Chinese childbearing decision-making in mainland China in the post-one-child-policy era.

In 2016, China enacted its two-child policy, further lifted to a three-child policy in 2021, in response to low birth rates and imbalanced sex ratios resulting from the almost 40-year one-child policy. Despite this, China's birthrate is at a historic low as fewer parents are having children. Now more than ever, inductive explorations are needed to understand what motivates Chinese parents to have first and second children in the post-one-child policy era, particularly explorations that situate individual decision-making within the larger social context. Individual and relational choices occur in larger sociopolitical contexts. Understanding these "personal" actions involves considering how micro and macro processes inform each other. In this study, we elicited qualitative responses from Chinese mothers (N = 117) with two children in early childhood (firstborn ≤8 years old) from Liao Ning province. Most mothers were well educated, employed, and married to children's fathers. Using inductive thematic analysis procedures, we coded qualitative responses about the factors that motivated mothers to have first and second children. Our data revealed that (a) mothers expressed different reasons for having firstborns compared to secondborns, and (b) decision-making occurred against a backdrop of interacting micro-level and macro-level influences (e.g., cultural norms, national policy changes). In particular, mothers described the decision to have secondborns as more deliberative than with firstborns, considering long-term benefits siblinghood and shared demands of elderly caregiving. If efforts to stimulate the national birthrate are likely to succeed, policymakers should consider micro-level as well as macro-level factors that shape mothers' childbearing decision-making.

Temporal-spatial assessment of the vulnerability of human settlements in urban agglomerations in China.

Although many studies have focused on the livability and satisfaction of the human settlement environment in Chinese cities, few have paid attention to the vulnerability of human settlements in urban agglomerations in China (VHSUAC). The analytic hierarchy process and the entropy method are combined in this paper to comprehensively weight the constructed four-dimensional evaluation index system. Then, we identified the key factors influencing VHSUAC. Finally, we use the environmental vulnerability index (EVI) to calculate the vulnerability value from 2008 to 2017 and display the vulnerability changes over time and space using ArcGIS software. The results show that (1) from the perspective of temporal pattern, VHSUAC showed a downward trend from 2008 to 2017, but the degree of decline in each urban agglomeration was not equal. There is a certain difference in the vulnerability value of the human settlement environment between the urban agglomeration and its inner cities, and their direction of change is not always the same. (2) From the perspective of spatial pattern, VHSUAC has obvious regional heterogeneity, presenting a spatial pattern of "low coastal areas and high inland areas." Coastal urban agglomerations pay more attention to the optimization of the human settlement environment. (3) In terms of influencing factors, the vulnerability values of the four system indicators are listed in the following order: economic support environment>urban ecological environment>public service environment>urban living environment. We found that domestic waste and sewage treatment have a more obvious impact on VHSUAC.

How Does Energy Intake Change in China? A Life Cycle Perspective.

China's population is showing the characteristics of "fewer children" and "aging", which will have a long-term and far-reaching impact on the food and nutritional needs of China and the world. In this paper, adult equivalent scale (AES) variables representing the household population structure were introduced into the energy intake model to quantify the impact of population structure changes on energy intake and reveal the characteristics of energy intake changes in the life cycle of Chinese residents. It is found that the change in the population structure has a significant impact on the energy intake of urban households in China, and the elasticity is 0.446. The energy intake of Chinese elderly over the age of 60 shows a trend of first increasing and then decreasing, especially after the age of 65, which indicates that the aging will promote a decline in food consumption in China. The energy intake of 1-10-year-old children, 22-30 year old, and 40-45 year old women all showed a change of first a decrease and then an increase, which may be related to parents' care for young children and women with children's management of body size. The average household size expressed by the adult equivalent scales of energy consumption is 2.341, which is smaller than the 3.052 calculated by the population number. The conclusion indicates that the prediction of the food and nutritional demand should be adjusted according to the changes and differences in accordance with the intensification of "fewer children" and "aging", as well as the life cycle changes in residents' energy intake, which is conducive to the formulation of food and nutrition security policies.

Influence of Food Safety Concerns and Satisfaction with Government Regulation on Organic Food Consumption of Chinese Urban Residents.

