中国学校卫生

Construction systems of adolescent health promotion towards Healthy China 2030

TAO Fangbiao

2023, 44(1): 1-5. doi: 10.16835/j.cnki.1000-9817.2023.01.001

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The health of adolescents is a barometer of social development, adolescents undergo a critical period for the development of competencies related to health and well-being, which is also an important stage for laying the foundation for health. This editorial proposes key considerations for the successful system optimization in adolescent health services and relevant policies in China, and presents an indicator and monitoring framework for adolescent health promotion toward Healthy China 2030, through summarizing the health and developmental challenges faced by Chinese adolescents, and embracing innovations in national policy development.

A scientific 24-hour movement behavior guideline for the implementation of the "double reduction" policy

LI Hongjuan, ZHANG Ting, GAO Yanhui

2023, 44(1): 6-10. doi: 10.16835/j.cnki.1000-9817.2023.01.002

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As the compositional nature of "constant sum" of physical activity, sedentary behavior and sleep are widely recognized, the methodological and result limitations of previous studies that considered physical activity, sedentary behavior, or sleep as independent influences on physical fitness and health have been highlighted. At present, physical activity guidelines of various countries have shifted from local recommendations based on physical activity amount to global recommendations based on 24 h time frame. From the perspective of time use, the content of daily schedule of children and adolescents also has the attribute of "constant sum" of compositional data, and the reduction of students' homework burden and extracurricular discipline training after "double reduction" inevitably means an increase in the time allocated to other activities. From the perspective of time use, the paper focuses on physical fitness and health promotion strategies in the context of "double reduction".

Multi-subject collaborative prevention and control of adolescent myopia in China

HE Jiamin, LI Hongyan, YANG Chuanghao, FAN Mengdan

2023, 44(1): 11-16. doi: 10.16835/j.cnki.1000-9817.2023.01.003

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Improving the system of adolescent myopia prevention and control and promoting adolescent healthy development is one of the main directions of healthy China construction in the new era. The paper reviewed national myopia policies and local practices, and proposed reflections on the high burden and complex etiology of myopia among adolescents, as well as unclear role and lack of coordination mandate during the COVID-19 epidemic. Based on the synergy theory, through the analysis of the functional positioning of multiple subjects in the prevention and control of myopia, the paper highlighted the multi-party linkage of government, schools, medical institutions, communities, families and markets, profiling the resources and advantages of each subject, as well as dynamic management of adolescent myopia, as well as a multi-subject collaborative prevention and control system with national unity, clear rights and responsibilities, and long-term cooperation.

Relationship between 24-hour movement behavior and physical fitness among pupils

ZHANG Hanmin, ZHANG Ting, WU Baoai, GAO Yanhui, LI Hongjuan

2023, 44(1): 17-22. doi: 10.16835/j.cnki.1000-9817.2023.01.004

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Objective To examine the relationship between 24-hour movement behavior and physical fitness of pupils by using compositional analyses, so as to provide a theoretical basis for physical activity promotion and physical fitness improvement. Methods By random cluster sampling method, 120 students of grade 4 and 5 from the Second Experimental Primary School of Yingze District of Taiyuan were selected. Physical fitness was evaluated by the indicators of the Protocol of National Physical Training Standard and 20-meter shuttle run. The movement behavior was measured by accelerometer. The relationship between each behavior and physical fitness was analysed by component multiple linear regression, and the effect of replacement of components on physical fitness was discussed. Results Girls' 1-minute sit-ups were lower than boys(24.79±7.77, 28.21±6.52), and sitting forward flexion was higher than boys[9.00(5.00, 14.00), 5.20(1.00, 9.75)cm](t/Z=2.60, -3.15, P < 0.05). Boys showed higher light physical activity(LPA), moderate-to-vigorous physical activity(MVPA) and lower sedentary behavior(SB), while girls showed lower LPA, MVPA and higher SB. MVPA was positively correlated with the performance of 30-second rope skipping and 20-meter shuttle run (β=13.19, 7.90, P < 0.05). Sleep(SLP), SB, and LPA were not significantly correlated with physical fitness. After re-allocating 10-min MVPA to SB and SLP, the performance of 30-second rope skipping and 20-meter shuttle run increased by 2.25, 2.28 and 1.28, 1.34 times, respectively, while significantly decreased after reverse reallocation (P < 0.05). MVPA replaced LPA, the 20-meter shuttle run performance increased 1.46 times, while decreased significantly in reverses (P < 0.05). Conclusion MVPA is positively correlated with the speed and endurance of pupils. There are gender differences in movement behavior patterns and physical fitness. Children, especially girls, should be encouraged to raise exercise awareness and increase PA, especially MVPA.

A systematic review of the association between 24-hour movement behavior and obesity in children and adolescents

ZHANG Ting, LI Hongjuan, ZHANG Zhaohua, GAO Yanhui

2023, 44(1): 23-27. doi: 10.16835/j.cnki.1000-9817.2023.01.005

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Objective To systematically review the associations of physical activity (PA), sedentary behavior (SB) and sleep with obesity, as well as isotemporal substitution effects among behaviors, determined with compositional data analysis methods, to provide a reference for obesity interventions among children and adolescents. Methods Studies in the CNKI, Wanfang, PubMed, SPORTDiscus, Web of Science and Medline databases were searched from January 1, 2014 to May 1, 2022. Two experienced reviewers independently completed document screening, data extraction and quality assessment. Results Sixteen articles were included, with a methodological quality score range of 7-12 points. Moderate to vigorous physical activity (MVPA), sleep and obesity were negatively correlated, and substituting other behaviors with MVPA decreased obesity risk. The substitution time ranged from 1.5 min/day to 60 min/day. Light physical activity(LPA) and SB were positively correlated with obesity. Conclusion MVPA is the primary focus of obesity interventions in children and adolescents, and extra 60 min of MVPA per week on the existing level of physical activity may be the minimum necessary to decrease the risk of obesity.

Relationship between 24-hour movement behavior and obesity indicators in children and adolescents

WANG Rongjia, WU Baoai, GAO Yanhui, LI Hongjuan, ZHANG Ting

2023, 44(1): 28-31. doi: 10.16835/j.cnki.1000-9817.2023.01.006

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Objective The method of compositional data analysis was used to explore the relationship between 24-hour movement behavior and obesity indicators, and to examine the difference of quantitative effect on obesity indicators when one behavior replaced another behavior, so as to provide specific movement behavior advice for weight control in children and adolescents. Methods In June 2021, 231 students from eight classes in a primary school and a middle school in Taiyuan City, Shanxi Province were voluntarily recruited by using random cluster sampling. ActiGraph GT3X+ accelerometer was used to measure 24-hour movement behavior and Inbody J20 body composition analyzer was used to measure body composition. The relationship between each component and obesity indicators was analyzed by compositional multivariate linear regression model. In addition, 30 minutes of one behavior was used to replace another behavior to predict the effect difference of the outcomes. Results After adjusting for covariates such as height, weight, age, and sex, compared with time spent in sedentary behavior(SB), sleep (SLP) and light physical activity (LPA), time spent on moderate to vigorous physical activity (MVPA) was positively correlated with fat-free mass index (FFMI) (β=0.40, P < 0.05), negatively correlated with waist circumference (WC) (β=-2.50, P < 0.05) and waist-hip ratio (WHR) (β=-0.04, P < 0.05). Compared with SB, SLP and MVPA, time spent on LPA was positively correlated with WHR (β=0.06, P < 0.05). If MVPA of 30 min/d replaces SLP, SB, and LPA respectively, WC and WHR decrease 1.10, 1.10, 1.34 cm and 0.02, 0.02, 0.02 respectively, and FFMI increases 0.19, 0.19, 0.15 kg/m² respectively. Conclusion In 24 h movement behavior, with consistent level of sedentary behavior, sleep or low-intensity movement behavior, maintaining a high level of MVPA and replacing sedentary with active activities are crucial for optimal abdominal fat and fat free mass in children and adolescents.

