Communities In Beijing Research Articles

The triglyceride glucose index predicts the risk of nonfatal cardio-cerebrovascular disease in the Beijing community: a prospective cohort study

Objective: To explore the characteristics of the association between the triglyceride glucose (TyG) index and nonfatal cardio-cerebrovascular disease risk in a community population. Method: This was a prospective cohort study. From December 2011 to April 2012, the first investigation was conducted among subjects with more than 40-year old who were from Shijingshan district and Pingguoyuan community in Beijing. The second investigation was conducted from April to October 2015. All the subjects were divided into three groups according to the tertile of the TyG index at baseline. The multivariate Cox proportional risk regression model was established to explore the correlation between the TyG index and nonfatal cardio-cerebrovascular disease risk and the Kaplan-Meier survival curve of the TyG index group was drawn. Subgroup analyses were performed according to age, gender, body mass index, type 2 diabetes mellitus (T2DM), hypertension, and hyperlipidemia to determine the correlation characteristics between the TyG index and nonfatal cardio-cerebrovascular disease among subgroups. Results: A total of 9 577 subjects were finally included to analyze. The mean follow-up time of this study was (34.14±3.84) months. During the follow-up, 363 subjects (3.8%) occurred nonfatal cardio-cerebrovascular disease. The multivariate Cox regression analysis results showed that the hazard ratio (HR) of nonfatal cardio-cerebrovascular disease in the high TyG index group was 1.54 (95%CI 1.19-1.98), 1.60 (95%CI 1.23-2.10), and 1.57 (95%CI 1.20-2.05) in the three models, compared with the low TyG index group. The Kaplan-Meier analysis showed that the risk of nonfatal cardio-cerebrovascular disease increased from the low-TyG index group to the high-TyG index group (P=0.015). In the six subgroups analysis, only gender was shown to have a significant interaction effect with the TyG index and nonfatal cardio-cerebrovascular disease risk. In the female population, the risk of nonfatal cardio-cerebrovascular disease is significantly increased with the increase in the TyG index level (P<0.001). Conclusions: A high TyG index is independently related to the increased risk of nonfatal cardio-cerebrovascular disease in the Beijing community population. Gender has a significant interaction with the TyG index and nonfatal cardio-cerebrovascular disease risk. Therefore, the TyG index may be a useful marker to predict the nonfatal cardio-cerebrovascular disease risk of a community population.

Optimization of integrated energy system for low-carbon community considering the feasibility and application limitation

Integrated energy system (IES) is characterized by high self-consumption ratio of on-site generated renewable energy, high efficiency of conventional energy utilization and possesses a significant flexibility in its operation. This overall, constitute to the foundation of low-carbon communities. Considering economic and environmental benefits, this paper proposes a two-layer co-optimization model with the upper layer optimizing the IES configuration and the lower layer optimizing IES operation. A community in Beijing is introduced as a case study to analyze the benefits of IES and compared with the conventional energy system. Multiple scenarios are researched, including (a) IES for low-carbon communities with PV roof area limitation, (b) IES for each of the four building types with PV roof area limitation, (c) IES for low-carbon communities without PV roof area limitation. The results indicate that the optimized IES for community can reduce the cost by 25% and CO2 emissions by 32% per year by considering the limitation of roof area for the PV system. Without this constraint, the costs and emissions could be reduced by 20% and 62%, respectively. In addition, IES is more appropriate for office and commercial buildings since their load characteristics allow for load shifting and community-level IES costs and emissions are 8% and 10% lower than building-level due to the complementary of community load. This study provides suggestions for the IES planning and application in low-carbon community.

