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Networked (neoendogenous) development is a prescriptive of rural development that merges the positive aspects of exogenous and endogenous approaches by integrating bottom-up demands and top-down planning, internal and external resources and networks, and vertical political-administrative and interterritorial contexts. The current paper opted for a multicase analysis approach and used a tailored networked rural development institutional analysis and development (NRD-IAD) framework to analyse four organizational aspect changes, namely, institutional characteristics, configuration and structure, actions and activities, and outcomes and evaluation, among four case studies; two studies came from the EU LEADER (links between actions for the development of the rural economy), and the other two came from China's resident work team in poor villages (RWTIPV). The research questions are as follows: What is the difference and common principle between these two approaches, and to what extent can they engage in exchange and be mutually learned from? Primary data were collected through involvement, observation, and open-ended interviews with actors in rural regions of China. Secondary data consisted of the resident cadre's job log, resident work team ledger, minutes of the meeting, village's work reports, government regulations, guidelines for poverty-alleviation planning in China's RWTIPV cases, and published journals and internet sources in EU LEADER cases. In terms of difference, we identified the LEADER system mainly as a regulation-based network with relationships as supplementary information, while the RWTIPV system was mainly found to be a relationship-based network with regulations as supplementary information. Although the two systems seem different, the underlying logic is the same, that is, to engage with a collective reflexivity and action agency (CRAA), embedded in the locality and representing much of the local resource base, and to obtain a sufficient level of relational capacity to create the necessary conditions for integrated rural development. These common principles enable exchange and mutual learning to occur between the LEADER and RWTIPV systems through the unified idea (theory) of CRAA. The current findings contribute to the emergence of a new rural development paradigm mechanism and the role of institutional work. [ABSTRACT FROM AUTHOR]

A large body of literature shows that the emotional health of rural elders in China is negatively affected by the migration of their adult children. However, the precise mechanism that underpins this relationship has yet to be fully uncovered. This paper introduces two new dimensions of analysis to expand the understanding of this 'left behind' phenomenon, and offers statistical insights, theoretical explanations and policy recommendations, as well as suggestions for further study. Firstly, in this paper, rural elders have been distinguished based on whether all , or any , of their adult children have migrated. This distinction leads to the finding that rural elders suffer more adverse mental health impacts when all adult children from a household move away. Secondly, the temporal dimension of migration is investigated, finding that there is a 'turning point' after which the mental health of rural elders appears to recover after the migration of their adult children. Comparison of the two groups shows that rural elders who see any of their adult children migrate recover from depression twice as quickly as those who see all of their children migrate. Receiving financial support or providing child care can only partly mediate the negative influence of migration. Also, the level of depression and wellbeing of rural elders can be significantly moderated by the emotional closeness between them and their adult children. Providing (grand)child-care assistance and receiving economic support is shown to have smaller mitigating effects. This paper concludes with a discussion of how the notion of 'filial piety' could, directly and indirectly, play a role in the emotional health of rural elders, with policy implications provided. [ABSTRACT FROM AUTHOR]

Objectives Informal care provided by adult children is of great importance for older adults' well-being in China. This paper investigates and compares the functional transitions among older adults living in rural areas who receive care from daughters' and from sons' families. Methods This study utilizes the "Well-being of Elderly Survey in Anhui Province" (WESAP) from 2001 to 2021. Our sample included 2,797 individuals aged 60 years or older. Functional status was based on the activities of daily living and the instrumental activities of daily living. We employed a random-effects ordered logit model to examine the functional transitions among the older adults. Results Receiving care from daughters' families is significantly associated with a lower likelihood of functional decline compared to receiving care from sons' families in rural China. The advantage associated with daughter care becomes more pronounced among older individuals with a severe functional difficulty compared to those with a mild or moderate functional difficulty. The difference is prevalent among older adults aged 75 and older, with less wealth or multiple chronic diseases, or who live alone. Furthermore, among those with severe functional difficulties, the daughter advantage is more significant for fathers as compared to mothers. Discussion Nowadays, daughters' families can provide high-quality informal care, often surpassing that offered by sons' families. This daughter advantage becomes even more significant among older adults who have a higher need for family care, such as those with severe disabilities and limited financial resources. [ABSTRACT FROM AUTHOR]