Mediating effect of 24-hour movement behavior in the association between smartphone addiction and anxiety among college students

LIN Ziqiang, CHENG Jinqun, TAN Jianyi, HUANG Baoying, HUANG Zhenhui, XU Huafu, ZHANG Yanbo, LI Hongjuan, GAO Yanhui

2023, 44(1): 32-35. doi: 10.16835/j.cnki.1000-9817.2023.01.007

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Objective To explore the mediation effect of movement behavior in the association between smartphone addiction and anxiety based on a compositional mediation model. Methods The electronic questionnaire surveys among 10 420 college students were conducted at two medical universities in Guangdong and Shanxi from February to March, 2020, including demographic characteristics, 24-hour movement behavior, Smartphone Addiction Scale Short Version, and Self-rating Anxiety Scale (SAS) scores. The compositional mediation model was used to analyze the mediating effect of 24-hour movement behavior on smartphone addiction and anxiety. Results There were 1 114 college students with anxiety, and the prevalence rate was 10.69%. Smartphone addiction was associated with increased sedentary behavior (SB) [coefficient α (95%CI)=0.07(0.05-1.00), P < 0.05], and reduced moderate-to-vigorous-intensity physical activity (MVPA) and light-intensity physical activity (LPA) [coefficient α (95%CI) were-0.19(-0.25--0.13) and-0.05(-0.08--0.03), P < 0.05]. Indirect effects of LPA were associated with smartphone addiction and anxiety [OR(95%CI)=0.99 (0.98-1.00), P < 0.05]. The relationship between mobile phone addiction and anxiety was mainly dominated by direct effects [total direct effect: OR(95%CI)=3.02(2.55-3.61), P < 0.05]. Conclusion Smartphone addiction is associated with an increase in SB and a decrease in MVPA and LPA. Smartphone addiction can increase the risk of anxiety among college students, and LPA might act as a mediator in the relationship between smartphone addiction and anxiety.School should pay attention to students' mobile phone addiction.

Trend analysis of drinking behavior among middle school students in Quzhou during 2012 to 2022

GAN Zhijuan, ZHANG Ning, LAI Shiming, JIAO Shilin, WANG Debing, XIE Haiyan

2023, 44(1): 36-39. doi: 10.16835/j.cnki.1000-9817.2023.01.008

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Objective To understand prevalence and trend of drinking behavior among middle school students in Quzhou during 2012 to 2022, and to provide a basis for formulating scientific and effective intervention measures for adolescent drinking. Methods By using stratified cluster sampling method, a questionnaire survey using Zhejiang adolescent health-related behavior questionnaire was conducted anonymously in selected classes in May 2012, 2017 and 2022, respectively. Changes of drinking behavior of middle school students in different years were analyzed. Results The prevalence of ever drinking, current drinking and drunkenness among middle school students in Quzhou decreased from 58.05%, 22.70% and 21.25% in 2012 to 41.83%, 15.35% and 11.54% in 2022, respectively (χ_trend²=82.69, 30.00, 58.24, P < 0.01). In the past 30 days, 66.67% of students reported drinking 1-2 days, the proportion of drinking for 3-5 days increased from 16.36% in 2012 to 26.19% in 2022, the proportion of drinking for 6-19 days decreased from 13.03% in 2012 to 3.40% in 2022. The proportion of buying alcohol increased from 22.12% in 2012 to 35.03% in 2022. The results of the three surveys showed that, now drinking rates, drinking rates, Male students (27.88%, 23.96%, 18.75%;24.69%, 17.44%, 13.75%) was higher than the girls (17.60%, 17.25%, 11.31%;17.87%, 10.61%, 8.91%), non-ordinary high schools (33.96%, 34.69%, 22.77%;33.65%, 23.91%, 19.49%) were higher than ordinary high schools (25.82%, 18.80%, 12.62%;25.82%, 17.35%, 9.94%) and junior middle school (16.53%, 15.83%, 12.22%;13.93%, 8.47%, 7.35%). Conclusion Progress in adolescent drinking control is being made in Quzhou, with the prevalence of ever drinking, current drinking and drunkenness significantly decreased. It is necessary to strengthen the control of drinking behavior among middle school students from the aspects of school, family and society, especially for boys and students in non-ordinary high school students.

Nutritional status on vitamin A, vitamin D and its relation with height among primary and middle school students in poor rural areas of Enshi from 2012 to 2021

CHENG Maowei, ZHANG Jie, PENG Fei, LIU Shuang

2023, 44(1): 40-42. doi: 10.16835/j.cnki.1000-9817.2023.01.009

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Objective To investigate the status of physical development, vitamin A and vitamin D among primary and middle school students in poor rural areas in Hubei, to evaluate the implementation effectiveness of the Nutrition Improvement Program for Rural Compulsory Education Students (abbreviated to the program) from 2012 to 2021. Methods In Enshi City, a pilot monitoring county of the program in Hubei, and a total of 2 554 students from one primary school and one junior middle school were randomly selected. During September to October in 2012-2021, height was measured, and fasting venous blood was collected from students, and serum vitamin A and vitamin D were detected. Results From 2012 to 2021, height, serum vitamin A and serum vitamin D concentration increased by 2.7 cm, 96.7 μg/L and 8.6 ng/mL. Growth retardation rate decreased by 1.0%. The subclinical and clinical deficiency of serum vitamin A decreased by 37.3% and 6.2%. The subclinical and clinical deficiency of serum vitamin D decreased by 45.7% and 8.5%. Height was positively correlated with serum vitamin A status and negatively correlated with serum vitamin D status (r=0.08, -0.08, P < 0.01). Conclusion The pilot counties of the program in Enshi, has witnessed improvement in height, serum vitamin A and vitamin D status among primary and secondary students. However, future efforts remains essential as subclinical deficiency of vitamin A and vitamin D are noted in some students. Serum vitamin A is positively associated with height, and vitamin D is negatively associated with height.Considering the correlation between serum vitamin A and vitamin D status with height, continued efforts should be implemented in poor rural areasto strengthen targeted nutrition intervention for students in Hubei.