Underload and overload communities: Revealing the conflicts between population distribution and carrying capacity at an inner-city community scale

The mismatch between population distribution and carrying capacity of the local living environment is an essential cause of the human-living environment conflict, threatening sustainable city development. Previous studies mostly focused on population density at coarse scales, e.g., national, regional, or city, but ignore carrying capacity at the inner-city scale, namely community scale hereafter. Accordingly, we define community carrying capacity of population (CCCP) as a reference to extract underload and overload communities to represent unsustainable development modes. We firstly establish an indicator system to measure living environments of diverse communities considering natural, built, and socioeconomic environments, based on which we then propose a cyclic random forest to measure the heterogeneous CCCPs of 1,335 communities in Beijing, and finally the CCCPs are compared to the actual population distribution for extracting underload and overload communities. The experimental results find 261 underload, 332 overload, and 742 well-balanced communities. The findings suggest to consider the main controlling factors of carrying capacities in diverse communities to improve the CCCPs of overload communities and restrict the further development of underload communities for reducing human-living environment conflicts. This research is a pioneer to consider CCCP for evaluating population loads and helps explore the inequality at the inner-city scale, which contributes to fine-scale land use policies for facilitating sustainable cities and communities.

14-LB: Abdominal Obesity Indices Predict Incident Renal Events in a 10-Year Cohort with Type 2 Diabetes Mellitus

Background: Obesity, especially abdominal obesity, has been associated with diabetes. However, few studies focused on the association between obesity indices and diabetic nephropathy, let alone the longitudinal studies. Waist circumference (WC), visceral adiposity index (VAI), Chinese visceral adiposity index (CVAI) and lipid accumulation product (LAP) are described as abdominal obesity indices. The present study aimed to explore the associations between these indices and incident renal events in a 10-year cohort with type 2 diabetes mellitus (T2DM). Methods: A total of 2709 participants with T2DM from the Beijing Community Diabetes Study were included. Prespecified renal outcomes included incident or worsening nephropathy (progression to macroalbuminuria, doubling of the serum creatinine, initiation of renal-replacement therapy, or renal death) and incident albuminuria. Multivariable Cox regression were applied to analyze the associations between these indices and renal events. Results: Multivariable analyses indicated that each 1-SD increase in WC, VAI, CVAI and LAP was associated with a higher risk of renal events, with adjusted hazard ratios (HRs) being 1.236 [95% CI (confidence interval): 1.079-1.417], 1.135 (1.026-1.257), 1.295 (1.132-1.483), and 1.144 (1.036-1.263), respectively. Moreover, participants in the highest quartile of abdominal obesity indices were at higher risk of renal events compared to those in the lowest quartile (all P for trend&amp;lt;0.05). However, only CVAI was always significantly positively associated with incident renal events in all subgroups, including gender (male vs. female), age (&amp;lt; 60 years vs. ≥60 years) and ACEI (angiotensin-converting enzyme inhibitor) or ARB (angiotensin II receptor blocker) treatment (no vs. yes). Conclusion: Abdominal obesity indices could predict renal events in a 10-year cohort with T2DM, and CVAI may be more universal to predict renal events than WC, VAI and LAP in certain population. Disclosure C. Ma: None. M. Yuan: None. Funding Capital's Funds for Health Improvement and Research (2022-1-1101, 2016-1-2057)

The association between brachial-ankle pulse-wave velocity and adverse cardiovascular events in 5719 community participants a prospective cohort study.

The brachial-ankle pulse-wave velocity (baPWV) is regarded as the gold standard in the evaluation of arterial stiffness. Its prognostic significance for major adverse cardiovascular events (MACE) has been demonstrated. However, the factors influencing the association between baPWV and MACE risk have not been determined. In this study, we investigated the association of baPWV and MACE risk and whether it is affected by the risk factors for different cardiovascular diseases (CVDs). This was a prospective cohort study that initially enrolled 6850 participants from 12 communities in Beijing. The participants were divided into three subgroups according to their baPWV values. The primary outcome was the first occurrence of MACE, defined as hospitalization from cardiovascular diseases, first occurrence of a nonfatal myocardial infarction, or nonfatal stroke. Cox proportional hazards regression and restricted cubic spline analyses were used to examine the association between baPWV and MACE. The effect of CVD risk factors on the relationship between baPWV and MACE was explored in subgroup analyses. The final study population consisted of 5719 participants. During a median follow-up of 34.73 months, MACE occurred in 169 participants. The restricted cubic spline analysis indicated a positive linear relationship between baPWV and MACE risk. After adjustment for cardiovascular risk factors, the hazard ratio (HR) for MACE risk per SD increase in baPWV was 1.272 [95% confidence interval (CI): 1.149-1.407, P < 0.001], and the HR for MACE in the high-baPWV vs. the low-baPWV group was 1.965 (95% CI: 1.296-2.979, P = 0.001). Adding baPWV to the conventional cardiovascular risk factors significantly improved the model's prediction performance and the net reclassification (NRI) [NRI: 0.379 (95% CI: 0.072-0.710), P = 0.025] in MACE discrimination. However, in the subgroup analysis, two CVD risk factors, stable coronary heart disease and hypertension, showed significant interaction effects (Pinteraction both < 0.05). This result indicated that the effect of CVD risk factors must be taken into account when assessing the relationship between baPWV and MACE. baPWV is a potential marker to improve the identification of MACE risk in the general population. A positive linear correlation was firstly determined between baPWV and MACE risk, but it may not be valid in participants with stable coronary heart disease and hypertension.