The effect of marriage pairings on fertility intentions is specific and has attracted increasing scholarly attention in recent years. Using data from the China Family Panel Studies (CFPS), this study explored the impact of couples' educational pairings, age pairings, and income pairings on women's desired number of children and their preference for sons. The results showed that marital-educational pairing had a greater effect on women's fertility intentions than age and income pairing. The effect of marital pairing on women's fertility intentions is also influenced by women's age and urban–rural differences. The study helps to understand the changes in women's fertility intentions and the factors influencing them after the fertility policy transition in China and inspires scholars to pay more attention to the interaction process between couples in the study of fertility intentions. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers. [ABSTRACT FROM AUTHOR]

Background: Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies. Objective: The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas. Methods: The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles. Results: Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05). Conclusion: Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) poses significant physical and psychological challenges that necessitate an exploration of factors influencing post-traumatic growth (PTG) for patient well-being. This study aims to investigate the effects of positive psychological capital (PsyCap) and perceived stress on mediating the social support-PTG relation among 673 CRC patients. Social support, positive PsyCap, perceived stress, and PTG were assessed through questionnaires. The results indicated a direct prediction effect of social support on PTG (LICI = 0.481, ULCI = 0.644), with the direct effect being 59.5%. Both positive PsyCap and perceived stress exerted a mediating role in the correlation between social support and PTG, with the mediating effects occupying 29.4% (LICI = 0.217, ULCI = 0.343) and 5.7% (LICI = 0.030, ULCI = 0.082), respectively. Positive PsyCap further had a chain mediating effect on perceived stress (LICI = 0.031, ULCI = 0.074)), with the chain effect accounting for 5.4%. The total impact of social support on PTG was 100% (LICI = 0.882, ULCI = 1.008). This model underscores the pivotal role of social support in promoting PTG in CRC patients. Positive PsyCap serves as a crucial mediator in the social support-PTG link, with perceived stress playing a sequential mediating role. These findings suggest that strengthening social support networks and cultivating positive PsyCap may reduce perceived stress and promote the development of PTG in CRC patients. Consequently, intervention programs are recommended to improve the psychosocial well-being of CRC patients. [ABSTRACT FROM AUTHOR]

The perception of the value of children (VOC) can elucidate why individuals consider it beneficial to have children by uncovering their subjective intentions and experiences regarding their fertility decisions. Using VOC perceptions to understand fertility change in the modernization process, this qualitative study explores how parents' VOC change meshes with China's socioeconomic and cultural contexts. This article examines intergenerational VOC evolution under the support and constraints of socioeconomic environments and cultural norms. Grandparents, embedded in the rural economy and traditional culture, exhibit economic/utilitarian and social/normative VOC. Young parents, living, and having grown up in urban economic and modernized cultural contexts, recognize emotional/psychological VOC for fertility intention. Migrant parents living in urban economies but bound by traditional culture believe that social/normative VOC is important for fertility intention. The results advance understanding of the integration of individuals' psychological intentions with the socioeconomic-cultural contexts that influence their fertility and VOC. [ABSTRACT FROM AUTHOR]

Background: The disparities in healthcare access due to varying insurance coverage significantly impact hospital outcomes, yet what is unclear is the role of insurance in providing care once the patient is in the hospital for a preventable admission, particularly in a weak gatekeeping environment. This study aimed to investigate the association between insurance types and readmission rates, healthcare expenditures, and length of hospital stay among patients with chronic ambulatory care sensitive conditions (ACSCs) in China. Methods: This retrospective observational study utilized hospitalization data collected from the Nanhai District, Foshan City, between 2016 and 2020. Generalized linear models (GLMs) were employed to analyze the relationship between medical insurance types and readmission rates, lengths of hospital stay, total medical expenses, out-of-pocket expenses, and insurance-covered expenses. Results: A total of 185,384 records were included. Among these, the participants covered by urban employee basic medical insurance (UEBMI) with 44,415 records and urban and rural resident basic medical insurance (URRBMI) with 80,752 records generally experienced more favorable outcomes compared to self-pay patients. Specifically, they had lower readmission rates (OR = 0.57, 95% CI: 0.36 to 0.90; OR = 0.59, 95% CI: 0.42 to 0.84) and reduced out-of-pocket expenses (β = −0.54, 95% CI: −0.94 to −0.14; β = −0.41, 95% CI: −0.78 to −0.05). However, they also experienced slightly longer lengths of hospital stay (IRR = 1.08, 95% CI: 1.03 to 1.14; IRR = 1.11, 95% CI: 1.04 to 1.18) and higher total medical expenses (β = 0.26, 95% CI: 0.09 to 0.44; β = 0.25, 95% CI: 0.10 to 0.40). Conclusions: This study found that different types of health insurance were associated with varying clinical outcomes among patients with chronic ambulatory care sensitive conditions (ACSCs) in China. Since the hospitalization of these patients was initially avoidable, disparities in readmission rates, lengths of hospital stay, and medical expenses among avoidable inpatient cases exacerbated the health gap between different insurance types. Addressing the disparities among different types of insurance can help reduce unplanned hospitalizations and promote health equity. [ABSTRACT FROM AUTHOR]