In order to study the impact of food safety concerns and government regulation on Chinese urban residents' organic food consumption willingness and behavior, an "online + offline" survey of 799 urban residents in Beijing has been conducted. Based on the theory of planned behavior, a structural equation model (SEM) was established and the government's food production support regulation (GP) and sales guarantee regulation (GC) were incorporated separately into the SEM as moderator variables. The path influence coefficients of respondents' food safety concerns, subjective norms, and perceived behavioral control on organic food consumption willingness were 0.065 (p < 0.05), 0.174 (p < 0.01) and 0.574 (p < 0.01), respectively. The influence of GP on organic food consumption willingness was 0.243 (p < 0.01), but its moderating effect on the promotion effect of food safety concerns and attitude to organic food consumption willingness was −0.001 (p < 0.01). The moderating effect of GC on the transformation from consumption willingness to behavior was 0.083 (p < 0.05). The results show that respondents attach the most importance to the comparison of costs and the benefits of organic food. Although the government's food production regulation will weaken the driving effect of food safety concern and benefit perception of organic food consumption willingness, it will still promote organic food consumption willingness on the whole. The government's supervision of food processing and sales is conducive to the occurrence of organic food consumption behavior.

Validation of the abbreviated indicators of perceived residential environment quality and neighborhood attachment in China.

The purpose of this research is to utilize factor analyses to evaluate the reliability and factorial structure of an abbreviated version of the instrument that includes indicators of perceived residential environment quality (PREQ) and neighborhood attachment (NA) in Chinese urban environments. The instrument has 11 scales that measure PREQ and 1 scale measuring neighborhood attachment (NA). Architectural and urban planning aspects (three scales: Architectural and Town-planning Space, Organization of Accessibility and Roads, Green Areas), socio-relational aspects (one scale: People and Social Relations), functional aspects (four scales: Welfare Services, Recreational Services, Commercial Services, and Transport Services), and contextual aspects (three scales: Pace of Life, Environmental Health, and Upkeep and Care) are all covered by the 11 PREQ scales. A total of 1,332 people living in Chinese urban cities completed a self-report questionnaire that included these 12 scales. A calibration sample and a validation sample that were randomly split from the total sample verified the factorial structures of this instrument, and the abbreviated instrument had acceptable reliability and validity. The validated abbreviated version of the PREQ and NA instruments allowed for a more reliable and manageable tool that might lessen respondents' exhaustion of a large number of items, this also contributed to the policy-making for urban planning and practical architectural design.

Affective well-being of Chinese urban postpartum women: predictive effect of spousal support and maternal role adaptation.

Due to shortage of childcare facilities while high social expectations for mothering, becoming a mother is a big life challenge for most women in urban China. The understandings on Chinese postpartum women's affective well-being and its relation with spousal support and maternal role adaptation remain limited. This study aims to investigate the affective well-being (including both positive and negative affect) of Chinese urban postpartum women and how it is associated with spousal support and maternal role adaptation. A cross-sectional survey was conducted in Shanghai, China, between June and July 2019. A total of 498 urban mothers whose babies were 0 to 1 year old participated in this survey. They completed the Postpartum Social Support Questionnaire (PSSQ), the Maternal Role Adaptation Scale, and the Positive and Negative Affect Scale (PANAS), and reported socio-demographic information. Results showed that positive and negative affect of postpartum women were not significantly associated with each other. Positive affect had a positive correlation with spousal support and maternal role adaptation. Negative affect was negatively associated with maternal role adaptation, while not significantly associated with spousal support. Maternal role adaptation partially mediated the relationship between spousal support and positive affect of the participants, controlling for age, household income, education, birth order, and inter-generational support. The findings indicate that intervention programs towards mental health of postpartum women should focus more on positive affect cultivation; moreover, clinical services should help postpartum women to adapt to maternal role by encouraging new fathers' or partners' involvement in daily childcare-giving.

Chinese Consumers' Acceptance of Novel Technologies Designed To Control Foodborne Bacteria.