Anemia among rural children aged 3-6 in central China and its association with dietary behaviors

LIU Yingjie, WANG Hui, YANG Ke, LI Mingli

2023, 44(1): 43-47. doi: 10.16835/j.cnki.1000-9817.2023.01.010

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Objective To understand the status of anemia among rural children aged 3-6 in central China and its relationship with dietary behavior, and to provide reference for prevention and intervention of anemia in rural children. Methods From April to June 2021, stratified cluster sampling was used to select 1 246 preschool children aged 3 to 6 years old in rural areas in central China. Peripheral blood of the ring finger was collected. Dietary behaviors regarding consumption of cereals and potatoes, fruits, vegetables, soy products, milk, animal foods, food diversity, and drinking water were investigated. Logistic regression analysis was used to analyze the association between anemia and dietary behaviors. Results The detection rate of anemia in rural children aged 3-6 in central China was 13.88%. The anemia detection rate of left-behind children (19.00%) was higher than that of non-left-behind children (11.27%), and the difference was statistically significant (χ²=13.93, P < 0.01). Logistic regression analysis showed that the proportion of left-behind children (OR=1.28, 95%CI=1.16-1.56) with anemia was higher than that of non-left-behind children (P < 0.01). Consumption of animal food intake ≥3 times/week (OR=0.82, 95%CI=0.69-0.91), and ≥2 kinds of vegetables (OR=0.86, 95%CI=0.71-0.93) were associated with lower rate of anemia (P < 0.05). Conclusion The detection rate of anemia in rural children aged 3-6 years in central China is relatively high, especially in left-behind children. Dietary literacy of caregivers should be further improved regarding increased intake of animal foods and vegetables to reduce the risk for anemia in preschoolers.

Awareness of nutrition labeling among primary and middle school students in six provinces of China

CUI Jia, ZHANG Jingwen, XIANG Lin, YE Lihong, YAN Ruijie, HU Yiluan, TANG Yuxiang, GONG Enying, ZHANG Juan

2023, 44(1): 48-51. doi: 10.16835/j.cnki.1000-9817.2023.01.011

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Objective To investigate the awareness of nutrition labeling and associated factors among primary and middle school students in six provinces of China, to provide a basis for improving the awareness level of nutrition table of primary and middle school students. Methods A questionnaire survey was conducted among primary and secondary school students and their parents from 72 schools from six provinces by using the multi-stage stratified sampling strategy during July, 2020 to March 2021. A total of 2 499 parent-child dyads were included in the analysis, demographic characteristics and awareness of nutrition labeling of both parents and students, as well as parents' ability to select healthy pre-packaged foods were collected by questionnaires. Univariate analysis and multivariate Logistic analysis were performed to explore associated factors related to awareness of the nutrition labeling. Results About 78.2%(1 953/2 499) of the students were aware of the nutrition labeling. Junior school students, urban students, students whose parents were older were more likely to be aware of the nutrition labeling [OR=1.54, 1.32, 1.60(parents aged from 41 to 45 years old), 1.45(parents aged above 45 years old), P < 0.05]. Parental awareness of the nutrition labeling showed a positive association with students' awareness (OR=1.28, P < 0.05). Conclusion Nearly 80% of Chinese primary and middle school students in six provinces are aware of nutrition labeling, and the level of parental awareness is closely related to the level of students awareness. Parents play an important role in students' nutrition education.

Analysis of the influencing factors on the perceptions of e-cigarette among adolescents in Shanghai

WANG Juanjuan, ZHANG Lulu, DAI Luojia, TAN Yinliang, ZHU Jingfen

2023, 44(1): 52-55. doi: 10.16835/j.cnki.1000-9817.2023.01.012

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Objective To assess the status of current e-cigarette perception and its influencing factors among adolescents in Shanghai, so as to provide reference for the refinement of the prevention and control measures of teenagers' e-cigarette use. Methods From May to June 2021, a stratified random cluster sampling was used to investigate 7 456 junior high and high school students in Shanghai. Harm and benefit perception of e-cigarette as well as its social-environment benefits were collected. Results The rate of adolescents' ever and current e-cigarette use was 3.19% and 1.09%, respectively. The top four risk factors for low harm perception of e-cigarette were adolescent e-cigarette use(OR=2.74, 95%CI=2.10-3.59), high school students (OR=1.47, 95%CI=1.32-1.64), family members (OR=1.45, 95%CI=1.24-1.70) and friends (OR=1.36, 95%CI=1.20-1.54) using e-cigarette. Adolescent e-cigarette use (OR=2.77, 95%CI=1.97-3.89), high school students(OR=2.11, 95%CI=1.89-2.36), friends (OR=1.63, 95%CI=1.42-1.87) and family members using e-cigarette(OR=1.39, 95%CI=1.18-1.65) were the top four associated factors for high benefit perception of e-cigarette. And, adolescent e-cigarette use (OR=1.95, 95%CI=1.47-2.59), high school students (OR=1.73, 95%CI=1.55-1.93), friends (OR=1.60, 95%CI=1.40-1.82) and pocket money≥200 yuan using e-cigarette(OR=1.29, 95%CI=1.17-1.43) were the top four risk factors for high social-environmental benefit perception of e-cigarette. Moreover, perception of e-cigarette harm, benefit and social-environmental benefit were associated with the risk of future use of e-cigarette(OR=0.78, 1.44, 1.21, P < 0.01). Conclusion Being high school students and using e-cigarette by oneself, friends, and family members are the important influencing factors for adolescents' e-cigarette perception. Both low-harm and high-benefit perception of e-cigarette elevate the risk of future e-cigarette use among adolescents, so effective measures should be taken to promote control education about e-cigarette and smoke-free environment construction.

Health information needs and use habits of primary and secondary school students in Shanghai

ZENG Yi, YANG Zhao, SONG Qiongfang, QIAN Haihong

2023, 44(1): 56-61. doi: 10.16835/j.cnki.1000-9817.2023.01.013

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Objective To investigate the health information needs and use habits of primary and secondary school students in Shanghai, and to provide a reference for appropriate health education. Methods An online survey was conducted from May to June 2022 for 979 primary and secondary school students in eight schools in Shanghai, using a self-administered questionnaire, through stratified random sample method. Results Health information with the higher demand among primary and secondary school students in Shanghai were myopia prevention [5(4, 5)], oral health [5(3, 5)], physical fitness [5(3, 5)], healthy posture enhancement[5(3, 5)], accidental injury protection[5(3, 5)], prevention of Internet addiction[5(3, 5)]. The most frequently used channels of health information were WeChat[4(3, 5)], family, friends, classmates[4(3, 5)], websites or online forums[4(3, 5)], school teachers[4(3, 5)], video websites or APPs[4(3, 5)], doctors and experts[4(3, 5)] and school activities or clubs[4(3, 5)]. The most interesting forms of health information dissemination were videos, cartoons, short videos[5(4, 5)]. High-trust recipients of help for health problems were parents[5(4, 5)], doctors and other professionals[5(4, 5)], grandparents[4(3, 5)], school teachers[4(3, 5)], as well as peers and friends[4(3, 5)]. Conclusion Shanghai primary and secondary school students had a high demand for health information. Most often obtained health information through social media and interpersonal communication. The most interested forms of health communication included videos, pictures, etc. The form and content of health education should be carefully designed according to the needs and characteristics of the audience. A three-dimensional matrix of media, organizations, and interpersonal health communication should be created to strengthen the effectiveness of health education.

