Background Extreme pre-pregnancy body mass index (BMI) values have been associated with reduced fecundability and prolonged time to pregnancy in previous studies. However, the effect in fertile couples is unclear. Objectives This study aimed to evaluate the association between pre-pregnancy BMI and fecundability, measured as time to pregnancy (TTP), among couples that achieved pregnancy within 1 year. Methods This was a retrospective cohort study of 50,927 couples wishing to conceive, enrolled in the National Free Preconception Health Examination Project (NFPHEP) in Chongqing, China, during 2012-2016. Participants' weight and height were measured by NFPHEP-trained preconception guidance physicians. TTP measured in months was used to determine subfecundity (TTP >6 months). The strength of association between BMI and TTP/subfecundity was measured with fecundability odds ratios (FOR)/odds ratios (OR) and their corresponding 95% confidence intervals (CI), calculated with Cox and logistic regression analysis. We used restricted cubic spline regression (RCS) to test the observed FOR trends. Results Compared to women with normal BMI, women with pre-pregnancy overweight/obesity had longer TTP (FOR = 0.96, 95% CI: 0.94-0.99) and increased risk of subfecundity (OR = 1.08, 95% CI: 1.00-1.17). There was no association between TTP and male BMI. RCS trends varied when data were stratified by male pre-pregnancy BMI, with the greatest change detected in pre-pregnancy underweight men.

Background: Parenting styles have a tremendous influence on a child’s development and behavior. Studies on parenting styles using latent profile analysis have been increasing in recent years. However, there are few such studies conducted in China, especially concerning joint parenting styles (that simultaneously characterize maternal and paternal practices), which are held over the age group of secondary vocational school students. This study aimed to identify the profiles of parenting styles and their associated factors among the parents of secondary vocational school students in China, based on natural samples and not a predetermined model. Method: Data were drawn from a cross-sectional study conducted among 3180 students from six secondary vocational schools in Shanghai Municipality and Shaanxi Province. A total of 2392 students who have lived with their parents for most of their lifetime were included in the study. Latent profile analysis was used to identify the profiles of parenting styles of the respondent’s parents. Multinominal logistic regression models were used to examine the association between parenting style and demographic characteristics and family background and adolescent outcomes. Results: We identified five latent profiles: “free-range parenting” (27.05%), “behavioral monitoring parenting” (33.65%), “authoritative parenting” (11.75%), “psychological control parenting” (14.38%) and “tiger parenting” (13.17%). The associations between these profiles and adolescent outcomes indicated that these profiles were rational. Participants’ gender, grade, residential area, family economic level, parental marital relationship, and parental educational level were predictive factors for parenting styles. Conclusions: The parenting styles held over secondary vocational school students were somewhat different from Baumrind’s parenting style model. A considerable number of students received a parenting style that might predispose them to behavioral and mental health outcomes and merit a tailored intervention using the predictive factors of parenting styles.

Individuals’ gender development is influenced by the characteristics of personal and contextual environments. However, the role of sibling contexts in shaping gender norms has rarely been studied among Chinese youth at early adolescence as most of them were the only child. The aim of this paper is to compare perceived gender norms among adolescents aged 10–14 with different sibling configurations, to help inform and tailor guidance for sexual and reproductive health education in the future. We used the Global Early Adolescent Study baseline data collected from Shanghai, China. The sample for analysis was 1615 students. We used univariate analysis and multivariate ordinal logistic regression to compare perceived gender-stereotyped traits and gender role attitudes, stratified by age and sex. The results showed that sibling context was more influential for boys than girls at early adolescence in their gender socialization process. Among boys those who were with mixed-sex siblings scored higher on gender-stereotyped traits (ORonly-childvs. mixed-sex siblings = 0.67, 95% CI: 0.48–0.94, p = 0.019; ORsame-sex siblingsvs. mixed-sex siblings = 0.59, 95% CI: 0.37–0.96, p = 0.033). Younger early adolescents aged 10–12 who were the only child or who had mixed-sex siblings perceived more traditional gender role attitudes than those living with same-sex siblings (ORonly-childvs. same-sex siblings = 1.71, 95% CI: 1.06–2.75, p = 0.028; ORmixed-sex siblingsvs. same-sex siblings = 1.74, 95% CI: 1.03–2.94, p = 0.037). Comprehensive sexuality education with gender and power components being well addressed, both in and out of the family, is needed to provide extra gender-inclusive and gender-egalitarian environments for youth.