ABSTRACT: Chinese consumers (n = 604) were asked three times to rate their acceptance of traditional thermal processing and several newer technologies (high pressure processing, irradiation, bacteriophages, antimicrobial packaging, pulsed electric fields, and rinsing meat carcasses with antimicrobial solutions) designed to control foodborne bacteria in food (i) based on their existing knowledge, (ii) after the provision of information about L. monocytogenes, and (iii) after further reading a brief description of the technology. Thermal processing (6.00 of 7 on Likert scale) and high pressure processing (5.73 of 7) were rated the most acceptable technologies, and rinsing with antimicrobial solutions (4.43 of 7) was rated the least acceptable technology. Information outlining the benefits of a technology had a larger positive effect on acceptance of every novel technology discussed (increases of 0.14 to 0.49 units depending on the technology) than information about L. monocytogenes and a brief description of the technology. This research has shown that providing information about foodborne bacteria and a technology designed to control them will improve consumers' acceptance of the technology, with the provision of information being of most importance for technologies for which the consumers are less familiar. Chinese consumers accepted or rejected a food technology for a variety of reasons; however, consumers with a greater awareness of foodborne bacteria rated the acceptability of novel technologies designed to kill bacteria higher than those with a low awareness (0.56 to 1.71 units depending on the technology). The results of this research will be of benefit to food companies considering adopting novel technologies to control foodborne bacteria because they provide insights that will enable them to develop more effective communication and implementation strategies.

The heterogeneous dynamic effect of financial development and environmental regulation on Chinese urban green technology management efficiency.

China is facing the large-scale urbanization and great pressure of energy consumption and environmental protection in the past few decades. In this process, urban green technology management efficiency (GMEC) is of great importance for the future work of greener transformation. Using China's 286 city-level panel data from 2006 to 2018, this paper proposes a global Malmquist index, PVAR, and panel quantile regression model to explore the heterogeneous dynamic effect of financial development (FIN) and environmental regulation (ER) on GMEC. The results indicate that during 2006-2018, (1) the growth rate of GMEC fluctuated violently, with a change of more than 28%. In addition, there is "one tight and one loose" phenomenon of GMEC. This indicates that there is much room for the improvement of GMEC; (2) in northeast cities, FIN is not conductive to GMEC, but in other regional cities, FIN has dynamic beneficial effect on GMEC. In addition, FIN represents a changing trend of dropping at first to rising afterwards in all regional cities; (3) furthermore, from time angle, ER has the heterogenous dynamic effect on GMEC among regional cities. Specifically, in northeast, eastern, central, and western cities, GMEC has an "M," "N," "U," and "U"-shaped relationship with the level of ER, respectively. From space angle, there is distinct heterogeneous effect of ER on GMEC at different quantiles within regional cities. Therefore, the local government are supposed to establish and implement policies based on regional cities' characteristics.

The heterogeneous impact of environmental regulation on urban green scale economy: an empirical analysis based on city-level panel data in China.

With continued expansions of scale, the Chinese cities are facing unprecedented economic, environmental, and energy sustainability challenges. The aim of this paper is to examine the heterogeneous impact of environmental regulation (ER) on urban green scale economy (GSEC), by combining the global Malmquist index approach, spatial econometric model, panel quantile regression model (QRPD), and the city-level panel data from 2004 to 2018. The estimation results show that (1) from 2004 to 2018, the growth rate of GSEC fluctuates sharply, and the values of GSEC are less than 1 in many years. This indicates that GSEC is far from efficient and needs to be improved in the future; (2) the results of the spatial econometric model show that GSEC has a U-shaped relationship with the level of ER. Furthermore, the estimation results of QRPD verify the above conclusions and show that there is distinct heterogeneity of ER on GSEC at different quantiles and regional cities; (3) the results further indicate that other vital control variables have a significant and heterogeneous effect on GSEC. Therefore, the focus of future work should be adapted to local conditions. Specifically, in the cities with lower-level GSEC, the policymakers should give top priority to break through the U-shaped inflection point as soon as possible and help enterprises to achieve pollution reduction by technical and financial subsidies. While in the cities with higher-level GSEC, the government should further strengthen its ER and encourage competition among enterprises by internal technological innovation. In addition, the government should try to avoid the negative effect of the "resource curse" trap, excessive financial leverage, and "race-to-the-bottom" phenomenon.

Health-related quality of life and determinants in North-China urban community residents.

