中国学校卫生

Strengthening research in prevention and treatment strategies for hypertension in children and adolescents

LIANG Xiaohua, AN Xizhou

2023, 44(10): 1441-1444. doi: 10.16835/j.cnki.1000-9817.2023.10.001

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In recent years, the blood pressure levels and the prevalence of hypertension and among Chinese children and adolescents have shown a rising trend, and the elevated blood pressure is associated with target organ damage and increases the risk of developing cardiovascular and cerebrovascular diseases in adulthood. The article analyzes the current epidemic situation and main risk factors of hypertension in children and adolescents in China, and proposes comprehensive prevention and control measures that can be implemented by government, medical institutions, schools, and families as part of a joint effort to target hypertension in youth, thereby providing evidence for preventing the occurrence of hypertension in this population.

Expert interpretation of Comprehensive Public Health Intervention Technical Guidelines for Prevention and Control of Myopia among Children and Adolescents

TAO Fangbiao

2023, 44(10): 1445-1449. doi: 10.16835/j.cnki.1000-9817.2023.10.002

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The National Bureau of Disease Control and Prevention has issued the Guidelines for Comprehensive Public Health Intervention Techniques for Prevention and Control of Myopia in Children and Adolescents, which summarizes and evaluates the practical experience of the Comprehensive National Children's Myopia Management Plan in the past 5 years, examines the causes and develops evidence-based interventions for myopia. The Guidelines recommend eight public health intervention techniques based on a three-tier prevention strategy, and propose three practical measures. The article interprets the Guidelines in terms of their background, theoretical basis, practical significance, content, and further examines their organization and implementation, so as to enhance understanding among professionals in public health institutions and related departments involved in the prevention and control of myopia in youth, while facilitating their application and promotion.

Association between secondhand smoke exposure in indoor public places and carotid intima-media thickness in children and adolescents

MA Chuanwei, LI Cheng, SUN Jiahong, ZHAO Min, XI Bo

2023, 44(10): 1450-1453. doi: 10.16835/j.cnki.1000-9817.2023.10.003

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Objective To examine the association between secondhand smoke exposure (SHS) in indoor public places and carotid intima-media thickness (cIMT) in children and adolescents, so as to provide guidance for the prevention of early abnormal vascular architecture. Methods The data were obtained from the second follow-up of the Children Cardiovascular Health Cohort Study conducted from November to December 2021. A total of 1 297 children and adolescents for who completed data relating to sex, age, cIMT, physical examinations, questionnaires variables and blood biochemical indices, were included for analysis. Linear regression analysis was performed to examine trends in the levels of cIMT with exposure to SHS in indoor public places. Multiple linear regression analysis was carried out to assess the association between SHS exposure in indoor public places and cIMT after adjustment for potential covariates. Results During the previous 7 days, 407 (31.4%) children and adolescents were exposed to SHS in indoor public places for 1-2 days, 86 (6.6%) for 3-4 days, and 82 (6.3%) for ≥5 days. The levels of cIMT in youth increased on different models, with the duration of SHS exposure during the previous 7 days (t=3.30, 3.05, 2.87, P < 0.05). After adjusting for various covariates, the cIMT values of children and adolescents were[0 day: (551.5±29.3) μm, 1-2 days: (554.0±28.6) μm, 3-4 days: (557.0±27.7) μm, ≥5 days: (559.4±27.5) μm]. Compared to those who were not exposed to SHS in indoor public places during the previous 7 days, those exposed for ≥5 days had significantly higher cIMT levels (β=7.91, 95%CI=1.47-14.34, P < 0.05). Conclusion Among children and adolescents, exposure to SHS in indoor public places remains high and is significantly associated with cIMT. The findings highlight the need for stricter regulation and tobacco control policies to provide healthy smoke-free environments for children and adolescents, and to reduce the risk of early abnormal vascular architecture.

Association between early-life factors and cardiometabolic risk factors in children and adolescents

JIANG Jianuo, ZHANG Yi, CHEN Li, LIU Jieyu, YUAN Wen, GUO Tongjun, MA Jun, DONG Yanhui

2023, 44(10): 1454-1458. doi: 10.16835/j.cnki.1000-9817.2023.10.004

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Objective To understand the early-life factors that influence cardiometabolic risk factors in children and adolescents, so as to provide effective measures to curb cardiometabolic risk factors such as hypertension and diabetes in children and adolescents. Methods Data were sourced from the 2020 follow-up survey of the Xiamen Adolescent Development Cohort. The study involved 1 197 subjects for whom completed anthropometric examination and blood biochemistry testing data, as well as early-life data. Early-life and sociodemographic data were obtained through questionnaire surveys, while cardiometabolic indicator data were sourced through physical examinations and blood testing. Logistic regression analysis was performed to analyze the impact of early-life factors on the cardiometabolic risk factors after adjusting for gender, age, and family history. Results The prevalence rate of cardiometabolic risk factors clustering in children and adolescents in Xiamen was 17.96%, with boys (26.67%) reporting higher rates than girls (9.64%), and the difference was statistically significant (χ²=57.69, P < 0.01). For every additional early-life risk factor, the risk factors of obesity increased 0.35 times (OR=1.35, 95%CI=1.03-1.78, P < 0.05). Post-term pregnancy may be a primary early-life risk factors for cardiometabolic risk factors, and it was associated with an increased risk of cardiometabolic risk factors clustering (OR=2.45, 95% CI=1.11-5.41) and high triglycerides (OR=3.25, 95%CI=1.39-7.61)(P < 0.05). Conclusion Increased cardiometabolic risk factors in youth is associated with early-life adverse factors. It is crucial to pay greater attention to post-term pregnancy as an early-life factor and to consider obesity as a cardiometabolic risk factors. Controlling early-life adverse factors is important for the prevention of cardiovascular disease.

Relationship between dietary fruit intake and overweight and obesity in children

WANG Fengming, LIU Qin, AN Xizhou, CHEN Jingyu, LUO Shunqing, LIANG Xiaohua

2023, 44(10): 1459-1463. doi: 10.16835/j.cnki.1000-9817.2023.10.005

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Objective To explore the relationship between fruit intake and the risk of overweight with obesity in children, so as to provide references for the prevention of childhood obesity. Methods From September to November 2014, a stratified cluster sampling method was used to select 6 369 children aged 6-12 from two elementary schools of a country in rural Chongqing for physical examinations and questionnaire surveys, and 1 814 children in grades 1-2 at baseline were followed up from March to May 2019. The relationship between fruit intake and the prevalence of overweight and obesity was analyzed. Results According to the percentile of fruit intake, the 6 369 children at baseline were assigned to three groups: Q1 (< P_33.3, fruit intake < 100 g/d), Q2 (P_33.3-P_66.7, fruit intake: 100-214.3 g/d), and Q3 (> P_66.7, fruit intake > 214.3 g/d). For the baseline survey results, children in the Q2 group had a lower weight and Body Mass Index (BMI) (P < 0.05); the prevalence of overweight and obesity among children in the Q1 group was the highest (32.03%), and the prevalence of overweight and obesity among boys in the Q2 group was the lowest (31.94%) after gender stratification (P < 0.05). The follow-up survey results showed no significant differences between the three groups in terms of changes in height, weight, and BMI (P > 0.05); but the prevalence of obesity among youth in the Q2 group was the lowest (5.07%, P < 0.05). Compared with youth in the Q2 group, the risk of obesity was higher among those in the Q1 group at baseline survey (OR=1.41, 95%CI=1.10-1.81, P < 0.05), and was higher among those in the Q3 group at follow-up survey (RR=1.83, 95%CI=1.21-2.75, P < 0.05). Conclusion Deviating from moderate fruit intake may increase the likelihood of overweight and obesity in children, and it is recommended that children are encouraged to consume fruits as part of a well-balanced diet to prevent the occurrence of obesity.

