference of the newborn were 2.54 kg (±0.5 kg), 46.3 cm (±3.1 cm), and 32.7 cm (±1.7 cm), respectively. Prevalence of LBW, stunting, and small head size was 41.6%, 42.2%, and 18.2%, respectively. Maternal height, weight, and BMI at delivery were all positively associated with placental weight (p < 0.01 for all). Mothers with placentas in the lowest placental weight tertile had an increased likelihood of producing an LBW baby [OR 7.7, 95% CI (5.0, 11.8)], a stunted baby [OR 1.9 (1.4, 2.9)], or a baby with a small head circumference [OR 2.4 (1.4, 4.0)]. Mothers in the lowest height tertile had odds of producing a LBW baby [OR 1.8 95% CI (1.2, 2.7)] or a stunted baby [OR 1.6 (1.1, 2.3)]. There is a need to improve the nutritional status of women in KOKAN region which may reduce the risk of NCD.
Among the major reform activities drawn from the transnational experiences of Korean women were the rural revitalization projects that took place from the late 1920s to the mid-1930s, a period of worsening economic conditions in the rural communities. Danish rural programs were a particular source of inspiration for Korean reformers. This chapter offers a detailed history of the role that women reformers played in the rural revitalization movement. At the core of these efforts was an interdenominational, global Christian network that brought together people, resources, and information and linked the urban elite with the rural populace. This chapter argues that these women reformers were pursuing an alternative modernity that was inspired by their transnational experience in Europe and the US but reworked for the local conditions in Korea.
To explore, adolescents’ and caregivers’ perspectives, about shaping of diet and physical activity habits in rural Konkan, India.
Five focus group discussions (FGD) were conducted with adolescents and two with caregivers. Data were analysed using thematic analysis.
FGD were conducted in secondary schools located in remote rural villages in the Ratnagiri district, Konkan region, Maharashtra, India.
Forty-eight adolescents were recruited including twenty younger (10–12 years) and twenty-eight older (15–17 years) adolescents. Sixteen caregivers (all mothers) were also recruited.
Three themes emerged from discussion: (i) adolescents’ and caregivers’ perceptions of the barriers to healthy diet and physical activity, (ii) acceptance of the status quo and (iii) salience of social and economic transition. Adolescents’ basic dietary and physical activity needs were rarely met by the resources available and infrastructure of the villages. There were few opportunities for physical activity, other than performing household chores and walking long distances to school. Adolescents and their caregivers accepted these limitations and their inability to change them. Increased use of digital media and availability of junk foods marked the beginning of a social and economic transition.
FGD with adolescents and their caregivers provided insights into factors influencing adolescent diet and physical activity in rural India. Scarcity of basic resources limited adolescent diet and opportunities for physical activity. To achieve current nutritional and physical activity recommendations for adolescents requires improved infrastructure in these settings, changes which may accompany the current Indian social and economic transition.
The end of the villa landscape in the north-western Roman provinces is characterized by significant transformation. One facet is the use of the villa complex and its surrounding area for funerary purposes. Traditionally, these burials have been divided into large-scale reuse of sites in the Migration period and small-scale transitional burials. The study of the latter has previously often been misguided or neglected. In this article, the author examines these transitional burials, addresses their historical background, and presents a new approach for assessing the scale, temporal distribution, and characteristics of a group of sites with funerary evidence in Belgica, Britannia, and the Germanic provinces.
On August 9, 2014, Michael Brown, an unarmed eighteen-year-old African American man, was fatally shot by Darren Wilson, a white police officer, following a violent altercation on the streets of Ferguson, Missouri. With many of the crucial facts surrounding Brown’s death under dispute – in particular, whether Wilson’s stop of Brown was justified, whether Wilson or Brown initiated the confrontation, whether Brown surrendered or resisted arrest – many residents in the majority African American community took to the streets to protest what they viewed as an emblematic instance of police brutality, as well as general indifference among community leaders toward the concerns of black and brown residents. In response, Ferguson police – and eventually the Missouri National Guard – mustered an intimidating show of force in an effort to contain the protests. The presence of large numbers of heavily armed police and guardsmen exacerbated an already tense situation, leading to charged and sometimes violent encounters between protestors and law enforcement officials. Wilson’s killing of Brown, the heated and sometimes violent protests, and the extraordinary heavy-handedness of the police response made the events in Ferguson national news, riveting public attention and forcing conversations about police brutality and the over-policing of communities of color.