Association of health literacy with smoking attempt behavior among middle school students in five provinces in China

HUANG Heming, LIU Zhihao, LYU Shuhong, LI Gaochi, WANG Jianbing

2023, 44(1): 62-64. doi: 10.16835/j.cnki.1000-9817.2023.01.014

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Objective To explore the association of health literacy with smoking attempt behavior among middle school students in China, and to provide ideas for health education for middle school students. Methods Using stratified cluster sampling method, 1 066 students were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces in China during June to November 2017, a questionnaire survey was conducted to collect health literacy and smoking attempt behavior. Results The score of health literacy among middle school students was (13.49±1.87). Students who lived in eastern and rural areas, girls, guardians who were jointly supervised by their parents and grandparents, the only child, non-smokers, and small amount of weekly pocket money had higher scores in health literacy(t/F=9.81, 3.10, 11.12, 2.65, 3.50, 4.47, 2.64, P < 0.05). The prevalence of smoking attempt behavior was 5.5%. Multiple Logistic regression analyses showed that central and western China, drinking and low healthy literacy were positively correlated with smoking attempt behavior (OR=2.75, 3.54, 21.62, 2.50, P < 0.05). Conclusion Low healthy literacy can be used as a predictor of smoking attempt among middle school students, the health education should be conducted to control the smoking attempt behavior.

Leisure-time physical activity, sedentary behavior and sleep of children and adolescents aged 6-14 in Beijing

YIN Ning, YU Xiaohui, GUO Dandan, WEN Jing, YU Yingjie, ZHAO Yao, WANG Junbo

2023, 44(1): 65-70. doi: 10.16835/j.cnki.1000-9817.2023.01.015

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Objective To describe the current situation of leisure-time physical activity, sedentary behavior, and sleep duration of children and adolescents aged 6-14 in Beijing, and provide a reference basis for guiding school-age children to carry out reasonable physical activities and formulating effective intervention measures. Methods A multistage stratified cluster random sampling method was used to investigate the nutritional and health status of 3 460 students in the first, third, fifth and seventh grades. Through the questionnaire surveys, the basic information of children and families and the activity information of children' physical activity, sedentary behavior, and sleep were collected and statistically analyzed. Results The results showed that the median time of children' daily leisure-time physical activity (LTPA) was 20.0 (8.6, 38.6) min, children in suburb areas (18.6 min) and seventh grade (14.3 min) had shorter LTPA time(Z/H=5.12, 119.11, P < 0.01). The average daily sleep duration of children was (8.71 ± 0.76) h, the proportion of school-age children with insufficient sleep reached 54.7%. With an increase in grades, the incidence of insufficient sleep increased significantly (χ²=407.13, P < 0.01). The median daily sedentary time of children was 195.7(145.0, 255.7) min, and 84.5% of children engaged in more than two hours of sedentary behavior every day. Urban (202.9 min) and obese children (210.4 min) had longer sedentary behavior time, and with the increase in grade, the daily sedentary behavior time of children gradually increased (Z/H=5.04, 14.83, 637.98, P < 0.01). Conclusion Children and adolescents aged 6-14 years in Beijing have less LTPA time, too much sedentary time, and insufficient sleep duration. Grade is an important factor affecting physical activity, sedentary behavior, and sleep duration of children, and body shape may be related to their sedentary behavior and sleep time.It is suggested that targeted policies should be adopted for children of different grades to increase their physical activity and reduce their sedentary behavior to promote their healthy development.

Relationship between attentional bias, anxiety, depression and post-traumatic stress disorder in primary and middle school students

LIU Junqiao, ZHANG Yuqing

2023, 44(1): 71-75. doi: 10.16835/j.cnki.1000-9817.2023.01.016

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Objective To investigate the relationship between negative attentional bias and post-traumatic stress disorder(PTSD) in the context of higher depression and anxiety symptoms after the outbreak of COVID-19, so as to provide scientific basis for mental health education in primary and secondary schools. Methods From March to April 2021, a total of 708 students from primary school and junior high school (grade 6 through grade 9) in Beijing, Shanxi, Hunan, Shandong, Hebei, Hubei of China were selected. The Children's Revised Impact of Event Scale(CRIES), the Attention to Positive and Negative Information Scale (APNI)and Depression, Anxiety and Stress Scale-21(DASS-21) were used in a questionnaire survey. Results A total of 242 students were diagnosed with PTSD, and the detection rate was 34.2%.The scores of intrusion and high arousal of boys(7.92±5.33, 8.60±5.41) were lower than those of girls(8.72±4.85, 9.50±4.76), and the difference was statistically significant (t=-2.04, -2.32, P < 0.05). There were statistically significant differences of negative attention bias, CRIES score, intrusion, debarb and high arousal among primary and middle school students of different grades (F=3.57, 5.99, 4.45, 4.60, 7.40, P < 0.05). Negative attention bias, anxiety, depression and post-traumatic stress symptoms were significantly positively correlated (r=0.27-0.84, P < 0.05). Logistic regression analysis showed that anxiety (OR=1.13, 95%CI=1.06-1.20) and negative attention bias (OR=1.10, 95%CI=1.07-1.12) were positively associated with PTSD symptoms in primary and middle school students(P < 0.01). Conclusion Anxiety and depressive symptoms show impacts on negative attention bias and might exacerbate the symptoms of post-traumatic stress disorder. Therefore, emotional adjustments can help reduce the post-traumatic stress response in the post-epidemic period.

Cross-lagged analysis of body shame, abnormal eating behavior and eating disorder tendency among adolescents

LIU Xuechun, YANG Kun, LIU Yong, BAO Rongjuan

2023, 44(1): 76-80. doi: 10.16835/j.cnki.1000-9817.2023.01.017

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Objective To understand the longitudinal relationship between body shame, abnormal eating behavior and eating disorder tendency of adolescents, so as to provide reference for the intervention of eating problems among adolescents. Methods From September 2020, a total of 1 097 students from two high schools and two universities in Heilongjiang Province were investigated for three times (T1, T2 and T3) with an interval of 9 months. Adolescents completed the Chinese Body Shame Scale, the Chinese Version of Dutch Eating Behavior Questionnaire and the Sick, Control, One, Fat, Food(SCOFF) questionnaire. A cross-lag analysis was used to explore the relationship between body shame, abnormal eating behavior and eating disorder tendency. Results The body shame, abnormal eating behavior and eating disorder tendency of adolescents showed an upward trend, but only the main effect of time on abnormal eating behavior was statistically significant (F=3.78, P < 0.05, η²=0.18), and the main effect of gender on three variables were statistically significant (F=18.06, 30.48, 25.09, P < 0.01). There were significant and positive correlations between body shame, abnormal eating behavior and eating disorder tendency at three wave survey (T1:r=0.34-0.58, T2:r=0.35-0.56, T3:r=0.33-0.53, P < 0.01). Body shame could predict abnormal eating behavior across time (β_T1-T2=0.13, β_T2-T3=0.08, P < 0.05), and the predictive effect was stronger in female (β_T1-T2=0.16, β_T2-T3=0.12, P < 0.05), only the effect between T1 and T2 was significant in male (β_T1-T2=0.09, P < 0.05). Abnormal eating behavior (β_T1-T2=0.14, β_T2-T3=0.15, P < 0.01) and eating disorder tendency (β_T1-T2=0.26, β_T2-T3=0.24, P < 0.01) had cross-time predictive effect. Abnormal eating behavior showed a mediating effect on the association between body shame and eating disorder tendency (β_ab=0.019, 95%CI=0.006-0.047, P < 0.05), and the mediating effect was stronger in female (β_ab=0.029, 95%CI=0.008-0.053, P < 0.05). Conclusion Adolescents' body shame positively predicts abnormal eating behavior. Abnormal eating behavior and eating disorder tendency interact with each other, and body shame can indirectly affect eating disorder tendency through acting on abnormal eating behavior.