Background: Since 2020, China has piloted an innovative payment method known as the Diagnosis-Intervention Packet (DIP). This study aimed to assess the impact of the DIP on inpatient volume and bed allocation and their regional distribution. This study investigated whether the DIP affects the efficiency of regional health resource utilization and contributes to disparities in health equity among regions. Methods: We collected data from a central province in China from 2019 to 2022. The treatment group included 508 hospitals in the pilot area (Region A, where the DIP was implemented in 2021), whereas the control group consisted of 3,728 hospitals from non-pilot areas within the same province. We employed the difference-in-differences method to analyze inpatient volume and bed resources. Additionally, we conducted a stratified analysis to examine whether the effects of DIP implementation varied across urban and rural areas or hospitals of different levels. Results: Compared with the non-pilot regions, Region A experienced a statistically significant reduction in inpatient volume of 14.3% (95% CI 0.061–0.224) and a notable decrease of 9.1% in actual available bed days (95% CI 0.041–0.141) after DIP implementation. The study revealed no evidence of patient consultations shifting from inpatient to outpatient services due to the reduction in hospital admissions in Region A after DIP implementation. Stratified analysis revealed that inpatient volume decreased by 12.4% (95% CI 0.006–0.243) in the urban areas and 14.7% in the rural areas of Region A (95% CI 0.051–0.243). At the hospital level, primary hospitals experienced the greatest impact, with a 19.0% (95% CI 0.093–0.287) decline in inpatient volume. Furthermore, primary and tertiary hospitals experienced significant reductions of 11.0% (95% CI 0.052–0.169) and 8.2% (95% CI 0.002–0.161), respectively, in actual available bed days. Conclusions: Despite efforts to curb excessive medical service expansion in the region following DIP implementation, large hospitals continue to attract a large number of patients from primary hospitals. This weakening of primary hospitals and the subsequent influx of patients to urban areas may further limit rural patients' access to medical services. The implementation of the DIP may raise concerns about its impact on health care equality and accessibility, particularly for underserved rural populations. [ABSTRACT FROM AUTHOR]

Background: Early childhood caries (ECC) remain a serious oral health problem on a global scale. Risk-based caries management (RBCM) implemented in some parts of the world has been effective in preventing ECC. However, there is a lack of prospective research on the application of RBCM among Chinese children, and little is known about its effectiveness. The purpose of this study was to evaluate the effectiveness of RBCM in preventing caries among children aged 3–5 years in Wanzhou District, Chongqing Municipality, China. Methods: Three- to five-year-old children from four kindergartens in Wanzhou were randomly selected for baseline dental examination and caries risk assessment (CRA) and randomly assigned to the experimental group (EG) or the control group (CG) according to the kindergarten. The EG received caries prevention measures of different intensities based on the child's caries risk level. The CG received full-mouth fluoride twice a year according to standard prevention, regardless of their caries risk. One year later, another dental examination and CRA were conducted, to observe changes in the decayed, missing, and filled teeth (dmft) index and caries risk, and to analyze potential factors that may affect the incidence of new caries. Results: Complete data were collected from 291 children (EG, N = 140, 84.8%; CG, N = 181, 83.4%). A total of 25.7% of the EG and 50.3% of the CG children developed new caries, with newly added dmft scores of 0.54 ± 1.12 and 1.32 ± 1.72, respectively (P < 0.05). Multivariate logistic regression indicated that children living in rural areas, assigned to the CG, and rated as high-risk at baseline were more likely to develop new caries (P < 0.05). The proportion of children with an increased caries risk in the EG was significantly lower than that in the CG (P < 0.05). Conclusions: RBCM effectively prevented new caries in 3- to 5-year-old Wanzhou children and reduced the proportion of children at increased risk of caries. It is an effective approach for preventing ECC. Clinical trial registration: This trial was registered in the Chinese Clinical Trials Register. The registration number was ChiCTR230067551 (11/01/2023). [ABSTRACT FROM AUTHOR]