The COVID-19 pandemic has posed many challenges in maintaining standards of care and treatment for patients while managing the increased anxieties of patients, carers and the public in general. This paper highlights several clinical, administrative, medicolegal and IT implications of COVID-19 on the delivery of mental healthcare to an elderly vulnerable patient cohort due to recommended social distancing measures. Our Psychiatry of Later Life team has adapted to this by restricting face-to-face consultation, while continuing to provide telephone support. We have modified our documentation standard and have improved some aspects of our team working by facilitating flexible working arrangement and relevant training for staff as well as by embracing new technology. Notwithstanding the challenges therefore, this exceptional time has also opened avenues for new and innovative opportunities that can be further explored even when the current crisis eventually passes.
Even though sub-Saharan African women spend millions of person-hours per day fetching water and pounding grain, to date, few studies have rigorously assessed the energy expenditure costs of such domestic activities. As a result, most analyses that consider head-hauling water or hand pounding of grain with a mortar and pestle (pilão use) employ energy expenditure values derived from limited research. The current paper compares estimated energy expenditure values from heart rate monitors v. indirect calorimetry in order to understand some of the limitations with using such monitors to measure domestic activities.
This confirmation study estimates the metabolic equivalent of task (MET) value for head-hauling water and hand-pounding grain using both indirect calorimetry and heart rate monitors under laboratory conditions.
The study was conducted in Nampula, Mozambique.
Forty university students in Nampula city who recurrently engaged in water-fetching activities.
Including all participants, the mean MET value for head hauling 20 litres (20·5 kg, including container) of water (2·7 km/h, 0 % slope) was 4·3 (sd 0·9) and 3·7 (sd 1·2) for pilão use. Estimated energy expenditure predictions from a mixed model were found to correlate with observed energy expenditure (r2 0·68, r 0·82). Re-estimating the model with pilão use data excluded improved the fit substantially (r2 0·83, r 0·91).
The current study finds that heart rate monitors are suitable instruments for providing accurate quantification of energy expenditure for some domestic activities, such as head-hauling water, but are not appropriate for quantifying expenditures of other activities, such as hand-pounding grain.
To test the independent and combined impact of social cohesion and geographic locale (urban/rural) on quality of life (QoL) for older adults in China. Using conditional process analysis, we tested three hypotheses: (1) QoL will be lower for persons living alone than those who live with family; (2) social cohesion will mediate the association of living arrangement and QoL; and (3) geographic locale will moderate direct and indirect pathways in the mediation model.
Cross-sectional data from WHO Study on Global Aging and Adult Health (SAGE) (China, Wave 1, 2007–2010).
National probability sample of 74 primary sampling units in China, 32 in urban, and 32 in rural areas.
A total of 9,663 adults aged 50 years and older.
We measured QOL with the 8-item version of the WHOQOL-Bref; living arrangement as alone versus with family; and social cohesion with an 9-item index of frequency of a range of social activities in the previous 12 months. We controlled for sociodemographic characteristics and health and mental health variables in multivariate analyses.
Data supported the first two hypotheses; however, the mediating effects of social cohesion held only in urban areas.
This study advances the large body of work on living arrangements and well-being of older adults in China. Social cohesion contributed to better QoL regardless of living arrangement, and cohesion mediated the association of living arrangement and QOL in urban but not rural areas. Programs and policies that strengthen social cohesion through older adults’ community involvement, especially in urban areas, will help to enhance QoL.