THE DIFFERENCE IN BLOOD PRESSURE BETWEEN THE TUNNEL BLOOD PRESSURE MONITORS IN THE WAITING AREA AND UPPER ARM BLOOD PRESSURE MONITORS IN THE CLINIC

Objective: Tunnel blood pressure as an out-of-clinic screening program is often more casual, and its consistency with office blood pressure dominated by upper arm blood pressure and whether it can replace office blood pressure remains unclear. The aim of this study was to analyze the differences between the two blood pressure measurements. Design and method: The study dates from the Majiapu community, which is a big community in Beijing. We analyzed blood pressure with different measurements containing tunnel (waiting area,9002P) and upper arm (clinic, OMRON 1120U) blood pressure measurements. We compare the two measurements by the mean average value and standard deviation (SD) of the two measurements. Besides, we compare the mean blood pressure in the subgroups which contain the age, sex, blood lipids, blood glucose, and different blood pressure levels. Results: In this study, a cohort of 35069 individuals aged 0 to 105 years, 19443 were randomly assigned to the tunnel blood pressure measurement group (TBPG) and 15626 to the upper arm blood pressure measurement group (UBPG). The qualified rate of the UBPG was 64.76% in 140/90 mm Hg and 54.66% in 130/80 mm Hg. In baseline, the mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.0±21.3 mm Hg and 76.3±12.0 in the TBPG, 134.9±22.3 mm Hg and 80.3±12.5 in the UBPG. In the age more than 60 years subgroup, the mean SBP in the TBPG with 139.0±21.1 mm Hg was similar to the other group, which was 138.5±22.4 mm Hg, the mean DBP was on the contrary, which was 74.8±11.4 and 79.6±11.9 mm Hg respectively. Similar results can be found in the age&lt; 60 years, sex, blood lipids, and blood glucose subgroups. In the BP more than 140/90 mmHg subgroup, the SBP difference was only 0.1 mmHg, but the DBP was 5 mmHg, as same as the BP more than 130/80 mmHg subgroup. The DBP difference was much smaller in the low BP level. Conclusions: The clinic SBP for the tunnel (waiting area) and upper arm (clinic) blood pressure monitors were similar, but the DBP differ significantly between the two groups.

FEWER ANTIHYPERTENSIVE DRUGS ACHIEVE STRICTER BLOOD PRESSURE TARGET IN LESS SEVERE HYPERTENSIVE PATIENTS: A RETROSPECTIVE STUDY IN A COMMUNITY IN BEIJING

