Correlation between Elderly Migrants’ Needs and Environmental Adaptability: A Discussion Based on Human Urbanization Features

Building concentrated resettlement community in small towns is mostly used to deal with resettlement construction for rural migrants in economically developed regions in China, which leads to migrants’ living environment changing from rural settlements where production and living are intertwined to an urban community that only supports living functions. However, the urbanized environment is contrary to elderly migrants’ behavior, resulting in contradictions or conflicts between migrants and resettlement communities, reflecting a lack of urbanization synchronization between migrants and resettlement community environments. Further, elderly migrants are also equipped with different degrees and types of urbanization characteristics, thus reflecting different abilities to adapt to the urban community environment. Based on the corresponding relationship between people’s different production and living needs and urbanization, this research starts by investigating the production and living needs of elderly migrants, and further clarifies the environmental adaptability of elderly migrants by sorting the types and characteristics of urbanization of elderly migrants to provide a reference basis for the planning and construction of future resettlement areas. The research uses questionnaires and semi-structured interviews to investigate the population attributes and characteristics of elderly migrants, as well as their different needs for production and living. The research uses hierarchical cluster analysis, the one-way ANOVA test and Chi-square test to constructed a four-quadrant model on human urbanization features: an Urban Group with both living and production urbanized (Group H-H); a Half-urban-half-rural Group with only living needs urbanized (Group H-L); a Half-urban-Half-rural Group with only production needs urbanized (Group L-H); and a Rural group with both living and production needs not urbanized (Group L-L). Finally, based on the results, this research proposed three elderly environment construction orientations of “Promote the Supply Level of Urban Public Services”, “Create a Place That Embodies the Spirit of Immigrants’ Homeland”, and “Moderate Consideration of Agricultural Production Needs” for residential planning.

MO759COMPERATIVE STUDY OF THE CARDIOVASCULAR SYSTEM IN PATIENTS WITH CKD ON HEMODIALYSIS IN URBAN AND RURAL POPULATIONS OF UZBEKISTAN

Background and Aims According to recently published WHO data, kidney disease has been the 10th leading cause of death in the world over the past 20 years. The lethality of dialysis patients with cardiovascular pathology is 3 times higher than that of patients without CVD. This is especially pronounced in developing countries. Uzbekistan is a country with a population of 34 million and has an equal urban and rural population. In this regard, it is of interest to comparatively study the structure of CVD in patients with CKD stage 5D of the rural and urban population of Uzbekistan. Method We examined 165 (90 men and 75 women) patients with CKD stage 5 receiving dialysis in urban and rural areas of Uzbekistan. The patients were divided into 2 groups depending on their permanent place of residence and the medical center where they receive hemodialysis. 104 (51 men and 53 women) patients were included in the Urban group and 61 (39 men and 22 women) patients were included in the Rural group. The average age of the urban population was 49.7 ± 1.38 years, the rural population was 45.5 ± 1.83 years. All patients underwent programmed hemodialysis according to the standard scheme for 4 hours 3 times a day (12 hours/week). The average duration of hemodialysis in the Urban group was 37.0 ± 4.77 months (M ± m) and 16.6 ± 2.4 months in the Rural group. The main causes of CKD 5D in both groups were glomerulonephritis (Urban-36.5%, Rural-62%) and type 2 diabetes (Urban-31.7%, Rural-18%). Results CVD comorbidity occurred in 55,8% (n=92) of all 165 examined patients, of which 52 were men and 40 were women. The most common CVDs in all groups were hypertension (51%, n=84), coronary heart disease, presented as angina (28%, n=47), heart failure (14%, n=23) and various types of arrhythmias (5%, n=8). 77% (n=127) of patients had anemia due ESRD. In the group Urban(n=104), 62.5% (n=65) had CVD. The main CVD was Hypertension. It was found in 92% (n=60) of patients with CVD in this group. Less (65%, n=42) were patients with angina. Heart failure was detected in 31% (n=20) of patients. Arrhythmia was diagnosed in only 5% (n=5). A large number of combined CVD have been identified. 69% (n=45) of all patients with CVD had a combined CVDs in different combinations. The most common combination was hypertension + angina (n = 26). It accounted for almost 58% of all combined cases. Only 28% (n=17) of all cases with hypertension had "isolated" hypertension. The main combination with hypertension was hypertension + angina (43%, n=26), 11% (n=11) of patients had hypertension + angina + heart failure, a combination in the form of hypertension + angina + arrhythmia had 3% (n=3) patients. Relatively fewer (n = 27, 44%) CVD were found in the Rural group. The most frequent CVD was also a hypertension. Patients with hypertension made up 89% (n = 24) of all patients with CVD in this group. The second place is occupied by angina, it was found in 18.5% (n=5) cases among patients with CVD. Combined CVS pathologies were less common in the rural group. A total of 8 patients (29.6% of all CVD cases) had several CVDs. Conclusion Сardiovascular diseases in the urban population (62.5%) occur almost one and a half times more often than in the rural population (44%). Combined CVD pathology occupies a leading place in the structure of CVD in patients with CKD 5D, both urban and rural.

