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Paddy fields contaminated with cadmium (Cd) present decreased grain yield and produce Cd-contaminated grains. Screening for low-Cd-accumulating cultivars is a useful method to reduce the amount of Cd in the grains. The present study aimed to examine the roles of the root morphology and anatomy in Cd translocation and accumulation in rice plants. Twenty-two rice cultivars were used in the first experiment, after which two cultivars [Zixiangnuo (ZXN) and Jinyou T36 (JYT36)] were selected and used in subsequent experiments under hydroponic conditions. The results showed that there were significant differences in Cd concentrations in the shoots (ranging from 4 to 100 mg/kg) and the Cd translocation rates (shoot/root) (from 7% to 102%) among the 22 cultivars, and the shoot Cd concentration was significantly correlated with the Cd translocation rate of the 22 cultivars under 0.1 mg/L Cd treatment. Compared with cultivar ZXN, JYT36 had greater root Cd uptake and accumulation but lower shoot Cd accumulation and Cd translocation rate. The number of root tips per surface area of cultivar ZXN was greater than that of JYT36, while the average root diameter was lower than that of JYT36. Compared with ZXN, JYT36 had stronger apoplastic barriers, and the Casparian bands and suberin lamellae in the root endodermis and exodermis were closer to the root apex in both the control and Cd treatments, especially for suberin lamellae in the root exodermis with Cd treatments, with a difference of 25 mm. The results also showed that, compared with ZXN, JYT36 had greater percentages of Cd bound in cell walls and intracellular Cd but lower Cd concentrations in the apoplastic fluid under the Cd treatment. The results suggested that Cd translocation, rather than root Cd uptake, is a key process that determines Cd accumulation in the rice shoots. The root morphological and anatomical characteristics evidently affect Cd accumulation in the shoots by inhibiting Cd translocation, especially via the apoplastic pathway. It was possible to pre-screen low-Cd-accumulating rice cultivars on the basis of their root morphology, anatomical characteristics and Cd translocation rate at the seedling stage.

Aim. To develop a scale for measuring nurse's perceived work environment during the public health emergencies (PHEs) and assess its reliability and validity. Background. Although there is extensive research on instruments for measuring nursing work environments in regular healthcare settings, there is a lack of specific scales tailored to address the unique work conditions experienced by nurses during PHEs. Design. This study employed a cross-sectional design for psychometric evaluation and adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Methods. A self-report scale, the Chinese Nursing Work Environment Scale for Public Health Emergencies (C-NWE-PHE), was developed, integrating situational characteristics. Data on demographics, adapted scale scores, and subjective evaluations of nursing management performance were collected from 1156 nurses through online surveys conducted between January 2023 and March 2023. Confirmatory factor analysis, Pearson correlations, and Cronbach's alpha analyses were conducted to evaluate the psychometric properties of the scale. Results. The adapted C-NWE-PHE scale comprised 28 items organized into five subscales: Workforce and Deployment Support, Leadership and Emergency Management, Autonomy and Empowerment, Teamwork and Collaboration, and Logistics and Humanistic Care. Structural equation modelling showed satisfactory factor loadings for each subscale and a good model fit, confirming construct validity. The content validity and reliability of the total scale were confirmed. Conclusion. This study provides empirical evidence for understanding and assessing the nursing work environment during PHEs with a psychometrically sound scale. Implications for Nursing Management. The C-NWE-PHE scale, along with its five identified constructs, provides a nuanced comprehension of working conditions amid PHEs. Implementing this scale could foster specific enhancements, support nurse retention efforts, and enhance the effectiveness of responses during challenging emergency situations. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study was to explore the phenomenon and determinants of healthcare service utilization in Chinese older adults with multimorbidity. Methods We adopted a mixed-methods explanatory design from July 2022 to May 2023. The quantitative research was a social network analysis to explore the phenomenon of healthcare service utilization in target participants. The quantitative results were further interpreted as the participant's propensity for healthcare services and the potential for information sharing between healthcare providers through shared patients. Logistic regression was conducted to identify individual determinants for healthcare service utilization. The quantitative research was followed by qualitative interviews with stakeholders to deeply understand the phenomenon of interest from the individual, healthcare system, and societal perspectives. Results We recruited 321 participants for the quantitative study. They preferred using medication services from primary healthcare providers, pharmacists at private pharmacies, and hospital specialists, and preferred using other services from hospital specialists. Dense relationships arose from shared patients among healthcare providers across various professions and settings, making it possible to share patient information. Primary healthcare providers were particularly important in the process, as they were closely related to others through patient sharing. Health status was identified through logistic regression and qualitative interviews as an individual determinant for healthcare service utilization. More determinants were explored in qualitative interviews with 30 stakeholders, including trust, resource allocation, healthcare accessibility, medical treatment process, and healthcare awareness. Discussion Strategies should be proposed to intervene with patients' nonoptimal propensity toward healthcare services and promote information sharing among healthcare providers. [ABSTRACT FROM AUTHOR]