BACKGROUND: The objectives of this study were to investigate the HRQoL of residents living in central urban areas (CUA) and developing neighborhoods (DN) areas of North-China and to examine the relationship between health conditions and the physical and mental components of quality of life. METHODS: A stratified random sample was taken and health survey scoring system questionnaire SF-36 was used to conduct the HRQoL survey among community residents in the two selected districts in 10 cities. A general questionnaire was also administered with questions that collected general information, population demographic characteristics and health behaviours, social relationships and perception of life satisfaction. RESULTS: Five thousand eight hundred eighty-one questionnaires were returned from 6059 invitations with a effective response rate of 97%. The residents in DN had a higher score of physical function, role limitation due to physical problems and vitality than those living in CUA. The prevalence of several chronic diseases was lower in DN's residents than CUA's residents. Age, presence/absence of chronic diseases, leisure time exercise, regular daily routine, sleep quality, appetite, family and social relationships and life satisfaction were significant determinants of HRQoL. CONCLUSIONS: Residents living in newly developed neighborhoods in China while keeping some habits and lifestyles of their original rural communities are healthier in terms of chronic diseases and HRQoL. Together with other risk factors chronic diseases are an important determinant on HRQoL. Several healthy habits and behaviors such as having a regular daily routine and exercising during leisure time improved HRQoL in Chinese urban communities. Targeted policies of public health based on these findings can better the health-related quality of life.

[An epidemiologic study of pelvic organ prolapse in urban Chinese women: a population-based sample in China].

Objective: This study aimed to assess the prevalence and factors associated with pelvic organ prolapse (POP) in a representative sample of Chinese urban women. Methods: A total of 29613 Chinese urban women were recruited to this cross-sectional study between February 2014 and March 2016. The prevalence of POP, defined as any stage Ⅱ or higher POP resulting in symptoms, was assessed using questionnaires and physical examinations. Multivariable logistic regression was used to assess factors associated with POP. Results: 2 864 of 29 613 women (9.67%) had POP. The prevalence of POP increased with age ranging from 1.23% (82/6 646) of women aged between 20 and 29 years to 26.11% (727/2 784) for those aged 70 years or older (P<0.000 1). Overweight and obese women were more likely to have POP than normal weight women [AOR=1.56, 95%CI 1.42-1.72 vs AOR=1.74, 95%CI 1.48-2.03]. In the multivariate analysis, the independent risk factors were cough (AOR=1.70, 95%CI 1.44-2.02), constipation (AOR=2.05, 95%CI 1.82-2.32), physical disease (AOR=1.27, 95%CI 1.15-1.41), and gynecological diseases (AOR=2.08, 95%CI 1.89-2.29). Nulliparous (AOR=0.12, 95%CI 0.06-0.22) and caesarean section (CS) (AOR=0.55, 95%CI 0.47-0.64) were protective factors for POP. Conclusions: POP affects nearly 10% of women in Chinese urban region. The prevalence of POP increases significantly with age. The independent risk factors for POP are body mass index, cough, constipation, physical disease and gynecological diseases. Nulliparous and CS are protective factors for POP.

Chinese Urban Hui Muslims' Access to and Evaluation of Cardiovascular Diseases-Related Health Information from Different Sources.

This research aims to identify the sources that urban Hui Muslims access to get health information related to cardiovascular diseases (CVD) and how they evaluate the information from different sources. This paper focuses on health information related to cardiovascular diseases among Hui Muslims. The data was gathered by means of an online survey administered on mobile devices. To put the answers given by Hui Muslims into perspective and make a comparison between Hui Muslims and the Han people, we also gathered information from Han-the dominant group in China. The results showed that Chinese Hui Muslims mostly used mediated sources, while Han people mainly used interpersonal sources. Both Hui Muslims and Han people trusted and preferred health information about cardiovascular diseases provided by health organizations, doctors, and healthcare providers. The information given by religious leaders was trusted the least, although Hui Muslims were significantly more positive about religious authority than the Han people. The current results are relevant for Chinese health information promoters and can help them diffuse CVD health information more effectively to urban Hui Muslims.

Prevalence of hyperhomocysteinemia and its associated factors in patients with primary hypertension in Chinese urban communities: A cross-sectional study from Nanjing.