Geographic influence on postoperative complications in children with complicated appendicitis: a single center study

Background Acute appendicitis is one of the most common abdominal emergencies in children. Complicated appendicitis is much more common in pediatric age group than in adults due to probability of delay in diagnosis or misdiagnosis. Geographic status has an influence on the clinical course of such surgical cases. This prospective comparative study was conducted at the pediatric surgery department in our hospital in Egypt during the period from December 2018 to August 2019, aiming to find the relation between residence of patients and occurrence of post-operative complications among patients in Sharkia Governorate, Egypt. Patients were divided into two groups: rural and urban. Data recorded included demographic data, preoperative assessment, operative findings, postoperative course, postoperative complications, and follow-up. Results Sixty patients were included in the study, 32 of them were from rural areas, and 28 were from urban areas. There was no significant difference between them regarding demographics. Duration of symptoms was significantly longer with rural group (3.7 ± 1.4 vs. 3.07 ± 0.92 days). Length of hospital stay was significantly longer with the rural group (4.7 ± 1.7 vs. 4.7 ± 1.7 days). The rate of wound infection was significantly higher with the rural group (34.37% vs. 10.7%), while other postoperative complications were increased with rural group, but that was not statistically significant. The regularity of follow-up was higher with the urban group. Conclusions Children with complicated appendicitis from rural areas are at higher risk for occurrence of postoperative complications and poor outcome, with less regularity in follow-up. This is because of many obstacles they faced, including difficulties of transportation, insufficient medical services, and low socioeconomic and educational statuses.

Outcomes of single bundle arthroscopic anterior cruciate ligament reconstruction in a limited resource setting

ObjectivesDespite various challenges, orthopaedic sports surgeons are still providing the arthroscopic service in low-income and middle-income countries like Nepal; however, it is hardly being reported. The main purpose of this study was to compare the clinical outcomes and complications of patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR) in the urban group and that of the rural group.MethodsWe evaluated a total of 194 patients, including 98 patients in the urban group and 96 patients in the rural group, undergoing arthroscopic ACLR between August 2015 and February 2018, and had completed a minimum of 2-year follow-up. Subjective evaluations were performed using the Tegner-Lysolm score and International Knee Documentation Committee (IKDC) subjective knee evaluation form. Laxity assessments were performed using the Lachman test and the Pivot-shift test. Functional evaluation included the range of motion, single-leg hop test and overall IKDC score. Radiological assessment was performed according to the IKDC guidelines. SPSS was used for data analysis.ResultsThere was statistically significant differences in the subjective assessments between 2 groups. No statistically significant differences existed between 2 groups in terms of laxity and functional assessments. However, the proportion of laxity, in terms of Lachman test and Pivot-shift test, was higher in the young and active individuals and the proportion of abnormal and severely abnormal in all parameters of functional outcomes was higher in the older female in the rural group. Graft failure occurred in 19 (17.6%) knees in the urban group and 17 (16.8%) knees in the rural group. Graft failure in the urban group was higher in young and active male patients, whereas failure in the rural group was more in female patients. Similarly, overall infection occurred in 13 (6.2%) knees, including 5 (2.3%) deep infections and 8 (3.8%) superficial infections.ConclusionWe advised similar rehabilitation protocol for all the patients; however, the outcomes were significantly lower in patients living in rural areas as they are found to have poor compliance with the rehabilitation protocol. The overall graft failure rate was 17.2%; however, the reoperation rate was higher in the urban group than the rural group. The rate of deep infection was higher in the rural group as compared with the urban group.Level of evidenceLevel III, retrospective comparative study.