Current status and multidimensional influences on the comorbidity of obesity and high blood pressure among children in Xiamen City

ZHANG Yi, JIANG Jianuo, CHEN Li, LIU Jieyu, YUAN Wen, GUO Tongjun, DONG Yanhui, MA Jun

2023, 44(10): 1464-1467. doi: 10.16835/j.cnki.1000-9817.2023.10.006

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Objective To understand the current status of obesity and high blood pressure (HBP) comorbidity and their multidimensional influencing factors in children aged 7-12 years in Xiamen, so as to provide reference basis for subsequent preventive measures. Methods Based on the baseline survey of the Xiamen pubertal development cohort in 2017, a total of 4 798 primary school students from second to sixth grade were selected in the study by cluster random sampling method. And physical examination and questionnaires were conducted. The Logistic regression was used to screen potential variables for obesity combined with HBP. A multivariate Logistic regression model was used to analyse the factors influencing obesity combined with HBP. Results About 9.15% children were found with obesity and 11.65% with HBP. The rate of obesity combined with HBP was 3.00% in boys and 1.80% in girls. The rate of HBP was 8.28% in normal-weight children and 26.88% in obese children. Multivariate Logistic regression models showed that consumption of sugary drinks at least once a week (OR=2.50), daily consumption of salted or pickled vegetables (OR=4.52), family history of obesity (OR=3.09) were positively associated with obesity combined with HBP (P < 0.05). Girls (OR=0.53), consumption of high-energy snacks at least once a week (OR=0.40) and adequate physical activity (OR=0.58) were negatively associated with comorbidity of obesity and HBP (P < 0.05). Conclusion Gender differences in comorbidity burden of obesity and HBP exist among children aged 7-12 years in Xiamen. Dietary behaviour and exercise behaviour are the main dimensions influencing the comorbidity of obesity and HBP. Prevention and control of obesity and HBP in children should be based on multiple dimensions, including diet and exercise behavioural environment, to prevent early the occurrence for comorbidity of obesity and HBP in children.

Evaluation of the intervention effect of conventional and peer AIDS voluntary counseling and testing services among young students

CHEN Xi, HE Tingting, CHEN Mengqing, LIANG Qinger, LI Shunming, CHEN Yuncong, LUO Yefei, CAI Yanshan, HAN Zhigang

2023, 44(10): 1468-1472. doi: 10.16835/j.cnki.1000-9817.2023.10.007

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Objective To explore the influence of two voluntary counseling and testing(VCT) services on young students' acquired immune deficiency syndrome(AIDS)-related knowledge and behaviour, so as to provide a new idea for further improvement and promotion of VCT services. Methods From April 2017 to December 2018, the sample size, selected from 12 patrol and fixed monitoring sites in colleges in Guangzhou, was calculated by non-inferiority trial, and the students who received services at the same period were 1∶1 matched. A total of 113 students received conventional VCT and 186 recerived peer VCT services. The Chi-square test was used to analyse the difference of AIDS-related knowledge and behavior before and after intervention, and a survey was conducted on satisfaction. Results After young students received conventional VCT services, the overall awareness rate of AIDS basic knowledge increased from 80.53% to 93.75%, and the frequency of condom use every time during heterosexual sexual activity in the past year increased by 29.17 percentage points (χ²=4.49, 4.10, P < 0.05). After young students received peer VCT services, the awareness rate of the Four Frees and One Care Policy increased from 34.95% to 58.26%, the rates of homosexual anal sex and more than or equal to 2 sexual partners in the past half a year decreased by 14.84 and 29.43 percentage points, respectively(χ²=15.69, 4.82, 10.97, P < 0.05). Conclusion After young students receive two modes of VCT services respectively, the AIDS-related knowledge and behavior have been improved, and the influence of the two VCT services has different advantages. The combination of conventional VCT and peer education might be a more effective way of AIDS intervention.

Eating behaviors and associated factors among preschool children in Tongling City

FANG Hongying, XU Chengheng, GAO Hongqiong, TANG Yinxia, CAO Yueting, HUANG Wei

2023, 44(10): 1473-1477. doi: 10.16835/j.cnki.1000-9817.2023.10.008

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Objective To examine the eating behaviors and associated factors among preschool children from multiple-child families, so as to provide a basis for promoting healthy eating habits in this population. Methods From April to June 2022, a stratified random cluster sampling method was employed to selected 2 647 guardians of preschool children in 11 kindergartens in Tongling City.Parenting style questionnaire, Identification and Management of Feeding Difficulty Questionnaire (IMFeD), Caregiver's Feeding Style Questionnaire (CFSQ) and a self-designed questionnaire were administered.Multiple linear regression was performed to analyze the factors influencing eating behaviors among preschool children. Results In the study, the detection of eating behavior problems among preschool children was 71.4%, and the detection of reduced appetite was the highest (55.6%).The detection rates of anorexia, picky eating, poor eating and improper eating behavior in only-child families were higher (60.6%, 41.0%, 32.0%, 19.5%), compared with those in multiple-child families (51.7%, 36.4%, 27.2%, 16.6%)(χ²=20.05, 5.95, 7.16, 3.92, P < 0.05).Among multiple-child families, the detection rates of fear of eating and underlying disease were the lowest in 5- < 10-year-old group (2.3%, 0.6%)(χ²=11.54, 8.51, P < 0.05).In multiple-child families, the detection rates of picky eating and poor eating habits for the first-born child were higher (42.0%, 32.5%), compared with second-born and third-born child (34.6%, 25.6%)(χ²=6.15, 6.38, P < 0.05).The results of multiple linear regression analysis showed that multiple-child families (β=-1.40), democratic parenting style (β=-0.07), higher feeding response scores (β=-0.33) were negatively associated with eating behavior problems among preschool children (P < 0.05).Eating behavior problems among preschool children were positively correlated with less educated mothers[high and junior high school education (β=0.87), primary school education and below (β=3.69)], longer average daily screen time (β=0.10), higher feeding requirements scores (β=0.64), doting parenting styles (β=0.21), permissive parenting styles (β=0.27) and inconsistent parenting styles (β=0.14)(P < 0.05). Conclusion The detection rate of the eating behaviors problems among preschool children is high in schools.Greater attention should be paid to only-child and first-born child of multiple-child families, and appropriate feeding and parenting styles, so as to promote healthy eating habits among this population.

Hydration status and knowledge, attitude and behavior regarding hydration among primary school students in a rural area of Guangxi

CHENG Shuai, JIAO Lijing, XIA Yunting, XU Luxi, ZHONG Gemei, LI Hongxing

2023, 44(10): 1478-1482. doi: 10.16835/j.cnki.1000-9817.2023.10.009

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Objective To investigate hydration status and knowledge, attitude and behavior regarding hydration among primary school students in a rural area of Guangxi, so as to provide guidance for hydration education in schools. Methods In october 2022, two rural township boarding primary schools with similar basic conditions including drinking water infrastructure, were selected in Guangxi.A total of 439 students in grades 3-6 from these two schools were selected as participants by the cluster sampling.Urinary osmolality of students was assessed to evaluate the random hydration status, and all the participants filled out the drinking water survey. Results About 35.54% of the participants were in normal hydration status (urine osmolality ≤800 mOsm/kg) during the interview, which was higher among female than male students (44.50%, 26.70%, χ²=15.18, P < 0.05).Among the participants, the overall awareness rate of knowledge was 37.36%, which was higher in the higher grades than in the lower grades (42.32%, 31.75%, χ²=26.10, P < 0.05).The overall positive attitude holding rate of students was 66.20%, more for girls than boys (71.27%, 61.20%) and higher for upper grades than lower grades (68.78%, 63.29%)(χ²=39.82, 11.77, P < 0.05).The overall correct drinking behavior formation rate was 40.83%, more for girls than boys (44.38%, 37.33%) and higher for upper grades than lower grades (43.56%, 37.74%)(χ²=9.03, 6.13, P < 0.05).The random hydration status of primary school students at school was associated with their drinking pattern (χ²=5.09, P < 0.05), and incorrect water intake patterns increased the risk of dehydration (OR=1.61, 95%CI=1.06-2.44, P < 0.05).No statistical association was found between the percentage of students with normal hydration status and its total rate of knowledge about drinking water, positive attitudes held and correct behaviors formed in the two schools at each grade level (P>0.05). Conclusion The proportion of primary school students with insufficient random hydration status during school in Guangxi is relatively high.The rates of awareness, concept holding and habit formation of healthy drinking water are low.It is recommended to strengthen the propaganda and education, and guide students to develop healthy drinking habits.