OBJECTIVE: This study aimed to investigate the prevalence of hyperhomocysteinemia (Hhcy) and its major determinants in Chinese urban population with new-onset hypertension. METHODS: A total of 574 adults (404 men and 170 women) with newly diagnosed primary hypertension were recruited from seven communities in Nanjing, China. Data on lifestyle factors, such as physical activities, current smoking and drinking status, dietary habits, and familial factors were collected in interviews, and laboratory examinations were performed by well-trained personnel. Potential factors related to the prevalence of Hhcy in this population were analyzed using a logistic regression model. RESULTS: Of the 574 participants, 421 (73.3%) were diagnosed with Hhcy whereas the remainder were only hypertensive. The study highlighted a number of factors that were significantly correlated (p < 0.001) with the prevalence of Hhcy. Subjects with Hhcy were more likely to be male (odds ratio [OR] 3.007, 95% confidence interval [CI] 1.781-5.079), have a smoking history (OR 1.052, 95% CI 1.031-1.074), older (OR 1.052, 95% CI 1.031-1.074), have an elevated Body Mass Index BMI (OR 1.160, 95% CI 1.080-1.246) and higher levels of low density lipoprotein cholesterol (LDL-c) (OR 1.590, 95% CI 1.226-2.063). Regular and adequate physical activity was associated with normal homocysteine levels in both male and female groups (p < 0.05). For males only, having a higher BMI, higher LDL-c or being older significantly (p < 0.05) affected the chances of Hhcy. Whereas for females, lower levels of eGFR could be related to Hhcy (p < 0.05). CONCLUSIONS: Our present study reported a high prevalence of Hhcy in the Nanjing population with new-onset hypertension. Associated factors like physical activity, gender, smoking history, age, BMI, and LDL-c were important modifiers of plasma homocysteine concentration. Management and intervention of the above associated factors should be implicated to improve H type hypertension control.

Serum Carotenoids and Risks of Diabetes and Diabetic Retinopathy in a Chinese Population Sample.

OBJECTIVE: Diabetes mellitus (DM) and diabetic retinopathy (DR) are associated with oxidative stress and carotenoids have antioxidant properties. This study aimed to test the relationship between serum carotenoid concentrations and the risk for DM and DR. METHODS: This is a cross-sectional study of the Chinese urban population. A total of 747 subjects, consisting of 272 DR patients, 190 diabetic patients without retinopathy, and 285 non-diabetes mellitus healthy controls, were recruited to this study. Demographic and lifestyle characteristics were ascertained by questionnaire. General physical and ophthalmic examinations were completed for all participants. Serum carotenoids were measured by high-performance liquid chromatography (HPLC). The associations of serum carotenoids with DM and DR were assessed by logistic regression with adjustment of known risk factors. The correlation analyses of serum carotenoids with the candidate influence factors were assessed using the single variable linear regression. RESULTS: Both pro-vitamin A (PVA) carotenoids and non-PVA carotenoids in the serum were measured and compared between different groups. Levels of α-carotene were significantly lower in DR patients and ß-carotene were significantly lower in DM patients as compared to non DM healthy control group. In contrast, levels of ß-cryptoxanthin, lycopene, lutein and zeaxanthin were comparable among different groups. After adjusting for confounding factors, ß-carotene concentration was associated with reduced risk for DM (OR (95%CI): 0.56 (0.34, 0.91), P=0.02) and α-carotene was associated with reduced risk for DR in non-smokers (OR (95%CI): 0.41 (0.17, 0.99), P=0.048). No significant association was found between hemoglobin A1c and any carotenoids (P>0.05). Significantly associations with serum carotenoids were found in age, sex, BMI, smoking, and exercise (P<0.05). CONCLUSION: Serum ß-carotene may have a protective effect on DM and α-carotene may be a protective factor for DR in non-smokers.

[Study on vitamin A nutritional status of Chinese urban elderly residents in 2010-2012].

Objective: To assess the vitamin A nutritional status of the Chinese urban elderly population by analyzing serum retinol level in 2010-2012. Methods: Data were collected from the Chinese National Nutrition and Health Survey in 2010-2012. Using the multi-stage stratified cluster sampling method, serum samples from elderly residents aged ≥60 years old were obtained from 34 metropolis and 41 middle-sized and small cities. Demographic data were collected using a questionnaire survey. The serum retinol concentration was determined by high-performance liquid chromatography. Vitamin A deficiency (VAD) was determined using the World Health Organization guidelines. A total of 3 200 elderly residents were included in the study. The serum retinol levels and prevalence of VAD and marginal VAD were also compared. Results: The serum retinol concentration (P(50)(P(25)-P(75))) of Chinese urban elderly residents was 1.83 (1.37-2.39) µmoL/L. Compared with middle-sized and small cities (1.91 (1.47-2.48) µmol/L), the retinol level of senior citizens in metropolis (1.70 (1.25-2.25) µmol/L) was significantly lower (P<0.001). The serum retinol levels of elderly male (1.89 (1.37-2.47) µmoL/L) was significantly higher than that of female (1.80 (1.36-2.28) µmoL/L) (P=0.001). The serum retinol concentration was 1.87 (1.42-2.43), 1.78 (1.32-2.33), and 1.71 (1.24-2.24) µmol/L for 60-69, 70-79, and ≥80 years olds, respectively. The retinol level in elderly people ≥70 years olds was significantly lower than that of 60-69 years olds (P<0.001). The overall prevalence of VAD among Chinese urban elderly residents was 4.22% (135/3 200); 6.00% (81/1 350) for metropolis residents and 2.92% (54/1 850) for middle-sized and small city residents. The overall marginal VAD rate of Chinese urban elderly residents was 8.19% (262/3 200); 10.51% (142/1 350) for metropolis residents and 6.49% (120/1 850) for medium-sized and small city residents. The prevalence of VAD and marginal VAD for males was 3.87% (61/1 577) and 8.24% (130/1 577), respectively (P<0.05). The prevalence of VAD according to age group was 3.65% (72/1 975), 4.96% (50/1 008), and 5.99% (13/217), respectively(P=0.097). The prevalence of marginal VAD according to age group was 6.99% (138/1 975), 9.82% (99/1 008), and 11.52% (25/217), respectively(P=0.05). Conclusion: Chinese urban elderly residents showed various levels of VAD, although marginal VAD was quite common. As VAD was more common in metropolis residents and older residents, specific strategies should target these populations.