Different Perceptions of Belief: Predicting Household Solid Waste Separation Behavior of Urban and Rural Residents in China

An unprecedented Household Solid Waste (HSW) separation program was launched in 46 cities and some pilot rural areas in China in 2019. This study examines the antecedents of waste separation behavior using the extended theory of planned behavior (TPB) to identify beliefs that are useful targets for interventions, and compares the urban-rural differences. Based on interviews with rural and urban residents, we identified residents’ beliefs influencing waste separation behaviors, including four behavioral, seven normative, and eight control beliefs. Then, we tested the conceptual model with a two-stage questionnaire survey using a sample of 604 residents from urban and rural areas. Evidence from structural equation modeling supports the extended TPB in that it predicts waste separation intention and behavior on the whole. Moral norm and self-identity were found to independently predict intention and may prove a useful addition to the TPB; however, the path from attitude to intention is not supported in both urban and rural models. Moreover, the specific difference of belief between urban and rural residents was examined. The behavioral beliefs associated to money, including earning, free waste bin or bag, and fine, are significant only in the rural group. The normative beliefs of family, Chinese Communist Party (CCP) members, and government can affect residents’ subjective norm in both urban and rural, while the beliefs of relatives, friends, and neighbors are significant only in the rural group. Implications for managers of operating waste separation programs were discussed. Further investigation into the potential of the model to intervene in waste separation behavior is required.

Heavy metal gradients from rural to urban lakes in central China

Background Limited information is available on heavy metal patterns in lakes under rapid watershed urbanization, especially considering a large spatial gradient with a long linear distance and great variations in topographic relief. To fill this gap, we studied concentrations of a series of heavy metals in both water and sediments from 20 lakes along a rural to urban gradient in central China, and we aimed to understand the effects of urban processes on heavy metal dynamics in lake ecosystems. Studied lakes were divided into five groups: A (rural reservoir group), B (rural commercial fishing group), C (urban park group), D (urban recreational fishing group), and E (urban commercial fishing group). An inductively coupled plasma optical emission spectrometer (ICP-OES) and an inductively coupled plasma-mass spectrometer (ICP-MS) were used to analyze the heavy metals in water and sediments. Results An increasing trend of most heavy metals in water from rural to urban lakes was observed. Concentrations of cadmium (Cd), cobalt (Co), lead (Pb), chromium (Cr), arsenic (As), nickel (Ni), magnesium (Mn), iron (Fe), and aluminum (Al) in water were significantly lower in rural group A than those in other groups. Arsenic in sediments of rural group A was lower than those in other groups. No other heavy metal element in sediments was significantly different among groups. The enrichment factor analysis of selected heavy metals showed there were different degrees of enrichments of heavy metals in sediments. The potential ecological risk index showed a low level for heavy metals in sediments of all studied lakes. Conclusions Results indicated that urban processes could have an impact on heavy metals in lake water. The sources of heavy metals in sediments were more likely from anthropogenic activities. These results could enhance our understanding of metal dynamics in lake ecosystems under urbanization and could help prevent heavy metal pollutions and promote sustainable management of urban ecosystems.

Outcomes of Single Bundle Arthroscopic Anterior Cruciate Ligament Reconstruction in a Limited Resource Setting.