The scarcity of Romano-British human remains from north-west England has hindered understanding of burial practice in this region. Here, we report on the excavation of human and non-human animal remains1 and material culture from Dog Hole Cave, Haverbrack. Foetal and neonatal infants had been interred alongside a horse burial and puppies, lambs, calves and piglets in the very latest Iron Age to early Romano-British period, while the mid- to late Roman period is characterised by burials of older individuals with copper-alloy jewellery and beads. This material culture is more characteristic of urban sites, while isotope analysis indicates that the later individuals were largely from the local area. We discuss these results in terms of burial ritual in Cumbria and rural acculturation. Supplementary material is available online (https://doi.org/10.1017/S0068113X20000136), and contains further information about the site and excavations, small finds, zooarchaeology, human osteology, site taphonomy, the palaeoenvironment, isotope methods and analysis, and finds listed in Benson and Bland 1963.
This paper studies rural populations in the Roman frontier province of Germania inferior, employing a perspective that allocates more space to the exploitative and repressive aspects of Roman rule. We draw attention to an alternative series of topics than the ones currently presented in rural archaeology. This includes attention to situations of crisis and instability, to fundamental reordering of rural populations, to issues of migration and to the interconnectivity of rural developments and imperial power structures. While these topics are usually considered as ‘historically given’, they are rarely the subject of serious archaeological research. This attempt at a more historicising approach does not mean a simple return to the traditional paradigm of historische Altertumskunde. Much better equipped than our predecessors of two or three generations ago, we archaeologists of the 21st century are able to engage in a critical and creative dialogue with historical sources and models.
Regional patient and physician density patterns pose problems to accessing care for people with Parkinson’s disease, though telehealth may improve access. We surveyed and conducted a focus group for people with Parkinson’s disease in Interior British Columbia regarding barriers to neurological care. Eighteen individuals completed the survey and seven parties joined the focus group. Perceived barriers include cost and difficulty of travel, wait times, and lack of specialized services outside large cities. 80% of participants (95% CI 64–96) would likely use telehealth for follow-up neurologist appointments. This sample of people with Parkinson’s disease reports willingness to use telehealth to reduce travel and improve access to specialty care.
This paper provides description and context for some of the discoveries made by the Royal Commission on the Ancient and Historical Monuments of Wales during aerial reconnaissance in the drought conditions of the summer of 2018. New discoveries include two marching camps, three auxiliary forts and a remarkable series of stone buildings outside the fort at Pen y Gaer. The photographs also clarify the plan of several known villas as well as identifying some potential villa sites and enclosure systems of probable Romano-British date in south-eastern, south-western and north-western Wales. The recognition of a new road alignment south of Carmarthen is suggestive of another coastal fort at or near Kidwelly.
Agricultural production in Brazil has increased in recent decades. Despite this, the rural population continues to face income inequality. Policies targeting this issue, such as rural credit, have been implemented during this period. This study estimates the influence of credit on income inequality in Brazilian rural areas. Results suggest that the family farming credit program (PRONAF) is not associated with increase in inequality. However, access to rural credit from sources other than PRONAF has led to greater household income inequality. Results also indicate that greater levels of education and access to rural extension have boosted the effect of credit on income.
Chapter 2 examines how the CCP recruited millions of workers to construct the Third Front. Party officials sought to socially engineer a labor force that embraced Maoist norms and disregarded difficulties that moving to remote inland areas brought to their family or their own person. In practice, people responded to recruitment in various ways. Some thought of expanding China’s industrial defenses as a way of manifesting their devotion to Chinese socialism. Many others were more concerned about the material benefits and burdens that Third Front participation would bring to their region, factory, family, or self. Shanghai leaders urged central planners not to neglect the coast, whereas administrators in inland provinces requested more skilled workers and equipment. Urban residents fretted over what housing, schooling, and cultural activities would be available in China’s impoverished hinterlands. Rural youth, on the other hand, were eager to earn higher wages. But many of their parents were worried about losing household labor and the possibility that their children might be accidentally injured or die. Overall, my research illustrates that the consequences of enlisting in the Third Front were not always clear and that the value of being involved varied according to one’s geographical, social, and economic position.
Southeastern Appalachian Ohio has more than double the national average of diabetes and a critical shortage of healthcare providers. Paradoxically, there is limited research focused on primary care providers’ experiences treating people with diabetes in this region. This study explored providers’ perceived barriers to and facilitators for treating patients with diabetes in southeastern Appalachian Ohio.