[Study on anemia and vitamin A and vitamin D nutritional status of Chinese urban pregnant women in 2010-2012].

Objective: To evaluate the prevalence of anemia and the nutritional status of vitamins A and D by analyzing hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels in Chinese urban pregnant women during 2010-2012. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and population proportional stratified random sampling, 2 250 pregnant women from 34 metropolis and 41 middle-sized and small cities were included in this study. Information was collected using a questionnaire survey. The blood hemoglobin concentration was determined using the cyanmethemoglobin method, and anemia was determined using the World Health Organization guidelines combined with the elevation correction standard. The serum retinol level was determined using high-performance liquid chromatography, and vitamin A deficiency (VAD) was judged by the related standard recommended by the World Health Organization. The vitamin D level was determined using enzyme-linked immunosorbent assay and vitamin D deficiency was judged by the recommendation standards from the Institute of Medicine of The National Academies. The hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels were compared, along with differences in the prevalence of anemia, VAD, and the vitamin D deficiency rate (including deficiency and serious deficiency). Results: A total of 1 738 cases of hemoglobin level, 594 cases of serum retinol level, and 1 027 cases of serum 25-hydroxyvitamin D were available for analysis in this study. The overall blood hemoglobin level (P(50) (P(25)-P(75))) was 122.70 (114.00-131.10) g/L; 123.70 (115.21-132.00) g/L for metropolis and 122.01 (113.30-130.40) g/L for middle-sized and small cities. The blood hemoglobin level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.027). The overall prevalence of anemia was 17.0% (295/1 738). The overall serum retinol level (P(50) (P(25)-P(75))) was 1.61 (1.20-2.06) µmol/L; 1.50 (1.04-2.06) µmol/L for metropolis and 1.63 (1.31-2.05) µmol/L for middle-sized and small cities. The serum retinol level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.033). The overall prevalence of VAD was 7.4% (47/639); 11.5% (33/286) for metropolis and 4.0% (14/353) for middle-sized and small cities. A significant difference was observed in the prevalence of VAD between metropolis and middle-sized and small city residents (P<0.001). The overall serum 25-hydroxyvitamin D level (P(50) (P(25)-P(75))) was 15.41 (11.79-20.23) ng/ml; 14.71 (11.15-19.07) ng/ml for metropolis and 16.02 (12.65-21.36) ng/ml for middle-sized and small cities. A significant difference was observed in the vitamin D level between metropolis and middle-sized and small city residents (P<0.001). The overall prevalence of vitamin D deficiency was 74.3% (763/1 027); A significant difference was observed in the prevalence of serious vitamin D deficiency between metropolis (30.64%(144/470)) and middle-sized and small city residents (26%(267/1 027))(P=0.002). There were no significant differences between blood hemoglobin level and the prevalence of anemia, VAD, and vitamin D deficiency. Conclusion: The prevalence of anemia in Chinese urban pregnant women improved from 2002 to 2012. The prevalence of vitamin D deficiency in pregnant women was generally more serious, while a certain percentage of women had VAD. The prevalence of VAD and serious vitamin D deficiency among pregnant women from metropolis was significantly higher than that of pregnant women from medium and small-sized cities.