Associations between maternal parenting styles and preschool children's quality of life in Chengdu

LI Chunrong, LUO Shengyu, LIN Li, CHEN Weiqing, REN Yan, ZHANG Meng, GUO Yawei

2023, 44(1): 81-84. doi: 10.16835/j.cnki.1000-9817.2023.01.018

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Objective To investigate the association between maternal parenting styles and quality of life among preschools, to provide a scientific theoretical basis for interventions targeting at prmoting early-life health. Methods From May to July, 2021, a stratified cluster sampling method was used to enroll 4 233 child-mother dyads from 14 preschools in Chengdu. An online questionnaire survey was administered to collect socio-demographic information, maternal parenting styles, and children's quality of life. Results The overall score of quality of life was (80.17±9.81) among preschool children in Chengdu. In the multivariate linear regression models, maternal emotional warmth were significantly associated with higher scores in emotional functioning, social functioning, school functioning, psychosocial health summary score, and total scores (β coefficients in the high-level group were 2.63, 4.95, 12.05, 6.54, 4.88, P < 0.05). In contrast, both maternal rejection and overprotection were significantly associated with lower scores in physical functioning, emotional functioning, social functioning, school functioning, psychosocial health summary score, and the total scores of children's quality of life (for rejection: β coefficients in the high-level group were -9.39, -10.82, -7.12, -6.04, -8.00, and -8.35, respectively; for overprotection: β coefficients in the high-level group were -6.71, -5.85, -3.08, -2.39, -3.77, and -4.51, respectively, P < 0.05). The associations between high level of maternal rejection and children's emotional functioning showed significant gender differences(β=-3.23, P < 0.05). Conclusion Maternal parenting style has a significant impact on children's quality of life. Interventions targeting at maternal parenting styles may be beneficial to improve the quality of life in preschool children.

Barriers and facilitators to implementing evidence-based mental health practice in primary schools

LI Jia, KONG Yajing, GAO Liru, TANG Xinfeng, QU Zhiyong

2023, 44(1): 85-89. doi: 10.16835/j.cnki.1000-9817.2023.01.019

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Objective To explore the facilitators and barriers of the implementation of evidence-based mental health practice, in order to provide practical experience for promoting the development of evidence-based mental health services in primary schools in China. Methods Semi-structured interviews were conducted with 4 education bureau managers, 8 school administrators, 7 classroom teachers, and 7 treatment providers after providing evidence-based practice in 10 primary schools in Henan Province, China.Data was analyzed using thematic analysis. Results Evidence-based practice in primary schools faced multiple factors at the macro level, school level, and individual level.A total of 8 facilitators and 9 barriers were extracted.Among these factors, some factors were particularly striking.These included the"exclusion"of teacher title evaluation system, time conflict between practice and school schedule, stigmatization of mental health and mismatch between perceived effectiveness of services and expectations. Conclusion Evidence-based mental health practice is feasible in Chinese schools.The implementation process needs to take full account of macro, school and individual multi-level factors to move evidence-based mental health services from theory and data to practice in China.

Influence of self-stigma on depression of disabled college students

TANG Weidong, ZHANG Jifang, YANG Mengdie

2023, 44(1): 90-93. doi: 10.16835/j.cnki.1000-9817.2023.01.020

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Objective To explore the causal relationship between self-stigma and depression among college students with disabilities, so as to provide reference for mental health promotion among disabled college students. Methods In October, 2021(T1) and April, 2022(T2), 291 college students from four majors of School of Special Education of Hebei Open University were selected by cluster sampling method to conduct two follow-up tests, and online questionnaires were conducted by using Disability Self-Stigma Scale, Perceived Social Support Scale and Center for Epidemiological Survey, Depression Scale, and the mediation of perceived social support was established in the cross-lag model. Results The average scores of depressive symptoms of disabled college students in T1 and T2 were (43.51±8.26, 46.82±9.13).The cross-lag model showed that T1 self-stigma could positively predict T2 depressive (β=0.17, P < 0.01).Cross-group analysis showed that T1 perceived social support plays a longitudinal mediating role between T1 self-stigma and T2 depressive.Predictive effects of self-stigma on depressive symptoms in female students (β=0.42) was stronger than that in males (β=0.29)(P < 0.01).Predictive effects of perceived social support on depressive in female students (β=-0.36) was stronger than that of the males (β=-0.19)(P < 0.01). Conclusion There is a causal relationship between self-stigma and depressive symptoms among college students with disabilities.Intervention aim at promoting perceived social support might help to control depressive symptoms.

Role of regulatory emotional self-efficacy and positive psychological capital in the relationship between resilience and the mental health of college students

ZOU Changhua, XIN Zhonggui, LI Yonghan, SU Puyu

2023, 44(1): 94-98. doi: 10.16835/j.cnki.1000-9817.2023.01.021

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Objective To explore the chain mediating effect of regulatory emotional self-efficacy and positive psychological capital on resilience and the mental health of college students. Methods A total of 809 college students of Chaohu University were selected and were administered with the the Self-report Symptom Invertory, Symptom Checklist, 90(SCL-90), Connor-Davidson Resilience Scale (CD-RISC), Regulatory Emotional Self-efficacy Scale (RES-C) and Positive Psychological Capital Questionnaire (PPQ).Multiple linear regression analysis was performed, taking resilience, regulatory emotional self-efficacy and positive psychological capital as independent variables and the mental health of college students as dependent variables, meanwhile test the intermediary effect. Results Differences were found in resilience (3.52±0.55, 3.27±0.42), regulatory emotional self-efficacy (3.58±0.59, 3.32±0.57), positive psychological capital (4.74±0.77, 4.49±0.76) and mental health (158.66±33.01, 176.53±34.73) among college students with different sources (urban and rural)(t=55.82, 39.22, 21.28, -54.14, P < 0.05).Resilience, regulatory emotional self-efficacy and positive psychological capital were significantly associated with the severity of mental health of college students (R²=0.21, P < 0.01).Regulatory emotional self-efficacy and positive psychological capital played a significant chain mediating role between resilience and poor mental health (effect=-0.03, P < 0.05), and the mediating effect accounted for 39.3% of the total effect. Conclusion The mental health of college students can be improved by strengthening levels of resilience and enhancing regulatory emotional self-efficacy, and constructing positive psychological capital could contribute to the association between resilience and mental health.

