Objectives: To study the relationship between social capital and depression among older adults from urban China and the mediating effect of social support on the influence of social capital on depression. Methods: Data were collected from face-to-face interviews targeting older adults (N = 928, response rate = 68.1%) aged over 60 years residing in Hangzhou, China, in 2013. Indicators of social capital included both cognitive (trust and reciprocity) and structural (social network and social participation) aspects. The dependent variable depression was measured by the Geriatric Depression Scale, social support was measured by the Multidimensional Scale of Perceived Social Support, and sociodemographic variables (age, education, and household income) and physical function were controlled for analysis. The data were analyzed by factor analysis and a hierarchical regression model. Results: Trust, reciprocity, and social network were significantly associated with geriatric depression after controlling. Social participation was not correlated with geriatric depression. Social support partially mediated the relationships between social capital and geriatric depression. Conclusion: This study provides new evidence that social capital effectively mediates geriatric depression directly and indirectly. The intervention of social capital on depression should therefore consider the two pathways. Future longitudinal studies should help further understand the mechanisms linking social capital and depression.

Tens of millions of rural “left-behind children (LBC)” in China grow up experiencing prolonged separation from their migrant worker parents. This study aimed to explore how children are affected by parental migration, from the perspectives of children, parents, and grandparents, focusing on the experiences of prolonged parent-child separation and relationship dynamics in the extended family. Qualitative in-depth interviews were conducted in a migrant-sending rural area of eastern China. Participants included 25 children (aged 7 to 14), 17 parents, and 13 grandparents, from 30 families, as well as 24 key informants from the communities. Data analysis followed a grounded theory approach. The results showed that despite the original purpose of benefiting children, parental migration resulted in challenges in child psychosocial well-being, due to the emotional impacts from prolonged parent-child separation. Parental absence also led to inadequate care and support for left-behind children. The negative effects of parental migration may be exacerbated by other vulnerabilities such as parents’ divorce, poverty and grandparent caregivers’ frailty. Concerns about child well-being made some migrants decide to return home permanently, because of the altered trade-offs of migration. Prolonged separation following migration often disrupts parent-child relationships and results in psychosocial difficulties in LBC, especially among those who live with multiple adversities in the family. Community-based interventions may help migrant parents and co-resident caregivers to better engage children and promote their resilience.

Purpose Prolonged separation from migrant parents raises concerns for the well-being of 60 million left behind children (LBC) in rural China. This study aimed to investigate the impact of current and previous parental migration on child psychosocial well-being, with a focus on emotional and behavioral outcomes, while considering factors in family care and support. Methods Children were recruited from schools in migrant-sending rural areas in Zhejiang and Guizhou provinces by random stratified sampling. A self-administered questionnaire measured children’s psychosocial well-being, demographics, household characteristics, and social support. Multiple linear regression models examined the effects of parental migration and other factors on psychosocial difficulties. Results Data from 1930 current, 907 previous, and 701 never LBC were included (mean age 12.4, SD 2.1). Adjusted models showed both previous and current parental migration was associated with significantly higher overall psychosocial difficulties, involving aspects of emotion, conduct, peer relationships, hyperactivity, and pro-social behaviors. Parental divorce and lack of available support demonstrated a strong association with greater total difficulties. While children in Guizhou had much worse psychosocial outcomes than those in Zhejiang, adjusted subgroup analysis showed similar magnitude of between-province disparities regardless of parental migration status. However, having divorced parents and lack of support were greater psychosocial risk factors for current and previous-LBC than for never LBC. Conclusions Parental migration has an independent, long-lasting adverse effect on children. Psychosocial well-being of LBC depends more on the relationship bonds between nuclear family members and the availability of support, rather than socioeconomic status.