Patterns of productive activity engagement as a longitudinal predictor of depressive symptoms among older adults in urban China.

OBJECTIVES: Using two waves of panel data from the China Health and Retirement Longitudinal Study, this study prospectively assessed whether four distinct patterns of productive activity engagement would predict depressive symptoms among older adults in urban China two years later. METHODS: A sample of urban residents aged 60 or above at Wave 1 and who were interviewed in both waves (N = 2398) was used. Latent class analysis (LCA) was conducted to identify distinct patterns of productive activity engagement that occurred within the Wave 1 data. Next, the generalized estimating equations were used to assess whether identified patterns predicted the levels of depressive symptoms measured at Wave 2. RESULTS: Our use of LCA confirmed the existence of four distinct patterns of productive activity engagement among the study sample: Informal Helper/Carer, Working-Caring Engager, Civic Contributor, and Low/Spousal Carer. All of these three patterns exhibited significantly lower levels of depressive symptoms than that of Low/Spousal Carer two years later. CONCLUSIONS: Our use of individual-based categorization of productive engagement better captured the reality of older adults performing various productive activities than summative scales of productive activities did and, therefore, provided a more valid clarification of differential well-being outcomes among older adults.

Study on anemia and vitamin A and vitamin D nutritional status of Chinese urban pregnant women in 2010-2012 / 中华预防医学杂志

Objective@#To evaluate the prevalence of anemia and the nutritional status of vitamins A and D by analyzing hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels in Chinese urban pregnant women during 2010-2012.@*Methods@#Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using multi-stage stratified sampling and population proportional stratified random sampling, 2 250 pregnant women from 34 metropolis and 41 middle-sized and small cities were included in this study. Information was collected using a questionnaire survey. The blood hemoglobin concentration was determined using the cyanmethemoglobin method, and anemia was determined using the World Health Organization guidelines combined with the elevation correction standard. The serum retinol level was determined using high-performance liquid chromatography, and vitamin A deficiency (VAD) was judged by the related standard recommended by the World Health Organization. The vitamin D level was determined using enzyme-linked immunosorbent assay and vitamin D deficiency was judged by the recommendation standards from the Institute of Medicine of The National Academies. The hemoglobin, serum retinol, and serum 25-hydroxyvitamin D levels were compared, along with differences in the prevalence of anemia, VAD, and the vitamin D deficiency rate (including deficiency and serious deficiency).@*Results@#A total of 1 738 cases of hemoglobin level, 594 cases of serum retinol level, and 1 027 cases of serum 25-hydroxyvitamin D were available for analysis in this study. The overall blood hemoglobin level (P50 (P25-P75)) was 122.70 (114.00-131.10) g/L; 123.70 (115.21-132.00) g/L for metropolis and 122.01 (113.30-130.40) g/L for middle-sized and small cities. The blood hemoglobin level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.027). The overall prevalence of anemia was 17.0% (295/1 738). The overall serum retinol level (P50 (P25-P75)) was 1.61 (1.20-2.06) μmol/L; 1.50 (1.04-2.06) μmol/L for metropolis and 1.63 (1.31-2.05) μmol/L for middle-sized and small cities. The serum retinol level of metropolis residents was significantly higher than that of middle-sized and small city residents (P=0.033). The overall prevalence of VAD was 7.4% (47/639); 11.5% (33/286) for metropolis and 4.0% (14/353) for middle-sized and small cities. A significant difference was observed in the prevalence of VAD between metropolis and middle-sized and small city residents (P<0.001). The overall serum 25-hydroxyvitamin D level (P50 (P25-P75)) was 15.41 (11.79-20.23) ng/ml; 14.71 (11.15-19.07) ng/ml for metropolis and 16.02 (12.65-21.36) ng/ml for middle-sized and small cities. A significant difference was observed in the vitamin D level between metropolis and middle-sized and small city residents (P<0.001). The overall prevalence of vitamin D deficiency was 74.3% (763/1 027); A significant difference was observed in the prevalence of serious vitamin D deficiency between metropolis (30.64%(144/470)) and middle-sized and small city residents (26%(267/1 027))(P=0.002). There were no significant differences between blood hemoglobin level and the prevalence of anemia, VAD, and vitamin D deficiency.@*Conclusion@#The prevalence of anemia in Chinese urban pregnant women improved from 2002 to 2012. The prevalence of vitamin D deficiency in pregnant women was generally more serious, while a certain percentage of women had VAD. The prevalence of VAD and serious vitamin D deficiency among pregnant women from metropolis was significantly higher than that of pregnant women from medium and small-sized cities.