Latent class analysis of health risk behaviors among middle school students in Beijing City

LUO Huijuan, GAO Ruoyi, ZHAO Hai, SUN Bingjie, WANG Lu, GUO Xin

2023, 44(10): 1483-1487. doi: 10.16835/j.cnki.1000-9817.2023.10.010

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Objective The study was aimed at exploring the latent classes and factors influencing middle school students health risk behaviors in Beijing, so as to provide a scientific basis for determining key intervention targets and formulating relevant intervention measures. Methods A questionnaire survey was conducted among 17 730 junior middle school, senior high school and vocational high school students in 16 districts of Beijing from October to December 2022.Six types of health risk behaviors were assessed with latent class analysis, including unhealthy diet, lack of exercise, unintentional harm, intentional harm, substance abuse and Internet addiction behavior. Results The latent classes of health risk behavior among middle school students in Beijing were divided into three classes: high risk behavior (961 participants, 5.42%), low lack of exercise/high intentional injury (1 099 participants, 6.20%), and low risk behavior (15 670 participants, 88.38%).Disordered multiple Logistic regression analysis indicated that middle school students who were male (OR=1.45), in high school (OR=2.00), had other family types (OR=1.90), possibly had depressed feelings (OR=2.27), had depressed feelings (OR=6.18), or were absent from school because of illness in the past year (OR=1.79) were more likely to be in the high-risk than the low-risk behavior group.Moreover, middle school students who were male (OR=2.30), had an extended family (OR=1.18), had a reorganized family (OR=1.70), had other family types (OR=1.94), possibly had depressed feelings (OR=3.10), had depressed feelings (OR=4.91), had taken sick leave in the prior 2 weeks (OR=1.54), or had absence from school because of illness in the past year (OR=1.71) were relatively more likely to be in the low lack of exercise or high intentional injury group (P < 0.05). Conclusion Clear latent classes of health risk behaviors among middle school students are found to be present in differing proportions in Beijing.Relevant departments should take targeted intervention measures in a timely manner to reduce the occurrence of health risk behaviors among middle school students.

Association of light-intensity physical activity, sedentary time and body composition in adolescents

YE Rongrong, HUANG Baoying, ZHANG Dongmei, TAN Jianyi, CHENG Jinqun, REN Zhiqiang, XU Peng, HUANG Yanhong, SHEN Jiaxin, LI Hongjuan, GAO Yanhui

2023, 44(10): 1488-1492. doi: 10.16835/j.cnki.1000-9817.2023.10.011

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Objective To explore the association between light-intensity physical activity (LPA) and sedentary behavior (SB) with body composition, so as to provide data references for improving adolescent physical health. Methods From August 2020 to January 2021, general information of 694 students in grade one of a high school in Foshan City was collected, and the 24-hour activity behavior and body composition of the students were measured objectively by triaxial accelerometer and bioelectrical impedance tester.Dual-component multivariate regression and dual-compositional isotemporal substitution model were used to explore the relationship between LPA and SB and body composition. Results LPA was associated with lower fat relative dominance (FRD)(male weekends FRD=-21.44%, female weekly FRD=-17.83%, weekdays FRD=-18.27%, P < 0.05), and LPA was also associated with higher muscle relative dominance (MRD) and bone relative dominance (BRD)(male weekends MRD=12.78%, BRD=12.87%;female weekly MRD=11.64%, BRD=9.01%;female weekdays MRD=12.02%, BRD=9.23%, P < 0.05).Replacing sedentary behavior (SB) with 10 minutes of LPA could reduce fat proportion[male: weekly-0.15(-0.26-0.04), weekdays-0.12(-0.22-0.02);female: weekly-0.18(-0.27-0.08), weekdays-0.16(-0.25-0.07)) and increase muscle proportion (male: weekly 0.14(0.03-0.24), weekdays 0.11(0.02-0.21);female: weekly 0.17(0.07-0.26), weekdays 0.15(0.07-0.24)]. Conclusion Interrupting continuous SB with LPA can serve as an intervention measure to promote physical health and fitness in adolescents.School should encourage students to engage in frequent LPA during breaks and after-school activities, while avoiding prolonged SB.

Association between secondhand smoke exposure in indoor public places and sleep deprivation in children

LI Cheng, SUN Jiahong, ZHAO Min, XI Bo

2023, 44(10): 1493-1496. doi: 10.16835/j.cnki.1000-9817.2023.10.012

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Objective To examine the association between secondhand smoke (SHS) exposure in indoor public places and sleep deprivation, so as to provide a reference for strengthening the management of a smoking ban in public places and to promote better sleep in childhood. Methods Data were obtained from the second follow-up survey of the Huantai Childhood Cardiovascular Health Cohort Study, which was conducted from November to December 2021.A total of 1 284 children aged 10-15 years old were included in the study.The participants were assigned to four groups (0, 1-2, 3-4 and ≥5 days) according to the frequency which they were exposed to SHS in indoor public places in the previous 7 days.Multiple linear regression was performed to examine the trend of children's sleep duration with the frequency of SHS exposure.Multivariate Logistic regression was carried out to determine the association between frequency of SHS and sleep deprivation. Results After adjusting for age, sex, grade, physical activity, intake of fruits/vegetables, intake of soft drinks, screen duration, body mass index (BMI) and blood pressure, the average sleep duration of children who were exposed to SHS for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 8.48, 8.41, 8.20 and 8.06 h/d, respectively, and the average sleep duration decreased with exposure frequency of SHS (t=5.96, 5.89, 5.91, P < 0.01).The proportion of sleep deprivation among children who were exposed to SHS in public places for 0, 1-2, 3-4 and ≥5 days in the previous 7 days was 40.02%, 43.07%, 54.65% and 63.41%, respectively.Compared to children who were not exposed to SHS in indoor public places in the past 7 days, those exposed for 3-4 days (OR=1.93, 95%CI=1.19-3.15) or ≥ 5 days (OR=2.95, 95%CI=1.76-4.94) had a significantly increased risk of sleep deprivation (P < 0.05). Conclusion Children's sleep time decreases with increasing frequency of exposure to SHS, and children who are frequently exposed to SHS are more likely to experience insufficient sleep.Smoking ban management in public places should be strengthened to promote children's sleep health, especially indoor public places.