Objective: Nowadays, it is not clear how many antihypertensive drugs should be used to achieve treatment goals from real-world studies. This study aims to analyze the BP control situation and the burden of anti-hypertensive drugs in a big community in Beijing. Design and method: We conducted a retrospective study of 4991 residents living in the Majiapu community and collected the baseline and the follow-up data including blood pressure (BP) and drug prescription. BP was analyzed by the mean average value. Hypertension is defined as office systolic BP &gt; = 140mmHg and/or diastolic BP &gt; = 90mmHg. We divided the patient with antihypertensive treatment into a strict control group (BP&lt;130/80mmHg) and a standard control group (BP range from 130-139/80-89mmHg). The comparison of baseline and follow-up data were used to recognize the burden of anti-hypertensive drugs for residents with hypertension and estimate the BP control rate in this population. Results: Of 4991 residents, the prevalence of hypertension was 54%, 34.80% (939) of the patients were under 140/90mmHg and 14.46% (390) were under 130/80mmHg. The control rate of standards of 140/90mmHg and 130/80mmHg among the whole population was 64.7% and 35.3%. And the treatment rate in the whole group of hypertension was 62.5%. In the standard control group, the average number of antihypertensive drugs was 1.66 keeping their BP range from 130-139/80-89mmHg, and the mean BP was 132.1±5.39/79.6±6.71mmHg. However, in the strict control group, the average number of antihypertensive drugs was 1.55, and the mean BP was controlled at 118.8±8.45/71.6±5.79mmHg (P&lt;0.05). There were no differences between the two subgroups by age and smoking status. BMI in the strict group (24.6±3.3 kg/m2) was lower than the mild group (25.5±3.3kg/m2, p&lt;0.01). About 49.2% in the strict control group and 47.0% in the standard control group were combined with lipid-lowing drugs. The LDL levels in the standard control group (2.8±0.8mmol/l) tended to be higher than that in the strict control group (2.7±0.9mmol/l, p = 0.06). Conclusions: In the Majiapu community where BP controls were insufficient, patients had fewer antihypertensive drugs to achieve stricter targets may be due to the lower risk profile of the patients.

Monitoring and mapping vegetation greenery in residential communities using street view images and a Normalized Vegetation Greenery Index: a case study in Beijing, China

Vegetation greenery is essential for the sensory and psychological wellbeing of residents in residential communities. To enhance the quality of regulations and policies to improve people’s living environments, it is crucial to effectively identify and monitor vegetation greenery from the perspective of the residents using effective images and methods. In this study, Baidu street view (BSV) images and a Normalized Vegetation Greenery Index (NVGI) based method were examined to distinguish vegetation greenery in residential communities of Beijing, China. The magnitude of the vegetation was quantified and graded, and spatial analysis techniques were employed to investigate the spatial characteristics of vegetation greenery. The results demonstrated that (1) the identified vegetation greenery using the proposed NVGI-based method was closely correlated with those of the reference classification (r = 0.993, p = 0.000), surpassing the comparison results from the SVM method, a conventional remote sensing classification means; (2) the vegetation greenery was distributed unevenly in residential communities and can be categorized into four grades, 63.79% of the sampling sites were found with relatively low (Grade II) and moderate (Grade III) vegetation greenery distribution, most of the districts in the study area contained zero-value green view index sites; and (3) there was significant spatial heterogeneity observed in the study area, with low-value clustering (cold spots) predominantly located in the central region and high-value clustering (hot spots) primarily concentrated in the peripheral zone. The findings of this study can be applied in other cities and countries that have street view images available to investigate greenery patterns within residential areas, which can help improve the planning and managing efforts in urban communities.

Revitalizing resource-depleted community through community empowerment: The case of Shougang Laoshan community in Beijing

In the process of transformation and development, resource-depleted areas face the parallel situation of economic system transformation and social foundation reconstruction. Since community building is an important aspect of social foundation reconstruction, how to revitalize resource-depleted communities is a critical issue faced by the transforming resource-depleted areas. This study starts from this background and explores how resource-depleted communities can be revitalized through community empowerment. Through a community regeneration case study of Shougang Laoshan Community in Beijing, two key points of community empowerment to resource-depleted communities in its early stage are proposed, namely, the professionals’ channeling to local level, and the linkage of resources. The most important goal of community empowerment is to energize individuals in the community, encourage their communications, and increase their mobilities by cultural empowerment and resource mobilization.

Revitalizing resource-depleted community through community empowerment: The case of Shougang Laoshan community in Beijing

In the process of transformation and development, resource-depleted areas face the parallel situation of economic system transformation and social foundation reconstruction. Since community building is an important aspect of social foundation reconstruction, how to revitalize resource-depleted communities is a critical issue faced by the transforming resource-depleted areas. This study starts from this background and explores how resource-depleted communities can be revitalized through community empowerment. Through a community regeneration case study of Shougang Laoshan Community in Beijing, two key points of community empowerment to resource-depleted communities in its early stage are proposed, namely, the professionals’ channeling to local level, and the linkage of resources. The most important goal of community empowerment is to energize individuals in the community, encourage their communications, and increase their mobilities by cultural empowerment and resource mobilization.