Study on vitamin A nutritional status of Chinese urban elderly residents in 2010-2012 / 中华预防医学杂志

Objective@#To assess the vitamin A nutritional status of the Chinese urban elderly population by analyzing serum retinol level in 2010-2012.@*Methods@#Data were collected from the Chinese National Nutrition and Health Survey in 2010-2012. Using the multi-stage stratified cluster sampling method, serum samples from elderly residents aged ≥60 years old were obtained from 34 metropolis and 41 middle-sized and small cities. Demographic data were collected using a questionnaire survey. The serum retinol concentration was determined by high-performance liquid chromatography. Vitamin A deficiency (VAD) was determined using the World Health Organization guidelines. A total of 3 200 elderly residents were included in the study. The serum retinol levels and prevalence of VAD and marginal VAD were also compared.@*Results@#The serum retinol concentration (P50(P25-P75)) of Chinese urban elderly residents was 1.83 (1.37-2.39) μmoL/L. Compared with middle-sized and small cities (1.91 (1.47-2.48) μmol/L), the retinol level of senior citizens in metropolis (1.70 (1.25-2.25) μmol/L) was significantly lower (P<0.001). The serum retinol levels of elderly male (1.89 (1.37-2.47) μmoL/L) was significantly higher than that of female (1.80 (1.36-2.28) μmoL/L) (P=0.001). The serum retinol concentration was 1.87 (1.42-2.43), 1.78 (1.32-2.33), and 1.71 (1.24-2.24) μmol/L for 60-69, 70-79, and ≥80 years olds, respectively. The retinol level in elderly people ≥70 years olds was significantly lower than that of 60-69 years olds (P<0.001). The overall prevalence of VAD among Chinese urban elderly residents was 4.22% (135/3 200); 6.00% (81/1 350) for metropolis residents and 2.92% (54/1 850) for middle-sized and small city residents. The overall marginal VAD rate of Chinese urban elderly residents was 8.19% (262/3 200); 10.51% (142/1 350) for metropolis residents and 6.49% (120/1 850) for medium-sized and small city residents. The prevalence of VAD and marginal VAD for males was 3.87% (61/1 577) and 8.24% (130/1 577), respectively (P<0.05). The prevalence of VAD according to age group was 3.65% (72/1 975), 4.96% (50/1 008), and 5.99% (13/217), respectively(P=0.097). The prevalence of marginal VAD according to age group was 6.99% (138/1 975), 9.82% (99/1 008), and 11.52% (25/217), respectively(P=0.05).@*Conclusion@#Chinese urban elderly residents showed various levels of VAD, although marginal VAD was quite common. As VAD was more common in metropolis residents and older residents, specific strategies should target these populations.

Perceived Residential Environment Quality Indicators and neighborhood attachment: A confirmation study on a Chinese sample in Chongqing.

This paper concerns people's assessment of their neighborhood of residence in a Chinese urban context. The aim of the study was to verify the factorial structure and the reliability of two instruments originally developed and validated in Italy (the full versions of the Perceived Residential Environment Quality Indicators [PREQIs] and of the Neighborhood Attachment Scale [NAS]) in a different cultural and linguistic context. The instruments consist of 11 scales measuring the PREQIs and one scale measuring neighborhood attachment (NA). The PREQIs scales include items covering four macroevaluative domains of residential environment quality: architectural and urban planning aspects (three scales: Architectural and Town-planning Space, Organization of Accessibility and Roads, Green Areas), sociorelational aspects (one scale: People and Social Relations), functional aspects (four scales: Welfare Services, Recreational Services, Commercial Services, and Transport Services), and contextual aspects (three scales: Pace of Life, Environmental Health, Upkeep and Care). The PREQIs and NAS were included in a self-report questionnaire, which had been translated and back-translated from English to Chinese, and was then administered to 340 residents in six districts (differing along various features) of a highly urbanized context in China, the city of Chongqing. Results confirmed the factorial structure of the scales and demonstrated good internal consistency of the indicators, thus reaffirming the results of previous studies carried out in Western urban contexts. The indicators tapping the neighborhood's contextual aspects (i.e., pace of life, environmental health, and upkeep) emerged as most correlated to NA.