Analysis of associated factors of the inconsistency for knowledge and behavior in condom use among college students in Zhuhai City

TAN Xiaoxia, ZHOU Yi, FENG Shuaixin, DAI Wencan, HUANG Zhaoqian, LIU Yawei, HUANG Ying, HUANG Shanzi, LIN Kaihao, LI Xiaofeng, YAN Yao, JIANG Hongbo

2023, 44(10): 1497-1500. doi: 10.16835/j.cnki.1000-9817.2023.10.013

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Objective To examine the prevalence and factors influencing the inconsistency for knowledge and behavior in condom use among college students, so as to provide suggestions for AIDS prevention and education in universities. Methods From October to December 2019, a multistage cluster sampling method was employed to collect data relating to inconsistency for knowledge and behavior in condom use and other related factors among 1 303 students from six colleges in Zhuhai, China.Chi-square test and Logistic regression were performed to analyze the influencing factors and moderating effect. Results The reporting rate of in consistency of knowledge and behavior in condom use among college students was 41.1%.Multivariate Logistic regression analysis showed that seeking sexual partners offline was negatively correlated with inconsistency for knowledge and behavior in condom use (OR=0.70, 95%CI=0.51-0.95).However, condom nonuse during the first sexual experience (OR=7.11, 95%CI=5.23-9.67), smoking before sex (OR=1.47, 95%CI=1.07-2.02), drinking before sex (OR=1.44, 95%CI=1.09-1.91), history of intimate partner violence (OR=1.53, 95%CI=1.13-2.07), and having multiple sexual partners (OR=1.69, 95%CI=1.25-2.29) were positively correlated with inconsistency for knowledge and behavior in condom use (P < 0.05).The moderating effect analysis showed that condom use during the first sexual experience had a moderating effect on smoking before sex and inconsistency for knowledge and behavior in condom use (β=0.92, P < 0.05).Among students who did not use condoms during the first sexual experience, a positive correlation was observed between smoking before sex and inconsistency for knowledge and behavior in condom use (OR=2.76, 95%CI=1.09-6.99, P < 0.05).However, no correlation was found between smoking before sex and inconsistency for knowledge and behavior in condom use (OR=1.32, 95%CI=0.92-1.88, P>0.05) among students who used condoms during the first sexual experience. Conclusion High levels of inconsistency for knowledge and behavior in condom use are found among college students in Zhuhai City.Colleges should carry out sex education activities as soon as possible, and explore new health education models to promote the transformation of their knowledge into behavior.

Effectiveness of sex education curriculum on sex-related knowledge, attitude and practice of preschool children in senior class

YAN Run, XIA Hua, YE Yunli

2023, 44(10): 1501-1504. doi: 10.16835/j.cnki.1000-9817.2023.10.014

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Objective To evaluate the effectiveness of sex education curriculum on sex-related knowledge, attitude and practice of preschool children in senior class, so as to provide a reference basis for the comprehensive development of early childhood sex education in the future. Methods From December 2021 to July 2022, the two-stage stratified sampling method was used to select 12 kindergartens in Luzhou City, of which 6 senior classes were chosen as the intervention group (360 before the intervention, 354 after the intervention), and the other 6 senior classes as the control group (416 before the intervention, 326 after the intervention).The intervention group was conducted with early childhood sex education classes in the form of a series of courses, with a total of four topics including one parent course and three child courses every month, while the control group received routine teaching schedule.A survey was conducted on the knowledge, attitude and practice of early childhood sex education among preschool children and their parents before and after the intervention.χ² text analysis was used to carry out the effect. Results There was no statistically significant difference in sexual education related knowledge, attitude and practice between the intervention group and the control group before intervention (P>0.05).There were statistically significant differences in the awareness rate of sexual knowledge (77.4%, 69.6%), positive attitude rate (73.7%, 10.1%), good practice rate (59.3%, 38.0%), and good knowledge, attitude and practice rate (37.9%, 1.8%) between the intervention group and the control group after intervention (χ²=5.28, 279.77, 30.77, 134.62, P < 0.05).Similar findings were observed in the intervention group before and after the intervention (χ²=63.39, 344.31, 41.41, 161.03, P < 0.05).The difference in the awareness rate of sexual related knowledge between the control group before and after intervention was statistically significant (χ²=44.29, P < 0.05). Conclusion The early childhood sex education curriculum might help improve sex-related knowledge, attitude and practice.Kindergartens should be encouraged to actively promote sex education, training, and guidance for preschool children and their parents, in order to improve the sex-related knowledge, attitude and practice.

Comparison of the effectiveness of reproductive health education intervention through different channels for female college students

TANG Haiying, TANG Ying, YANG Jie

2023, 44(10): 1505-1508. doi: 10.16835/j.cnki.1000-9817.2023.10.015

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Objective To understand the knowledge of reproductive health among female college students and the effectiveness of intervention measures, so as to provide a reference for conducting reproductive health education and health guidance for female college students. Methods From March to November 2022, 1 019 female college students of grade 1 to 3 from a university were selected by convenient sampling method, who were included in the conventional group(n=315), WeChat group(n=462) and outpatient and peer group(n=242). The Outpatient and peer group was provided with reproductive health education and health knowledge manuals and relevant guidance by receiving medical staff, the conventional group received routine health education and guidance from the school, and the WeChat group received online reproductive health education and guidance on the WeChat platform. Survey questionnaires were filled out before and after reproductive health related education and health guidance, and the results were compared and analyzed. Results After intervention, the awareness rates of women's menstrual cycle, ovulation period, AIDS detection window period and suitable contraceptive methods in outpatient and peer groups and WeChat group were higher than those in conventional group (χ²=26.78, 31.70, 61.50 and 13.96 respectively). The awareness rates of women's physiological time easy to be pregnant and unreliable contraceptive methods in outpatient and peer groups were higher than those in conventional group (χ²=9.10, 10.68), and the awareness rates of unreliable contraceptive methods and main precautions during menstruation were higher than those in WeChat group (χ²=9.10, 8.02). The awareness rate of emergency contraception methods in WeChat group was higher than that in conventional group (χ²=7.94). All the differences were statistically significant (P < 0.05). After intervention, the knowledge scores of reproductive physiology (2.55±1.09, 2.42±1.08), contraception (2.62±1.20, 2.53±1.06), sexually transmitted disease (2.89±1.35, 2.76±1.24) and the total score of reproductive health knowledge (12.82±3.94, 12.12±3.06) among female college students of the outpatient and peer group and WeChat group were higher than those in the conventional group (2.10±0.91, 2.33±1.09, 2.55±1.18, 11.39±3.07). The knowledge score of accidental pregnancy and induced abortion (1.78±0.91) and the total score of reproductive health knowledge (12.82±3.94) among female college students of the outpatient and peer group were higher than those in the conventional group and WeChat group (1.57±0.87, 1.62±0.87; 11.39±3.07, 12.12±3.06). All the differences were statistically significant (F=14.94, 5.27, 5.28, 13.02; 4.15, 13.02, P < 0.05). Conclusion Female college students lack comprehensive understanding of reproductive health related knowledge. The reproductive health education and health care guidance to female college students should be developed through multiple channels, which would improve the reproductive health knowledge cognition of female college students and promote the formation of good health care behavior.

The current situation and influencing factors of college students' use of fitness live stream

CHENG Yafei, PENG Yulin, LI Ya'nan

2023, 44(10): 1509-1512. doi: 10.16835/j.cnki.1000-9817.2023.10.016

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Objective To study the current situation and influencing factors of college students' use of fitness live stream, so as to provide a reference basis for promoting the scientific fitness of the whole people, especially the physical health of young college students. Methods A total of 2 151 sample students of 18 colleges from Zhengzhou, Kaifeng and Luoyang in He'nan Province, were by the three-stage random sampling method from May to August in 2022. Univariate analysis and Logistic regression model were constructed to study the influencing factors of the use of fitness live stream among college students. Results About 48.6% of college students reported of using fitness live stream, which varied significantly by genders, grades, major, monthly consumption, health attitudes, fitness awareness, fitness motivation, and fitness frequency (χ²=111.17, 39.06, 218.45, 278.05, 515.67, 30.45, 104.17, P < 0.01). The results of Logistic regression analysis showed that gender, grade, major, monthly consumption, health attitude, fitness awareness, fitness motivation and fitness frequency were the main factors related to the use of fitness live stream among college students (OR=1.12-2.25, P < 0.01). Conclusion The college student community has a high acceptance of fitness live stream. Appropricate fitness awareness and fitness behaviors could also promote college students to actively participate in the activities of fitness live stream.