Physical fitness and associated factors among primary and middle school students in Henan Province in 2019

FU Bowen, AN Tongyan, LOU Xiaomin, HAO Changfu

2023, 44(1): 99-103. doi: 10.16835/j.cnki.1000-9817.2023.01.022

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Objective To understand physical fitness among primary and middle school students in Henan Province, so as to provide theoretical basis for physical fitness promotion among primary and middle school students. Methods Based on data of National Survey on Student Physical Fitness and Health in Henan Province in 2019, a total of 42 734 students were investigated.The Z-value of each physical fitness index were calculated by Z method, physical fitness index (PFI) was obtained to reflect the physical fitness condition synthetically.Physical fitness of different groups were compared, and associated factors of PFI were analyzed by multiple linear regression. Results Lung capacity, grip strength, standing long jump, 50 m run, 50 m×8 shuttle run and PFI in boys were, respectively, which were significantly higher than that of girls (t=59.35, 62.66, 81.87, -74.92, -16.72, 85.96, P < 0.01).The seated forward flexion of boys was significantly lower than that of girls, the difference was statistically significant (t=-68.57, P < 0.01).Significant sex differences were observed in physical fitness at different age (P < 0.01).There was a certain gap between urban boys and rural boys in terms of strength quality, endurance quality and flexibility quality, and the physical quality of urban girls was better than that of rural girls as a whole.The detection rates of poor eyesight, malnutrition, overweight and obesity, anemia and high blood pressure of primary and middle school students were 68.0%, 5.4%, 26.0%, 15.9% and 18.0%, respectively.Region, sex, age and nutritional status (malnutrition, overweight and obesity) were the influencing factors of PFI (β=-0.23, -2.92, -0.11, -1.19, -0.78, P < 0.05). Conclusion Physical fitness among primary and middle school students varies in gender, age group, region and disease condition in Henan Province.Scientific intervention should be administered, especially for rural, female students, senior students, undernourished and overweight and obese students, to improve health awareness and physical fitness.

Physical fitness and health status and gender differences of middle school students among five Chinese minorities during 2010 to 2019

LIU Yunfei, SHI Di, ZHONG Panliang, DANG Jiajia, MA Ning, CAI Shan, HU Peijin, MA Jun, SONG Yi

2023, 44(1): 104-109. doi: 10.16835/j.cnki.1000-9817.2023.01.023

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Objective To analyze physical fitness and health status and gender differences of middle school students among 5 minorities (Mongolian, Hui, Uyghur, Zhuang and Korean), and to provide the theoretical basis for the strategy formulation. Methods The present data came from 3 waves of Chinese National Survey on Students Constitution and Health (2010, 2014, and 2019).According to National Standards for Students' Physical Health (2014 Revision), excellent, and excellent-good physical fitness and health status were defined.Cochran-Armitage test was used to examine the trends of physical fitness and health status.Chi-square test and Logistic regression were used to analyze the difference of physical fitness and health status by sex and survey year. Results From 2010 to 2019, the excellent physical fitness and health status rate of Mongolian, Hui, Uyghur, Zhuang and Korean students increased from 1.8%, 0.7%, 0.3%, 0.5% and 1.3% to 4.3%, 2.8%, 1.2%, 1.3% and 3.5%, respectively.The excellent-good physical fitness and health status rate of Mongolian, Hui, Uyghur and Zhuang students increased from 12.9%, 8.0%, 7.2% and 8.4% to 24.7%, 20.1%, 12.6% and 19.8%(Z=6.15, 6.71, 4.12, 3.06, 5.26;11.88, 13.42, 6.70, 11.08, P < 0.05), respectively.In 2019, students aged 13 to 15 years showed higher proportion of excellent/excellent-good physical fitness and health status than that of students aged 16 to 18.Boys were more likely to be in excellent/excellent-good physical fitness and health status than girls from 2010 to 2019.The sex difference in excellent/excellent-good physical fitness and health status narrowed during 2010 and 2019. Conclusion Physical fitness and health status of minority students improved while sex difference narrowed during last decade, but there is still a long way to reach the goal proposed by China.Targeted intervention should be proposed to promote physical fitness and health status in accordance with the developmental characteristics, especially for girls and students aged 16 to 18 years.

Abnormal uterine bleeding and associated factors among female medical college students in Shanghai

LU Xuan, XIAO Tongtong, YOU Xiaofang, TAN Hui, QIAN Xu

2023, 44(1): 110-114. doi: 10.16835/j.cnki.1000-9817.2023.01.024

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Objective To understand the prevalence and pattern of abnormal uterine bleeding (AUB) among female medical college students in Shanghai, to provide a basis for menstrual health intervention for female college students. Methods A total of 912 female medical students from a university in Shanghai were selected through cluster sampling.An anonymous questionnaire survey on menstrual history and related factors was conducted in March 2021. Results The prevalence of AUB among female medical college students was 39.9%, with cycle-disordered and non-cycle-disordered AUB of 24.7% and 15.2%, respectively.Among female college students with AUB, 21.7% had two or three abnormal menstrual symptoms.Multivariate Logistic analysis showed that sleep quality was associated with both types of AUB, and female undergraduates with poorer and poor sleep quality were at increased risk of both cyclic-disordered AUB (OR=2.05) and non-cyclic-disordered AUB (OR=2.00).Low BMI (OR=1.66) and weight gain and loss (OR=1.76) were associated with cycle-disordered AUB.Frequent insomnia (OR=2.45) was associated with non-cyclic-disordered AUB (P < 0.05). Conclusion Abnormal uterine bleeding (AUB) is common in female college students, female medical college students with AUB have multiple concurrent abnormal bleeding patterns.Factors associated with AUB varied according to the type of AUB, with sleep quality correlates with both types of AUB.

Analysis of epidemiological characteristics and influencing factors of scoliosis among middle school students in Tianjin

ZHANG Xianwei, SUN Zhiying, LIU Zhonghui, FENG Baojia, XU Ke

2023, 44(1): 115-118. doi: 10.16835/j.cnki.1000-9817.2023.01.025

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Objective To understand the prevalence and influencing factors of scoliosis among middle school students in Tianjin, and to provide scientific basis for the prevention and treatment of scoliosis. Methods Based on stratified cluster random sampling method, 21 679 middle school students from 62 middle schools (35 middle schools and 27 high schools) in Tianjin were selected for scoliosis screening and completed relevant questionnaires. Results The prevalence of scoliosis in middle school students in Tianjin was 4.00%, with girls (5.13%) higher than that in boys (2.94%), vocational high school (5.96%) higher than that in ordinary senior high school (4.98%) and junior high school (3.00%), the differences were statistically significant (χ²=67.56, 71.46, P < 0.01).Multivariate Logistic regression showed that gender, district, school segment, number of physical educaiotn (PE) classes per week, outdoor activity time per day, and days of 60 minutes or more of moderate and vigorous exercise per day in a week were related to the detection rate of scoliosis (OR=0.12-1.95, P < 0.05). Conclusion The detection rate of scoliosis among middle school students in Tianjin varies in gender, resident area and school level, so more attention should be paid to girls, high school students and students in middle economic area.Comprehensive efforts should incorporate duration, intensity and type of physical exercise.