Purpose The purpose of this study is to determine the incidence and severity of symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy, form a symptom burden report, evaluate the distribution characteristics of symptoms, identify symptom clusters, and provide a basis for clinical doctors and nurses to improve the symptom management of patients with cervical cancer after radiotherapy and chemotherapy. Methods The patients with cervical cancer within 6 months after radiotherapy and chemotherapy were recruited to investigate their symptom burden. Exploratory factor analysis was used to identify symptom clusters. Results A total of 250 patients participated in the study. The study found that the most common symptom among the 40 symptoms was fatigue, and the most serious symptom was nocturia. Based on the occurrence rate and severity of symptoms, nine symptom clusters were identified, including psycho–emotion-related symptom cluster, pain–disturbed sleep-related symptom cluster, menopausal symptom cluster, tinnitus–dizziness-related symptom cluster, urinary-related symptom cluster, dry mouth–bitter taste-related symptom cluster, intestinal-related symptom cluster, memory loss–numbness-related symptom cluster, and emaciation-related symptom cluster. The three most serious symptom clusters are pain–disturbed sleep-related symptom cluster, urinary-related symptom cluster, and memory loss–numbness-related symptom cluster. Conclusion The symptoms of patients with cervical cancer within 6 months after radiotherapy and chemotherapy are complex, and nine symptom clusters can be identified according to the incidence and severity of symptoms. We can find the potential biological mechanism of each symptom cluster through the discussion of previous mechanism research and clinical research. The number of symptom clusters and the number of symptoms within the symptom cluster are closely related to the symptom evaluation scale selected for the study. Therefore, the symptom cluster study urgently needs a targeted symptom evaluation scale that can comprehensively reflect the patient’s condition.

Background Gender nonconformity (GNC) (i.e., gender expression that differs from gender role expectations for feminine or masculine appearance and behavior) is an under-researched area of adolescent sleep health. The COVID-19 lockdown offers an opportunity to understand how the effect of GNC on adolescent health outcomes changes between school closure and reopening. Methods We conducted a cross-sectional study in Shanghai, China, in 2020. The sample size for analysis was 3,265. The age-specific insufficient sleep was estimated according to National Sleep Foundation's sleep duration recommendations. The self-perceived and self-rated GNC were measured by the two items “On the same scale that goes from 100% as a girl to 100% as a boy, where do you think others see you?” and “On a scale that goes from feeling 100% like a girl to feeling 100% like a boy, where do you see yourself?”, and birth sex. In addition, we calculated sex-stratified adjusted odds ratios (AORs) of insufficient sleep for students with high and moderate GNC compared to students with low GNC. Finally, we measured the AORs with self-perceived and self-rated GNC during COVID-19 school closure and reopening. Results Among 3,265 students in grade 6–12 in the analytic sample, 1,567(48.0%) were assigned female at birth (AFAB), 3,188 (97.6%) Han, and 1,921(58.8%) in grade 6–9. Among AFAB students, high self-perceived GNC was significantly associated with insufficient sleep (AOR,1.65; 95%CI,1.30–2.09) during school closure. Insufficient sleep was associated with high self-rated GNC (AOR,1.73; 95%CI,1.23–2.44) and moderate self-rated GNC (AOR,1.69; 95%CI,1.29–2.22) during school closure. After school reopening, neither self-perceived nor self-rated GNC was associated with insufficient sleep among AFAB students. Among assigned male at birth (AMAB) students, none of the two kinds of GNC was associated with insufficient sleep in the two periods during the COVID-19 pandemic. Conclusions This study suggests GNC is only associated with insufficient sleep among AFAB students during school closure. Furthermore, the association is nonsignificant among AMAB students. These findings indicate that GNC-related stigma within the family could be a risk factor for insufficient sleep among AFAB adolescents.