Potential categories of lifestyle behavior and its relation with traditional Chinese medicine constitutions among higher vocational medical students

WANG Xumei, JIANG Wenyi, PAN Yun, HU Chenchen

2023, 44(10): 1513-1516. doi: 10.16835/j.cnki.1000-9817.2023.10.017

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Objective To understand potential categories of lifestyle behaviors and its association with traditional Chinese medicine (TCM) constitution among higher vocational medical students, so as to provide reference for the physical health management of them. Methods From October to December 2022, 2 720 medical students from three higher vocational medical colleges in Anhui Province were selected by stratified cluster sampling method and were investigated with a questionnaire of lifestyle and TCM body constitution. Potential category analysis (LCA) and multiple linear regression were used to explore the relationship between potential categories of lifestyle behaviors and TCM constitutions. Results The lifestyle behavior of vocational medical students were classified into three potential categories: general health group (83.60%), smoking and drinking group (4.85%) and diet preference group (11.55%). There were significant differences in the distribution of TCM constitution types among the three groups (χ²=46.32, P < 0.01). The proportion of general health group was the higher in balanced constitution (46.39%), and the proportion of smoking and drinking type was higher in phlegm-dampness (25.00%). The dietary preferences were higher in phlegm-dampness (20.38%), Yin deficiency (15.92%) and damp-heat (20.70%). Taking balanced constitution as a reference, the occurrence risk of phlegm and dampness in smoking and drinking type and diet preference type was 1.75 times higher (95%CI=1.09-2.77) and 1.78 times higher (95%CI=1.26-2.49) than that in general health group (P < 0.05). Conclusion There are certain aggregation characteristics in lifestyle behaviors among higher vocational medical students, which show significant relations with TCM constitutions. Targeted intervention should be carried out according to the demographic characteristics of higher vocational medical students, potential categories of behavior and lifestyle characteristics and TCM constitutions.

Neglect and associated factors among children aged 3-6 years in families with non-only children in Beijing-Tianjin-Hebei Region

LI Zilin, ZHONG Yuan, HAN Dong, LI Tao

2023, 44(10): 1517-1521. doi: 10.16835/j.cnki.1000-9817.2023.10.018

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Objective To analyze the neglect status of children aged 3-6 years old from non-only-child families in Beijing-Tianjin-Hebei region and influencing factors, so as to provide assistance for the healthy growth of preschool children from non-only-child families. Methods From April to June 2022, 2 882 parents of preschool children from 15 kindergartens were selected in urban areas of Beijing-Tianjin-Hebei by randomized cluster sampling method, and were investigated with general information and neglect experiences. The χ² test, t-test and ANOVA were used to compare the neglect status of different categories of preschool children, and the binary Logistic regression method was used to analyze the influencing factors of the neglect of preschool children who were not only children. Results The detection rate of neglect among children aged 3-6 years from non-only-child families in the Beijing-Tianjin-Hebei region was 33.47%, the detection rate of neglect among children from only-child families was 9.24%, and the difference was statistically significant (χ²=261.94, P < 0.01). The neglect score for children aged 3-6 years in non-only-child families was (42.35±7.52), the neglect score for one-child families was (38.16±6.56), and the difference was also statistically significant (t=15.95, P < 0.01). Binary Logistic regression analysis showed that family income < 4 000 yuan/month (OR=2.75, 95%CI=1.18-6.32), grandparents or other relatives as the primary guardian (OR=2.18, 95%CI=1.35-3.52), and poor parental relationship (OR=2.64, 95%CI=1.42-3.87), average (OR=2.31, 95%CI=1.32-4.01) non-only-child preschoolers had a higher risk of neglect (P < 0.05). Conclusion Neglect is prevalent among 3-to 6-year-old children from non-only-child families in the Beijing-Tianjin-Hebei region. Targeted intervention measures based on influencing factors should be taken to reduce neglect among preschool children.

The relationship between fine motor skills and executive function in boys with attention deficit hyperactivity disorder

SONG Yiling, REN Yuanchun, FAN Biyao, YANG Li, WANG Fang, FENG Lei

2023, 44(10): 1522-1526. doi: 10.16835/j.cnki.1000-9817.2023.10.019

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Objective To investigate the relationship between fine motor skills and executive function in school-aged boys with attention deficit hyperactivity disorder (ADHD) aged 6-10 years, so as to provide a reference for promoting executive function. Methods From November 2022 to May 2021, 65 boys with ADHD were recruited from a tertiary hospital in Beijing and a public elementary school in Beijing, and 65 boys with typical development according to age and sex were recruited as controls. Children's fine motor skills were assessed using the movement assessment battery for children, second version (MABC-2), and children's inhibitory control, working memory, and cognitive flexibility were assessed using the Stroop color word test (SCWT), Rey osterrich complex figure test (ROCFT) and trail making test (TMT), respectively. Independent samples t-tests were used to analyze the differences between the two groups, and Pearson correlation analysis and stratified regression analysis were used to explore the relationship between fine motor skills and executive functioning in boys with ADHD. Results In the fine motor skills test, boys with ADHD scored significantly lower (8.68±3.62) than control boys (11.22±2.27)(t=4.80, P < 0.05); in the executive function test, the results of SCWT, ROCFT, and TMT tests were significantly worse in boys with ADHD than in normal boys (t=-4.53-4.42, P < 0.05). Correlation analysis showed that the fine motor skill scores of boys with ADHD were negatively correlated with the number of word sense errors (r=-0.35) and color errors (r=-0.42), and positively correlated with memory scores for delayed structure (r=0.30) and detail (r=0.25), which were negatively correlated with TMT-A (r=-0.34), TMT-B reaction time (r=-0.26), number of errors (r=-0.43) (P < 0.05). Stratified regression analysis showed that fine motor skill scores of boys with ADHD were predictive of test results for inhibitory control, working memory and cognitive flexibility, with explanatory rates of 15%, 7%, and 19%, respectively. Conclusion Fine motor skills in boys with ADHD are correlated with executive functions, and fine motor skills could predict inhibitory control, working memory and cognitive flexibility to some extent. The development of fine motor skills in boy with ADHD could promote their executive functions.

Association between suicidal ideation and exposure to social-ecological risk factors among middle school students in Taiyuan City

PU Xin, YONG Zhongtian, WANG Kai, WANG Liyan, CHEN Jin, WANG Li, BAI Tao

2023, 44(10): 1527-1531. doi: 10.16835/j.cnki.1000-9817.2023.10.020

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Objective To understand the current situation of suicidal ideation among middle school students in Taiyuan City and its correlation with exposure to social-ecological risk factors, so as to provide a reference basis for exploring the causes of suicidal ideation among middle and high school students and formulating effective preventive measures. Methods A questionnaire survey was conducted among 2 639 middle school students in urban and rural areas of Taiyuan City by multistage stratified random cluster sampling, including general demography characteristics, social ecological risk factors and suicidal ideation. SPSS 26.0 software was used for Chi-squared test and binary Logistic regression analysis. Results The overall detection rate of suicidal ideation was 24.7%. There were statistically significant differences in the detection rate of suicidal ideation among middle school students in different gender, grade, family residence, maternal education level, perceived family economic conditions, number of close friends, self-perceived academic burden (χ²=38.17, 13.44, 10.77, 8.15, 19.76, 18.95, 59.75, P < 0.05). After adjusting the general demography characteristics, the binary Logistic regression showed that moderate and high risk in the individual, family and cultural dimension, and high risk in the school dimension of the social ecology were all positively correlated with suicidal ideation among middle school students (OR=1.38, 2.28, 1.97, 3.28, 1.48, 2.15, 1.71, P < 0.05). Conclusion The suicidal ideation among middle school students is related to individuals, families, and schools in the social ecological microsystem, as well as the cultural environment in the macro system. It is necessary to conduct intervention in suicidal ideation at the individual, family, and school levels, meanwhile, strengthening social and cultural construction to reduce the impact of adverse factors on the mental health among adolescents.