Factors associated with frailty transitions among the old‐old in a community

The study aimed to explore the factors associated with frailty transitions among the old-old (aged ≥75 years) in a community. The participants were all from a prospective cohort study in a community in Beijing, China. Frailty states were assessed using FRAIL at baseline and at 1-year follow-up. The association between factors, including comprehensive geriatric assessment and laboratory indicators, and frailty transitions were explored by binary logistic regression. The predicted value of the factors associated with frailty transitions was analyzed using the receiver operating characteristic curve (ROC) and the area under the ROC (AUC) for each factor was calculated. In total, 183 older adults (mean age: 83.9 ± 4.4 years; women, 59%) completed the frailty state assessment at baseline and 1-year follow-up. After adjusting for age and sex, physical function, including walking speed, timed up-and-go test and short physical performance battery, serum albumin and serum high-sensitivity C-reactive protein (hsCRP) were associated with worsening of the frailty state. Cognitive function was associated with improving the frailty state. ROC analysis showed that low walking speed (AUC: 0.81), long timed up-and-go test time (AUC: 0.77), low short physical performance battery score (AUC: 0.75), low serum albumin (AUC: 0.68) and high serum hsCRP (AUC: 0.80) could predict the decline in frailty state. Good cognitive function (AUC: 0.69) predicted an improvement in the frailty state. The frailty state of the old-old with poor physical function, low serum albumin and high serum hsCRP was likely to decline, but it could improve with good cognitive function. Geriatr Gerontol Int 2023; 23: 405-410.

Incomplete-ownership property communities: Informal gated communities in Beijing and the issue of life satisfaction

Informal housing and social inequality are key issues when building sustainable societies in many developing countries. Informal gated communities on the urban fringe are common in many cities in China. This article presents a micro-case in Beijing in an attempt to uncover the reasons for this informal land development and its impact on residents' life satisfaction. We investigated three groups of people, namely local rural villagers who hold local rural Hukous, local urban residents who hold local urban Hukous, and migrants without local Hukous who live in informal communities in Beijing. We found that villagers, migrants and local urban residents have significant differences in economic income levels, housing areas and subjective satisfaction with their quality of life. Although the difference in subjective well-being between migrants and urban people is not obvious, those who own illegal housing in informal communities have higher levels of happiness than those who rent housing. It seems that ownership of informal housing plays a positive role in enhancing life satisfaction, despite it being illegal. These findings enhance our existing knowledge of the formation mechanism and the effects of informal development.

Association of Remnant-like Particle Cholesterol with Major Adverse Cardiovascular Events in Subjects with Different Levels of Proprotein Convertase Subtilisin/Kexin 9: A 9.5-year Follow-up Study in a Beijing Community Population