Objective To explore the heterogenous subtypes and the associated factors of health literacy among patients with metabolic syndrome. Methods A cross-sectional study was conducted, and 337 patients with metabolic syndrome were recruited from Sir Run Run Shaw Hospital in Zhejiang Province from December 2021 to February 2022. The Social Support Questionnaire, Short version of the Health Literacy Scale European Questionnaire (HLS-EU-Q16), and MacArthur Scale of Subjective Social Status were used for investigation. Latent class analysis (LCA) was performed to explore the heterogenous subtypes of health literacy among Metabolic syndrome patients. Univariate analysis and logistic regression were used to identify the predictors of the latent classes. Results The findings of LCA suggested that three heterogeneous subtypes of health literacy among individuals with metabolic syndrome were identified: high levels of health literacy, moderate levels of health literacy, and low levels of health literacy. The multinomial logistic regression results indicated that compared with low levels of health literacy class, the high levels of health literacy class were predicted by age (OR 0.932, 95%CI[0.900-0.966]), socio-economic status (OR 1.185, 95%CI[1.058–1.328]), and social support (OR 1.065, 95%CI[1.012–1.120]). Compared with low levels of health literacy class, the moderate levels of health literacy class were predicted by age (OR 0.964, 95%CI[0.934–0.995]), socio-economic status (OR 1.118, 95%CI[1.006–1.242]), male (OR 0.229, 95%CI[0.092–0.576]). Conclusion The levels of health literacy among patients with metabolic syndrome can be divided into three heterogenous subtypes. The results can inform policy-makers and care professionals to design targeted interventions for different subgroups among patients with metabolic syndrome who are male, at older age, have less social support, and with disadvantaged socio-economic status to improve health literacy. [ABSTRACT FROM AUTHOR]

Metabolic Syndrome (MetS) is a serious public health issue. Dietary changes form the core of MetS treatment. The adherence to dietary recommendations is critical for reducing the severity of MetS components and preventing complications. However, the adherence to dietary recommendations was not adequate among adults with MetS. This study utilizes the Behaviour Change Wheel (BCW) to develop an individualized WeChat mini program-based behavioural change intervention aimed at strengthening adherence to dietary recommendations in people with MetS. The BCW theory was used to design an individualized WeChat mini program-based behavioural change intervention. A descriptive qualitative study was conducted to identify the determinants of adherence to dietary recommendations in individuals with MetS. The study was conducted at the health promotion centre of a prominent general university hospital in Zhejiang, China. Subsequently, the intervention functions (IFs) and policy categories were selected following the identified determinants. Afterwards, behaviour change techniques (BCTs) were chosen to translate into potential intervention strategies, and the delivery mode was determined. Our study identified fifteen barriers to improve the adherence to dietary recommendations in this population. These were linked with six IFs: education, training, persuasion, enablement, modelling, and environmental restructuring. Then, twelve BCTs were linked with the IFs and fifteen barriers. The delivery mode was a WeChat mini program. After these actions, an individualized WeChat mini program-based behavioural change intervention was developed to enhance adherence to dietary recommendations for individuals with MetS. The BCW theory helped scientifically and systematically develop an individualized WeChat mini program-based behavioural change intervention for individuals with MetS. In the future, our research team will refine and upgrade the WeChat mini program and then test the usability and effectiveness of the individualized WeChat mini program-based behavioural change intervention program. This is the first paper to specify the content and active ingredients of an individualized WeChat mini program-based behavioural change intervention using a systematic evidence- and theory-based method for individuals with MetS. The findings can be used to provide guidance to improve dietary adherence, and ultimately improve the lives of people with MetS. This methodology can serve as a reference for other researchers who are developing behavioural change interventions. [ABSTRACT FROM AUTHOR]