In China, there are an estimated 41 million left-behind children (LBC). The objective of this study was to examine the mental health of current-left-behind children (current-LBC) and previous-left-behind children (previous-LBC) as compared to never-left-behind children (never-LBC), while considering factors like parent-child communication. Children were recruited from schools in rural areas of Anhui province in eastern China. Participants completed a questionnaire focusing on migration status, mental health, and parent-child communication, measured with the validated Strengths and Difficulties Questionnaire (SDQ) and Parent–Adolescent Communication Scale (PACS). Full data were available for 1251 current-, 473 previous-, and 268 never-LBC in Anhui province. After adjusting for all confounding variables, the results showed that both current and previous parental migration was associated with significantly higher mental health difficulties, including aspects of emotional symptoms, conduct problems, hyperactivity, and total difficulties. Additionally, we found that difficulties communicating with parents were strongly associated with the presence of greater total difficulties in children. Parental migration has an independent, long-lasting negative effect on children. Poor parent-child communication is strongly associated with children’s mental health. These results indicate that parent–child communication is important for the development of children, and interventions are needed to improve migrant parents’ understanding and communication skills with their children.

China has undergone massive socio-economic change over the past 30 years. In parallel, there have been huge changes in social and sexual mores. Until the end of the Mao era strict norms prevailed, with sex outside marriage widely regarded as immoral and unacceptable. Detraditionalisation theory describes the abandonment or reconfiguration of the socio-cultural traditions and has been explored widely in Western settings. This study aimed to explore its relevance for China through exploring attitudes towards premarital sex, extramarital sex, same-sex relations and sex work. We conducted semi-structured interviews with 212 men and women aged 18 to 39 in urban and rural areas of three provinces: Zhejiang, Guizhou and Yunnan. Analysis identified emerging themes. Results show varying degrees of acceptance of the four sexual behaviours, with premarital sex seen as common, homosexuality still regarded as unacceptable by the majority but considerable acceptance of commercial sex work as part of male business transactions and social life. China appears to be on a pathway of detraditionalisation with specific Chinese features. This study suggests that the concept of detraditionalisation applies well to non-Western contexts, but the path it takes is culture-specific and relatively unpredictable.

Objective: Inappropriate antibiotic use leads to antibiotic resistance. This has become a serious global crisis, with more multi-drug resistant infections and fewer effective antibiotics available. This study aims to understand knowledge, attitude, and practice (KAP) with respect to antibiotic use for self-limiting illnesses among medical students in China. Methods: An online cross-sectional survey instrument questionnaire was distributed in six regional universities in China from September to November 2015. Overall, 1819 medical students were enrolled. A pre-tested questionnaire was delivered by the researchers. KAP scores were calculated to determine the appropriation. Chi-squared and multivariable logistic regression and adjusted odd ratios (aORs) with 95% confidence interval (CI) were used to assess the relationship between the demographic characteristics and antibiotic use knowledge and behaviour. Results: In total, 11,192 students completed the questionnaires, with a response rate of 95%. In total, 529 (29%) medical students reported at least one self-limiting illness in the prior month. Of those with a self-limiting illness, 285 (54%) self-medicated, with 77 (27%) using antibiotics; 111 (21%) went to see a doctor, of which 64 (58%) were prescribed antibiotics, and 133 did nothing (25%). In the past year, 279 (15%) of medical students had used antibiotics as prophylaxis, and 273 (15%) of medical students had demanded an antibiotic from a doctor. Meanwhile, 1166 (64%) of them kept a personal stock of antibiotics, and 1034 (57%) of them had bought antibiotics at a pharmacy, of which 97% were purchased without a prescription. Students with high KAP scores with respect to antibiotics were significantly less likely to self-medicate with antibiotics (aOR 0.37, 95% CI 0.15–0.91, p = 0.031), use antibiotics for prophylaxis (aOR 0.35, 95% CI 0.21–0.60, p < 0.0001), or demand an antibiotic (aOR 0.46, 95% CI 0.26–0.81, p = 0.007) from the doctor. Logistical regression showed that students whose fathers had a higher education level, whose mothers had medical background, who were from urban areas were more likely to stock antibiotics and self-medicate with antibiotics. Conclusion: High rates of antibiotic self-medication for self-limiting illness and stocking of antibiotics among medical students were observed. Along with the high rates of medical students receiving unnecessary antibiotics from their doctors were observed. The students’ knowledge and attitude towards to antibiotics, which drive prescribing, highlight the urgent need for effective antibiotic stewardship and training programs in Chinese healthcare institutes and medical schools.