Campus bullying and associated factors among college and middle school students in Tibet

TAN Liming, PUBU Zhuoma, MA Xiao, WU Fang, YANG Zong, ZHANG Qiang, XIE Borong, ZHANG Dengcheng

2023, 44(10): 1532-1536. doi: 10.16835/j.cnki.1000-9817.2023.10.021

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Objective To understand campus bullying in colleges and middle schools in Tibet, and to analyze related influencing factors, so as to provide reliable basis and reference for formulating targeted intervention measures. Methods A stratified cluster sampling method was used to investigate the status and influencing factors of being bullied by questionnaire among 3 875 college and middle school students in Ngari, Qamdo, Lhasa, Nagqu and Xigaze of Tibet, from September to November 2019. Chi-square test and Logistic regression method were used for data analysis. Results The report rate of campus bullying among college and middle school students in Tibet was 5.50%; 4.35% for girls and 6.76% for boys; 8.81% for college students, 1.64% for senior high school students and 5.94% for junior high school students. The results of multivariate Logistic regression analysis showed that smoking (OR=1.71), Internet addiction (OR=3.82), depression (OR=3.84), obesity (OR=2.02), single parent family (OR=1.67) and reorganized family (OR=3.74) were positively correlated with campus bullying (P < 0.05). Girls (OR=0.66) and senior high school (OR=0.28) were negatively correlated with campus bullying (P < 0.05). Conclusion Campus bullying is related to campus environment, family type, behaviors and life styles, etc. Efforts should be committed to build a caring campus culture and a good family moral education environment, in order to reduce the incidence of campus bullying and associated adverse effects.

The relationship between behavior isotemporal substitution and depression among vocational school students with different moderate-to-vigorous physical activity durations

TANG Biaoqian, CHEN Bohao, LI Yiyang, LIU Hanqing, XU Shuqing, WANG Shumei.

2023, 44(10): 1537-1541. doi: 10.16835/j.cnki.1000-9817.2023.10.022

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Objective To explore the relationship between isotemporal substitution of 10 min/d of vigorous physical activity (VPA), moderate physical activity (MPA), walking, sedentary behavior (SB) and sleep (SLP) and depression among vocational school students with different duration of moderate-to-vigorous physical activity (MVPA), so as to provide time allocation suggestions for reducing depression levels. Methods The convenient cluster sampling method was adopted to conduct a questionnaire survey among 8 149 grade one to grade three students in 14 vocational schools in Shanghai and Jiangsu Province from December 2021 to January 2022. According to whether the MVPA reached 60 min/d, the vocational school students were divided into the MVPA standard group and the MVPA non-standard group, and the isotemporal substitution model was used for analysis. Results About 19.81% of students were in the MVPA standard group. In the MVPA non-standard group, substituting MPA for all other studied behaviors and substituting SLP for walking and SB were negatively correlated with depression (β=-0.78, -0.90, -0.88, -0.83; -0.07, -0.05, P < 0.05), and the association of MPA substitution was much greater than that of SLP substitution. In the MVPA standard group, replacing VPA, walking and SB with SLP were all negatively associated with depression (β=-0.23, -0.12, -0.10), whereas replacing MPA, SB and SLP with VPA was all positively associated with depression (β=0.15, 0.13, 0.23) (P < 0.05). Conclusion The MVPA level of vocational school students is low. The effects of isotemporal substitution for VPA and MPA are different when MVPA duration is up to standard and when MVPA duration is not up to standard. Appropriate time allocation suggestions should be provided based on the characteristics of adolescents with different MVPA durations.

Cross-lagged analysis of upward social comparison and online aggressive behavior among college students

LEI Zeyu, JIN Tonglin, WU Yuntena

2023, 44(10): 1542-1544. doi: 10.16835/j.cnki.1000-9817.2023.10.023

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Objective To explore the longitudinal relationship between upward social comparison and online aggressive behavior among college students, in order to provide an empirical evidence for educators to carry out mental health promotion for college students. Methods From December 2021 to March 2022, 539 college students from one university in Inner Mongolia were recruited to complete the Upward Social Comparison Questionnaire (USCQ) and Online Aggressive Behavior Scale (OABS) in a 4-month follow-up study. The structural equation model was used to conduct cross-lagged analysis. Results The mean scores of upward social comparison for college students tracked at baseline (T1) and 4-months follow-up (T2) were (2.77±0.93, 2.70±1.00) points, and the mean scores of online aggressive behavior were (1.06±0.13, 1.05±0.11) points. There were positive relations between upward social comparison and online aggressive behavior of college students at both cross-sectional levels (r=0.14-0.19, P < 0.05). In the autoregression, T1 upward social comparison could positively predict T2 upward social comparison (β=0.66), and T1 online aggressive behavior could positively predict T2 online aggressive behavior (β=0.47)(P < 0.01); In the cross-lagged regression, T1 upward social comparison could positively predict T2 online aggressive behavior (β=0.10, P < 0.01), whereas T1 online aggressive behavior could not predict T2 upward social comparison (β=0.04, P>0.05). Conclusion Upward social comparison is the cause of online aggressive behavior among college students. The probability of online aggressive behavior among college students should be reduced by guiding students to correctly view the gap between themselves and others.

Neglect of preschool children in urban area of Xi'an under the background of multi-child policy

YANG Wuyue, PAN Jianping, XIANG Xiaomei, ZHANG Shuiping, DONG Ning, WEI Jiaojie, ZANG Baocai

2023, 44(10): 1545-1549. doi: 10.16835/j.cnki.1000-9817.2023.10.024

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Objective To understand the situation of neglect of preschool children in the urban area of Xi'an under the background of multi-child policy, so as to provide a reference for making effective prevention. Methods In Novmber 2022, according to the multi-stage stratified cluster sampling principle, 2 450 parents of children aged 3-6 years were randomly selected from 7 urban areas of Xi 'an to participate in the questionnaire survey. A questionnaire survey was conducted using the "Neglect Evaluation Norms of 3-6 Years Old (Preschool) Children in Urban Areas of China". SPSS 18.0 software was used for statistical description, Chi-square test and variance analysis. Results The total neglect rate of preschool children in the urban area of Xi 'an was 29.0% and the total neglect score was (37.58±8.44). There was no statistical difference in the neglect status of children in different grade groups (χ²/F=1.61, 2.98, P>0.05). The neglect score of boys was higher than girls (t=2.45, P < 0.05). There was no statistical difference in the neglect rate and neglect score of boys and girls in other levels (P>0.05); except for the significant difference in the neglect degree of medical treatment, education and safety (t=2.01, 2.28, 2.02, P < 0.05). The rate and score of neglect in multi-child families were higher than only-child families (χ²/t= 13.68, -4.54, P < 0.05). There were significant differences in the rate and degree of neglect of children with different birth order, which were "third- and fourth-born>second-born>first-born" (χ²/F=10.84, 2.79, P < 0.05). The neglect rate and score of "single parent family" were significantly higher than that of "nuclear family" and "three-generation family" (χ²/F=4.78, 2.79, P < 0.05). Conclusion The neglect situation of preschool children in urban area of Xi'an is still serious, especially in multi-child families. It should actively explore the risk factors and formulate effective intervention measures.