Evidence of the relationship between fecal short-chain fatty acids (SCFA) levels, dietary quality and type 2 diabetes mellitus (T2DM) in rural populations is limited. Here, we aimed to investigate the association between fecal SCFA levels and T2DM and the combined effects of dietar quality on T2DM in rural China. In total, 100 adults were included in the case–control study. Dietary quality was assessed by the Alternate Healthy Eating Index 2010 (AHEI-2010), and SCFA levels were analysed using the GC-MS system. Generalised linear regression was conducted to calculate the OR and 95 % CI to evaluate the effect of SCFA level and dietary quality on the risk of T2DM. Finally, an interaction was used to study the combined effect of SCFA levels and AHEI-2010 scores on T2DM. T2DM participants had lower levels of acetic and butyric acid. Generalised linear regression analysis revealed that the OR (95 % CI) of the highest acetic and butyric acid levels were 0·099 (0·022, 0·441) and 0·210 (0·057, 0·774), respectively, compared with the subjects with the lowest tertile of level. We also observed a significantly lower risk of T2DM with acetic acid levels > 1330·106 μg/g or butyric acid levels > 585·031 μg/g. Moreover, the risks of higher acetic and butyric acid levels of T2DM were 0·007 (95 % CI: 0·001, 0·148), 0·005 (95 % CI: 0·001, 0·120) compared with participants with lower AHEI-2010 scores (all P < 0·05). Acetate and butyrate levels may be important modifiable beneficial factors affecting T2DM in rural China. Improving dietary quality for body metabolism balance should be encouraged to promote good health. [ABSTRACT FROM AUTHOR]

Objectives. To examine the effectiveness of a patient-family (carer) partnership intervention on the BP control, self-care and self-efficacy for hypertensive people, and dyadic-relationship quality, depressive and anxiety symptoms, and health-related quality of life for the family dyads (hypertensive people and family carers) in rural communities of mainland China. Design. A randomised controlled trial. Methods. A total of 110 family dyads were randomly recruited from village clinics and randomly allocated to the intervention group (n = 55) or control group (n = 55). Family dyads in the control group received usual care. In addition to the usual care, family dyads in the intervention group received the individual-based, five-session patient-family (carer) partnership intervention. The primary outcomes included SBP, DBP, and the proportion of people with normal controlled BP. EuroQol five-dimensional-five-level (EQ-5D-5L) was adopted to evaluate participants' health-related quality of life. Data were collected at the baseline (T0), one-month (T1), and three-month postintervention (T2). Generalised estimating equation model was adopted to test the study hypotheses on all study outcomes. Results. Compared with the control group, hypertensive people in the intervention group had a greater reduction in SBP by 10.10 mmHg and DBP by 4.66 mmHg and a larger proportion of people with normal BP at T2, as well as statistically significant improvements at T1 and T2 in dyadic relationship, self-care, antihypertensive drug-titration rate, anxiety symptoms, and health-related quality of life. The intervention also had statistically significant positive effects on family carer's dyadic relationship and health-related quality of life at T1 and T2. Conclusion. The patient-family (carer) partnership intervention has the potential to improve hypertensive people's BP control and family dyad's dyadic-relationship quality and mental health at short-to-medium term follow-ups. Implications for the Profession and/or Patient Care. This study provided evidence and direction to support healthcare providers in developing and implementing patient-family (carer) partnership intervention for hypertension care in rural areas. This trial is registered with ChiCTR1900027087. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. Methods: This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6–8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. Results: After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost–benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. Conclusions: Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health. [ABSTRACT FROM AUTHOR]