Effectiveness of Longji Daoyin exercise on adolescents of mild idiopathic scoliosis

LIU Lu, ZHANG Wei, HU Zengping, GAO Yang, GU Chuanchuan, YAN Yuntao, DU Shuangqing

2023, 44(1): 119-122. doi: 10.16835/j.cnki.1000-9817.2023.01.026

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Objective To explore the effectiveness of spinal guidance exercise on adolescents of mild idiopathic scoliosis, so as to provide an experimental reference and method for promoting adolescents'spinal health. Methods From the scoliosis screening, 96 children who met the diagnostic criteria were selected in June 2021, and were divided into the experimental group and the control group, with 48 cases in each group.The experimental group received a 12-week Longji Daoyin exercise training, and the control group received health education, observation and monitoring.Before and after the experiment, the axial trunk rotation (ATR) and scoliosis Cobb angle of the two groups were tested respectively, and the subjective sensation of the patients was measured by Scoliosis Research Society-22(SRS-22) questionnaire. Results After 12 weeks, the ATR and Cobb angles of the experimental group decreased, compared to (7.08±2.84)° and (15.84±2.00)° before intervention (t=14.02, 17.09, P < 0.01).Scores of functional activity, self-image and mental health in the SRS-22 score increased from (4.65±0.14)(3.49±0.21) and (3.99±0.17) to (4.77±0.14)(4.62±0.13)(4.42±0.13)(t=-4.86, -39.12, -13.92, P < 0.01).The ATR and Cobb angles of the control group increased from (6.94±2.15)° and (15.82±1.76)° to (8.25±2.49)° and (18.63±3.12)°(t=7.44, 8.99, P < 0.01), and the scores of self-image and mental health in the SRS-22 score decreased from (3.49±0.19) and (4.00±0.15) to (3.44±0.18) and (3.94±0.14)(t=-3.74, -4.39, P < 0.05). Conclusion Early adolescent idiopathic scoliosis is easy to aggravate during the observation period.Longji Daoyin exercise is of preventive and therapeutic significance.

Epidemiology of dental caries and its influences on jaw function in children

ZHANG Xuemei, MA Zheng, NIE Xiaohan, WEI Lin, WU Mixun, GUO Yibai, LYU Jiao

2023, 44(1): 123-126. doi: 10.16835/j.cnki.1000-9817.2023.01.027

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Objective To understand and analyze the epidemiological characteristics of dental caries in children and its effects on jaw function, so as to prevent occurrence of abnormality of jaw function. Methods In October 2020, 860 cases of children from 5 kindergartens and 3 primary schools in Beijing were selected by adopting the convenience sampling method.All of them received oral examination, and the questionnaire according to the fourth national oral health epidemiological survey standard, including demographic information, eating habits, oral hygiene habits, oral health care, etc.The epidemiological characteristics of dental caries in children and its effects on jaw function were analyzed. Results A total of 190 children had dental caries, with a dental caries incidence rate of 22.09%.Dental caries in children's deciduous teeth or permanent teeth was related to age, residence, parents' education level, whethe to eat before going to bed, whether eating sweet food, tooth brushing age, daily brushing frequency, whether parents have assisted tooth brushing, whether regular oral examination, whether parents have received oral health guidance (χ²=5.04, 4.70, 75.37, 7.91, 12.03, 9.30, 7.64, 255.47, 253.27, 11.38, P < 0.05).Compared with the non-caries group, the sella-nasion-A point (SNA), sella-nasion-B point (SNB), A point-nasion-B point (ANB), frankfot horizontal mandibular plane angle (FH-MP), skull nasion mandibular plane angle (SN-MP), anteriors relationship palataplane mandibular (Ptm-ANS) decreased in the dental caries group (t=78.62, 79.35, 10.94, 30.69, 32.15, 48.62, P < 0.05). Conclusion The prevalence of caries in children was high and jaw structure abnormalities and dysfunction.It is suggested that caries prevention and control work should be carried out early to strengthen the prevention and control of oral disease education work.

Analysis of findings of ear, nose, and throat exam of some freshmen in military college entrance examination in Shandong Province

TIAN Xiujuan, HE Zhen, SUN Jingjing, LI Hui, REN Hengyi, CHEN Jianqiu

2023, 44(1): 127-130. doi: 10.16835/j.cnki.1000-9817.2023.01.028

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Objective To analyze the ear, nose, and throat exam of some freshmen in the military college entrance examination in Shandong Province in 2020 and to facilitate adolescent targeted health promotion. Methods The 1 411 freshmen participating in the military college entrance examination in Jinan, Zibo and Weifang of Shandong Province were included. The ear, nose, and throat exam were performed by professionals using electric otoscope, 5 meter whispering test, and front rhinoscope. Results Nasal septal deviation and hypertrophy of inferior turbinate accounted for the highest proportion. Among 489 cases of nasal septum deviation, the detection rate of Jinan (15.97%) was significantly lower than that of Weifang (43.60%) and Zibo (46.53%) (χ²=63.32, P < 0.05). For deviation of nasal septum, the detection rate in students with urban residence (31.53%) was significantly lower than that of rural students (39.03%) (χ²=4.11, P < 0.05). Seventy two cases of inferior turbinate hyperplasia were detected, and the detection rate in Jinan (2.99%) was significantly lower than that in Weifang (6.51%) and Zibo (6.04%) (χ²=6.63, P < 0.05). The detection rate of tonsil hypertrophy was significantly lower in boys (4.63%), students from urban area (3.94%), compared with that of girls(9.56%) and rural students (6.70%) (χ²=5.35, 4.86, P < 0.05). In pharyngeal examination, tonsil hyperplasia was the most common condition of enlarged tonsils (n=214), which was significantly higher in Jinan(22.36%) than that of Weifang (11.71%) and Zibo (10.74%) (χ²=22.39, P < 0.05), and was significantly lower in boys (14.38%) and rural students (12.40%) than that in girls (22.79%) and urban students (17.24%) (χ²=4.70, 4.65, P < 0.05). Conclusion Nasal septum deviation and tonsil hypertrophy are the most prevalent upper airway diseases among freshmen participating in the military college entrance examination. Prevention and treatment of nasopharynx diseases should be emphasized.

A qualitative study on high risk behaviors of HIV/AIDS among young adult males in Shandong Province

ZHANG Na, LI Jinhai, LI Ling, ZHU Xiaoyan, YANG Xingguang, ZHAO Shuai, HAO Lianzheng, WANG Guoyong, KANG Dianmin

2023, 44(1): 131-134. doi: 10.16835/j.cnki.1000-9817.2023.01.029

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Objective To identify high risk behaviors and infection-related factors among young adult males diagnosed with HIV/AIDS in Shandong Province, to provide evidence for targeted AIDS prevention and control strategies. Methods By using convient sampling method, an face-to-face in-depth interview on HIV-related behaviors was conducted among young adult males newly diagnosed with HIV/AIDS in Shandong Province in July 2021. Results A total of 31 young adult males diagnosed with HIV/AIDS were interviewed. All were male and infected through homosexuality behavior. Average age was (20.6±1.8) years. Totally 90.3% (28/31) were enrolled in tertiary education at the time of diagnosis. The findings revealed that 93.5% (29/31) of participants got infection due to unprotected homosexual behavior with the temporary partner whose HIV infection status was unknown, and 86.2% (25/29) got in touch with these temporary partner by social software. The awareness rate of knowledge about AIDS among all the participants was 100%, however, 83.9% (26/31) reported occasion condom usage while having homosexual behavior, and 16.1% (5/31) never did. Totally 74.2% (23/31) of the young adult males diagnosed with HIV/AIDS had a history of HIV testing before diagnosis. Conclusion The primary high risk behavior of HIV infection in young adult students are unawareness of HIV infection status for temporary sexual partner and the separation of knowing and doing. A targeted strategy should be developed to control the spread of HIV in young adult students.