Objective: The purpose of this study was to determine the relationship between remnant-like particle cholesterol (RLP-C) and major adverse cardiovascular events (MACEs) in patients with different levels of proprotein convertase subtilisin/kexin 9 (PCSK9). Methods: From September 2007 to January 2009, 1,859 subjects in Pingguoyuan communities in Beijing were initially screened. After excluding those with bedridden status, mental illness, severe systemic diseases, and missing data, 1,680 subjects were recruited for follow up. All recruited subjects were followed up from February 2013 to September 2013 (181 subjects were lost to follow-up) and from June 2017 to September 2018 (174 subjects were lost to follow up). Finally, 1,325 subjects were included in the study. General demographic characteristics, lifestyle and behaviors, disease history and use of medication was collected. Levels of total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fast blood glucose, RLP-C, low-density lipoprotein triglycerides and PCSK9 were measured. The levels of RLP-C (low: RLP-C ≤ 157 mg/L; high: RLP-C &gt; 157 mg/L) and PCSK9 (low: PCSK9 ≤ 135.87 μg/L; high: PCSK9 &gt; 135.87 μg/L) were represented using quartiles. Subjects were categorized into 4 groups according to their RLP-C and PCSK9 levels: Q4, high levels of RLP-C with high levels of PCSK9; Q3, high levels of RLP-C with low levels of PCSK9; Q2, low levels of RLP-C with high levels of PCSK9; and Q1, low levels of RLP-C with low levels of PCSK9. The association of RLP-C with MACEs in subjects with different PCSK9 levels was evaluated. Results: After a median follow-up of 9.5 years, 1,325 subjects were included in the study and a total of 191 MACEs had occurred. The incidence of MACEs was higher in the RLP-C &gt; 157 mg/L group than the RLP-C ≤ 157 mg/L group (18.40% vs. 10.42%). Cox proportional hazards regression model analysis showed that increased RLP-C levels were associated with an increased risk of MACEs (hazard ratio: 1.405; 95% confidence interval: 1.005–1.964; P &lt; 0.005). The incidence of MACEs was higher in the high RLP-C/PCSK9 group vs. the low RLP-C/PCSK9 group (20.68% vs. 8.76%). Cox proportional hazards regression model analysis showed that RLP-C was associated with an increased risk of MACEs in subjects with high PCSK9 levels independent of traditional risk factors (hazard ratio: 1.791; 95% confidence interval: 1.168–2.825; P = 0.001), but not in those with low PCSK9 levels. Conclusions: RLP-C was identified as a risk factor for MACEs, particularly in subjects with high PCSK9 levels. Lowering PCSK9 levels may reduce residual risk in subjects with elevated plasma RLP-C levels.

An intervention study on a hospital-community integrated management model of tobacco dependence based on a community intervention trial.

To assess the effect of the hospital-community integrated management model of tobacco dependence on smoking cessation among community residents compared with a brief smoking cessation intervention. Our study recruited 651 smokers who were willing to quit in 19 communities in Beijing and conducted a 6-month smoking cessation intervention. The control group receiving a brief smoking cessation intervention and the pilot group receiving an integrated smoking cessation intervention. Intention-to-treat analysis (ITT) and generalized estimating equations were used to assess the effects of the integrated intervention and smoking cessation medication on average number of cigarettes smoked per day (ACSD) and smoking cessation rate. Simple effects analysis showed that smokers taking medication had significantly lower ACSD than those not taking medication at follow-up, the control group reduced smoking by 3.270, 4.830, and 4.760 cigarettes in the first, third and sixth months, respectively, while the pilot group reduced by 6.230, 5.820, and 4.100 cigarettes. The integrated intervention significantly reduced ACSD among medication-taking smokers at 1st month (reduced by 3.420, P < 0.05) and 3rd month (reduced by 2.050, P < 0.05), but had no significant effect among non-medication taking smokers. The 3rd month smoking cessation rate among medication-taking smokers was 27.0%, which was significantly higher than the smokers with brief smoking cessation intervention. The integrated hospital-community intervention can significantly promote smoking cessation among smokers taking medication, but the issue of payment for medication and additional labor compensation for medical staff should be addressed before its popularization.

Comparison of the predictive value of intrinsic capacity and comorbidity on adverse health outcome in community-dwelling older adults

ObjectivesTo compare the predictive value of intrinsic capacity (IC) and comorbidity on all-cause mortality and falls. MethodsThis prospective cohort study included 220 older adults (84.0±4.4 years) followed for 3 years in a community in Beijing. The methodology recommended by the World Health Organization was used to assess IC, and comorbidity was assessed by the Cumulative Illness Rating Scale for Geriatrics. ResultsThe areas under the characteristic curve of IC and comorbidity were 0.78 vs. 0.67 (p=0.033), respectively, in predicting all-cause mortality, and 0.69 vs. 0.61 in predicting falls (p=0.032). The vitality domain impairment (odds ratio [OR]=3.28, p=0.013), and cognition domain impairment (OR=3.97, p=0.004) were significantly associated with all-cause mortality. Locomotion domain impairment (OR=2.35, p=0.010) was associated with higher fall risk. ConclusionIC might be a better predictor than comorbidity in community-dwelling older adults, in which the vitality, locomotion and cognition domains should be given more attention.