Component analysis of relationship between 24-hour movement behavior and physical fitness in college students

HUANG Zan, ZHOU Yulan, HE Jiabei, LIU Yanjie

2023, 44(10): 1550-1554. doi: 10.16835/j.cnki.1000-9817.2023.10.025

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Objective To explore the relationship between 24-hour movement behavior and physical fitness in college students, so as to provide a reference for physical fitness interventions for college students. Methods A survey was conducted from September 23 to November 12, 2022, involving 342 college students selected from one comprehensive college among Shanghai City, Hubei Province and Zhejiang Province. Accelerometers were used to measure 24-hour movement behavior, and programs specified in the National Physical Fitness Standards for Students (2014 revision) were used to evaluate physical fitness. Compositional linear regression was used to analyze the association between 24-hour movement behavior and physical fitness. The effects of compositional isotemporal substitution of 24-hour movement behavior on physical fitness were also examined. Results The geometric means for sleep, sedentary behavior, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were 515.89, 678.88, 196.30, 48.92 min/d, respectively, and the comprehensive physical fitness score was (73.09±8.55). The proportion of participants who passed the fitness test was 72.51%. Overall, 20.76% had excellent or good scores, whereas 6.73% failed. Compositional linear regression indicated that physical fitness was significantly positively associated with MVPA (β=2.55) and LPA (β=5.88)(P < 0.05), but no significantly associated with sleep (β=-5.18) and sedentary behavior (β=-3.24)(P>0.05). Isotemporal substitution indicated that reallocation of 15 minutes from sleep and sedentary behavior to MVPA resulted in a 0.71 and 0.64 point increase in physical fitness, respectively. Similarly, reallocating the same duration to LPA led to a 0.50 and 0.43 point increase in physical fitness, respectively. Dose-response analysis revealed that the mutual substitution of LPA with sedentary behavior and sleep had symmetry, whereas the mutual substitution of MVPA with sedentary behavior and sleep had asymmetry. The effectiveness of replacing sleep or sedentary behavior with MVPA in improving physical fitness decreased with increasing allocation time, whereas the adverse effects of replacing MVPA with sleep or sedentary behavior increased with increasing allocation time. Conclusion In the context of 24-hour movement behavior, increasing the time spent on LPA and MVPA is beneficial for physical fitness among college students. It should be recommend that college students actively transition from sedentary behavior to engaging in physical activity, with a particular emphasis on incorporating MVPA.

Growth and intelligence development among a cohort of low birth weight infants

ZHANG Yuerong, SUN Yu, LI Peipei, WANG Yan, CHEN Zhenzhen, SHAO Ziyu, JI Pengyun

2023, 44(10): 1555-1559. doi: 10.16835/j.cnki.1000-9817.2023.10.026

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Objective To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI. Methods A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale. Results Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children (P < 0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions (t=-4.17, -3.82, -3.21, -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P < 0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age (β=0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P < 0.05). Conclusion The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children's intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Cluster characteristics of physical activities among children inside and outside kindergartens and its relationship with athletic abilities

FU Jinmei, HUANG Ting, SUN Shunli, CHEN Ruiming, CHEN Delong, JIANG Tianle, HU Xuewen, LYU Wendi, HE Zihao, SU Liqiang, ZHAO Guanggao, ZOU Weilu

2023, 44(10): 1560-1563. doi: 10.16835/j.cnki.1000-9817.2023.10.027

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Objective Based on physical activity (PA) and sedentary behavior (SB) variables on weekdays and weekends, the study aims to cluster the physical activities inside and outside kindergartens and to explore the cluster characteristics of different children using physical fitness indicators, so as to provide new strategies and methods for early childhood education and health. Methods From March to June 2019, 291 children aged 3-6 years from 6 kindergartens in Nanchang were recruited by a stratified cluster random sampling method. The ActiGraph GT3X-BT triaxial accelerometer was used to measure and analyze the PA and SB levels inside and outside the kindergarten. A two-step clustering algorithm model was employed for cluster analysis. Physical fitness were measured and evaluated according to the "National Physical Fitness Measurement Standard Manual (Preschool Section)". Differences in physical fitness among different clusters of children were compared, and the cluster characteristics of different children were analyzed. Results The clustering algorithm model indicated that based on six indicators, including PA and SB inside the kindergarten on weekdays, and PA and SB outside the kindergarten on both weekdays and weekends, children could be divided into three categories: active inside (high PA, low SB inside), active outside (high PA outside), and inactive (low PA, high SB both inside and outside). The average silhouette coefficient of the model was 0.3, indicating good clustering results. Both the active inside and active outside children showed significantly higher PA inside on weekdays, PA outside on weekdays and weekends, daily low-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) than the inactive children (F=157.91, 80.79, 95.86, 95.52, 124.74, P < 0.05). After adjusting for gender and age, the physical fitness scores of both active outside (19.03±0.47) and active inside (19.11±0.40) were significantly higher than those of the inactive children (17.94±0.31). Additionally, active inside children (3.91±0.14) also showed significantly better performance in continuous double-leg jumps, compared to inactive children (3.45±0.11) (P < 0.05). Conclusion Children active inside and those active outside perform well in PA. Future research should focus on the proportion of structured and unstructured PA time to enhance the overall physical fitness of children.

A 5-year follow-up analysis of cases in a high school tuberculosis outbreak

QIN Linrong, LIU Bin, WANG Jiang, YANG Jing, LUO Chunyan, XIANG Dengfeng, ZHANG Ting, PANG Yan

2023, 44(10): 1564-1567. doi: 10.16835/j.cnki.1000-9817.2023.10.028

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Objective To explore the effectiveness of preventive treatment for latent tuberculosis infection (LTBI) patients, so as to provide reference for the management and preventive treatment of clustered epidemic in schools. Methods Data came from the school tuberculosis outbreak of a boarding high school in Kaizhou District, Chongqing, which occurred between June 2017 and March 2018 among 2016 grade high school teachers and students for investigation and analysis. The total incidence, LTBI patients, and the incidence after preventive treatment for 5 years were followed up. Results A total of 34 cases of pulmonary tuberculosis from June 2017 to March 2018. A total of 1 357 individuals were screened for 6 concentrated contact screenings, with a confirmed tuberculosis rate of 2.43%, a tuberculosis skin test (TST) positive rate of 27.41%, and a strong TST positive rate of 7.39%. Among them, the confirmed tuberculosis rate and TST positive rate in the first case class were much higher than those in other classes, with statistically significant differences (χ²=286.30, 98.59, P < 0.01). 88 cases of LTBI were found, with 31 cases receiving preventive treatment (35.23%), of which 28 completed preventive treatment (90.32%). After five years of follow-up, 73 cases of pulmonary tuberculosis were diagnosed in 2016 by the school senior high school, with a incidence rate of 0.98/10² (person/person years). Fifteen of the 88 LTBI patients were diagnosed with pulmonary tuberculosis, and the incidence rate was 3.33/10² (person/person years). The incidence rate of the preventive treatment group was 0.7/10² (person/person years)lower than that of the medical observation group 4.5/10² (person/person years), with a statistically significant difference (χ²=4.31, P < 0.05). Conclusion The classes with higher TST positive rate and strong positive rate have higher incidence rate. Improving the preventive treatment rate of LTBI patients can effectively reduce the incidence rate of tuberculosis.