Spinal curvature and associated factors among middle school students in the Yangtze River Delta Region

CHEN Jingjing, SUN Xijie, LI Wan

2023, 44(1): 135-138. doi: 10.16835/j.cnki.1000-9817.2023.01.030

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Objective To understand the prevalence and associated factors of spinal curvature in children and adolescents in the Yangtze River Delta Region and to provide reference and help for the prevention and intervention of spinal curvature in children and adolescents. Methods From September to November 2021, 8 246 middle school students in Anhui, Jiangsu, Shanghai, and Zhejiang provinces in the Yangtze River Delta Region were selected by stratified cluster sampling for spinal curvature assessment and questionnaire survey. Results The detection rate of spinal curvature in middle school students in the Yangtze River Delta was 8.46%. Girls (9.82%) were significantly higher than boys (7.20%)(χ²=18.25, P < 0.01), and students from urban area (10.77%) was significantly higher than that of suburban area (4.94%)(χ²=86.75, P < 0.01). Junior high school students (6.65%) were significantly lower than high school students (10.34%)(χ²=36.26, P < 0.01). Logistic regression analysis showed that urban area(OR=2.58, 95%CI=1.72-3.86), time usage of electronic equipment ≥ 3 h/d(OR=1.61, 95%CI=1.14-2.29), break between near work for more than 1 h (OR=1.42, 95%CI=1.01-1.97) and outdoor activity < 2 h/d(OR=1.84, 95%CI=1.26-2.69) were positively correlated with the occurrence of spinal curvature(P < 0.05). Conclusion The detection rate of spinal curvature in middle school students in the Yangtze River Delta is relatively high, which is related to time spent on screen, near work and outdoor activity. Education and guidance should be strengthened to reduce the detection rate of spinal curvature.

Epidemiological evaluation for vaccine effectiveness of varicella attenuated live vaccine among students in collective institutions in Jing'an District, Shanghai from 2017 to 2019

ZHANG Xiaojuan, AO Jianjun, YU Ping, QUAN Li, BEI Weihui, HUA Ruijue, HUANG Jin

2023, 44(1): 139-142. doi: 10.16835/j.cnki.1000-9817.2023.01.031

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Objective To understand the vaccination of varicella attenuated live vaccine (VarV) among students in collective institutions, to provide a basis for analying the protective effect of vaccination. Methods All collective institutions with chickenpox epidemic and post-exposure vaccination in Jing'an District from 2017 to 2019 were investigated. All students(n=6 473) in the affected class were included. Vaccination status and the incidence information of disease were collected to analyze vaccine effectiveness (VE). Results The proportion of study subjects without an immunization history decreased year by year, and 7.5% in 2017, 7.2% in 2018, and 4.9% in 2019. The proportion with a history of one dose prior to exposure in cases was 90.0%, it was lower than 93.5% in the non cases (χ²=6.53, P < 0.05). The proportion with one dose as post-exposure prophylaxis in cases was 8.3%, it was much lower than 44.1% in the non cases (χ²=179.06, P < 0.01). The proportion with one dose as post-exposure prophylaxis in secondary cases was 28.6%, much lower than 44.1% in the non cases (χ²=9.44, P < 0.01).Unvaccinated ones and the second dose as post-exposure prophylaxis ones in cases had the highest rate of varicella development (11.0%), a history of one dose prior to exposure and one dose as post-exposure prophylaxis in cases had the lowest varicella rate (1.0%).There was a clear protective effect within two years after one dose of VarV inoculation, VE was 63.1%(95%CI=11.0%-84.7%). Conclusion The vaccine effectiveness of one-dose VarV was limited. Post-exposure prophylaxis as early as possible was highly effective in decreasing secondary attack rate.

Correlation analysis of sleep behavior and overweight and obesity in junior high school students

CAI Yepeng, CAI Qian, LUO Wen, SONG Huizi, JIANG Tianhua, SUN Yun, JIAO Xiuping, LIAO Yuexia

2023, 44(1): 143-146. doi: 10.16835/j.cnki.1000-9817.2023.01.032

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Objective To analyze the association between different sleep behaviors and overweight and obesity of junior high school students in Yangzhou City, and to provide a basis for policies and interventions related to adolescent health management. Methods A total of 1 589 students in grades 7-9 from two middle schools in Yangzhou City were selected using the cluster sampling method and were administered with sleep time, bedtime, social jetlag difference, and sleep habits. Results Totally 64.38% were sleep-deprived during the school days, 86.78% went to bed too late, 46.51% had a social jetlag of ≥1 h, and 37.44% took a nap every day(Incluldes holidays and school days). Social jetlag length was statistically different between grades(F=6.97, P < 0.01). Girls shown significantly higher social jetlag than the boys(t=6.19, P < 0.01). Later bedtime on weekends, later wake-up time on weekends and poor sleep behavior were risk factors for overweight and obesity in junior high school students(OR=1.20, 1.14, 1.04, P < 0.05). Conclusion Junior high school students had less sleep and later bedtimes with the increase of grade, and weekend bedtimes, wake-up times and poor sleep behavior were independently associated with the risk of overweight and obesity in junior high school students. Parents and schools should be instructed to pay attention to their sleep health and carry out adolescent sleep health guidance.

Research progress of association between the built environment in community and the obesity of children and adolescents

WANG Jiaojiao, XIE Yang, WAN Yuhui, TAO Fangbiao

2023, 44(1): 147-151. doi: 10.16835/j.cnki.1000-9817.2023.01.033

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With the socio-economic development and urbanization, obesity increased dramatically worldwide among children and adolescents over the past years. The determinants of obesity are complicated, and its association with built environment in community has received great concern in recent years. To provide theoretical basis for building supportive environment beneficial for obesity prevention, the review summarizes obesity-related built environment, including food environment, physical activity environment, road traffic environment, lighting at night.

Research progress of association on flow experience and adolescents mental health

JIANG Jing, LI Huijie, XU Sheng, QU Shuo

2023, 44(1): 152-156. doi: 10.16835/j.cnki.1000-9817.2023.01.034

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The popularity of electronic devices helps the spread of the flow experience. Flow experience affects many aspects of life for adolescents as for its double articulation. In order to provide suggestions for the improvement in adolescent mental health, this paper reviews flow experience and adolescent mental health in different situations. In learning situation, the state of flow makes a difference in students' self-confidence, learning experience, positive affect in school, positivity, self-esteem and self-efficacy, etc., at the same time, it is beneficial to relieve academic pressure and academic procrastination. In entertainment situation, the state of flow experience directly leads to addiction, and indirectly affects online game addiction by the mediating roles of self-control and cognitive bias.

Progress in application of virtual reality in prevention and treatment of childhood obesity

DU Yuchen, YANG Qiaoju, ZHAO Huifang, MA Mengyuan

2023, 44(1): 157-160. doi: 10.16835/j.cnki.1000-9817.2023.01.035

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As a new non-drug treatment technology, virtual reality technology is commonly available for childhood obesity prevention and treatment. This technology offers a great opportunity to carry out research on parental feeding behavior. Also, its combination with child nutritional education and exercise managementis is gaining popularity. This review summarizes the application progress of virtual reality technology in childhood obesity prevention and treatment, such as parental feeding, children's nutrition education and children's sports management, providing reference for childhood weight management and related research.

2023 Vol. 44, No. 1