We conducted in-depth interviews with healthcare providers who treat people with diabetes in rural southeastern Ohio. Interviews were transcribed, coded, and analyzed via content and thematic analyses using NVivo 12 software (QSR International, Chadstone, VIC, Australia).
Qualitative analysis revealed four themes: (1) patients’ diabetes fatalism and helplessness: providers recounted story after story of patients believing that their diabetes was inevitable and that they were helpless to prevent or delay diabetes complications. (2) Comorbid psychosocial issues: providers described high rates of depression, anxiety, incest, abuse, and post-traumatic stress disorder among people with diabetes in this region. (3) Inter-connected social determinants interfering with diabetes care: providers identified major barriers including lack of access to providers, lack of access to transportation, food insecurity, housing insecurity, and financial insecurity. (4) Providers’ cultural understanding and recommendations: providers emphasized the importance of understanding of the values central to Appalachian culture and gave culturally attuned clinical suggestions for how to use these values when working with this population.
Evidence-based interventions tailored to Appalachian culture and training designed to increase the cultural competency and cultural humility of primary care providers may be effective approaches to reduce barriers to diabetes care in Appalachian Ohio.
The Revolution of 1949 did not begin the shift to greater state capitalism. Chapter 2 examines the shift toward greater state capitalism in the lead up to and after 1949 by addressing why the CCP decided that facilitating the expansion of industrial production was more important than transforming the social relations of production. In short, military competition required rapid industrialization. Together, the first two chapters show how the CCP built on the pre-existing institutional foundations for the expansion of consumerism. The CCP consistently subordinated the transformation of social relations to the goal of amassing ever greater sums of capital and control over it and tolerated contradictory policies toward capitalists as long as those policies helped facilitate more immediate goals. Two mass campaigns examined illustrate how the CCP instrumentalized class warfare and used it only for greater capital accumulation rather than socialist transformation. Then the final section shows that the same CCP outcome of accumulation over social transformation applies to the countryside.
Chapter 4 chronicles everyday life in the first Third Front project that Mao proposed – the steel town of Panzhihua in southern Sichuan. I demonstrate that Maoist ideas about how to build Chinese socialism profoundly impacted daily affairs in Panzhihua. In accordance with Maoism’s productivist ethos, officials focused on increasing production and building high-tech industry. Workers, meanwhile, were housed for years in barracks-style tents and provided with minimal consumer goods. Many Panzhihua residents did not experience the austerity of everyday life in ways that the Party considered appropriate to a good Maoist subject. Some recruits did not accept the CCP’s expectation that they be satisfied with building socialism wherever the Party decided was best. Others tired of their hectic work schedule and were bored with Panzhihua’s limited cultural life. Urban recruits desired to be with family in distant locations and move to a city higher up in socialist China’s socioeconomic order. Rural folk also wished to be with family but in contrast to urbanites they considered gaining access to the welfare provisions of a state–owned enterprise to be a route out of rural poverty. On both sides of the urban–rural divide, practices of daily life became the contested ground of Maoist developmentalism.
Japan has been described as ‘the land of cooperatives’. This chapter looks at the long history of agricultural, consumer and medical cooperatives in Japan, and explores the role of cooperatives in Japan’s informal life politics by focusing particularly on the story of one experiment in cooperative medicine: Saku Central Hospital in Nagano Prefecture, founded in 1944. In the first half of the twentieth century, cooperatism in Japan was promoted both by the government, which saw it as a means of combatting political radicalism, and by some left-of-centre activists who saw it as a path to fundamental social reform. During the 1930s, the Christian social reformer Kagawa Toyohiko gained international fame for a social vision (particularly influential in the United States) centred on cooperatives. Building on aspects of these diverse traditions, Saku Central Hospital was the starting point for an innovative postwar program of rural medicine, in whose development the hospital’s second director, Wakatsuki Toshikazu, played a key role. The hospital’s philosophy defined ‘health’ as a social phenomenon whose scope went far beyond the immediate treatment of diseases. This social vision of health care has had widespread influence in Japan and other parts of Asia.