Association between dietary inflammatory index and metabolic syndrome with its components among children aged 6-14 years in Beijing City

DONG Xiaocong, ZHANG Mingjie, GUO Dandan, PENG Shanshan, YU Xiaohui, LI Hong, FANG Aiping, ZHAO Yao, YU Yingjie

2023, 44(10): 1568-1573. doi: 10.16835/j.cnki.1000-9817.2023.10.029

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Objective To explore the association between dietary inflammatory index (DII) and metabolic syndrome (MetS) and its components among children aged 6-14 years in Beijing, so as to provide a reference for preventing MetS. Methods A cross-sectional study was carried out in 2 086 records of 1 832 children from the 2017 and 2019 Nutrition and Health Surveillance in Primary and Secondary school students of Beijing (NHSPSB). Three-day consecutive 24-hour dietary recalls combined with weighing household cooking oils and condiments were used to collect dietary intake and calculate DII. MetS was diagnosed according to "Definition and Suggestion on the Metabolic Syndrome of Chinese Children and Adolescent". The Generalized estimating equations (GEEs) models were used to analyze the association between DII and the presence of MetS and its components (abdominal obesity, high triglyceride, low high-density lipoprotein cholesterol, hypertension, and hyperglycemia). Results The mean DII score was (1.64±1.07) for the included children. No significant association was found between DII scores and the likelihood of MetS (per 1-point increment: OR=1.16, 95%CI=0.92-1.48, P>0.05). In terms of the components of MetS, DII scores were positively associated with the odds of high triglyceride (per 1-point increment: OR=1.17, 95%CI=1.01-1.36, P < 0.05). There was no statistically significant difference in the association among different age groups (P>0.05). No significant associations were observed between DII and other MetS components(P>0.05). Conclusion DII scores may not be correlated with the risk of MetS, but proinflammatory diet might increase the risk of high triglyceride. DII score in childhood should be emphasized to identify and prevent MetS as soon as possible.

Epidemiological and genetic characteristics of sapovirus clusters in Changzhou schools from 2019 to 2022

YAO Ping, LI Qiong, JIANG Xia, MAO Xujian, XU Jian, TU Bowen, WANG Fengming, JIANG Jingyi

2023, 44(10): 1574-1577. doi: 10.16835/j.cnki.1000-9817.2023.10.030

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Objective To analyze the epidemiological characteristics and genetic characteristics of sapovirus (SaV) in a cluster of schools in Changzhou, so as to provide a reference for the treatment of clustered vomiting and diarrhea events in schools. Methods The epidemiological data and laboratory test data of sapovirus clusters in Changzhou from 2019 to 2022 were collected and analyzed. Partial VP1 genes of SaV positive samples were amplified and sequenced for phylogenetic analysis. Results A total of 8 cases of clusters of SaV epidemics were reported in Changzhou City from 2019 to 2022, with 118 reported cases. The total attack rate was 1.47%, and the median of the attack number was 15. There were 6 outbreaks in kindergartens and 2 outbreaks in primary schools, which were reported in the epidemic period from September to December. The main clinical manifestations were vomiting (113 cases, 95.76%), abdominal pain (39 cases, 33.05%), and diarrhea (16 cases, 13.56%). Among the 8 outbreaks, 17 sample strains were successfully sequenced. 5 outbreaks were GII.3, and the other 3 outbreaks were GI.1, GI.3 and GII.2. GI and GII were the main genotypes in this area, and GII.3 was the predominant strain. Conclusion SaV is an important pathogen in the clusters of vomiting and diarrhea in schools after the transmission of norovirus. Continuous surveillance of SaV should be carried out to further understand its epidemiological characteristics and genotype distribution, so as to provide scientific basis for the prevention and control of the epidemic in schools.

Relevant factors of eating out-of-home and its association with overweight and obesity among middle school students in Wuhan City

ZHAO Zhi, HU Chenghua, YANG Jiuyu, ZHU Wenzi, WU Yating

2023, 44(10): 1578-1581. doi: 10.16835/j.cnki.1000-9817.2023.10.031

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Objective To investigate the prevalence and relevant factors of eating out-of-home among middle school students in Wuhan, and to analyze its association with overweight/obesity, so as to provide scientific basis for the prevention of overweight/obesity among middle school students. Methods From March to April 2023, 1 654 middle school students in Wuhan were selected by convenient sampling method for a questionnaire survey. The multivariate Logistic regression model was used to analyze the relevant factors of eating out-of-home and to explore its relationship with overweight/obesity among middle school students. Results On weekdays, 57.19% of the middle school students ate out-of-home at least once a week. On weekends, 81.38% of the participants ate out-of-home at least once a week. The multivariate analysis showed non-resident students were more likely to eat out-of-home on weekdays (OR=4.32, 95%CI=2.10-8.90, P<0.05). Middle school students whose fathers with educational backgrounds of high school, technical secondary school or college above, and families with per capita monthly income levels of 2 000-5 000 and >5 000 yuan, and average monthly food expenses of 500-<1 000 and 1 000-<1 500 yuan were more likely to eat out-of-home on weekends (OR=2.12, 2.77; 2.58, 3.32; 1.70, 1.98, P<0.05). Middle school students with qualified nutrition and health knowledge scores were more likely to eat out-of-home on weekends than those with excellent nutrition and health knowledge scores (OR=1.51, 95%CI=1.12-2.06, P<0.05). Students who ate out-of-home once or twice per week on weekends had 1.50 times higher risk of overweight/obesity than those who ate out-of-home none per week on weekends (adjusted OR=1.50, 95%CI=1.05-2.15, P<0.05). Conclusion Eating out-of-home is common among middle school students in Wuhan. Middle school students should actively cultivate awareness of healthy eating, and decrease the frequency of eating out-of-home to reduce the incidence of overweight and obesity.

Research progress on the association and mechanism between dietary rhythm, circadian rhythm and cardiovascular health in children and adolescents

WANG Yuwei, REN Yanling, CHEN Xin, YUAN Shuanggui, LIANG Xiaohua

2023, 44(10): 1582-1586. doi: 10.16835/j.cnki.1000-9817.2023.10.032

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Hypertension in children can have adverse health effects such as vascular damage, cardiac metabolic risk, and organ damage during childhood, and can also increase the risk of hypertension in adulthood. Obesity has been recognized as an important cause of elevated blood pressure in children. By reviewing and summarizing relevant literature at home and abroad, the study analyzes the relationship between dietary and circadian rhythm and explores the role and mechanism of circadian rhythm in terms of the metabolic health of youth, thereby providing a scientific basis for the prevention and treatment of cardiovascular diseases in this population and to identify directions for future research.

Research progress on the characteristics and influencing factors of energy expenditure in children and adolescents of different ages

ZHOU Haonan, LIU Yang, WEN Deliang

2023, 44(10): 1587-1591. doi: 10.16835/j.cnki.1000-9817.2023.10.033

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The physical health of children and adolescents has received widespread attention in recent years, and a series of problems due to unbalanced energy expenditure have come into focus. Energy expenditure in children and adolescents is influenced by multiple factors including body composition and physical activity level. By analyzing and summarizing the characteristics and specificities of energy expenditure in children and adolescents at different ages, the review aims to formulate a targeted design and implementation plans for future intervention studies.

Research progress in the effects of parent-child separation on depression among left-behind children

LIU Heng, ZHOU Tiemin, ZHANG Changlu, WANG Xiaotong

2023, 44(10): 1592-1595. doi: 10.16835/j.cnki.1000-9817.2023.10.034

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Compared with normal children, left-behind children who experience parent-child separation receive less care and attention from their parents, and are more likely to have cognitive and behavioral adaptation problems, thus leading to an elevated risk of depression. The study systematically examines the effects of parent-child separation type, separation duration and separation age on depression among left-behind children. Attachment theory, interpersonal relationship, theory attribution theory and behavior theory have been used to explain how parent-child separation influences depression among left-behind children, so as to provide reference for relevant research and mental health education for left-behind children.

Research progress of adolescent sexting behavior

ZHU Hongrui, LI Xianhong, ZHANG Yan

2023, 44(10): 1596-1599. doi: 10.16835/j.cnki.1000-9817.2023.10.035

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With the rapid development of information technology and the popularity of intelligent electronic devices, increasing attention has been to sexting behavior among adolescents and its negative consequences which are driven by social networking. Therefore, the paper reviews the assessment tools and current situation regarding adolescent sexting exposure, the influencing factors of sexting behavior, and the impact of sexting behavior on adolescent physical and mental health. It also proposes future research prospects based on the shortcomings of existing research, thereby providing a reference for further studies and the follow-up development of intervention strategies to address sexting behavior, so as to promote sexual health and sexual development among adolescents.

2023 Vol. 44, No. 10