Residents’ Sense of Place on Micro Small Public Spaces on Epidemic Perspective

Like other historical preservation areas, the Fayuansi Community in Beijing’s old city zone faces many problems such as high population density and a shortage of public spaces. As a community that has lasted for more than a thousand years, its block pattern embodies the early historical pattern of Beijing city. Micro Small Public Spaces (MSPS) in the community are of great significance to the physical and mental health of residents, especially during the COVID-19 epidemic. This research investigates the habit shifts of residents’ usage of these spaces and introduces the theory of “Sense of Place”, which is a concept that refers to the manner in which individuals relate or feel about the place they live, and conducts a questionnaire survey of residents in the Fayuansi community. After analyzing the residents’ needs according to the survey, this study gives suggestions on the management of MSPSs, such as increasing the supply of both spaces and facilities, strengthening management, paying more attention to senior residents’ needs, and providing more cultural events. All these measures would strengthen residents’ sense of place and develop popular support for policy.

Investigation on prevalence and risk factors associated with genitourinary syndrome of menopause in middle-aged and older women in Beijing community: a cross sectional study

BackgroundGenitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections) associated with menopause. To avoid invasive testing and painful physical examinations, validated questionaries, which can assess the prevalence and risk factors associated with symptoms of GSM. We aimed to investigate the prevalence and risk factors associated with GSM in middle-aged and older women in the communities of Beijing, China.MethodsA cross-sectional, questionnaire study was performed among 35–70 years old Chinese woman. Vaginal health index score and urinary distress inventory (UDI-6) was used to evaluate vulvovaginal atrophy (VVA) and urinary incontinence (UI). Stages of pelvic organ prolapse (POP) was measured during gynecological examination with POP-Q system. Mean ± standard deviation (SD) and proportion/percentages were used to summarize continuous and categorial variables respectively. The Bonferroni method was used to adjust for multiple comparisons.ResultsA total of 2702/3000 participants completed the questionnaire survey. The mean ± SD age of participants was 53.7 ± 7.0 years and prevalence of VVA among participants was 34.8% (941/2702). In UDI-6 questionnaires total 47.5% (1284/2702) participants reported experiencing urinary incontinence (UI). Further, POP was highly prevalent in anterior vaginal wall 38.9% (1050/2702) followed by posterior vaginal wall 25.3% (683/2702) and uterine 22.2% (599/2702). Besides, multiple logistic regression analysis inferred older age (45–54 years [OR (95% CI): 3.38 (2.03, 5.64)]; 55–64 years [OR (95% CI): 8.63 (5.09, 14.64)]), menopause [OR (95% CI): 2.20 (1.71, 2.85)] and Faecal Inconsistence (FI) [OR (95% CI): 1.31(1.00, 1.72)] as independent risk factors for VVA.ConclusionsOur study evidenced that GSM is prevalent in old age Chinese women. GSM is related with UI, POP and VVA. Further older age, menopause and FI were risk factors associated with VVA. Our findings could help health care personnel to get a comprehensive overview of factors associated with VVA and urinal distress, which may facilitate early detection and prevention of GSM.

Conicity-index predicts all-cause mortality in Chinese older people: a 10-year community follow-up