Objective: This research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions. Methods: Through utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran's I). Logistic regression identified factors that influenced the transition to non-primary institutions. Results: Primary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division. Conclusions: This study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the relationship between family socioeconomic status (SES) and adolescents' learning conformity and self-esteem among a sample of 15–18 year-old high school students. Methods: A survey was conducted on 339 adolescents using measures of family SES, self-esteem, and learning conformity. An intermediary effect model was constructed to examine the mediating mechanism of self-esteem in the impact of family SES on adolescents' learning conformity. Results: In our study, we observed that male adolescents were more likely to come from families with higher socioeconomic status (SES) and exhibited relatively higher levels of self-esteem compared to female adolescents. However, this finding should be regarded as an observational outcome specific to our study sample and does not directly indicate a causal relationship between gender and family SES or self-esteem. Adolescents from rural areas were more likely to exhibit tendencies towards learning abidance and compliance. Family SES positively predicted self-esteem. The intermediary model indicated that family SES significantly positively influenced learning abidance and compliance, with self-esteem partially mediating the effects at 33.49% and 33.33%, respectively. Family SES negatively affected learning obedience, with self-esteem partially mediating the effect at 39.77%. Conclusion: Among the 15–18 year-old high school student population, family SES not only directly affects learning abidance, compliance, and obedience but also generates an indirect mediating effect through self-esteem. [ABSTRACT FROM AUTHOR]

Digital village construction is not only a vital component of the digital China strategy but also a crucial measure by which to realize common prosperity. This study theoretically elaborates the influence of digital village construction on the urban–rural income gap (URIG) and its mechanism and empirically tests it by using a panel fixed-effect model, a mediating-effect model, and a moderating-effect model based on the provincial data of major producing areas from 2011 to 2020. The results show that digital village construction can significantly narrow the URIG, and rural industry revitalization is a vital channel for digital village construction in driving the decline of the URIG. The construction of transportation infrastructure can significantly enhance the inhibition effect of digital village construction on the URIG. Moreover, there is a human capital threshold for the impact of digital village construction on the URIG; after crossing the threshold, digital village construction better suppresses the URIG. So, the government should increase the financial support and technical support for digital village construction, improving the rural production conditions and industrial development environment and establishing a rural digital talent cultivation mechanism so as to achieve the goal of common prosperity. [ABSTRACT FROM AUTHOR]

In rural areas of China, the challenges of efficient and cost-effective distribution are exacerbated by underdeveloped infrastructure and low population density, with last mile logistics distribution posing a significant obstacle. To address the gap in drone application for last mile logistics in rural areas, a truck–drone distribution model was developed based on the specific conditions of rural regions. The improved fuzzy C-means algorithm (FCM) and genetic simulated annealing algorithm (GASA) were employed to tackle real−world cases in rural areas. The focus of the truck–drone system is to optimize the rural logistics distribution process, reduce delivery time, and minimize costs while considering factors such as maximum mileage of trucks and drones as well as customer priority. Compared to traditional methods, this system has demonstrated notable improvements in distribution efficiency and cost reduction, offering valuable insights for practical drone applications in last mile rural logistics. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers play important roles in supporting breastfeeding. Although there has been insufficient actual breastfeeding support from healthcare providers in China, little research has been conducted to understand Chinese healthcare providers' perceived barriers to providing breastfeeding support, especially in rural China. This study aims to identify these perceived barriers to providing breastfeeding support in Northwestern rural China. Methods: This study was conducted during the period from March 2018 to December 2018. Forty-one healthcare providers were recruited through purposive sampling in two rural counties in Northwest China that are in close proximity to each other and share similar demographic features. Participants included obstetrician-gynecologists, midwives, nurses, "village doctors", and township and village maternal and child health workers. Qualitative data were collected through one-on-one in-depth semi-structured interviews and focus group discussions. Transcripts were thematically analyzed. Results: Analysis of interview data resulted in four themes that the participants perceived as barriers to supporting breastfeeding: (1) lack of medical resources, within which inadequate staffing, and lack of financial incentives were discussed, (2) lack of clear and specific responsibility assignment, within which no one takes the lead, and mutual buck-passing were discussed, (3) healthcare providers' lack of relevant expertise, within which lack of knowledge and skills, and low prestige of village healthcare providers were discussed, (4) difficulties in accessing mothers, within which medical equipment shortages reduce services utilization, mothers' housing situation, mothers' mobility, and cultural barriers were discussed. Conclusions: The study identified HCPs perceived barriers to providing breastfeeding support. Unique to China's Tri-Level Healthcare System, challenges like staffing and financial incentives are hard to swiftly tackle. Recommendations include mHealth enhancement and clarified responsibilities with incentives and tailored training. Further research is crucial to evaluate these strategies in rural Northwestern China and comparable underdeveloped areas nationwide. [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]

