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Low fertility willingness has become a major practical reality in China. From the perspective of family gender equality, this paper analyzes the impact of division of housework on women's fertility willingness by using the data of China Family Panel Studies (CFPS). The results of propensity score matching method and instrumental variable method show that husbands' participation in housework can effectively improve wives' fertility willingness. Mechanism analysis shows that husbands' active participation in housework can effectively reduce wives' work–family conflict, increase wives' satisfaction with husbands' housework contribution, and help improve wives' happiness and fertility willingness. Further discussion on whether families have had children or not shows that women who have had children are more sensitive to their husbands' participation in housework. This study provides empirical evidence for the applicability of family gender equality theory in China and the factors affecting women's fertility willingness. [ABSTRACT FROM AUTHOR]

Insulated plastic greenhouses (IPG) were a new type of facility emerging in production in China. The mechanism of construct parameters on the indoor solar radiation deserves further study. A mathematical model that can well describe the spatial and temporal distribution of solar radiation in the greenhouse was established. Based on this model, the effects of multiple construct parameters, such as insulation blanket shading, height–span ratio, greenhouse azimuth, and geographical latitude, on the indoor solar radiation of IPG were quantitatively specified. The results showed that the spatial and temporal distribution of inside solar radiation was highly variable along the span direction of IPG. And by analyzing the simulation data, it was found that for different heights of greenhouses, the corresponding optimal span is different. Therefore, in the construction of greenhouses, the appropriate height–span ratio should be selected according to the planting demand. And by simulating the inside solar radiation under different greenhouse azimuth angles, it was found that accumulated daily solar radiation in the greenhouse reaches the optimum value when the greenhouse azimuth angle is in the range of 0–20°. This paper can provide theoretical guidance for the design and optimization of structure parameters of IPG in China. [ABSTRACT FROM AUTHOR]

This paper is the second in a two-part series on the concavity-convexity of the distribution system security region (DSSR). In Part I, the concave-convex characteristics and mechanism of DSSR are revealed by observing many case grids. In Part II (this paper), the concave-convex principle of DSSR is revealed through mathematical deduction. Firstly, the relevant concepts of sub-regions are proposed, and a DSSR model based on the union of sub-regions is developed. Secondly, the concave-convex principle of DSSR is proposed. The proposed criteria show that the security region of a distribution system with a single load transfer path for each feeder is convex, while that with multiple load transfer paths for some feeders can be concave or convex. Thirdly, the proposed criteria are deduced mathematically. Fourthly, based on the criteria, a method is proposed to judge whether a DSSR is concave or convex. Fifthly, the proposed criteria and method are verified through several cases, and the DSSR concavity-convexity of real distribution systems in China is also analyzed. Finally, the applications of DSSR concavity-convexity are illustrated. This work lays a mathematical foundation for the research of the topological properties of DSSR and is also useful for the application of DSSR. • The DSSR mathematical model based on the union of sub-regions is developed. • Three criteria are proposed and proved, revealing the concave-convex principle of DSSR. • A judgment method for DSSR concavity-convexity is proposed based on these criteria. • The DSSR concavity-convexity of real distribution systems in China is analyzed. • The application values of DSSR concavity-convexity are demonstrated. [ABSTRACT FROM AUTHOR]

The Affective Reactivity Index (ARI) is one of the most studied scales for assessing youth irritability, but little is known about its measurement performance in community populations. This study applied item response theory (IRT), network analysis, and classical test theory (CTT) to examine the psychometric properties of the ARI in a sample of n = 395 community-based children (M age = 13.44, SD = 2.51) and n = 403 parents. In this sample, the ARI demonstrated good reliability, as well as convergent and concurrent validity. The one-factor structure was supported by both confirmatory factor analysis (CFA) and network analysis. IRT analysis revealed that the ARI effectively distinguished between various levels of irritability within the community population. Network analysis identified "Loses temper easily,""Gets angry frequently," and "Often loses temper" are central aspects of irritability. The findings support the ARI as a brief, reliable, and valid instrument to assess irritability in community children and adolescents. [ABSTRACT FROM AUTHOR]