BackgroundAbdominal obesity (AO) has been regarded as the most dangerous type of obesity. The Conicity-index (C-index) had a high ability to discriminate underlying AO. The purpose of this study was to determine the ability of C-index to predict all-cause mortality among non-cancer Chinese older people.MethodsThe participants were residents of the Wanshou Road community in Beijing, China. Receiver operating curve (ROC) curves were used to determine the sensitivity and specificity of the best cut-off values for different anthropometric measures for predicting all-cause mortality. The area under the curve (AUC) of the ROC curves were calculated to compare the relative ability of various anthropometric measures to correctly identify older people in the community where all-cause mortality occurs. Included subjects were grouped according to C-index tertiles. The association between C-index and all-cause mortality was verified using Kaplan–Meier survival analysis and different Cox regression models.ResultsDuring a mean follow-up period of 9.87 years, 1821 subjects completed follow-up. The average age was 71.21 years, of which 59.4% were female. The ROC curve results showed that the AUC of the C-index in predicting all-cause mortality was 0.633. Kaplan–Meier survival curves showed a clear dose–response relationship between C-index and all-cause mortality. With the increase of C-index, the survival rate of the study population showed a significant downward trend (P < 0.05). Adjusted for age, gender, hip circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin, high-density lipids protein (LDL), triglyceride, serum creatinine, serum uric acid, urine albumin-creatinine ratio (UACR), Mini-Mental State Examination (MMSE), smoking history, and drinking history, COX regression analysis showed that in the model adjusted for all covariates, the risk of all-cause mortality in tertile 3 was 1.505 times that in tertile 1, and the difference was statistically significant.ConclusionsThe C-index is an independent risk factor for all-cause mortality in the non-cancer Chinese older people.

Study on the reliability and validity of the Chinese Criteria of Health Scale for the elderly people

Objective: To evaluate the reliability and validity of the Chinese Criteria of Health Scale for the elderly people. Methods: A cross-sectional study was performed among older adults of Meiyuan Community in Haidian District, Beijing and Nanwangkong Village in Qingzhou City,Shandong Province during July 2021. Using a cluster sampling method, totally 667 elderly people were investigated by face-to-face interview, using the scale which was formulated after two rounds of the Delphi method and pilot study. The overall scale includes physical health, mental health and social health subscales, including 9, 52 and 15 items, respectively. Four weeks after the survey, 56 elderly people were randomly selected and repeated the survey with the same method. The test-retest reliability, split-half reliability and internal consistency reliability of the scale were evaluated, and the validity was evaluated at the same time, including construct validity and content validity. Results: A total of 710 questionnaires were distributed and 667 valid questionnaires were obtained, with a total effective rate of 93.94%. The score of the overall scale was 79.79±16.22, the scores of the physical health, mental health, social health sub-scores were 41.64±9.76, 26.82±3.92 and 11.34±5.19, respectively. The scale had excellent reliability. In the test-retest reliability, the intraclass correlation coefficient (ICC) of the overall scale and each subscale were 0.766-0.861, and the weighted Kappa values were 0.762-0.817. The Spearman-Brown coefficient of the overall scale and each subscale in the split-half reliability were 0.722-0.855 (all P<0.001). The Cronbach's α coefficients of the overall scale of internal consistency reliability and each subscale were 0.748-0.899, and the Cronbach's α coefficients of each dimension were from 0.709 to 0.963(all P<0.001). At the same time, the scale had good construct validity and content validity. The correlation coefficients between the score of each dimension and its sub-scale were larger, from 0.641 to 0.873 (all P<0.05). The cumulative variance contribution rates of the scale and three subscales were all more than 50% of the approved standard. A total of 11 common factors were extracted, and all the load values of each item on the corresponding factors were ≥0.04. Conclusion: The Chinese Criteria of Health Scale for the elderly people has good validity and excellent reliability. It can be used as a basis for the scientific division of the health status of the elderly, the formulation of relevant policies by the government and the provision of appropriate health services for the elderly.

COVID-19 lockdown and municipal solid waste: evidence from the discarding records of 252 communities in China

AbstractThis study investigates the impacts of the COVID-19 lockdown on municipal solid waste (MSW). Based on a unique data set of daily discarding records of 252 communities in Beijing, China, we conduct a difference-in-differences estimation and find that the total daily MSW decreased by 134.16 kg in a community, which is equivalent to at least 0.22 kg per household per day, and the average weight of MSW per package decreased by 56.8 per cent after the COVID-19 lockdown. We consider a series of potential mechanisms, such as MSW hoarding, shifts in discarding time, and fear of going out, and find the most support for consumption pattern shifts with reduced consumption. We then discuss the effect of the lockdown on the reduction of MSW generation because of the strict restriction of consumption. We also conduct various heterogeneity analyses. Our results present clear implications for municipal waste management by highlighting the effect of the lockdown on the generation of MSW and the underlying consumption mechanism.