Purpose: Despite various challenges, orthopaedic sports surgeons are still providing the arthroscopic service in developing countries like Nepal; however, it is hardly being reported. The main purpose of this study was to compare the clinical outcomes and complications of patients undergoing arthroscopic ACLR in the Urban group and that of the Rural group. Methods: We evaluated a total of 194 patients, including 98 patients in the Urban group and 96 patients in the Rural group, undergoing arthroscopic ACLR between August 2015 and February 2018. The subjective evaluations were performed using the Tegner-Lysolm score and International Knee Documentation Committee (IKDC) form. The laxity assessments were performed using the Lachman test and the Pivot-shift test. The functional evaluation included the ROM, single-leg hop test, and overall IKDC score. Radiological assessment was performed according to the IKDC guidelines. SPSS was used for data analysis. Results: There was statistically significant differences in the subjective assessments between 2 groups. No statistically significant differences existed between 2 groups in terms of Laxity and Functional assessments. However, the proportion of laxity, in terms of Lachman test and Pivot-shift test, was higher in the young and active individuals and the proportion of abnormal and severely-abnormal in all parameters of functional outcomes was higher in the older female in the Rural group. Graft failure occurred in 19(17.6%) knees in the Urban group and 17(16.8%) knees in the Rural group. Graft failure in the urban group was higher in young and active male patients, whereas failure in the Rural group was more in female patients. Similarly, overall infection occurred in 13 (6.2%) knees, including 5 (2.3%) deep infections and 8 (3.8%) superficial infections. Conclusion: We advised the similar rehabilitation protocol for all the patients; however, the outcomes were significantly lower in patients living in rural areas as they are found to have poor compliance with the rehabilitation protocol. The overall graft failure rate was 17.2%; however, the reoperation rate was higher in the Urban group than the Rural group. The rate of deep infection was higher in the Rural group as compared to the Urban group.

Profiling of Koumiss Microbiota and Organic Acids and their Effects on Koumiss Taste

Background Koumiss is a naturally fermented mare’s milk. Over recent decades, numerous studies have revealed the diversity of lactic acid bacteria in koumiss. However, there is limited information available regarding its secondary major component yeast profile. Results A total of 119 bacterial and 36 yeast species were identified among the 14 koumiss samples. The dominant bacterial species in koumiss were Lactobacillus helveticus , Lactobacillus kefiranofaciens , Lactococcus lactis , Lactococcus raffinolactis , and Citrobacter freundii. The main yeast species were Dekkera anomala , Kazachstania unispora , Meyerozyma caribbica , Pichia sp.BZ159 , Kluyveromyces marxianus , and uncultured Guehomyces . The bacterial and yeast Shannon diversity of the Xilinhaote-urban group were higher than those of the Xilingol-rural group. The most dominant organic acids were lactic, acetic, tartaric, and malic acids. Lactic acid bacteria species were mostly responsible for the accumulation of those organic acids, although Kazachstania unispora , Dekkera anomala , and Meyerozyma caribbica may also have contributed. Redundancy analysis suggested that both bacteria and yeast respond to koumiss flavor, such as Lactobacillus helveticus and Dekkera anomala are associated with sourness, astringency, bitterness, and aftertaste, whereas Lactococcus lactis and Kazachstania unispora are associated with umami. Conclusions Our results suggest that differences were observed in koumiss microbiota of Xilinhaote-urban and Xilingol-rural samples. The biodiversity of the former was higher than the latter group. Positive or negative correlations between bacteria and yeast microbiota and taste also were found.

Profiling of Koumiss Microbiota and Organic Acids and their Effects on Koumiss Taste

Background Koumiss is a naturally fermented mare’s milk. Over recent decades, numerous studies have revealed the diversity of lactic acid bacteria in koumiss. However, there is limited information available regarding its secondary major component yeast profile. Results A total of 119 bacterial and 36 yeast species were identified among the 14 koumiss samples. The dominant bacterial species in koumiss were Lactobacillus helveticus , Lactobacillus kefiranofaciens , Lactococcus lactis , Lactococcus raffinolactis , and Citrobacter freundii. The main yeast species were Dekkera anomala , Kazachstania unispora , Meyerozyma caribbica , Pichia sp.BZ159 , Kluyveromyces marxianus , and uncultured Guehomyces . The bacterial and yeast Shannon diversity of the Xilinhaote-urban group were higher than those of the Xilingol-rural group. The most dominant organic acids were lactic, acetic, tartaric, and malic acids. Lactic acid bacteria species were mostly responsible for the accumulation of those organic acids, although Kazachstania unispora , Dekkera anomala , and Meyerozyma caribbica may also have contributed. Redundancy analysis suggested that both bacteria and yeast respond to koumiss flavor, such as Lactobacillus helveticus and Dekkera anomala are associated with sourness, astringency, bitterness, and aftertaste, whereas Lactococcus lactis and Kazachstania unispora are associated with umami. Conclusions Our results suggest that differences were observed in koumiss microbiota of Xilinhaote-urban and Xilingol-rural samples. The biodiversity of the former was higher than the latter group. Positive or negative correlations between bacteria and yeast microbiota and taste also were found.