Aim: Being front‐line healthcare professionals is associated with possible severe information anxiety during the COVID‐19 pandemic. Investigating signs of information anxiety is the first and key step of its targeted medical intervention. This study aims to explore the signs of front‐line healthcare professionals' information anxiety during the COVID‐19 pandemic. Design: This study is qualitative research. Grounded theory was used to classify information anxiety signs of front‐line healthcare professionals. Methods: Twenty‐four front‐line healthcare professionals from a general hospital with over 5000 beds in Wuhan were recruited to participate in semi‐structured interviews. According to the frequency and frequency variation of signs appearing in interviews, the trends of signs during the virus encounter, lockdown, flattening and second wave were compared. Based on the interviews, those signs that were conceptually related to each other were extracted to construct a conceptual model. Results: Psychological signs (emotion, worry, doubt, caution, hope), physical signs (insomnia, inattention, memory loss, appetite decreased) and behavioural signs (panic buying of goods, be at a loss, pay attention to relevant information, change habits) could be generalized from 13 subcategories of information anxiety signs. Psychological signs were the most in every period of the pandemic. Furthermore, psychological signs decreased significantly during lockdown, while behavioural and physical signs increased. Finally, severe psychological and behavioural signs were associated with physical signs. [ABSTRACT FROM AUTHOR]

Background: Medical insurance stands as a pivotal component within the overarching framework of public service systems. The intricate interplay between the extent of healthcare coverage and the overall well-being of the populace remains a pivotal research question within the academic sphere. Methods: Drawing from the comprehensive dataset of the Chinese Household Livelihood Survey, this article employs a rigorous data model to delve into the profound implications of medical coverage on population health. Results: The descriptive analysis revealed that areas with broader medical coverage tend to exhibit higher levels of overall population health. This initial observation provided a foundation for further quantitative exploration using multiple regression analysis. The regression analysis demonstrated a statistically significant positive relationship between medical coverage and population health. This finding is particularly noteworthy as it suggests that expanding access to healthcare services has tangible benefits for improving the overall health of a population. Conclusion: From the lens of familial sustenance, this article delves into the intricate health implications of medical coverage, thereby introducing a novel theoretical lens to the evolving discourse surrounding medical insurance healthcare systems and their impact on public health. This approach aims to enrich the current understanding of this complex relationship and contribute to the scholarly dialogue. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy, whilst treating tumours, can also lead to numerous adverse reactions such as nausea and vomiting, fatigue and kidney toxicity, threatening the physical and mental health of patients. Simultaneously, misuse of chemotherapeutic drugs can seriously endanger patients' lives. Therefore, to maintain the safety of chemotherapy for cancer patients and to reduce the incidence of adverse reactions to chemotherapy, many guidelines state that a comprehensive assessment of the cancer patient should be conducted and documented before chemotherapy. This recommended procedure, however, has yet to be extensively embraced in Chinese hospitals. As such, this study aimed to standardise the content of pre-chemotherapy assessment for cancer patients in hospitals and to improve nurses' adherence to pre-chemotherapy assessment of cancer patients by conducting a national multi-site evidence implementation in China, hence protecting the safety of cancer patients undergoing chemotherapy and reducing the incidence of adverse reactions to chemotherapy in patients. Methods: The national multi-site evidence implementation project was launched by a JBI Centre of Excellence in China and conducted using the JBI approach to evidence implementation. A pre- and post-audit approach was used to evaluate the effectiveness of the project. This project had seven phases: training, planning, baseline audit, evidence implementation, two rounds of follow-up audits (3 and 9 months after evidence implementation, respectively) and sustainability assessment. A live online broadcast allowed all participating hospitals to come together to provide a summary and feedback on the implementation of the project. Results: Seventy-four hospitals from 32 cities in China participated in the project, four withdrew during the project's implementation, and 70 hospitals completed the project. The pre-and post-audit showed a significant improvement in the compliance rate of nurses performing pre-chemotherapy assessments for cancer patients. Patient satisfaction and chemotherapy safety were also improved through the project's implementation, and the participating nurses' enthusiasm and belief in implementing evidence into practice was increased. Conclusion: The study demonstrated the feasibility of academic centres working with hospitals to promote the dissemination of evidence in clinical practice to accelerate knowledge translation. Further research is needed on the effectiveness of cross-regional and cross-organisational collaborations to facilitate evidence dissemination. [ABSTRACT FROM AUTHOR]

Aims: To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life. Design: A multi‐centre cross‐sectional study. Methods: 2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self‐reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis. Results: The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were.083,.085 and.111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain‐mediated effect of physical and psychological symptoms, accounting for 16.74%. Conclusions: Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms. Relevance to Clinical Practice: It is important to design non‐pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life. Reporting Method: Study methods and results reported in adherence to the STROBE checklist. No Patient or Public Contribution: No patients or members of the public were involved in the study. [ABSTRACT FROM AUTHOR]