The universal two-child policy in China did not lead to a significant increase in fertility, which results in many public debates. In this study, we examine to what extent a couple's desires for more children are associated with their behavior for having a second child, and whether there is a gender power imbalance in the realization process. Using the China Family Panel Studies data in 2014 and 2018, the findings suggest that the overall rate of having a second child is low after the policy relaxation. Compared to wives, husbands have greater power in the second-child realization, and this phenomenon is only salient in rural areas. Education, as an indicator of resources and a tool of empowerment, played a limited role in reversing the husband's dominance in fertility outcomes in rural areas. This study sheds light on domestic power relations and fertility realization in an era right after the policy relaxation in China and calls for policies to target the issues of how to raise fertility levels without sacrificing women's interests. [ABSTRACT FROM AUTHOR]

• We examined the educational aspirations of migrant children in urban China. • Migrant children with agricultural hukou showed higher aspirations of completing at least tertiary education. • Family social capital benefited migrant children's aspirations more than it did for their non-migrant counterparts. • Academic segregation of schools channeled migrant children with agricultural hukou to a less desirable condition. Rural–urban migrant children are a rapidly growing population in Chinese cities. There is emerging literature on the educational inequality faced by migrant children, but most studies focus on their educational performance or attainments and use non-migrant children with non-agricultural hukou in urban areas as one single reference group. This paper argues that Chinese society is segmented by both hukou type and location, and examines the educational aspirations of migrant children from the perspective of segmented assimilation theory. On the basis of the 2013–2014 wave of the China Education Panel Survey, the results show a segmented assimilation pattern: migrant children with non-agricultural hukou had a similar likelihood of aspiring to tertiary education or above; whereas migrant children with agricultural hukou showed higher aspirations of completing at least tertiary education, and the disparity remained significant after considering family resources and school segregation. In family resources, social capital, in form of social communication with parents, benefited migrant children's aspirations more than it did for their non-migrant counterparts, regardless of their hukou type. In school segregation indicators, academic segregation channeled migrant children with agricultural hukou to a less desirable condition. These findings carry practical and policy implications for understandings of migrant children's educational aspirations. [ABSTRACT FROM AUTHOR]

Trace elements may play an important role in obesity. This study aimed to assess the plasma and dietary intake levels of four trace elements, Mn, Cu, Zn and Se in a rural Chinese population, and analyse the relationship between trace elements and obesity. A cross-sectional study involving 2587 participants was conducted. Logistic regression models were used to analyse the association between trace elements and obesity; restricted cubic spline (RCS) models were used to assess the dose–response relationship between trace elements and obesity; the weighted quantile sum (WQS) model was used to examine the potential interaction of four plasma trace elements on obesity. Logistic regression analysis showed that plasma Se concentrations in the fourth quartile (Q4) exhibited a lower risk of developing obesity than the first quartile (Q1) (central obesity: OR = 0·634, P = 0·002; general obesity: OR = 0·525, P = 0·005). Plasma Zn concentration in the third quartile (Q3) showed a lower risk of developing obesity in general obesity compared with the first quartile (Q1) (OR = 0·625, P = 0·036). In general obesity, the risk of morbidity was 1·727 and 1·923 times higher for the second and third (Q2, Q3) quartiles of dietary Mn intake than for Q1, respectively. RCS indicated an inverse U-shaped correlation between plasma Se and obesity. WQS revealed the combined effects of four trace elements were negatively associated with central obesity. Plasma Zn and Se were negatively associated with obesity, and dietary Mn was positively associated with obesity. The combined action of the four plasma trace elements had a negative effect on obesity. [ABSTRACT FROM AUTHOR]