Background: Education has been recognised as necessary in forming and internalising professional values. The system and instructors' content in existing educational institutions focus on developing students' knowledge, skills and practices. Still, the development of values has yet to achieve significant effects, leading to a crisis in students' professional identity. Aims: To construct a professional values growth theory for undergraduate nursing students and develop a corresponding education framework. Methods: Through the review, some databases(PubMed、CINAHL、Web of Science、Wiley and Google Scholars)were searched using a systematic search strategy to collect relevant literature on professional values education. Based on the nursing professional values growth theory (Li and Li, Nursing Ethics In press, 2022), a theory of professional values growth of nursing undergraduates was developed using the method of theory derivation. Two rounds of expert meetings were conducted to review and revise an education framework of professional values of nursing undergraduates derived from that theory. Findings: A total of 10 studies were included. The contents of two themes were analysed: theories and models and the current status of the professional values development of nursing students. The resulting professional values growth theory for undergraduate nursing students consists of five parts: key aspects, decisive opportunities, drivers, embodiment (humanistic sentiments, moral emotions), and outcomes. A total of five experts in the relevant fields were invited to this study. After two rounds of expert meetings, an education framework for undergraduate nursing students was finally developed, which consists of four parts: education objectives, education process and content, environment and conditions, and evaluation. Conclusion: The education framework developed in this study has practical implications for the development of professional values of undergraduate nursing students, providing educational strategies and methods for the growth and internalisation of professional values of undergraduate nursing students. [ABSTRACT FROM AUTHOR]

Dietary antioxidant indices (DAI) may be potentially associated with relative telomere length (RTL) of leucocytes. This study aimed to investigate the relationship between DAI and RTL. A cross-sectional study involving 1656 participants was conducted. A generalised linear regression model and a restricted cubic spline model were used to assess the correlation of DAI and its components with RTL. Generalised linear regression analysis revealed that DAI (β = 0·005, P = 0·002) and the intake of its constituents vitamin C (β = 0·043, P = 0·027), vitamin E (β = 0·088, P < 0·001), Se (β = 0·075, P = 0·003), and Zn (β = 0·075, P = 0·023) were significantly and positively correlated with RTL. Sex-stratified analysis showed that DAI (β = 0·006, P = 0·005) and its constituents vitamin E (β = 0·083, P = 0·012), Se (β = 0·093, P = 0·006), and Zn (β = 0·092, P = 0·034) were significantly and positively correlated with RTL among females. Meanwhile, among males, only vitamin E intake (β = 0·089, P = 0·013) was significantly and positively associated with RTL. Restricted cubic spline analysis revealed linear positive associations between DAI and its constituents' (vitamin E, Se and Zn) intake and RTL in the total population. Sex-stratified analysis revealed a linear positive correlation between DAI and its constituents' (vitamin E, Se and Zn) intake and RTL in females. Our study found a significant positive correlation between DAI and RTL, with sex differences. [ABSTRACT FROM AUTHOR]

Background: Higher intakes of dietary antioxidants have been linked to a lower type 2 diabetes mellitus (T2DM) risk. However, few studies have comprehensively examined the overall dietary antioxidant capacity, assessed by dietary antioxidant quality scores (DAQS) and dietary total antioxidant capacity (DTAC), related to T2DM risk, especially in populations consuming relatively monotonous diets. This study aimed to evaluate the associations of DAQS, DTAC, and T2DM among rural Chinese adults. Methods: Data from 12,467 participants from the Natural Population Cohort of Northwest China: Ningxia Project was analyzed. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. DAQS were calculated based on vitamins A, C, and E, zinc (Zn), and selenium (Se) intake. DTAC was estimated using the ferric-reducing ability of plasma assay. Logistic regression models were used to evaluate the associations of DAQS and DTAC with T2DM risk. Restricted cubic splines were used to assess potential non-linear relationships between DTAC and T2DM. Results: T2DM was observed in 1,238 (9.9%) participants. After adjusting for confounders, compared to the lowest tertiles (T1) of DAQS, the odds ratios (ORs) for T2DM were 1.03 (95% CI 0.82–1.30) in T2 and 0.85 (95% CI 0.68–1.06) in T3 (P = 0.010). Compared to T1, the ORs for T2DM in the highest T3 were 0.78 (95% CI 0.67–0.91, P-trend = 0.008) for vitamin A, 1.34 (95% CI 1.15–1.56, P-trend < 0.001) for vitamin E, 0.83 (95% CI 0.71–0.97, P-trend = 0.007) for Se, and 0.86 (95% CI 0.74–1.01, P-trend = 0.033) for Zn. Compared to the lowest quartile(Q1) of DTAC, the OR in the highest Q4 was 0.96 (95% CI 0.80–1.17, P-trend = 0.024) for T2DM. A non-linear relationship was observed between DATC and T2DM. Conclusion: Higher DAQS and DATC were associated with a lower T2DM risk, suggesting that consuming antioxidant-rich foods may reduce the T2DM risk. [ABSTRACT FROM AUTHOR]